Instrumentação interespinhosa na doença degenerativa da coluna lombar: medição da altura do disco no segmento instrumentado Instrumentación interespinosa en la enfermedad degenerativa de la columna lumbar: medición de la altura del disco en el segmento instrumentado Interspinous instrumentation in patients with degenerative lumbar spine disease: disc height measurement on instrumented segment

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José Alberto de Castro Guimarães Consciência

2009-09-01

Full Text Available INTRODUÇÃO: na última década, a instrumentação interespinhosa vem sendo mais frequentemente utilizada. Apesar dos inúmeros artigos publicados em revistas internacionais de reconhecido mérito científico, são escassas as referências à modificação da altura do disco no segmento tratado, secundária àquela instrumentação. OBJECTIVO: quantificar uma eventual modificação da altura discal decorrente da aplicação de instrumentação interespinhosa (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©. MÉTODOS: o autor avalia um grupo de 20 pacientes com patologia degenerativa da coluna lombar e os seguintes critérios de inclusão: idade >40 e 6; Oswestry Disability Index (ODI >30; Zung Depression Rating Scale INTRODUCCIÓN: la instrumentación interespinosa tiene sido empleada con creciente frecuencia en la última década. Pero, apesar de las numerosas publicaciones científicas hechas en jornales científicos de reconocido mérito internacional, se han producido muy escasas referencias a una hipotética modificación de la altura discal dependiente de la técnica. OBJETIVO: cuantificar una eventual modificación de la altura discal inherente a la aplicación de instrumentación interespinosa. MÉTODOS: el autor hace una evaluación de un grupo de 20 pacientes con patología degenerativa de la columna lumbar, y diversos criterios de inclusión, a saber: edad >40 y 6; Oswestry Disability Index >30; Zung Depression Rating Scale INTRODUCTION: the use of interspinous instrumentation has been increasing in the last decade. However, in spite of the numerous papers seen in relevant scientific publications, there are very few references to an eventual disc height variation in the instrumented segment. OBJECTIVE: to certify eventual changes in disk height after interspinous instrumentation (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©. METHODS: the author evaluated 20 patients with degenerative lumbar disease and the following

Use of CT scanning for the study of posterior lumbar intervertebral articulations

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Hermanus, N.; de Becker, D.; Baleriaux, D.; Hauzeur, J.P.

1983-01-01

CT scan is peculiarly effective in the study of architectural pathologies of the column; it appears that a number of etiological factors of low back pain are involved and they are often related. Indeed, dis herniation, for instance, is frequently associated with facetal asymmetry, the first signs of arthroses and ligamentous calcification after treatment. The three vertebral axes must be evaluated, one discal and two facetal, the slightest defect in one of which can affect the two others. Moreover, in view of the complexity of the innervation, the entire lumbar column from L1 to L5 S1 must be investigated: it is not uncommonly that low sciatica is caused by a more cranial lumbar pathology. This systematic study promotes better understanding of the etiology of low back pain and suggests a stet judicious therapeutic attitude.

Tratamiento quirúrgico de la hernia discal lumbosacra en el hospital "Ernesto Guevara de la Serna"

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Henry López Jimenez

2015-11-01

Full Text Available Fundamento: la hernia discal lumbosacra tiene una alta prevalencia en el mundo y en Cuba. El resultado del tratamiento quirúrgico tiene gran impacto individual, familiar, laboral, social y económico.Objetivo: describir los resultados del tratamiento quirúrgico de la hernia discal en pacientes operados en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período de tiempo comprendido entre enero de 2005 y mayo de 2015.Métodos: se realizó una investigación observacional descriptiva, retrospectiva, en el referido hospital de la provincia de Las Tunas y durante el período de tiempo declarado antes. Se utilizaron fuentes de recolección de datos secundarias, como expedientes clínicos e informes operatorios. Se confeccionaron registros para la recolección de datos continuos. Se creó una base de datos para el procesamiento de la información que se analizó mediante la estadística descriptiva, utilizando el valor porcentual para reportar los resultados.Resultados: la hernia discal fue más frecuente en el sexo masculino y en el grupo de edad de 40 - 49 años. El nivel discal más afectado fue L4-L5, la raíz de S1 fue la más comprimida y predominó la hernia posterolateral. Primaron los resultados satisfactorios en el tratamiento quirúrgico y las complicaciones más frecuentemente encontradas fueron la discitis y fibrosis postquirúrgica.Conclusiones: se logró describir los principales resultados del tratamiento quirúrgico de la hernia discal en pacientes operados en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, durante los últimos diez años.

The use of CT scanning for the study of posterior lumbar intervertebral articulations

International Nuclear Information System (INIS)

Hermanus, N.; Becker, D. de; Baleriaux, D.; Hauzeur, J.P.

1983-01-01

CT scan is peculiarly effective in the study of architectural pathologies of the column; it appears that a number of etiological factors of low back pain are involved and they are often related. Indeed, dis herniation, for instance, is frequently associated with facetal asymmetry, the first signs of arthroses and ligamentous calcification after treatment. The three vertebral axes must be evaluated, one discal and two facetal, the slightest defect in one of which can affect the two others. Moreover, in view of the complexity of the innervation, the entire lumbar column from L1 to L5 S1 must be investigated: it is not uncommonly that low sciatica is caused by a more cranial lumbar pathology. This systematic study promotes better understanding of the etiology of low back pain and suggests a stet judicious therapeutic attitude. (orig.)

Epidural cystic masses associated with interspinous bursitis, synovial and discal cysts

International Nuclear Information System (INIS)

Santos, Frederico Guilherme de Paula Lopes; Souza, Ricardo Andre de; Brotto, Marcos Pama D'Almeida; Suguita, Fabio Massaaki; Amaral, Denise Tokechi; Amaral, Lazaro Luis Faria do

2009-01-01

The authors describe some cases of epidural cysts, namely synovial, discal, ligamentum flavum cysts, and cysts secondary to interspinous bursitis, all of these conditions determining radicular, dural sac compression or spinal canal stenosis. Magnetic resonance imaging findings and localization of these entities are described. (author)

Variação de conduta cirúrgica em doença degenerativa da coluna lombar Variación de conducta quirúrgica en la enfermedad degenerativa de la columna lumbar Surgical decision making variation in degenerative lumbar spine

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Luís Felipe Pamplona Novaes

2009-03-01

Full Text Available OBJETIVO: examinar a variação da decisão de tratamento entre cirurgiões de coluna para cinco situações clínicas que envolvam condições degenerativas da coluna lombar e determinar se fatores como tipo de treinamento do cirurgião, experiência e idade são como preditores da tomada de decisões para cada caso. MÉTODOS: dez ortopedistas e dez neurocirurgiões, de diferentes idades, responderam questões sobre a necessidade de cirurgia, opções de via de acesso, realização de descompressão, realização de artrodese, com ou sem instrumentação, para cinco casos de doença degenerativa da coluna lombar por meio de informações da história, exame clínico e exames de imagem adequados (todos tiveram acesso às mesmas informações e foram orientados a responder com base em sua prática clínica. Os casos foram: discopatia com instabilidade vertebral em um paciente jovem; hérnia de disco extrusa em paciente jovem; estenose de canal vertebral múltiplos níveis sem deformidade; estenose canal múltiplos níveis com cifoescoliose degenerativa; hérnia de disco com artrose facetária. Na análise estatística foi utilizado o teste "t" de student para comparar o fator especialidade e médias de idade com as variáveis de tratamento (significativo quando pOBJETIVOS: examinar la variación de la decisión de tratamiento entre cirujanos de la columna para cinco escenarios clínicos involucrando condiciones degenerativas de la columna lumbar. Determinar si el tipo del entrenamiento del cirujano, experiencia y edad sirve como factores predictivos en la toma de decisiones de cada caso. MÉTODOS: diez ortopedistas y diez neurocirujanos de diferentes edades respondieron un cuestionario sobre la necesidad de cirugía, opciones de vías de acceso, realización de descompresión, realización de artrodesis con o sin instrumentación para 5 casos de enfermedad degenerativa de la columna lumbar por medio de informaciones de la historia, examen cl

Ozonoterapia en patologías de columna: Revisión de casos

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Danilo Ruiz Reyes

2017-05-01

Full Text Available El objetivo de esta revisión de casos clínicos, es demostrar el beneficio de la Ozonoterapia en las lesiones de columna lumbar en casos de hernias discales y artrosis vertebral. Fueron seleccionados cuatro pacientes: Dos con hernias discales en la región lumbosacra y dos con artrosis vertebral lumbar y daño del disco vertebral (discartrosis en la misma región lumbar, atendidos en el Centro Médico Ozonocenter de Quito, Ecuador, en el segundo semestre 2016. Los pacientes presentaron signos clínicos característicos de esta patología: dolor lumbar, dolor región glútea, dolor lumbar a la deambulación, dolor al permanecer sentado por largos períodos. Estudios de Resonancia Magnética (MRI de la región lumbo-sacra se utilizaron para corroborar la presencia, el tamaño y tipo de las lesiones antes y al concluir la terapia. En los cuatro pacientes se obtuvo una mejoría notable tanto en el tamaño de las protrusiones discales como en las lesiones artrósicas vertebrales. Se efectuó un seguimiento mensual a los pacientes durante seis meses, permaneciendo asintomáticos durante ese período. Se puede concluir que la ozonoterapia paravertebral constituye un excelente procedimiento médico para la resolución de las hernias discales y lesiones discartrósicas en la región lumbosacra.

Patogenia, cuadro clínico y diagnóstico imagenológico por resonancia magnética de las hernias discales

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Yoandra Aroche Lafargue

2015-03-01

Full Text Available Las hernias discales constituyen un importante problema de salud que causa ausentismo laboral en personas laboralmente activas, de ahí que el costo generado por esta afección sea motivo de preocupación a escala mundial. La revisión bibliográfica acerca de su patogenia, cuadro clínico y diagnóstico imagenológico resulta de vital importancia para su prevención, diagnóstico y tratamiento oportunos. En el diagnóstico por imágenes, la resonancia magnética ha tenido un mayor impacto en el análisis de las afecciones de la columna vertebral, pues posibilita investigar las características del disco intervertebral. Tiene superioridad diagnóstica respecto a la tomografía axial computarizada y la mielografía, debido a que no utiliza radiaciones ionizantes, en tanto, se considera más sensible y específica para demostrar anomalías, lesiones, así como enfermedades de la columna que no pueden visualizarse o quedar ocultas con los otros métodos

Revision and simplification of the boarding previous minimum of the lumbar column

International Nuclear Information System (INIS)

Lazannec, JY; Del Vecchio, R; Ramare, S; Saillant, G

2001-01-01

This paper describes the boarding retroperineal previous minimum, which provides access at any level discal and vertebral between T12 and S1. It is carried out a technique of dissection retroperineal that facilitates the renal and duodenum-pancreatic mobilization to consent to the face previous left of the whole lumbar column and of the thoracic-lumbar union. They were carried out careful anatomical dissections in fresh cadavers and preserved to determine the topography and the anatomical relationships of interest and this way to develop a sure boarding and easily reproducible. Special attention has been paid to the description of the lumbar veins and the anastomosis between the vein renal left and the hemiacigos system for the exhibition of the expensive left anterolateral of T12 and L1. A series of 94 patients is reported with lesions caused by traumas or degenerative processes. For all the lumbar levels, even in-patient with antecedents of surgery intraperitoneal, the boarding minimum retroperitoneal, was safe for the kidneys, ureters, spleen, hypo gastric plexus and duodenum-pancreatic union. Better cosmetic results are reported, decrease of the time surgical, scarce bled intraoperatory and easiness for the decortications and placement of implants. The previous boarding minimum retro peritoneal of the column developed starting from the boarding classic retroperineals, offers significant advantages on the endoscopic techniques, which require sophisticated machinery and they are technically plaintiffs. The exhibition of all the lumbar levels, as well as the reduction maneuvers and placement of implants, they can be carried out with easiness without causing muscular damage

Síndrome de la cola de caballo secundario a hernia discal traumática Horse-tail syndrome secondary to traumatic disc herniation

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Isael Olazábal Armas

2012-09-01

Full Text Available La cola de caballo representa la continuación caudal de la médula espinal. Esta porción del sistema nervioso es asiento de numerosas patologías. Se presenta un caso clínico que debutó de forma aguda con un síndrome de la cola de caballo, secundario a una hernia discal lumbar traumática. Se trata de un paciente masculino de 45 años de edad, que acude al servicio de urgencias, porque refiere síntomas que inician siete días antes de forma aguda y progresiva, luego de haber caído de una altura de tres metros. Al interrogarlo existía debilidad muscular del miembro inferior izquierdo y dificultad para caminar. El examen físico corroboró la disminución de la fuerza muscular y arreflexia Aquileo-plantar. Se realizó estudio de resonancia magnética, que demostró una hernia discal extruída en el interespacio L5-S1. El paciente se llevó al salón de urgencia y se realizó exeresis de la hernia. Egresó al séptimo día con discreta mejoría clínica. Se ha seguido en consulta externa durante un periodo de 8 meses, con muy poca recuperación del control esfinteriano, de la actividad motora y sensitiva.Horse-tail represents the caudal continuation of the spinal cord. This portion of the nervous system is the seat of numerous pathologies. We present a case report of acute debuted with a syndrome of the cauda equina, secondary to traumatic lumbar disc herniation. This is a male patient aged 45, who was admitted to the emergency room because he referred acute and progressive symptoms starting seven days before, after falling from three meters high. By questioning, we found muscle weakness in his left leg and difficulty at walking. The physical examination confirmed the decrease in muscle strength and Achilles-plantar areflexia. We performed MRI, which showed extruded disc herniation in L5-S1 interspace. The patient was taken to the emergency room and we performed the hernia excision. He was discharged at the seventh day with mild clinical

Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA).

Science.gov (United States)

Vilariño Villaverde, Raquel; Bruguier, Christine; Zerlauth, Jean-Baptiste; De Froidmont, Sébastien; Grabherr, Silke

2016-05-01

Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Postmortem investigation confirmed the intra-abdominal haemorrhage and revealed a laceration of the proximal portion of the left common iliac artery and left iliac vein. The source of bleeding could be detected especially thanks to multi-phase postmortem CT angiography (MPMCTA), which was performed prior to autopsy. We also found a haemorrhagic path through the intervertebral disc between the L4-L5 vertebrae, caused by the surgeon's instrument (pituitary rongeur). To date, a few cases have been described of iatrogenic death resulting from a tear in the iliac vessels during lumbar surgery, but not from the postmortem perspective. Such investigations have recently been modernized thanks to the introduction of forensic imaging. In particular, MPMCTA offers new possibilities in postmortem investigations and can be considered the new gold standard for investigating deaths related to medical intervention. Here we describe the first case of a death during lumbar surgery using this new method. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Tratamento cirúrgico de recidivas de hérnias discais lombares: que resultados? Tratamiento quirúrgico de recidivas de hernias lumbares de disco: cuáles son los resultados? Surgical treatment in recurrent lumbar disc herniation: what results?

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Pedro Alberto Pinto da Silva

2011-01-01

Full Text Available OBJETIVOS: No tratamento da recidiva de hérnia discal lombar, em particular no âmbito cirúrgico, vários aspectos se mantêm controversos. O presente trabalho pretende contribuir para definir características pré-operatórias que influenciem os resultados subjetivo e objetivo da cirurgia. MÉTODOS: Foram selecionados doentes submetidos à intervenção cirúrgica por hérnia discal lombar recidivada em um período de dez anos; foram revistos os processos clínicos e reavaliados os pacientes, de forma subjetiva (grau de satisfação, Pain Visual Analogue Scale, Score de Stanford e objetiva (Índice de Incapacidade de Oswestry, Questionário de Zurich. Foi realizada uma análise estatística desses dados. RESULTADOS: O número total foi de 55 doentes, com predomínio do sexo masculino. A taxa de complicações foi de 7,3%. Onze doentes (20% necessitaram de terceira intervenção cirúrgica. A grande maioria (91,5% dos doentes afirma-se satisfeita com o tratamento cirúrgico. Houve uma variação média favorável pelo Índice de Oswestry (-46,27%, confirmada pelas restantes escalas; 81,6% dos pacientes ativos retomaram a atividade laboral prévia. Foram encontrados preditores significativos do resultado funcional, e a necessidade de terceira cirurgia para o retorno à atividade laboral. CONCLUSÕES: O tratamento cirúrgico da recidiva de hérnia discal lombar permite resultados favoráveis no controle sintomático e funcional, em todos os testes aplicados. Algumas variáveis pré-operatórias podem ajudar a prever os pacientes menos susceptíveis à melhoria.OBJETIVOS: En el tratamiento de la hernia de disco lumbar recurrente, especialmente en relación con la cirugía, algunos aspectos siguen generando controversias. Este trabajo tiene por objetivo definir las características preoperatorias que influyen en los resultados subjetivos y objetivos de la cirugía. MÉTODOS: Seleccionamos los pacientes sometidos a cirugía de hernia de disco

Electromechanical characteristics of discal piezoelectric transducers with spiral interdigitated electrodes

International Nuclear Information System (INIS)

Pan, Chengliang; Xiao, Guangjun; Feng, Zhihua; Liao, Wei-Hsin

2014-01-01

In this study, piezoceramic thin disks with spiral interdigitated electrodes on their surfaces are proposed to generate in-plane torsional vibrations. Electromechanical characteristics of the discal piezoelectric transducers are investigated. Working principles of the transducers are explained while their static deformations are formulated. Dynamic models are derived to analyze the in-plane torsional vibrations of the disks together with the radial vibrations. The corresponding electromechanical equivalent circuits are also obtained. With different boundary conditions and structural parameters, frequency responses of their electric admittances are calculated numerically. Resonant frequencies, mode shapes, and electromechanical coupling coefficients of the vibration modes are also extracted. Prototype transducers are fabricated and tested to validate the theoretical results. (paper)

Formações císticas epidurais relacionadas a bursite interespinhosa, cisto sinovial e cisto discal Epidural cystic masses associated with interspinous bursitis, synovial and discal cysts

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Frederico Guilherme de Paula Lopes Santos

2009-04-01

Full Text Available Os autores apresentam casos de cistos epidurais, dentre eles os cistos sinoviais, discais, do ligamento amarelo e relacionados a bursite interespinhosa, todas essas condições determinando compressão radicular, do saco dural ou estenose do canal vertebral. Descrevem as características de imagem e localização na ressonância magnética nessas diferentes afecções.The authors describe some cases of epidural cysts, namely synovial, discal, ligamentum flavum cysts, and cysts secondary to interspinous bursitis, all of these conditions determining radicular, dural sac compression or spinal canal stenosis. Magnetic resonance imaging findings and localization of these entities are described.

MORPHOMETRIC STUDY OF THE AREOLAR SPACE BETWEEN THE GREAT VESSELS AND THE LUMBAR SPINE

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Luis Marchi

2015-12-01

Full Text Available Objective : This work aims to study the areolar space anterior to the lumbar spine, and also the positioning of the large vessels focusing a lateral approach. Methods :This is a morphometric study of 108 cases based on T2 weighted-MRI images in the supine position. The following measurements were performed: lumbar and segmental lordosis; anteroposterior disc diameter; space between the disc/vertebral body and the vessels; bifurcation between the abdominal aorta and the common iliac veins confluence in relation to the lumbar level. Results :The areolar space with respect to the iliac veins, and with the vena cava increased cranially (p<0.001, starting from average 0.6mm at L4-L5 and reaching 8.4mm at L2, while the abdominal aorta showed no increase or decrease pattern across the different levels (p=0.135 ranging from 1.8 to 4.6mm. The diameter of the discs increased distally (p<0.01 as well as the lordosis (p<0.001. The disc diameter was 11% larger when compared to the adjacent vertebral bodies (p<0.001 and that resulted in a smaller distance of the vessels in the disc level than in the level of the adjacent vertebral bodies (p<0.001. The aortic bifurcation was generally ahead of L4 (52% and less frequently at L3-L4 (28% and L4-L5 (18%. The confluence of the veins was usually at the L4-L5 level (38% and at L5 (37%, and less frequently at L4 (26%. Conclusions : There is an identifiable plane between the great vessels and the lumbar spine which is particularly narrow in its distal portion. It is theoretically feasible to reach this plan, handle the anterior complex disc/ALL and protect the great vessels by lateral approach, however, it is challenging.

Determinantes clínicos com influência no prognóstico da discectomia lombar: análise multifatorial Determinantes clínicos que influyen en el pronóstico de la disectomía lumbar: análisis multifactorial Clinical determinants' influence on lumbar discectomy prognosis: multi-factor analysis

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Paulo Jorge Da Rocha Carvalho

2010-03-01

Full Text Available A seleção e o agendamento temporal inadequados dos pacientes permanecem as causas mais importantes de insucesso da cirurgia discal lombar. OBJETIVO: Este trabalho pretende avaliar os resultados clínicos e os factores preditivos que influenciam o prognóstico dos pacientes submetidos à discectomia lombar através de um modelo analítico multifatorial. MÉTODOS: Apresentamos uma série prospectiva de 68 pacientes com hérnias discais lombares que foram submetidos à discectomia entre 2003 e 2007. O seguimento médio foi de 3,9±0,1 anos. Os resultados clínicos foram avaliados utilizando o escore JOA (Japonese Orthopaedic Association Assessment Scoring System (JOA=29. RESULTADOS: Resultados pós-operatórios bom e excelente foram obtidos em 75% dos casos. Pacientes do sexo masculino e a preponderância de sintomas subjectivos sobre sintomas clínicos estiveram associados com os melhores resultados clínicos e com o retorno mais precoce à actividade laboral. O tempo de espera pela cirurgia não teve influência no resultado final. A necessidade de cirurgia foi questionada na ausência de défices neurológicos significativos (JOA para resultados clínicos >3/6. Um valor JOA pré-operatório >15 (debilidade inicial baixa está correlacionado com piores resultados clínicos pós-operatórios. CONCLUSÕES: O escore JOA é de fácil aplicação para clínicos e pacientes, uniformiza dados subjectivos e apresenta valor preditivo para os resultados dos pacientes submetidos à discectomia lombar.La selección y la agenda temporal inadecuada de los enfermos permanecen como las causas más importantes de la falta de éxito en la cirugía discal lumbar. OBJETIVO: este trabajo pretende evaluar los resultados clínicos y los factores predictivos que influyen en el pronóstico de los pacientes sometidos a la discectomía lumbar por medio de un modelo analítico multifatorial. MÉTODOS: se presenta una serie prospectiva de 68 pacientes con hernias discales

Magnetic resonance imaging findings of disc-related epidural cysts in nonsurgical and postoperative patients

Energy Technology Data Exchange (ETDEWEB)

Simao, Marcelo Novelino, E-mail: marcelo_simao@hotmail.com [Central de Diagnostico Ribeirao Preto (CEDIRP), Ribeirao Preto, SP (Brazil); Helms, Clyde A. [Radiology, Musculoskeletal Section, Duke University Medical Center, Durham, NC (United States); Richardson, William J. [Orthopedic Surgery, Spine Surgery Section, Duke University Medical Center, Durham, NC (United States)

2012-07-15

Objective: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. Materials And Methods: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. Results: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. Conclusion: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified. (author)

Magnetic resonance imaging findings of disc-related epidural cysts in nonsurgical and postoperative patients

International Nuclear Information System (INIS)

Simao, Marcelo Novelino; Helms, Clyde A.; Richardson, William J.

2012-01-01

Objective: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. Materials And Methods: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. Results: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. Conclusion: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified. (author)

Enfermedad de Alzheimer

OpenAIRE

Serrano Reyes, Carlos Daniel; Fundación Valle de Lili

2001-01-01

¿Cuáles son las manifestaciones de la enfermedad de Alzheimer?/ Signos de alarma de la enfermedad de Alzheimer/ ¿Cómo se diagnostica la enfermedad?/ ¿Cómo se trata la enfermedad de Alzheimer?/ ¿Qué se está investigando sobre la enfermedad?/ ¿Qué otras enfermedades se parecen al Alzheimer?

Enfermedad de Parkinson

OpenAIRE

Orozco V., Jorge Luis; Fundación Valle de Lili

2002-01-01

¿Qué tan frecuente es la enfermedad de Parkinson?/ ¿Qué ocasiona la enfermedad?/ ¿Existen otras formas de Parkinsonismo?/ ¿Quién desarrolla la enfermedad de Parkinson?/ ¿Cuales son los síntomas principales?/ ¿Cómo se diagnostica la enfermedad de Parkinson?/ ¿Cómo se trata la enfermedad?/Tratamiento quirúrgico/Aspectos prácticos del tratamiento/Verdades sobre la enfermedad de Parkinson.

El anisakis y sus enfermedades como enfermedad profesional

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José Manuel Vicente Pardo

Full Text Available El anisakis es un parásito complejo de los animales marinos. El hombre no es el hospedador adecuado, ya que en él la larva L3 no puede completar su ciclo vital, siendo por tanto un hospedador accidental u ocasional, que se interpone en el ciclo vital del nemátodo, y al que el anisakis le puede causar tanto la parasitación como la alergia, cuando ingiere pescado o cefalópodos crudos o poco cocinados: tales como sushi, sashimi, ceviche gravlax noruego, lomi-lomi hawaiano, así como pescados en escabeche, vinagre, desecado, ahumados, semiconservas, o en salazón que contengan este parásito en su forma de larva en estadio tres L3. Las enfermedades por anisakis constituyen un problema de salud pública, generalizado y que ha aumentado su incidencia en los últimos años. En 2012, se notificaron 20.000 casos de anisakiasis en todo el mundo. España es el segundo país con mayor número de intoxicaciones por Anisakis después de Japón. Diversos estudios en España sobre la prevalencia de la sensibilización reflejan una elevada prevalencia entre pacientes que han sufrido episodios de reacciones alérgicas. El 50 por ciento de quienes manipulan directamente el pescado presentan sensibilidad a anisakis. Siendo por tanto cada vez más común la afectación por y en el desarrollo del trabajo, constituyendo entonces procesos considerados como enfermedad profesional cuando se dan las circunstancias determinantes causales de trabajo, riesgo y exposición que para ello deben concurrir. La afección puede presentarse tanto por contacto laboral como por contacto en el consumo ordinario de pescado infestado, lo que hará difícil el estimar como causa exclusiva o consecuente la aparición de la enfermedad a consecuencia del desempeño del trabajo. Los sectores laborales de riesgo por enfermedades por anisakis, son los pescadores, pescaderos ("pescateros" y cocineros. En general todos aquellos que trabajan tanto en la captura, limpieza, manipulación, venta

Enfermedades de la pobreza, enfermedades tropicales desatendidas

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Pecoul, Bernard; Alvarado, J.

2014-01-01

Las enfermedades tropicales desatendidas (ETDs) se caracterizan por su altísima incidencia en países de renta baja haciendo bueno el nefasto ciclo pobreza-enfermedad-pobreza. Las ETDs son ajenas al mundo occidental por lo que no son consideradas prioritarias, pero tampoco lo son para los gobiernos de los países endémicos al afectar a las poblaciones rurales sin voz política. Los escasos beneficios que proporcionan los medicamentos para estas enfermedades las hacen poco atractivas para la inve...

Enfermedad acido-peptica

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Echavarría, Hector Raúl; Fundación Valle de Lili; Mendoza, Alfredo

1999-01-01

¿En qué consisten las enfermedades que se denominan con el término genérico de enfermedad acido-péptica?/ ¿Cuáles son sus síntomas?/ ¿Cómo se comporta la enfermedad acido-péptica y cuáles son sus causas?/ ¿Cómo se evitan estas enfermedades y como se tratan?

El Implante discal cervical como alternativa a la artrodesis en el tratamiento quirúrgico de la cervicoartrosis

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Lafuente Baraza, Jesús

2004-01-01

Consultable des del TDX Títol obtingut de la portada digitalitzada Objetivo: Evaluación de la prótesis de Bryan como alternativa a la artrodesis en el tratamiento de la espondilosis cervical. Materiales y métodos: 54 pacientes consecutivos con radiculopatía o mielopatía fueron intervenidos quirúrgicamente de discectomía cervical con implantación de la prótesis discal cervical. Dichos implantes presentan medidas variables que van de 14 a 18 mm. El seguimiento se realizo a las seis semana...

Factores de riesgo para la recurrencia de hernia de disco lumbar Fatores de risco de recorrência de hérnia de disco lombar Risk factors for recurrent lumbar disc herniation

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Angel Rodríguez Segura

2012-06-01

Full Text Available OBJETIVO: La recurrencia de hernia del disco lumbar es un padecimiento que implica algunas dificultades en relación con el diagnóstico y tratamiento. Es importante tratar de identificar los factores que puedan influir en la presentación de la recurrencia. MÉTODOS: Se revisaron los casos de pacientes operados por hernia de disco lumbar recurrente entre los años de 2006 y 2008, buscando identificar los factores que tuvieran relación con dicha patología, y también se revisaron los casos de pacientes operados por hernia de disco lumbar en forma primaria. RESULTADOS: Se analizaron los casos de 20 pacientes con hernia discal lumbar recurrente y de 27 con hernia discal lumbar operados en forma primaria. Para los pacientes con recurrencia, se encontró que el 95% de ellos presentaban algún grado de obesidad, determinado por la Fórmula de Quetelet basada en el Índice de Masa Corporal; se observó también que el 75% de los casos tenían protrusión, con resultados excelentes en 35%, y buenos en 55%, el 10% presentó molestias residuales de forma grave. Para los pacientes con hernia primaria se estudiaron 27 casos, en los que se observó que el 92% de ellos se operaron antes de los 6 meses de iniciado el cuadro, 38% tuvieron resultados excelentes, 40% buenos y el 19% malos resultados. Al estudiar las variables, con el índice de Pearson, se encontró relación de la recurrencia con tabaquismo, trabajo, diabetes e hipertensión, y nivel de estudios, no con la obesidad. CONCLUSIONES: es destacable que dos de los factores relacionados son susceptibles de modificación antes del evento quirúrgico o posteriormente a este, lo cual puede beneficiar el desenlace del mismo.OBJETIVO: A hérnia de disco envolve algumas dificuldades com relação ao diagnóstico e tratamento. É importante identificar os fatores que podem influenciar a recorrência. MÉTODOS: Foram analisados casos de pacientes operados de hérnia de disco lombar recidivante entre 2006 e

Pseudoaneurisma de artéria ilíaca comum como complicação de cirurgia para hérnia discal lombar: relato de caso

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HANEL RICARDO A.

1999-01-01

Full Text Available A cirurgia para tratamento da doença discal lombo-sacra pode cursar com complicações severas, iatrogênicas incluindo-se as neurológicas, vasculares, entéricas, ureterais e disfunção sexual podendo levar o paciente à morte dependendo da extensão da lesão. Abramovitz relata que as complicações vasculares do acesso posterior para o tratamento hérnia discal lombo-sacra ocorrem em menos de 0,1% dos casos As lesões vasculares podem manifestar-se de maneira imediata como hemorragia arterial levando a choque hipovolêmico no per ou pós-operatório imediato, devendo ser diagnosticadas e tratadas prontamente. Sinais precoces de hemorragia retroperitoneal se manifestam na vigência de lesões traumáticas, sendo os pseudoaneurismas e as fístulas arteriovenosas diagnosticados tardiamente, semanas ou mesmo após anos. Descrevemos o caso de uma paciente de 39 anos que foi submetida a tratamento cirúrgico de hérnia discal no espaço L4-L5, à direita, em outro serviço. Devido ao fato de persistirem os sintomas dolorosos, foi encaminhada ao nosso serviço. Na investigação a ressonância magnética mostrou lesão paravertebral sugestiva de abscesso. A angiografia aorto-ilíaca revelou a presença de pseudoaneurisma na artéria ilíaca comum esquerda, o qual foi reparado cirurgicamente com sucesso. Discutimos os mecanismos das lesões vasculares e as precauções para evitá-las.

Reabilitação precoce de atletas utilizando hidroterapia após o tratamento cirúrgico de hérnia discal lombar: relato preliminar de 3 casos Early rehabilitation of athletes using hydrotherapy after surgical treatment of lumbar disc herniation: preliminary report of three cases

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Marcelo Wajchemberg

2002-06-01

Full Text Available Os autores avaliaram três atletas do sexo masculino, submetidos a tratamento cirúrgico de hérnia discal lombar, com o objetivo de avaliar os resultados, após serem submetidos a um protocolo de reabilitação com base em hidroterapia. Este método permitiu a reabilitação precoce dos atletas, iniciando-se na primeira semana após a cirurgia. Os atletas foram avaliados em 5 ocasiões: pré-operatório e nos 4 meses seguintes. Houve melhora completa da dor em dois atletas. O terceiro caso apresentou no 4º mês 1,3% da intensidade máxima. As atividades de vida diária no período pré-operatório em média apresentaram-se com 21,6% da freqüência máxima, chegando a 99,3% no 4º mês. A freqüência de prática esportiva teve em média 10% da intensidade no pré-operatório, no 4º mês os atletas já praticavam a atividade esportiva com uma freqüência de 84,6% do normal. O nível de atividade esportiva foi relatado em média como 10% daquele estabelecido pelos atletas antes do início dos sintomas, atingindo 88,3% no 4º mês. Concluímos que os atletas apresentaram melhora evolutiva em todos os parâmetros analisados, especialmente em relação a dor. Portanto, a hidroterapia mostrou-se um método eficaz e bem tolerado na reabilitação precoce da cirurgia de hérnia discal em atletas.Three male athletes submitted to surgical treatment of lumbar disc herniation were assessed aiming to evaluate the results of a rehabilitation protocol based on aquatic therapy. This method allowed early rehabilitation of the athletes, within a week after surgery. The athletes were evaluated in 5 occasions: pre-operatively and in the 4 following months. Complete improvement of pain was observed in two athletes. The third case had 1.3% of the maximum intensity in the 4th month. The daily life activities during the pre-operative period presented 21.6% of the maximum frequency on average, reaching 99.3% in the 4th month. The frequency of practicing sports was

Intervenciones para la mejoría del uso apropiado de la imaginología en las personas con enfermedades musculoesqueleticas

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Simon D. French

2013-01-01

Veinte estudios cumplieron los criterios de inclusión. La mayoría de los estudios evaluó intervenciones diseñadas para cambiar el comportamiento de los profesionales de la salud, por ejemplo, distribución de materiales didácticos, recordatorios a los profesionales de la salud y educación a los pacientes. Para mejorar el uso de la imaginología en la osteoporosis la mayoría de las intervenciones que tuvieron como objetivo a los profesionales de la salud demostraron beneficios, y las intervenciones mediadas por el paciente, de recordatorios e institucionales parecieron tener el mayor potencial de beneficio. Para los estudios de dolor lumbar la intervención evaluada con mayor frecuencia fue la distribución de materiales didácticos, que mostró efectos variables. Otras intervenciones en los estudios de dolor lumbar mostraron efectos variables. Para otras enfermedades musculoesqueléticas la distribución de materiales didácticos, las reuniones educativas y la auditoría y retroalimentación no mostraron ser efectivas para cambiar el comportamiento de solicitar imaginología. En todas las enfermedades, el aumento del número de componentes de la intervención no dio lugar a un efecto mayor de las intervenciones

Enfermedades de notificación obligatoria

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Instituto Nacional de Salud

2008-01-01

Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia anima y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

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Instituto Nacional de Salud

2009-01-01

Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

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Instituto Nacional de Salud

2008-01-01

Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

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Instituto Nacional de Salud

2005-01-01

Presenta enfermedades inmunoprevenibles como: Sarampión y rubéola, Tos Ferina; Enfermedades trnasmitidas por vectores: dengue, Fiebre amarilla, Leismaniosis; Enfermedades de transmisión sexual: VIH/SIDA; Enfermedades zoonóticas: rabia animal

Enfermedades de notificación obligatoria

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Instituto Nacional de Salud

2009-01-01

Artículo online Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

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Instituto Nacional de Salud

2011-01-01

Presenta datos estadísticos de las enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; enfermedades zoonóticas como: Rabia animal y Rabia humana y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2010-01-01

Artículo online Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y Rabia humana y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedad de Kawasaki

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Carlos Coronel Carvajal

2003-09-01

Full Text Available Se realizó una revisión actualizada de la enfermedad de Kawasaki, con el objetivo de familiarizar a pediatras y médicos de la familia con los elementos clínicos de la enfermedad, para que de esta manera pueda ser diagnosticada y manejada oportunamente. La enfermedad de Kawasaki fue descrita por Tomisaki Kawasaki en 1967, y se manifiesta como un síndrome febril en la niñez temprana. La enfermedad se diagnostica con mayor frecuencia en los menores de 5 años, a través de una serie de criterios clínicos establecidos. La forma típica de la enfermedad tiene 3 fases de duración variable. La afectación cardíaca es la manifestación más importante de la enfermedad, del 10 al 40 % de los niños muestran signos de vasculitis coronaria, manifestada por aneurismas de las arterias coronarias.An updated review of Kawasaki disease was carried out to make pediatricians and family physicians familiar with the clinical elements of the disease so that it can be properly diagnosed and managed. Kawasaki disease was described by Tomisaki Kawasaki in 1967 and manifests as a febrile syndrome at early childhood. The disease is very often diagnosed in under five years-old children on the basis of a series of set clinical criteria. The typical form of the disease had 3 phases of variable duration. The cardiac effect is the most important manifestation of the disease since 10 to 40 % of children show signs of coronary vasculitis in the form of coronary arterial aneurysms.

Fusión intersomática lumbar extraforaminal mínimamente invasiva

Science.gov (United States)

Landriel, Federico; Hem, Santiago; Rasmussen, Jorge; Vecchi, Eduardo; Yampolsky, Claudio

2018-01-01

Resumen Objetivo: El objetivo del presente trabajo es mostrar la indicación, técnica quirúrgica, resultados y complicaciones de la vía de abordaje extraforaminal para fusión intersomática (ELIF) mínimamente invasiva. Introducción: El ELIF se caracteriza por la remoción del proceso articular superior (PAS) y el acceso a la raíz intracanalicular y disco a través del triángulo de seguridad de Kambin. Material y Métodos: Estudio retrospectivo de 40 pacientes operados consecutivamente entre el 2013 y 2015. Se incluyeron pacientes con lumbalgia o dolor radicular por enfermedad degenerativa discal, espondilolistesis grado 1 y 2, hernia discal recurrente y estenosis receso-foraminales. Se utilizó la escala visual analógica, el índice de Oswestry, la escala de Weiner y los criterios de MacNab modificados para evaluar el dolor, resultados clínico-funcionales y satisfacción del paciente al año de la cirugía. Las complicaciones fueron documentadas de acuerdo a su gravedad en 4 grados. Resultados: 25 mujeres/15 hombres con una edad promedio de 57 años. El 47.5% fueron tratados por espondilolistesis, el 25% por estenosis receso-foraminal. Se colocaron 54 cajas intersomáticas y 188 tornillos pediculares percutáneos. La duración quirúrgica promedio fue 245 (±25.4) minutos. El tiempo de internación promedio fue 3.5 (±0.49) días. Presentamos 9 complicaciones Grado 1 y una complicación Grado 2. La escala de ODI preoperatoria promedio fue de 51.9 ± 4.96, al año de 12.2 ± 3.19, evidenciando una mejoría significativa (P < 0.0001). La EVA promedio para lumbalgia mejoró de 8.81 ± 0.62 a 2.12 ± 0.89 (P < 0.0001). El 77.5% presentó fusión en los grados 1 y 2 de Bridwel al año del procedimiento quirúrgico. Conclusión: El ELIF es una alternativa de tratamiento quirúrgico segura y eficaz. Se pueden lograr resultados clínicos satisfactorios comparables con las técnicas tradicionales con la resección facetaria limitada al proceso articular superior

[Lumbar spondylosis].

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Seichi, Atsushi

2014-10-01

Lumbar spondylosis is a chronic, noninflammatory disease caused by degeneration of lumbar disc and/or facet joints. The etiology of lumbar spondylosis is multifactorial. Patients with lumbar spondylosis complain of a broad variety of symptoms including discomfort in the low back lesion, whereas some of them have radiating leg pain or neurologenic intermittent claudication (lumbar spinal stenosis). The majority of patients with spondylosis and stenosis of the lumbosacral spine can be treated nonsurgically. Nonsteroidal anti-inflammatory drugs and COX-2 inhibitors are helpful in controlling symptoms. Prostaglandin, epidural injection, and transforaminal injection are also helpful for leg pain and intermittent claudication. Operative therapy for spinal stenosis or spondylolisthesis is reserved for patients who are totally incapacitated by their condition.

Assessment of Lumbar Lordosis and Lumbar Core Strength in Information Technology Professionals.

Science.gov (United States)

Mehta, Roma Satish; Nagrale, Sanket; Dabadghav, Rachana; Rairikar, Savita; Shayam, Ashok; Sancheti, Parag

2016-06-01

Observational study. To correlate lumbar lordosis and lumbar core strength in information technology (IT) professionals. IT professionals have to work for long hours in a sitting position, which can affect lumbar lordosis and lumbar core strength. Flexicurve was used to assess the lumbar lordosis, and pressure biofeedback was used to assess the lumbar core strength in the IT professionals. All subjects, both male and female, with and without complaint of low back pain and working for two or more years were included, and subjects with a history of spinal surgery or spinal deformity were excluded from the study. Analysis was done using Pearson's correlation. For the IT workers, no correlation was seen between lumbar lordosis and lumbar core strength (r=-0.04); however, a weak negative correlation was seen in IT people who complained of pain (r=-0.12), while there was no correlation of lumbar lordosis and lumbar core in IT people who had no complains of pain (r=0.007). The study shows that there is no correlation of lumbar lordosis and lumbar core strength in IT professionals, but a weak negative correlation was seen in IT people who complained of pain.

Artrodese lombar minimamente invasiva com acesso intermuscular sem material cirúrgico especial: estudo de série de casos Artrodesis lumbar mínimamente invasiva con acceso intermuscular sin material quirúrgico especial: estudio de serie de casos Minimally invasive lumbar arthrodesis with intermuscular approach without special surgical material: a case series

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Bruno de Azevedo Oliveira

2011-01-01

Full Text Available OBJETIVOS: Analisar os resultados clínicos de uma série de pacientes com doença degenerativa da coluna lombar tratados com artrodese circunferencial com acesso minimamente invasivo intermuscular sem material cirúrgico especial. MÉTODOS: Análise de uma série prospectiva de 12 pacientes consecutivos não-randomizados submetidos à fusão lombossacra de 1 nível para doença degenerativa. Avaliados os Índices de Oswestry 2.0 e a escala visual analógica de dor (VAS no pré-operatório e seis meses após a cirurgia. A artrodese foi realizada por acesso paramediano bilateral entre os músculos multifidus e longissimus com o uso de afastador cervical simples com lâminas cambiáveis e implantes convencionais. RESULTADOS: Houve uma melhora média de 3,6 pontos na VAS e 27,5 pontos percentuais no Índice de Oswestry quando comparadas as avaliações pré-operatórias e após seis meses de follow-up. As melhoras mais marcadas foram nos pacientes que apresentavam ciatalgia por hérnia discal associada à discopatia. Os quesitos do Índice de Oswestry que apresentaram melhor resultado foram a intensidade da dor e a qualidade do sono. Os que apresentaram pior resultado foram a capacidade de levantamento de pesos e a dor ao sentar. Não houve dificuldade adicional devido à técnica e ao material utilizado. CONCLUSÕES: A artrodese da coluna lombossacra por abordagem minimamente invasiva transmuscular pode ser realizada com afastadores cirúrgicos normais e implantes semelhantes ao da técnica tradicional sem prejuízo técnico ou no resultado clínico.OBJETIVOS: Analizar los resultados clínicos de una serie de pacientes con enfermedad degenerativa de la columna lumbar, tratados con artrodesis circunferencial con acceso intermuscular mínimamente invasivo, sin material quirúrgico especial. MÉTODOS: Análisis de una serie prospectiva de 12 pacientes consecutivos, no seleccionados aleatoriamente, sometidos a la fusión de un sólo nivel lumbosacro

LUMBAR CORSETS CAN DECREASE LUMBAR MOTION IN GOLF SWING

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Koji Hashimoto

2013-03-01

Full Text Available Swinging a golf club includes the rotation and extension of the lumbar spine. Golf-related low back pain has been associated with degeneration of the lumbar facet and intervertebral discs, and with spondylolysis. Reflective markers were placed directly onto the skin of 11young male amateur golfers without a previous history of back pain. Using a VICON system (Oxford Metrics, U.K., full golf swings were monitored without a corset (WOC, with a soft corset (SC, and with a hard corset (HC, with each subject taking 3 swings. Changes in the angle between the pelvis and the thorax (maximum range of motion and angular velocity in 3 dimensions (lumbar rotation, flexion-extension, and lateral tilt were analyzed, as was rotation of the hip joint. Peak changes in lumbar extension and rotation occurred just after impact with the ball. The extension angle of the lumbar spine at finish was significantly lower under SC (38° or HC (28° than under WOC (44° conditions (p < 0.05. The maximum angular velocity after impact was significantly smaller under HC (94°/sec than under SC (177°/sec and WOC (191° /sec conditions, as were the lumbar rotation angles at top and finish. In contrast, right hip rotation angles at top showed a compensatory increase under HC conditions. Wearing a lumbar corset while swinging a golf club can effectively decrease lumbar extension and rotation angles from impact until the end of the swing. These effects were significantly enhanced while wearing an HC

TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

Science.gov (United States)

Mendoza-Ticona, Alberto

2014-01-01

Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

The influence of lumbar extensor muscle fatigue on lumbar-pelvic coordination during weightlifting.

Science.gov (United States)

Hu, Boyi; Ning, Xiaopeng

2015-01-01

Lumbar muscle fatigue is a potential risk factor for the development of low back pain. In this study, we investigated the influence of lumbar extensor muscle fatigue on lumbar-pelvic coordination patterns during weightlifting. Each of the 15 male subjects performed five repetitions of weightlifting tasks both before and after a lumbar extensor muscle fatiguing protocol. Lumbar muscle electromyography was collected to assess fatigue. Trunk kinematics was recorded to calculate lumbar-pelvic continuous relative phase (CRP) and CRP variability. Results showed that fatigue significantly reduced the average lumbar-pelvic CRP value (from 0.33 to 0.29 rad) during weightlifting. The average CRP variability reduced from 0.17 to 0.15 rad, yet this change ws statistically not significant. Further analyses also discovered elevated spinal loading during weightlifting after the development of lumbar extensor muscle fatigue. Our results suggest that frequently experienced lumbar extensor muscle fatigue should be avoided in an occupational environment. Lumbar extensor muscle fatigue generates more in-phase lumbar-pelvic coordination patterns and elevated spinal loading during lifting. Such increase in spinal loading may indicate higher risk of back injury. Our results suggest that frequently experienced lumbar muscle fatigue should be avoided to reduce the risk of LBP.

Relación entre el dolor lumbar y los movimientos realizados en postura sedente prolongada. Revisión de la literatura

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Fernanda Maradei García

2016-01-01

Full Text Available La evidencia científica muestra que existe asociación entre dolor lumbar y postura sedente prolongada y que una de las poblaciones más propensa a esta enfermedad es la de conductores, con una alta prevalencia. De igual manera, los movimientos posturales en la silla son la respuesta natural del cuerpo debida a la incomodidad percibida por el dolor lumbar, pero esta difiere en función de la historia previa. Con base en esto se realizó una revisión de los estudios relacionados con el dolor lumbar y el movimiento en postura sedente prolongada, incluyendo la población de conductores, con el fin de comprender esta relación. Se recuperaron 6226 artículos, de los cuales 16 fueron publicados entre 1970 y 2010; estos proporcionaron la información necesaria para contestar la pregunta de revisión. Se pudo constatar que ninguno de los estudios fueron realizados en actividades de conducir y la mayoría involucró sujetos voluntarios sin considerar si la población era trabajadora. El movimiento con dolor lumbar en postura sedente prolongada solo se pudo explicar desde el rango de movimiento lumbar, debido a que solo se encontró un artículo con estas características. También se encontró que los sintomáticos se mueven más, pero que el dolor lumbar no disminuye en función del tiempo, es decir que conocemos muy poco acerca de la paradoja movimiento y dolor en postura sedente prolongada.

Enfermedad de Chagas en Nicaragua

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Carlos N. Talavera - López

2008-04-01

Full Text Available LA ENFERMEDAD DE CHAGAS ES UN PROBLEMA DE SALUD pública en toda Latinoamérica; alrededor de 20 millones de personas están infectadas y 200 millones están en riesgo de contraer la enfermedad. En 2006, la prevalencia en Centroamérica era del 7%. Actualmente no existe vacuna contra el protozoo y el tratamiento disponible resulta, aparte de poco efectivo, muy tóxico para el paciente. Los programas de control de vectores han ayudado a reducir los índices de infestación en Latinoamérica, pero aún falta mucho por hacer. En Nicaragua, la enfermedad de Chagas está subvalorada y los trabajos publicados son muy pocos. Es necesario investigar sobre esta enfermedad en nuestro país con otro enfoque, uno que no subvalore la enfermedad y ayude a desarrollar métodos diagnósticos y posibles tratamientos. Este artículo recopila información sobre los trabajos realizados porlos grupos más importantes de investigación en Chagas de Nicaragua en cuanto a epidemiología, control vectorial, diagnóstico y caracterización molecular.

Effect of aging and lumbar spondylosis on lumbar lordosis

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Francis Osita Okpala

2018-01-01

Full Text Available Background: Lumbar lordosis (LL, the anterior convexity of the lumbar spine in the mid-sagittal plane, gives the spine some resilience and helps in protecting it from compressive forces because some of the force is taken by the anterior longitudinal ligaments. In aging and lumbar spondylosis, the intervertebral discs undergo the same degenerative changes though at different rates, and in both, while some authors reported a straightening of LL, others reported no significant change. This morphologic information would hopefully influence therapeutic decision-making, particularly in lumbar spondylosis, which though usually asymptomatic, is a common cause of low back pain. Aim: The aim of the study was to investigate the effect of aging and lumbar spondylosis on LL. Subjects and Methods: Lumbosacral joint angle (LSJA, an angular measure of LL, was retrospectively measured in 252 normal and 329 spondylotic adolescent and adult supine lateral lumbosacral spine archival radiographs, and data were analyzed with IBM SPSS Statistics 23.0 (New York, USA. Results: Normal LSJA range was 5°–39°; the mean was 18.7° and showed insignificant variation with gender and aging. Spondylotic range was 5°–40° and the mean (20.8° differed from the normal mean by about 2°, which probably have inconsequential effect on the lumbar curvature, suggesting that the normal and spondylotic mean values are essentially equal. The spondylotic mean also showed insignificant variation with aging and inconsequential 1° gender difference in favor of females. Conclusion: LL is substantially maintained in aging and lumbar spondylosis.

Side effects after diagnostic lumbar puncture and lumbar iohexol myelography

International Nuclear Information System (INIS)

Sand, T.; Stovner, L.J.; Salvesen, R.; Dale, L.

1987-01-01

A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n=97) and diagnostic lumbar puncture (n=85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (16 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effets after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent. (orig.)

Magnetic resonance imaging of lumbar spine disc diseases. Frequency of false negatives; Imagerie par resonance magnetique pour pathologie discale lombaire. Frequence des faux-negatifs

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Berthelot, J.M.; Maugars, Y.; Delecrin, Y.; Caillon, F.; Prost, A. [Hopital Hotel-Dieu de Nantes, 44 (France)

1995-10-01

Magnetic resonance imaging (MRI) has had an impressive impact on evaluation of degenerative diseases of the spine. Nevertheless, false negatives can occur on images involving lumbar discs. Degenerative disc diseases documented on discography and/or pathology examination of the discs can go unrecognized. Likewise sensitivity for the detection of protruding disc hernias is not totally satisfactory (20% false negatives). Finally, a magnetic resonance image visualizing displacement of the disc is not specific (10 to 15% false positives); images showing protrusion or hernia can be seen in 30% of asymptomatic patients. Although MRI gives slightly more information than other imaging techniques, false images do exist. Moreover, the usefulness of MRI to demonstrate disc disease in case of a negative CT-scan remains to be demonstrated. (authors). 26 refs.

Influence of Lumbar Lordosis on the Outcome of Decompression Surgery for Lumbar Canal Stenosis.

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Chang, Han Soo

2018-01-01

Although sagittal spinal balance plays an important role in spinal deformity surgery, its role in decompression surgery for lumbar canal stenosis is not well understood. To investigate the hypothesis that sagittal spinal balance also plays a role in decompression surgery for lumbar canal stenosis, a prospective cohort study analyzing the correlation between preoperative lumbar lordosis and outcome was performed. A cohort of 85 consecutive patients who underwent decompression for lumbar canal stenosis during the period 2007-2011 was analyzed. Standing lumbar x-rays and 36-item short form health survey questionnaires were obtained before and up to 2 years after surgery. Correlations between lumbar lordosis and 2 parameters of the 36-item short form health survey (average physical score and bodily pain score) were statistically analyzed using linear mixed effects models. There was a significant correlation between preoperative lumbar lordosis and the 2 outcome parameters at postoperative, 6-month, 1-year, and 2-year time points. A 10° increase of lumbar lordosis was associated with a 5-point improvement in average physical scores. This correlation was not present in preoperative scores. This study showed that preoperative lumbar lordosis significantly influences the outcome of decompression surgery on lumbar canal stenosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery

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Ding Zi-hai

2011-04-01

Full Text Available Abstract Background Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery. Methods To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH data set were prepared and used in the study. Three-dimensional (3D computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set. Results The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP. All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle. Conclusion The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical

Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery.

Science.gov (United States)

Lu, Sheng; Chang, Shan; Zhang, Yuan-zhi; Ding, Zi-hai; Xu, Xin Ming; Xu, Yong-qing

2011-04-14

Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery. To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH) data set were prepared and used in the study. Three-dimensional (3D) computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set. The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP). All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle. The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical operations by its relative position to the lumbar plexus. 3D

Lumbar facet syndrome - Lumbar facet joint injection and low back pain

International Nuclear Information System (INIS)

Acevedo Gonzalez, Juan Carlos; Jimenez Hakim, Enrique; Rodriguez, Jose Maria; Hakim Daccach, Fernando; Quinonez, German; Rodriguez Munera, Andres

2004-01-01

The authors conducted a retrospective study lo evaluate the effectiveness of injection therapy in the lumbar zygapophysial joints with anesthetics and steroids in patients with persisting low back pain and lumbar facer syndrome. Thirty-seven patients with low back pain who reported immediate relief of their pain after controlled blocks into the facet joints between the fourth and fifth lumbar vertebrae and the fifth lumbar and first sacral vertebrae were evaluated. Outcome was evaluated using the visual analog pain scales. All outcome measures were repeated at eight days and six weeks alter controlled injection. At six-week follow-up examination 83,7% of thirty-seven patients experienced a good response to controlled blocks of the lumbar zygaphyseal (facet) joints. Good result is the pain relief of 50% or more. Fifteen patients experienced a good response with pain relief of eight points or more in the VAS

Enfermedad coronaria en pacientes con psoriasis

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Walter Masson

2013-10-01

Full Text Available Comunicaciones previas asociaron la psoriasis con la enfermedad coronaria. Desconocemos si en nuestro país o región existe dicha asociación. Se realizó un estudio transversal analizando los datos de la historia clínica electrónica de un sistema de salud de Buenos Aires. Analizamos todos los pacientes mayores de 18 años con diagnóstico de psoriasis entre el 1 de enero de 2003 y el 31 de julio de 2011 y los comparamos con un grupo control, en una relación 2:1, obtenido en forma aleatoria del mismo sistema de salud, apareados por edad y sexo. Determinamos la prevalencia de los factores de riesgo cardiovascular y de enfermedad coronaria. Analizamos la asociación entre la enfermedad coronaria y la psoriasis mediante análisis uni y multivariado. Se incluyeron 3 833 sujetos (1 286 pacientes con psoriasis y 2 547 controles. La prevalencia de hipertensión arterial (50% vs. 38%, p < 0.001, tabaquismo (25% vs. 17%, p < 0.001, diabetes (12% vs. 8%, p < 0.001 y enfermedad coronaria (4.98% vs. 3.06%, p = 0.003 fue mayor en los sujetos con psoriasis en comparación con el grupo control. Independientemente de la edad, la presencia de diabetes, hipertensión arterial o tabaquismo, hubo una asociación significativa entre la enfermedad coronaria y la psoriasis (OR 1.48, IC95% 1.04-2.11, p = 0.03. En conclusión, en esta población de Buenos Aires, los pacientes con psoriasis tuvieron una mayor prevalencia de diabetes, hipertensión arterial, tabaquismo y enfermedad coronaria. La asociación entre la psoriasis y la enfermedad coronaria fue independiente de los factores de riesgo explorados.

Enfermedad de Hirschsprung

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K A Santos-Jasso

2017-01-01

Full Text Available El diagnóstico de la enfermedad de Hirschsprung se debe sospechar en el recién nacido que presenta datos de obstrucción intestinal: vómito, distensión abdominal y falla para el paso de meconio, en la primera semana de vida, lo que sustenta su origen congénito. Los pacientes con esta enfermedad son predominantemente del sexo masculino (84%; suelen presentar impactación fecal colónica y en la valoración abdominal muestran desimpactación, que puede ser explosiva en el examen digital del recto con vaciamiento en el 96% de los pacientes.

Enfermedad de Chagas o Tripanosomiasis Americana.

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Felipe Guhl

2000-08-01

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Situación Actual de Colombia.

La enfermedad de Chagas o tripanosomiasis americana es una enfermedad parasitaria crónica causada por un protozoario flagelado el Trypanosoma cruzi, descrito por primera vez por Carlos Chagas, médico brasileño, a comienzos de este siglo y en su honor se denominó la enfermedad que lleva su nombre.

Este parásito normalmente se transmite al ser humano a través de insectos triatomíneos estrictamente hematófagos de la familia Reduviidae, en el momento en que perforan la piel para succionar la sangre que los alimenta.

Sin embargo, no se inocula directamente por intermedio de las estructuras bucales del insecto en el momento de la picadura como en el caso de las tripanosomiasis africanas, si no que se deposita pasivamente en la piel a través de las heces del insecto, penetrando en el cuerpo por la herida que causa la picadura u otras abrasiones de la piel o de la mucosa. El T. cruzi, también puede transmitirse por infección congénita, por transfusión de sangre contaminada o por el transplante de órganos contaminados. El ciclo vital del parásito es largo y complejo y su desarrollo tiene varias etapas, tanto en el vector triatomineo como en el huésped vertebrado .

La Enfermedad de Chagas constituye una amenaza permanente para casi la cuarta parte de toda la población de América Latina. Si bien la enfermedad se encuentra presente en toda América Central y del Sur, sus manifestaciones y características epidemiológicas son altamente variables entre una y otra zona endémica. Existe una gran diversidad en las tasas de prevalencia, formas de transmisión, características parasitarias, patología clínica, vectores y reservorios.

Más que cualquier otra enfermedad parasitaria, la enfermedad de Chagas se relaciona con el desarrollo económico y social de la población: los insectos triatomineos y las enfermedades que ellos transmiten existirán mientras en

Biomechanical study of percutaneous lumbar diskectomy

International Nuclear Information System (INIS)

Li Yuan; Huang Xianglong; Shen Tianzhen; Hu Zhou; Hong Shuizong; Mei Haiying

2003-01-01

Objective: To investigate the stiffness of lumbar spine after the injury caused by percutaneous diskectomy and evaluate the efficiency of percutaneous lumbar diskectomy by biomechanical study. Methods: Four fresh lumbar specimens were used to analyse load-displacement curves in the intact lumbar spine and vertical disc-injured lumbar spine. The concepts of average flexibility coefficient (f) and standardized average flexibility coefficient (fs) were also introduced. Results: The load-displacement curves showed a good stabilization effect of the intact lumbar spine and disc-injured lumbar spine in flexion, extension, right and left bending. The decrease of anti-rotation also can be detected (P<0.05). Conclusion: In biomechanical study, percutaneous lumbar diskectomy is one of the efficiency methods to treat lumbar diac hernia

[Biomechanics changes of lumbar spine caused by foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy].

Science.gov (United States)

Qian, J; Yu, S S; Liu, J J; Chen, L; Jing, J H

2018-04-03

Objective: To analyze the biomechanics changes of lumbar spine caused by foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy using the finite element method. Methods: Three healthy adult males (aged 35.6 to 42.3 years) without spinal diseases were enrolled in this study and 3D-CT scans were carried out to obtain the parameters of lumbar spine. Mimics software was applied to build a 3D finite element model of lumbar spine. Graded resections (1/4, 2/4, 3/4 and 4/4) of the left superior articular process of L(5) were done via percutaneous transforaminal endoscopic lumbar discectomy. Then, the pressure of the L(4/5) right facets, the pressure of the L(4/5) intervertebral disc and the motion of lumbar spine were recorded after simulating the normal flexion and extension, lateral flexion and rotation of the lumbar spine model during different resections. The data were compared among groups with analysis of variance. Results: Comparing with the normal group, after 1/4 resection of the left superior articular process of L(5), the pressure of the L(4/5) right facets showed significant differences during left lateral flexion and rotation of lumbar spine ( q =8.823, 8.248, both P biomechanics and the stability of lumbar spine changed partly after 1/4 resection of the superior articular process and obviously after more than 2/4 is resected. The superior articular process should be paid more attention during foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy.

Enfermedad pulmonar intersticial asociada a rituximab

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Marcelo Fernández Casares

2013-08-01

Full Text Available La introducción en la práctica clínica del anticuerpo anti-CD20 rituximab ha mejorado sustancialmente el pronóstico de diversas enfermedades autoinmunes y hematológicas. Con el incremento de su uso ha aumentado el registro de efectos adversos, entre ellos la toxicidad pulmonar. Una de sus complicaciones más serias es la enfermedad pulmonar intersticial, entidad potencialmente fatal que debe ser considerada en pacientes que han recibido rituximab y presentan disnea, fiebre y tos sin clara evidencia de infección. Presentamos un caso de enfermedad pulmonar intersticial asociada a rituximab.

[Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation].

Science.gov (United States)

Hu, Hua; Xiong, Chang-Yuan; Han, Guo-Wu

2012-07-01

To study the changes of displacement and stress in the model of lumbar pelvic and proximal femur during lumbar rotatory manipulation. The date of lumbar pelvic and proximal femur CT scan by Mimics 10.01 software was established a lumbar pelvic and proximal femur geometric model, then the model was modified with Geomagic 9, at last the modified model was imported into hypermesh 10 and meshed with tetrahedron, at the same time,add disc and ligaments. According to the principle of lumbar rotatory manipulation,the lumbar rotatory manipulation were decomposed. The mechanical parameters assigned into the three-dimensional finite element model. The changes of displacement and stress in the model of lunbar pelvic and proximal femur under the four conditions were calculated with Abaqus model of Hypermesh 10. 1) Under the same condition,the displacement order of lumbar was L1>L2>L3>L5 L5, anterior column > middle column > posterior column. 2) Under the different conditions, the displacement order of lumbar,case 3>case 1>case 4>case 2. 3) Under the same conditions, the displacement order of lumbar inter-vertebral disc from L1,2 to L5S1 was L1,2>L2,3>L3,4>L4,5>L5S1, as for the same inter-vertebral disc, the order was: second quadrant>third quadrant>first quadrant>fourth quadrant. 4) Under the different conditions,the displacement order of the inter-vertebral disc was L1,2>L2,3>L3,4>L4,5>L5S1, but to same inter-vertebral disc: case 3>case 4>case 1 >case 2. 5) There were apparent displacement and stress concentration in pelvis and hip during the manipulation. 1) The principles of lumbar rotation manipulation closely related to the relative displacement caused by rotation of various parts of lumbar pelvic and proximal femur model; 2) During the process of lumbar rotatory manipulation, the angle of lateral bending and flexion can not be randomly increased; 3) During the process of lumbar rotatory manipulation, all the conditions of lumbar pelvic and proximal femur must be

Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration.

Science.gov (United States)

Sparrey, Carolyn J; Bailey, Jeannie F; Safaee, Michael; Clark, Aaron J; Lafage, Virginie; Schwab, Frank; Smith, Justin S; Ames, Christopher P

2014-05-01

The goal of this review is to discuss the mechanisms of postural degeneration, particularly the loss of lumbar lordosis commonly observed in the elderly in the context of evolution, mechanical, and biological studies of the human spine and to synthesize recent research findings to clinical management of postural malalignment. Lumbar lordosis is unique to the human spine and is necessary to facilitate our upright posture. However, decreased lumbar lordosis and increased thoracic kyphosis are hallmarks of an aging human spinal column. The unique upright posture and lordotic lumbar curvature of the human spine suggest that an understanding of the evolution of the human spinal column, and the unique anatomical features that support lumbar lordosis may provide insight into spine health and degeneration. Considering evolution of the skeleton in isolation from other scientific studies provides a limited picture for clinicians. The evolution and development of human lumbar lordosis highlight the interdependence of pelvic structure and lumbar lordosis. Studies of fossils of human lineage demonstrate a convergence on the degree of lumbar lordosis and the number of lumbar vertebrae in modern Homo sapiens. Evolution and spine mechanics research show that lumbar lordosis is dictated by pelvic incidence, spinal musculature, vertebral wedging, and disc health. The evolution, mechanics, and biology research all point to the importance of spinal posture and flexibility in supporting optimal health. However, surgical management of postural deformity has focused on restoring posture at the expense of flexibility. It is possible that the need for complex and costly spinal fixation can be eliminated by developing tools for early identification of patients at risk for postural deformities through patient history (genetics, mechanics, and environmental exposure) and tracking postural changes over time.

Does Lordotic Angle of Cage Determine Lumbar Lordosis in Lumbar Interbody Fusion?

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Hong, Taek-Ho; Cho, Kyu-Jung; Kim, Young-Tae; Park, Jae-Woo; Seo, Beom-Ho; Kim, Nak-Chul

2017-07-01

Retrospective, radiological analysis. To determine that 15° lordotic angle cages create higher lumbar lordosis in open transforaminal lumbar interbody fusion (TLIF) than 4° and 8° cages. Restoration of lumbar lordosis is important to obtain good outcome after lumbar fusion surgery. Various shapes and angles of cages in interbody fusion have been used; however, it is not proved that lordotic angle of cages determine lumbar lordosis. Sixty-seven patients were evaluated after TLIF using 15° cages and screw instrumentation. For comparison, TLIF using 4° lordotic angle cages in 65 patients and 8° cages in 49 patients were analyzed. Lumbar lordosis angles, segmental lordosis angles, disc height, and bony union rate were measured on the radiographs. The lumbar lordosis was 31.1° preoperatively, improved to 42.9° postoperatively, and decreased to 36.4° at the last follow-up in the 15° group. It was 35.8° before surgery, corrected to 41.5° after surgery, and changed to 33.6° at the last follow-up in the 4° group. In the 8° group, it was 32.7° preoperatively, improved to 39.1° postoperatively, and decreased to 34.5° at the last follow-up. These changes showed statistical significances (P lordosis at L4-5 was 6.6° before surgery, 13.1° after surgery, and 9.8° at the last follow-up in the 15° group. It was 6.9°, 9.5°, and 6.2° in the 4° group and 6.7°, 9.8°, and 8.1° in the 8° group, respectively (P lordosis after TLIF. Cages with sufficient lordotic angle showed better restoration of lumbar lordosis and prevention of loss of correction. 4.

¿Qué es una enfermedad rara?

OpenAIRE

Dirección General de Salud Pública y Participación. Gobierno del Principado de Asturias

2014-01-01

Enfermedades Raras en Asturias. Dirección General de Salud Pública y Participación. Informes breves 01 Defining what is meant by rare diseases. Definición de lo que se entiende por enfermedades raras.

Enfermedad de Chagas en Colombia

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Fernando Serpa Florez

1985-12-01

Full Text Available

Generalidades.

La tripanosomiasis americana o enfermedad de Chagas se halla ampliamente distribuida en Centro y Sur América. La Organización Mundial de la Salud considera que pueden haber doce millones de casos de esta dolencia en el continente (1, estudiados principalmente en Argentina, Brasil y Venezuela. Se calcula que en Colombia tendríamos una incidencia muy alta de casos, (Marinkelle (2 estima que 7.140/0 de la población podría estar infectada o sea cerca de dos millones de personas, distribuidos en las zonas rurales del nordeste del país (cuenca del Catatumbo Magdalena Medio y Llanos Orientales (Piedemonte, Macarena y Meta cercano (3 (4 (5 Y que seis millones de nuestros compatriotas -22.30/0 de la población total- (2 corren el riesgo de adquirir la enfermedad pues habitan en regiones donde se dan las condiciones para que ésta se propague.

RESEÑA HISTORICA DE LA ENFERMEDAD EN COLOMBIA
La existencia de casos de tripanosomiasis americana y de sus vectores fue comprobada en Colombia desde 1929 cuando César Uribe Piedrahita (6 encontró en Prado, Tolima, vectores del mal infectados con T.

cruzi e Ignacio Moreno Pérez observó dicho hemoflagelado en sangre de seres humanos en Cali (4. En los años siguientes Hernando Ucrós, Benjamín Otálora, Hernando Groot, Santiago Renjifo, Hernando Osorno, Carlos Duarte Rangel, C.J. Marinkelle, Augusto Corredor, Ernesto Suescún y varios otros investigadores colomb iano s describieron diversos focos de la enfermedad en Colombia y estudiaron la distribución de sus vectores y huéspedes intermediarios. En 1947 1. Caicedo y C. Hernández publicaron su informe sobre los primeros casos crónicos de enfermedad de Chagas comprobados en nuestro país, procedentes de la región de Fusagasugá, Cundinamarca (7 en tanto que, en 1961, Marcos Duque inicia los estudios sobre cardiopatía chagásica (8 y Hernando Rocha, en 1971, comunica

ACTUALIZACIÓN EN LA ENFERMEDAD DE PARKINSON

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Dr. Raúl Martínez-Fernández.

2016-05-01

Full Text Available La enfermedad de Parkinson es un trastorno neurodegenerativo complejo y de presentación heterogénea. Aunque aún no se dispone de ningún fármaco que enlentezca la progresión de la enfermedad, existe un arsenal terapéutico extenso y eficaz para el control sintomático en cada una de sus fases, por lo que es importante realizar un diagnóstico preciso así como un correcto manejo de fármacos que garantice un estado óptimo en los paciente que la sufren, lo que resultará en una mejora en su calidad de vida. Además, dado que es el trastorno neurodegenerativo más frecuente tras la enfermedad de Alzheimer y que su factor de riesgo principal es la edad, la enfermedad de Parkinson supone, cada vez más, un reto de salud pública en nuestras sociedades occidentales progresivamente envejecidas. Esta revisión pretende actualizar los aspectos clínicos y diagnósticos fundamentales de la enfermedad de Parkinson así como las principales estrategias terapéuticas disponibles.

Gossypiboma complicated with paraspinal abscess and lumbar sinus: An uncommon complication of posterior lumbar spinal surgery

OpenAIRE

Sahoo, Ranjan Kumar; Tripathy, Pradipta; Das, Pulin Bihari; Mohapatra, Debahuti

2017-01-01

A 42-year-old female presented with the complaint of purulent discharging sinus over posterior lumbar area following one month of lumbar spinal surgery for prolapsed intervertebral disc. Gossypiboma complicated with paraspinal abscess and sinus track formation over posterior lumbar area was diagnosed in magnetic resonance imaging which was confirmed in re- exploration of lumbar spinal operative site.

Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis

Science.gov (United States)

Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

2017-01-01

Abstract The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery. In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared. The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively. PELD operation was superior in terms of operation time, bleeding volume, recovery period

Subjetividad e interseccionalidad: experiencias de Enfermedad de Mujeres Negras con enfermedad falciforme

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Eliana Costa Xavie

2017-05-01

Full Text Available El estudio tuvo el objetivo de conocer y analizar la historia de mujeres negras con enfermedad falciforme y comprender cómo la subjetividad de estas es construida y confrontada a partir de los sentidos subjetivos asociados con los marcadores de género, raza y clase social. Se trata de una investigación cualitativa en la que participaron 9 mujeres negras acompañadas por el Centro de Referencia de la Anemia Falciforme del Hospital de Clínicas de Porto Alegre. Las entrevistas semiestructuradas fueron analizadas por medio del análisis crítico del discurso. Los resultados mostraron que las mujeres negras perciben su enfermedad como condición de salud que estrecha los lazos entre su pertenencia racial y sus construcciones de género y de clase. El discurso de esas mujeres negras trascendió a la complejidad de la enfermedad crónica, transformándola y construyendo posibilidades que las potencializan como mujeres, madres y sujetos sociales. Las mujeres señalaron que la interseccionalidad de raza, género y clase social impulsa la ceguera pública de la mujer negra y de las cuestiones relacionadas con la población negra intensificando el sentimiento de invisibilidad.

Enfermedad óseo mineral relacionada con la enfermedad renal crónica: Klotho y FGF23; implicaciones cardiovasculares

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Laura Salanova Villanueva

2016-07-01

Full Text Available Una de las principales causas de morbimortalidad en el paciente con enfermedad renal crónica es la cardiovascular. La inflamación y las alteraciones en el metabolismo óseo mineral son una condición patológica que conlleva aumento del riesgo cardiovascular en la enfermedad renal crónica. Los parámetros bioquímicos clásicos del metabolismo óseo mineral como fósforo, calcio, vitamina D y PTH tienen una implicación muy conocida en el riesgo cardiovascular. Los nuevos marcadores, FGF23 y klotho, también podrían estar implicados en la enfermedad cardiovascular.

Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

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Yılmaz, Tevfik; Turan, Yahya; Gülşen, İsmail; Dalbayrak, Sedat

2014-01-01

Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury. PMID:25210343

Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

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Tevfik Yilmaz

2014-01-01

Full Text Available Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury.

Lumbar lordosis.

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Been, Ella; Kalichman, Leonid

2014-01-01

Lumbar lordosis is a key postural component that has interested both clinicians and researchers for many years. Despite its wide use in assessing postural abnormalities, there remain many unanswered questions regarding lumbar lordosis measurements. Therefore, in this article we reviewed different factors associated with the lordosis angle based on existing literature and determined normal values of lordosis. We reviewed more than 120 articles that measure and describe the different factors associated with the lumbar lordosis angle. Because of a variety of factors influencing the evaluation of lumbar lordosis such as how to position the patient and the number of vertebrae included in the calculation, we recommend establishing a uniform method of evaluating the lordosis angle. Based on our review, it seems that the optimal position for radiologic measurement of lordosis is standing with arms supported while shoulders are flexed at a 30° angle. There is evidence that many factors, such as age, gender, body mass index, ethnicity, and sport, may affect the lordosis angle, making it difficult to determine uniform normal values. Normal lordosis should be determined based on the specific characteristics of each individual; we therefore presented normal lordosis values for different groups/populations. There is also evidence that the lumbar lordosis angle is positively and significantly associated with spondylolysis and isthmic spondylolisthesis. However, no association has been found with other spinal degenerative features. Inconclusive evidence exists for association between lordosis and low back pain. Additional studies are needed to evaluate these associations. The optimal lordotic range remains unknown and may be related to a variety of individual factors such as weight, activity, muscular strength, and flexibility of the spine and lower extremities. Copyright © 2014 Elsevier Inc. All rights reserved.

Enlargement of lumbar spinal canal in lumbar degenerative spondylolisthesis. Evaluation with three-dimensional computed tomography

International Nuclear Information System (INIS)

Kunishi, Yoshihiko

2003-01-01

A number of clinical studies have demonstrated that enlargement of the lumbar spinal canal is one of the effective surgical procedures for the treatment of the lumbar degenerative spondylolisthesis and provides a good result. In the present study, we have evaluated the long-term outcome of the enlargement of the lumbar canal without fusion in thirty eight patients with lumbar degenerative spondylolisthesis using three-dimensional computed tomography (3D-CT) The improvement rate was excellent in 80% of the patients (mean improvement ratio, 83%) according to the Japanese Orthopedic Association scoring system. We found that the sufficient enlargement of the canal was obtained by the surgery and maintained for a long period of time. The results from 3D-CT suggested that a round shape was maintained in the canal after the surgery because of pressures of the dura mater against to the bony canal. None of patients showed lumbar instability. In conclusion, enlargement of lumbar canal without fusion is useful for the treatment of lumbar degenerative spondylolisthesis, and the enlarged canal has been maintained for a long period of time after the surgery. The results demonstrated the clinical utility of 3D-CT to evaluate the preoperative and postoperative shape of the spine. (author)

NEUROMUSCULAR CONTROL IN LUMBAR DISORDERS

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Ville Leinonen

2004-03-01

Full Text Available Impaired motor and sensory functions have been associated with low back pain (LBP. This includes disturbances in a wide range of sensorimotor control e.g. sensory dysfunctions, impaired postural responses and psychomotor control. However, the physiological mechanisms, clinical relevance and characteristics of these findings in different spinal pathologies require further clarification. The purposes of this study were to investigate postural control, lumbar muscle function, movement perception and associations between these findings in healthy volunteers (n=35, patients with lumbar disc herniation (n=20 and lumbar spinal stenosis (LSS, n=26. Paraspinal muscle responses for sudden upper limb loading and muscle activation during flexion-extension movement and the lumbar endurance test were measured by surface electromyography (EMG. Postural stability was measured on a force platform during two- and one-footed standing. Lumbar movement perception was assessed in a motorised trunk rotation unit in the seated position. In addition, measurements of motor-(MEP and somatosensory evoked potentials (SEP and needle EMG examination of lumbar multifidus muscles were performed in the LSS patients. Clinical and questionnaire data were also recorded. A short latency paraspinal muscle response (~50 ms for sudden upper limb loading was observed. The latency of the response was shortened by expectation (p=0.017. The response latency for unexpected loading was similar in healthy persons and disc herniation patients but the latency was not shortened by expectation in the patients (p = 0.014. Also impaired postural control (p < 0.05 and lumbar movement perception (p = 0.012 were observed in disc herniation patients. The impaired lumbar movement perception (p=0.054 and anticipatory muscle activation (p = 0.043 tended to be restored after successful surgery but postural control had still not recovered after 3 months of follow-up. The majority of LSS patients were unable

Clinical application of percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation under CT guidance

International Nuclear Information System (INIS)

Wang Linyou; Li Yuan; Shao Yangtong

2004-01-01

Objective: To evaluate the effect of the percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation. Methods: 75 cases of lumbar disc herniation with significant clinical signs were confirmed by CT scan. The technique of the percutaneous lumbar puncture led the needle to approach nerve root and injected medicine diffusing into extraduramater, and then relieved the symptom of sciatica. Results: The rate of success of percutaneous lumbar puncture guided by CT reached to 100%. After two weeks of follow-up, the symptom of pain was obviously improved and disappeared in 63.3% cases. There were 23.0% cases needed a second procedure, and no change was obsesved in 9.3% cases. Conclusions: The percutaneous lumbar puncture guided by CT to treat sciatica resulted from lumbar disc herniation is one of the safe, reliable, effective new methods with no complication. The long term effectiveness is still in need of investigation. (authors)

a enfermedades laborales en España, 2004

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Ana M. García García

2007-01-01

Full Text Available Fundamento: El registro de enfermedades profesionales en España resulta insuficiente para valorar el impacto de las enfermedades de origen laboral en nuestro país. En el presente estudio se estima la mortalidad por enfermedades laborales y sus costes en base a riesgos atribuibles estimados en la literatura internacional. Métodos: Se aplican estimaciones de riesgo atribuible para la mortalidad de origen laboral calculadas por Nurminen y Karjalainen (Finlandia, 2001 al total de muertes por las enfermedades y grupos de edad relevantes en España y por comunidades autónomas en 2004. Se calculan los años potenciales de vida y de vida laboral perdidos. A partir de estos últimos, se estiman los costes actualizados de la pérdida de vida productiva debida a las muertes por enfermedades laborales en España. Resultados: Según nuestras estimaciones, en 2004 se habrían producido en España cerca de 16.000 muertes por enfermedades relacionadas con exposiciones laborales, la mayoría en hombres (87%. Estas muertes habrían causado cerca de 152.000 años potenciales de vida perdidos y algo más de 47.000 años potenciales de vida laboral perdidos, lo que conllevaría un coste actualizado en pérdidas de productividad entre 580 y 1.000 millones de euros. Conclusiones: En 2004 el registro de enfermedades profesionales en España sólo recogió dos muertes por esta causa. Sin embargo, los resultados del presente estudio ponen de manifiesto la importancia de las condiciones de trabajo como determinantes de muertes evitables en la población y la inminente necesidad de sistemas de vigilancia y prevención adecuados para afrontar en toda su magnitud este problema para la salud pública.

Trastornos del sueño en las enfermedades neurodegenerativas

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Dr. C. Marcelo Miranda

2013-05-01

Full Text Available Las enfermedades degenerativas del cerebro son cada vez más frecuentes, debido al envejecimiento de la población en Chile y en prácticamente todas las regiones del mundo. Las alteraciones del sueño son un componente importante cada vez mejor reconocido en sus manifestaciones clínicas, si bien frecuentemente ignorados en muchas de las evaluaciones. No obstante, es muy importante reconocer estos trastornos porque dificultan el manejo óptimo de estas complejas enfermedades. Por ejemplo, cuadros como el trastorno conductual del sueño REM (por Rapid Eye Movements, en Inglés, un componente de los ciclos del sueño que incluye el fenómeno de “actuar los sueños” se han configurado como potenciales biomarcadores de la presencia de la enfermedad de Parkinson. Por lo tanto, se trata no sólo de identificar trastornos y manifestaciones específicas dentro del contexto de las enfermedades ya aludidas, sino que también de utilizar estos trastornos clave como elementos importantes en el diagnóstico precoz de las mismas. En esta revisión analizamos los principales problemas relacionados al sueño que es posible observar en este tipo de enfermedades, y que forman parte de las consideraciones esenciales para un manejo óptimo, actualizado e integral de estas enfermedades (Parasomnias, enfermedades neurodegenerativas, apneas del sueño.

Enfermedad de Gumboro. Histopatología de la Bursa de Fabricio en la enfermedad natural y experimental en pollos de engorde

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E, Babaahmady; R, Joa.-; Julia, Noda.

2005-01-01

La Enfermedad de Gumboro, o Enfermedad Infecciosa de la Bolsa de Fabricio (EIBF) es una enfermedad viral, infectocontagiosa de los pollos jóvenes, que puede afectar al pollo de engorde provocando inmunosupresión y mortalidad. Las cepas del virus EIBF se diferencian en su patogenicidad basado en el efecto que producen en los órganos linfoides principalmente la bolsa de Fabricio y como consecuencia la reducida respuesta inmune a infecciones con otros patógenos o vacunas que se aplican. En este ...

Artrodesis cervical anterior mediante implante de tantalio: Resultados clínicos y radiológicos

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Vicario, C.; Lopez-Oliva, F.; Sánchez-Lorente, T.; Zimmermann, M.; Asenjo-Siguero, J.J.; Ladero, F.; Ibarzábal, A.

2006-01-01

La discectomía cervical anterior con artrodesis intersomática (DCAA) es una técnica quirúrgica ampliamente aceptada en el tratamiento de la enfermedad discal cervical. Recientemente se han introducido con esta indicación las cajas de tantalio debido a sus excelentes propiedades mecánicas y biológicas. Presentamos los resultados iniciales clínicos y radiológicos de un estudio prospectivo de 24 pacientes intervenidos en nuestro servicio tras el empleo de cajas de tantalio en la DCAA. La evaluac...

Enfermedad injerto contra huesped: sus manifestaciones bucales

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Claudia Marcela Hernández Cancino

Full Text Available La enfermedad injerto contra huésped es la principal complicación que sufren los pacientes que han recibido trasplante alogénico. Se produce como consecuencia de una reacción inflamatoria exagerada mediada por los linfocitos del donante y estimulada por aquellos tejidos que han sido lesionados por la enfermedad de base, por las infecciones previas o por el tratamiento de acondicionamiento. El diagnóstico es clínico e histopatológico. Los pacientes presentan rash maculopapular pruriginoso y doloroso que puede extenderse por toda la superficie corporal, fiebre, vómito, náuseas, diarrea y anorexia. En la mucosa bucal se observan erosiones ulceradas, extremamente dolorosas y pueden ser la primera o la única manifestación detectable clínicamente de esta enfermedad. El objetivo es presentar un caso de enfermedad de injerto contra huésped. Se trata de una mujer de 54 años de edad con linfoma no-Hodgking, que recibió tratamiento con quimioterapia, radioterapia y trasplante de células madre hematopoyéticas en el 2009. Tres meses después, presentó lesiones en la piel diagnosticadas como enfermedad injerto contra huésped y tratadas con corticoesteroides, a los seis meses fue remitida al odontólogo porque se quejaba de ardor en la boca, xerostomía y dificultad para masticar, tenía úlceras en la mucosa bucal y en la lengua. En la ocasión recibió tratamiento con corticoesteroides, clorhexidina, orientaciones de higiene bucal y controles clínicos permanentes. Aunque existen protocolos para la prevención y el tratamiento de la enfermedad injerto contra el huésped, su frecuencia ha aumentado en los últimos años debido al incremento en el número de trasplantes. Por esta razón, es fundamental que el odontólogo forme parte del grupo multidisciplinario que asiste al paciente y que esté familiarizado con los signos y síntomas de esta enfermedad en la mucosa bucal, pues las manifestaciones clínicas pueden ser las únicas para

Respuesta inmune en las enfermedades del periodonto : desde salud hasta enfermedad y sus implicaciones terapéuticas

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Botero Torres, Javier Enrique

2009-01-01

Los cambios estructurales en las enfermedades periodontales, considerando desde gingivitis hasta periodontitis, son el resultado de un evento inflamatorio, que es iniciado y perpetuado por bacterias por largos períodos de tiempo. Una serie de eventos celulares y moleculares ocurren en diferentes grados de complejidad tan pronto las bacterias comienzan a acumularse alrededor de los dientes. No obstante, aunque las bacterias son necesarias para iniciar la enfermedad periodontal, es la respuesta...

Lumbar Scoliosis Combined Lumbar Spinal Stenosis and Herniation Diagnosed Patient Was Treated with “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy

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Binbin Wu

2017-01-01

Full Text Available The objective was to report a case of a 63-year-old man with a history of low back pain (LBP and left leg pain for 2 years, and the symptom became more serious in the past 5 months. The patient was diagnosed with lumbar scoliosis combined with lumbar spinal stenosis (LSS and lumbar disc herniation (LDH at the level of L4-5 that was confirmed using Computerized Topography and Magnetic Resonance Imaging. The surgical team preformed a novel technique, “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD, which led to substantial, long-term success in reduction of pain intensity and disability. After removing the osteophyte mass posterior to the thecal sac at L4-5, the working channel direction was changed to the gap between posterior longitudinal ligament and thecal sac, and we also removed the herniation and osteophyte at L3-4 with “U” route PELD. The patient’s symptoms were improved immediately after the surgical intervention; low back pain intensity decreased from preoperative 9 to postoperative 2 on a visual analog scale (VAS recorded at 1 month postoperatively. The success of the intervention suggests that “U” route PELD may be a feasible alternative to treat lumbar scoliosis with LSS and LDH patients.

Lumbar lordosis in female collegiate dancers and gymnasts.

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Ambegaonkar, Jatin P; Caswell, Amanda M; Kenworthy, Kristen L; Cortes, Nelson; Caswell, Shane V

2014-12-01

Postural deviations can predispose an individual to increased injury risk. Specifically, lumbar deviations are related to increased low back pain and injury. Dancers and gymnasts are anecdotally suggested to have exaggerated lumbar lordosis and subsequently may be at increased risk of lumbar pathologies. Our objective was to examine lumbar lordosis levels in dancers and gymnasts. We examined lumbar lordosis in 47 healthy collegiate females (17 dancers, 29 gymnasts; mean age 20.2 ± 1.6 yrs) using 2-dimensional sagittal plane photographs and the Watson MacDonncha Posture Analysis instrument. Participants' lordosis levels were cross-tabulated and a Mann-Whitney U-test compared lumbar lordosis between groups (plordosis deviations. The distribution of lordosis was similar across groups (p=0.22). Most dancers and gymnasts had moderate or marked lumbar lordosis. The extreme ranges of motion required during dancing and gymnastics may contribute to the participants' high lumbar lordosis. Instructors should be aware that there may be links between repetitive hyperextension activities and lumbar lordosis levels in dancers and gymnasts. Thus, they should proactively examine lumbar lordosis in their dancers and gymnasts. How much age of training onset, regimens, survivor bias, or other factors influence lumbar lordosis requires study. Longitudinal studies are also needed to determine if lumbar lordosis levels influence lumbar injury incidence in dancers and gymnasts.

Lumbar radiculopathy due to unilateral facet hypertrophy following lumbar disc hernia operation: a case report.

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Kökeş, Fatih; Günaydin, Ahmet; Aciduman, Ahmet; Kalan, Mehmet; Koçak, Halit

2007-10-01

To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three years ago, was hospitalized and re-operated with a diagnosis of unilateral facet hypertrophy. She had complaints of left leg pain and walking restrictions for the last six months. Left Straight Leg Raising test was positive at 40 degrees , left ankle dorsiflexion muscle strength was 4/5, left Extensor Hallucis Longus muscle strength was 3/5, and left Achilles reflex was hypoactive. Lumbar spinal Magnetic Resonance Imaging revealed left L5-S1 facet hypertrophy. Lumbar radiculopathy due to lumbar facet hypertrophy is a well-known neurological condition. Radicular pain develops during the late postoperative period following lumbar disc hernia operations that are often related to recurrent disc herniation or to formation of post-operative scar tissue. In addition, it can be speculated that unilateral facet hypertrophy, which may develop after a disc hernia operation, might also be one of the causes of radiculopathy.

Surgical outcome of posterior lumbar interbody fusion with pedicle screw fixation for lumbar spondylolisthesis

International Nuclear Information System (INIS)

Shoda, Motoi; Kuno, Shigehiko; Inoue, Tatsushi

2009-01-01

Problems of lumbar spondylolisthesis treatment are many surgical tactics, elderly patient, osteoporosis, complications and recurrence of the symptoms. PLIF (posterior lumbar interbody fusion) and PS (pedicle screw) fixation technique for lumbar spondylolisthesis provide good patient satisfaction. Good outcome has been reported by only laminectomy alone, but patient satisfaction becomes worse year after year. The role of instrumentation for lumbar spondylolisthesis is decompression of the nerve root, correction of lumbar pathologies, bony fusion and early mobilization. We show our surgical technique and long term outcome of PLIF with PS for lumbar spondylolisthesis. Three hundred and fifty cases of lumbar spondylolisthesis were operated on in Department of Neurosurgery, Fujita Health University during the period of from December 1992 to August 2008. Patient background: age 16-84 years old (mean 62.5), Gender: male 153, female 197. Follow-up period 1-180 months (mean 61.2). Degenerative: 255, Isthmic: 63, Dysplastic: 10, Fracture: 5 and scoliosis 16 cases. Surgical procedure was PS with interbody fusion cage: 331, Hybrid cage (titanium cage with hydroxyapatite) 314, PS with Cerabone: 2 and PS with autograft: 17. CT was done to evaluate bony fusion postoperatively. Post operative improvements by JOA (Japan Orthopedic Association) score is 11.4 before surgery, 24.1 (post op. within 2 years), 25.4 (post op. 2-5 years), 25.0 (post op. 5-10 years) and 22.4 (post op. 10-15 years). Significant improvements were observed in %Slip and Slip angle but no remarkable change was observed in lumbar lordotic angle by postoperative X-ray evaluation. No root injury, and systemic complication except 4 cases of cerebrospinal fluid (CSF) leakage during surgery. Two cases were reoperated in whom cage with autograft migration due to pseudoarthrosis. Two cases had to undergo screw and cage system removal due to infection. Two cases of adjacent level stenosis had to undergo operation 10

Spinaplasty following lumbar laminectomy for multilevel lumbar spinal stenosis to prevent iatrogenic instability

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Surendra Mohan Tuli

2011-01-01

Conclusion: Spinaplasty following posterior decompression for multilevel lumbar canal stenosis is a simple operation, without any serious complications, retaining median structures, maintaining the tension band and the strength with least disturbance of kinematics, mobility, stability and lordosis of the lumbar spine.

Desigualdades sociales en la mortalidad de enfermedades por causas externas, tumores, enfermedades metabólicas en el departamento de Caldas 2010-2013

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Marín Ocampo, Angela María

2017-01-01

Objetivo. Determinar las desigualdades sociales en la mortalidad de enfermedades por causas externas, enfermedades metabólicas y tumores en los municipios del departamento de Caldas en el período 2010-2013.

Lumbar stenosis: clinical case

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Pedro Sá

2014-08-01

Full Text Available Lumbar stenosis is an increasingly common pathological condition that is becoming more frequent with increasing mean life expectancy, with high costs for society. It has many causes, among which degenerative, neoplastic and traumatic causes stand out. Most of the patients respond well to conservative therapy. Surgical treatment is reserved for patients who present symptoms after implementation of conservative measures. Here, a case of severe stenosis of the lumbar spine at several levels, in a female patient with pathological and surgical antecedents in the lumbar spine, is presented. The patient underwent two different decompression techniques within the same operation.

Confiabilidade de um método de análise histológica da degeneração discal experimental em coelhos Confiabilidad de un método para el análisis histológico de la degeneración discal experimental en conejos Reliability of a method for histological analysis of experimental disc degeneration in rabbits

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Emiliano Neves Vialle

2011-01-01

Full Text Available OBJETIVO: Validar um método para avaliação histológica da degeneração discal experimental em coelhos, baseando-se na confiabilidade da análise interobservador. MÉTODOS: Treze coelhos da raça New Zealand foram submetidos a procedimento de indução da degeneração discal através de punção direta de três discos intervertebrais (DIV consecutivos com agulha 18G sob anestesia. Ao fim de dois meses, coletou-se a coluna vertebral completa de cada coelho e procedeu-se preparo das peças para análise histológica dos discos intervertebrais (Experimentais e Controle, sendo coradas pelo método hematoxilina-eosina. As lâminas histológicas foram avaliadas quanto à ocorrência de degeneração através da análise dos seguintes critérios: presença de vasos sanguíneos; presença de protrusão do núcleo pulposo (NP através do ânulo fibroso (AF; e ruptura das fibras do AF. RESULTADOS: Ao final dos processos de eutanásia, retirada da coluna e preparo histológico, obteve-se 60 DIV viáveis para avaliação de degeneração. Deste total, 25 peças eram de DIV experimentais e 35 peças de DIV controle. A presença de vaso sanguíneo foi observada em 18 dos 25 DIV degenerados, com concordância de Kappa = 0,95 entre os observadores. A presença da extrusão do NP foi identificada em 19 dos 25 DIV experimentais, com concordância de Kappa = 0,78 entre os observadores. Com relação à ruptura das fibras do AF, pode-se identificar a positividade em 24 dos 25 DIV degenerados, com concordância entre os observadores de Kappa = 0,65. CONCLUSÃO: Este modelo de avaliação histológica da degeneração experimental do DIV mostrou-se viável, com alto grau de concordância entre os observadores na identificação da degeneração discal.OBJETIVO: Validar un método para evaluación histológica de la degeneración discal experimental en conejos, basándose en la confiabilidad del análisis interobservadores. MÉTODOS: Trece conejos de la raza New

Simple prediction method of lumbar lordosis for planning of lumbar corrective surgery: radiological analysis in a Korean population.

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Lee, Chong Suh; Chung, Sung Soo; Park, Se Jun; Kim, Dong Min; Shin, Seong Kee

2014-01-01

This study aimed at deriving a lordosis predictive equation using the pelvic incidence and to establish a simple prediction method of lumbar lordosis for planning lumbar corrective surgery in Asians. Eighty-six asymptomatic volunteers were enrolled in the study. The maximal lumbar lordosis (MLL), lower lumbar lordosis (LLL), pelvic incidence (PI), and sacral slope (SS) were measured. The correlations between the parameters were analyzed using Pearson correlation analysis. Predictive equations of lumbar lordosis through simple regression analysis of the parameters and simple predictive values of lumbar lordosis using PI were derived. The PI strongly correlated with the SS (r = 0.78), and a strong correlation was found between the SS and LLL (r = 0.89), and between the SS and MLL (r = 0.83). Based on these correlations, the predictive equations of lumbar lordosis were found (SS = 0.80 + 0.74 PI (r = 0.78, R (2) = 0.61), LLL = 5.20 + 0.87 SS (r = 0.89, R (2) = 0.80), MLL = 17.41 + 0.96 SS (r = 0.83, R (2) = 0.68). When PI was between 30° to 35°, 40° to 50° and 55° to 60°, the equations predicted that MLL would be PI + 10°, PI + 5° and PI, and LLL would be PI - 5°, PI - 10° and PI - 15°, respectively. This simple calculation method can provide a more appropriate and simpler prediction of lumbar lordosis for Asian populations. The prediction of lumbar lordosis should be used as a reference for surgeons planning to restore the lumbar lordosis in lumbar corrective surgery.

Tratamiento de la enfermedad de Graves Basedow

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Hernando Vargas-Uricoechea

2014-05-01

Full Text Available Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatología y el diagnóstico de la Enfermedad de Graves-Basedow son motivo de otra publicación.

Cumulative occupational lumbar load and lumbar disc disease – results of a German multi-center case-control study (EPILIFT

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Michaelis Martina

2009-05-01

Full Text Available Abstract Background The to date evidence for a dose-response relationship between physical workload and the development of lumbar disc diseases is limited. We therefore investigated the possible etiologic relevance of cumulative occupational lumbar load to lumbar disc diseases in a multi-center case-control study. Methods In four study regions in Germany (Frankfurt/Main, Freiburg, Halle/Saale, Regensburg, patients seeking medical care for pain associated with clinically and radiologically verified lumbar disc herniation (286 males, 278 females or symptomatic lumbar disc narrowing (145 males, 206 females were prospectively recruited. Population control subjects (453 males and 448 females were drawn from the regional population registers. Cases and control subjects were between 25 and 70 years of age. In a structured personal interview, a complete occupational history was elicited to identify subjects with certain minimum workloads. On the basis of job task-specific supplementary surveys performed by technical experts, the situational lumbar load represented by the compressive force at the lumbosacral disc was determined via biomechanical model calculations for any working situation with object handling and load-intensive postures during the total working life. For this analysis, all manual handling of objects of about 5 kilograms or more and postures with trunk inclination of 20 degrees or more are included in the calculation of cumulative lumbar load. Confounder selection was based on biologic plausibility and on the change-in-estimate criterion. Odds ratios (OR and 95% confidence intervals (CI were calculated separately for men and women using unconditional logistic regression analysis, adjusted for age, region, and unemployment as major life event (in males or psychosocial strain at work (in females, respectively. To further elucidate the contribution of past physical workload to the development of lumbar disc diseases, we performed lag

Reproduction of the lumbar lordosis

DEFF Research Database (Denmark)

Andreasen, Marianne Løgtholt; Langhoff, Lotte; Jensen, Tue Secher

2007-01-01

OBJECTIVE: This study investigates whether it is possible to reproduce the lumbar lordosis in the upright position during magnetic resonance imaging (MRI) by positioning the patient supine with straightened lower extremities and investigates intra- and interexaminer reliability of measurements...... of the lumbar lordosis on radiographs and MRI. METHODS: This was an observational study, which included an intra- and interexaminer reliability study. The lumbar lordosis was measured digitally on radiographs taken from 22 patients in an upright standing position, and 22 MRI scans of the same patients lying...... supine with straightened lower extremities. These measurements were compared statistically. Intra- and interexaminer reliability was calculated applying the Bland and Altman method. RESULTS: The lumbar lordosis in the standing position was reproduced in the straightened supine position with a median...

La Tuberculosis, Una Enfermedad Modificada*

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Valentin Malagón Castro

1993-12-01

Full Text Available

Con ocasión de un estudio de revisión que hemos llevado a cabo recientemente sobre la tuberculosis osteoarticular, *** se ha apreciado un cambio notable en las características y manifestaciones de esta enfermedad.

Hemos sido testigos del comportamiento de la tuberculosis en los últimos 40 años. Realizamos la tesis profesional en el Hospital de niños de la Misericordia de Bogotá en el año 1950 (86, basada en el análisis de más de 300 enfermos de Mal de Pott tratados con pobres resultados en esa institución en la época prequimioterápica. Efectuamos estudios de control del tratamiento quirúrgico de esa afección en el Hospital Infantil Lorencita Villegas de Santos y publicamos sus resultados en los años 1975,1980 Y1987 (85-87-88. Los pacientes correspondientes a estas nuevas series, ya en la época de la quimioterapia moderna, presentaban un mejor pronóstico vital y funcional. Cuadro 1A.

En el decenio 1978-1988 asistimos al descenso espectacular de la frecuencia de tuberculosis osteoarticular en las salas de nuestros hospitales. Posteriormente hemos sido igualmente testigos de su lenta y progresiva reaparición.

El estudio actual nos ha mostrado profundos cambios, como ya se ha dicho, en el comportamiento de la entidad, por lo que estamos de acuerdo en denominarla: La tuberculosis, una enfermedad modificada, diferente a la que hasta hace un década parecía derrotada, vencida por las nuevas drogas y las recientes técnicas quirúrgicas.

La actual es una enfermedad diferente que ha tomado una fuerza avasalladora que amenaza con volverse resistente al tratamiento específico y dar lugar a una pandemia de incalculables proporciones y de terribles consecuencias para la humanidad.

El objeto de publicar este estudio es recordar a nuestros colegas, en especial a aquellos de las nuevas promociones que quizás no han tenido la oportunidad de estar en contacto con pacientes de tuberculosis osteoarticular, de

Genes y variantes polimórficas asociadas a la enfermedad cardiovascular

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Eliana C. Portilla

2014-09-01

Full Text Available La aterosclerosis se considera como la principal causante de enfermedades cardiovasculares. Es una enfermedad multifactorial, caracterizada por procesos inflamatorios y la internalización continua de moléculas lipídicas al interior del vaso. Los estudios de genes candidato han proporcionado conocimiento acerca de la fisiopatología de esta enfermedad y han permitido la postulación de algunos polimorfismos como responsables de la susceptibilidad genética en diversas poblaciones. En particular, estos polimorfismos que modulan ciertas vías moleculares tales como el estrés oxidativo, el metabolismo lipídico y la trombogénesis se asocian con el desarrollo de las enfermedades cardiovasculares. Se han conducido varios estudios para identificar nuevas variantes asociadas con la enfermedad que han permitido el descubrimiento de nuevas vías de la enfermedad. Aunque el hallazgo de nuevos genes asociados a la enfermedad cardiovascular a través de enfoques como el escaneo global del genoma ha contribuido al entendimiento del desarrollo de esta condición, el conocimiento aún es limitado y poco concluyente. El objetivo de esta revisión es identificar los genes y las variantes polimórficas asociadas a la enfermedad cardiovascular, de acuerdo con los diferentes enfoques de análisis de asociación genética.

Nursing care for patients receiving percutaneous lumbar discectomy and intradiscal electrothermal treatment for lumbar disc herniation

International Nuclear Information System (INIS)

Mou Ling

2009-01-01

Objective: To summarize the nursing experience in caring patients with lumbar intervertebral disc herniation who received percutaneous lumbar discectomy (PLD) together with intradiscal electrothermal treatment (IDET) under DSA guidance. Methods: The perioperative nursing care measures carried out in 126 patients with lumbar intervertebral disc herniation who underwent PLD and IDET were retrospectively analyzed. Results: Successful treatment of PLD and IDET was accomplished in 112 cases. Under comprehensive and scientific nursing care and observation, no serious complications occurred. Conclusion: Scientific and proper nursing care is a strong guarantee for a successful surgery and a better recovery in treating lumbar intervertebral disc herniation with PLD and IDET under DSA guidance. (authors)

Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck

International Nuclear Information System (INIS)

Juhng, Seon Kwan; Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon

2001-01-01

To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm 2 in the femoral neck, while for controls the corresponding figures were 0.989g/cm 2 and 0.765g/cm 2 . Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures

Enfermedades poco comunes: una prioridad de los sistemas de salud

OpenAIRE

RAP

2017-01-01

Las enfermedades poco comunes, incluidas las de origen genético, son aquellas enfermedades que tienen una prevalencia baja, menor de 5 casos por cada 10.000 habitantes en la comunidad, según la definición de la Unión Europea. Estas enfermedades tienen ciertas características comunes. Son, en su mayor parte, degenerativas y constituyen una prioridad de los sistemas de salud.

Enfermedades pulmonares intersticiales en el niño

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Roberto Razón Behar

Full Text Available Las enfermedades pulmonares intersticiales en el niño, comprenden un gran y heterogéneo grupo de raras enfermedades difusas pulmonares de morbilidad variada. Se caracterizan por cambios inflamatorios y fibróticos que causan remodelación de las paredes alveolares y de las vías respiratorias distales, y ocasionan un defecto restrictivo funcional y una alteración en el intercambio gaseoso, con hipoxemia progresiva. Son muchas las enfermedades que pueden afectar al intersticio pulmonar y múltiples las formas etiológicas causadas por una variedad de procesos patológicos, que incluyen, factores genéticos, asociación a enfermedades sistémicas, así como a respuestas inflamatorias o fibróticas a diferentes estímulos. Sin embargo, algunas veces su origen es desconocido, y se catalogan entonces como idiopáticas. Los neumólogos pediátricos han tratado de clasificar los casos de las enfermedades pulmonares intersticiales en las diferentes categorías descritas originalmente en adultos, pero, en realidad, existen formas del adulto que no se observan en la infancia, y formas únicas de presentación pediátrica. Se señala la importancia del conocimiento de estas entidades, particularmente las de origen desconocido o idiopáticas.

Papel de la fisioterapia en la enfermedad de Alzheimer

OpenAIRE

Lallana Jiménez, Lucía

2013-01-01

La enfermedad de Alzheimer es una enfermedad neurodegenerativa que representa entre el 50% y el 60% de las demencias. Se caracteriza por déficits cognitivos, desorientación espacio-temporal y pérdida de memoria a corto plazo, lo cual da lugar a una dificultad en la realización de las tareas cotidianas por parte del enfermo. La enfermedad evoluciona a los largo de cuatro estadios: -Fase 1: se caracteriza por perdidas de memoria a corto plazo pero el paciente es todavía relativamente independie...

Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

Science.gov (United States)

Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

2017-07-01

The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial

Tratamiento de la enfermedad de Hansen en Colombia: medicalización y control de la enfermedad a lo largo del siglo XX

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Natalia Botero-Jaramillo

2017-09-01

Full Text Available Objetivo: investigar el tratamiento de la enfermedad de Hansen durante el siglo XX en Colombia, para analizar el proceso de medicalización, la biopolítica, el significado de la curación y su impacto en el control de la enfermedad y en los enfermos. Metodología: estudio histórico, descriptivo y analítico sobre los tratamientos para la enfermedad de Hansen a lo largo del siglo XX, por medio de metodologías cualitativas como entrevistas con relatos de vida y entrevistas temáticas, y se trabajó con fuentes documentales primarias y secundarias en archivos nacionales y locales. Resultados y discusión: La enfermedad de Hansen, causada por el microorganismo Mycobacterium leprae, fue controlada mediante el aislamiento y reclusión de los enfermos de lepra en hospitales y lazaretos. El desarrollo de algunos tratamientos y el descubrimiento de la terapia antibiótica, las sulfas, que representó una cura efectiva desde la medicina y su poder político y social, participaron en la transformación de las políticas de manejo de la enfermedad y de la comprensión de la misma, en los Lazaretos de Contratación y Agua de Dios.

Lumbar interspinous bursitis in active polymyalgia rheumatica.

Science.gov (United States)

Salvarani, Carlo; Barozzi, Libero; Boiardi, Luigi; Pipitone, Nicolò; Bajocchi, Gian Luigi; Macchioni, Pier Luigi; Catanoso, Mariagrazia; Pazzola, Giulia; Valentino, Massimo; De Luca, Carlo; Hunder, Gene G

2013-01-01

To evaluate the inflammatory involvement of lumbar interspinous bursae in patients with polymyalgia rheumatica (PMR) using magnetic resonance imaging (MRI). Ten consecutive, untreated new patients with PMR and pain in the shoulder and pelvic girdles were investigated. Seven patients with spondyloarthritis (4 with psoriatic spondyloarthrits, one with entheropatic spondyloarthritis, and 2 with ankylosing spondylitis) as well as 2 patients with spinal osteoarthritis and 2 patients with rheumatoid arthritis with lumbar pain served as controls. MRI of lumbar spine was performed in all PMR patients and controls. Nine patients (5 PMR patients and 4 controls) also had MRI of the thoracic spine. MRI evidence of interspinous lumbar bursitis was found in 9/10 patients with PMR and in 5/11 controls. A moderate to marked (grade ≥2 on a semiquantitative 0-3 scale) lumbar bursitis occurred significantly more frequently in patients with PMR than in control patients (60% vs. 9%, p=0.020). In most of the patients and controls lumbar bursitis was found at the L3-L5 interspaces. Only 2 patients had bursitis at a different level (one patient had widespread lumbar bursitis, and one control at L2-L4). No interspinous bursitis was demonstrated by MRI of the thoracic spine in patients and controls. Inflammation of lumbar bursae may be responsible for the low back pain reported by patients with PMR. The prominent inflammatory involvement of bursae including those of the lumbar spine supports the hypothesis that PMR may be a disorder affecting predominantly extra-articular synovial structures.

Encefalopatías espongiformes transmisibles: enfermedad crónica desgastante

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M. A. Reyes-López

2006-01-01

Full Text Available Las enfermedades por encefalopatías espongiformes transmisibles (EET, algunas veces llamadas enfermedades “por priones”, son un grupo de enfermedades raras, incurables, neurodegenerativas y fatales, las cuales afectan a una variedad de mamíferos. En los pasados 20 años, las EET pasaron de ser “las enfermedades de fascinación” a enfermedades difíciles de entender, causantes de pérdidas económicas en el sector ganadero, además de provocar problemas de salud humana. Las EET incluyen Creutzfeldt-Jakob (CJD y kuru en humanos; scrapi en ovejas, encefalopatía en visón (TME y caquexia crónica del ciervo y alce (CWD. En el ganado, se propuso de manera sugestiva el nombre de “vacas locas” o encefalopatía espongiforme bovina (BSE. La CWD puede ser transmitida indirectamente a animales susceptibles a través de ambientes contaminados, mediante heces o cadáveres descompuestos. En los últimos 5 años, la distribución conocida de CWD en Norte América se extendió, incrementando las dudas sobre el impacto de esta enfermedad en cérvidos de vida libre y la viabilidad de ranchos cinegéticos. En México, no existe evidencia de CWD en venados de vida silvestre o cautiverio, aunque se ha detectado en un condado fronterizo de Nuevo México, EUA. La CWD es considerada una enfermedad exótica y deben de tomarse las medidas pertinentes para evitar su introducción en México.

The Neandertal vertebral column 2: The lumbar spine.

Science.gov (United States)

Gómez-Olivencia, Asier; Arlegi, Mikel; Barash, Alon; Stock, Jay T; Been, Ella

2017-05-01

Here we provide the most extensive metric and morphological analysis performed to date on the Neandertal lumbar spine. Neandertal lumbar vertebrae show differences from modern humans in both the vertebral body and in the neural arch, although not all Neandertal lumbar vertebrae differ from modern humans in the same way. Differences in the vertebral foramen are restricted to the lowermost lumbar vertebrae (L4 and L5), differences in the orientation of the upper articular facets appear in the uppermost lumbar vertebrae (probably in L1 and L2-L3), and differences in the horizontal angle of the transverse process appear in L2-L4. Neandertals, when compared to modern humans, show a smaller degree of lumbar lordosis. Based on a still limited fossil sample, early hominins (australopiths and Homo erectus) had a lumbar lordosis that was similar to but below the mean of modern humans. Here, we hypothesize that from this ancestral degree of lumbar lordosis, the Neandertal lineage decreased their lumbar lordosis and Homo sapiens slightly increased theirs. From a postural point of view, the lower degree of lordosis is related to a more vertical position of the sacrum, which is also positioned more ventrally with respect to the dorsal end of the pelvis. This results in a spino-pelvic alignment that, though different from modern humans, maintained an economic postural equilibrium. Some features, such as a lower degree of lumbar lordosis, were already present in the middle Pleistocene populations ancestral to Neandertals. However, these middle Pleistocene populations do not show the full suite of Neandertal lumbar morphologies, which probably means that the characteristic features of the Neandertal lumbar spine did not arise all at once. Copyright © 2017 Elsevier Ltd. All rights reserved.

Caries temprana de infancia: ¿enfermedad infecciosa?

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F. Sandra Rojas, Dra.

2014-05-01

Full Text Available La caries dental es una de las enfermedades más comunes en la infancia y las personas continúan siendo susceptible a través de la vida. Aunque actualmente puede ser detenida y potencialmente revertida en etapas tempranas, no es autolimitada, progresa en forma crónica si no existe un cuidado y control de los factores que la producen, llegando a la destrucción de dientes, dolor, alteraciones funcionales, sistémicas y consecuencias en la calidad de vida de las personas. La caries temprana de infancia, de inicio precoz en niños, es causada en forma frecuente por hábitos alimenticios inapropiados y la adquisición temprana de microorganismos como Streptococcus mutans. Se ha sugerido una transmisión vertical de madre a hijo como la vía principal de adquisición de Streptococcus mutans, y también se ha demostrado en la literatura, que existiría una transmisión horizontal entre niños y sus cuidadores, compañeros de jardín infantil y colegios. Por esta razón durante muchos años se ha definido la enfermedad caries como infecciosa y transmisible. Nuevos avances en técnicas moleculares han dado evidencia acerca de la microflora autóctona y cómo la placa dental o biofilm funciona como un sistema ecológico dinámico y complejo. Existe evidencia que la caries dental no es una enfermedad infecciosa clásica, como se creía hace unos años, por el contrario, esta enfermedad es el resultado de un cambio ecológico en la biopelícula adquirida en la superficie dental. Además la transmisión de Streptococcus mutans de la madre hacia el hijo no implica que la enfermedad se desarrolle, por el contrario, la caries dental hoy se describe como una enfermedad común, compleja y multifactorial, donde interactúan varios factores de riesgo, entre los más destacados conductuales, ambientales y genéticos.

Lumbar kinematic variability during gait in chronic low back pain and associations with pain, disability and isolated lumbar extension strength.

Science.gov (United States)

Steele, James; Bruce-Low, Stewart; Smith, Dave; Jessop, David; Osborne, Neil

2014-12-01

Chronic low back pain is a multifactorial condition with many dysfunctions including gait variability. The lumbar spine and its musculature are involved during gait and in chronic low back pain the lumbar extensors are often deconditioned. It was therefore of interest to examine relationships between lumbar kinematic variability during gait, with pain, disability and isolated lumbar extension strength in participants with chronic low back pain. Twenty four participants with chronic low back pain were assessed for lumbar kinematics during gait, isolated lumbar extension strength, pain, and disability. Angular displacement and kinematic waveform pattern and offset variability were examined. Angular displacement and kinematic waveform pattern and offset variability differed across movement planes; displacement was highest and similar in frontal and transverse planes, and pattern variability and offset variability higher in the sagittal plane compared to frontal and transverse planes which were similar. Spearman's correlations showed significant correlations between transverse plane pattern variability and isolated lumbar extension strength (r=-.411) and disability (r=.401). However, pain was not correlated with pattern variability in any plane. The r(2) values suggested 80.5% to 86.3% of variance was accounted for by other variables. Considering the lumbar extensors role in gait, the relationship between both isolated lumbar extension strength and disability with transverse plane pattern variability suggests that gait variability may result in consequence of lumbar extensor deconditioning or disability accompanying chronic low back pain. However, further study should examine the temporality of these relationships and other variables might account for the unexplained variance. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of Lumbar Fusion Surgery with ISOBAR Devices Versus Posterior Lumbar Interbody Fusion Surgery on Pain and Disability in Patients with Lumbar Degenerative Diseases: A Meta-Analysis.

Science.gov (United States)

Su, Shu-Fen; Wu, Meng-Shan; Yeh, Wen-Ting; Liao, Ying-Chin

2018-06-01

Purpose/Aim: Lumbar degenerative diseases (LDDs) cause pain and disability and are treated with lumbar fusion surgery. The aim of this study was to evaluate the efficacy of lumbar fusion surgery with ISOBAR devices versus posterior lumbar interbody fusion (PLIF) surgery for alleviating LDD-associated pain and disability. We performed a literature review and meta-analysis conducted in accordance with Cochrane methodology. The analysis included Group Reading Assessment and Diagnostic Evaluation assessments, Jadad Quality Score evaluations, and Risk of Bias in Non-randomized Studies of Interventions assessments. We searched PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, ProQuest, the Airiti Library, and the China Academic Journals Full-text Database for relevant randomized controlled trials and cohort studies published in English or Chinese between 1997 and 2017. Outcome measures of interest included general pain, lower back pain, and disability. Of the 18 studies that met the inclusion criteria, 16 examined general pain (802 patients), 5 examined lower back pain (274 patients), and 15 examined disability (734 patients). General pain, lower back pain, and disability scores were significantly lower after lumbar fusion surgery with ISOBAR devices compared to presurgery. Moreover, lumbar fusion surgery with ISOBAR devices was more effective than PLIF for decreasing postoperative disability, although it did not provide any benefit in terms of general pain or lower back pain. Lumbar fusion surgery with ISOBAR devices alleviates general pain, lower back pain, and disability in LDD patients and is superior to PLIF for reducing postoperative disability. Given possible publication bias, we recommend further large-scale studies.

Fuerza lumbar en jugadores de hockey hierba

OpenAIRE

Til Pérez, Lluís; Barceló Peiró, Oriol; Pomés Díes, Teresa; Martínez Navas, Roberto; Galilea Ballarini, Pedro; Bellver Vives, Montserrat

2007-01-01

Introducción: El dolor lumbar tiene una alta prevalencia entre los deportistas, se ha relacionado con déficits en la fuerza extensora lumbar, y el hecho de padecerlo representa un obstáculo importante para la práctica de deportes de alta intensidad. Método: Se ha medido la fuerza lumbar en 2 grupos de practicantes de hockey hierba mediante máquina MedX® y un test de resistencia isométrico lumbar. Resultados: Entre ambos grupos los resultados han sido muy homogéneos....

Biomechanical effect of altered lumbar lordosis on intervertebral lumbar joints during the golf swing: a simulation study.

Science.gov (United States)

Bae, Tae Soo; Cho, Woong; Kim, Kwon Hee; Chae, Soo Won

2014-11-01

Although the lumbar spine region is the most common site of injury in golfers, little research has been done on intervertebral loads in relation to the anatomical-morphological differences in the region. This study aimed to examine the biomechanical effects of anatomical-morphological differences in the lumbar lordosis on the lumbar spinal joints during a golf swing. The golf swing motions of ten professional golfers were analyzed. Using a subject-specific 3D musculoskeletal system model, inverse dynamic analyses were performed to compare the intervertebral load, the load on the lumbar spine, and the load in each swing phase. In the intervertebral load, the value was the highest at the L5-S1 and gradually decreased toward the T12. In each lumbar spine model, the load value was the greatest on the kypholordosis (KPL) followed by normal lordosis (NRL), hypolordosis (HPL), and excessive lordosis (EXL) before the impact phase. However, results after the follow-through (FT) phase were shown in reverse order. Finally, the load in each swing phase was greatest during the FT phase in all the lumbar spine models. The findings can be utilized in the training and rehabilitation of golfers to help reduce the risk of injury by considering individual anatomical-morphological characteristics.

Clinical study of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability

OpenAIRE

GUO, SHUGUANG; SUN, JUNYING; TANG, GENLIN

2013-01-01

The aim of this study was to observe the clinical effects of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability. The 48 patients comprised 27 males and 21 females, aged 47?72 years. Three cases had first and second degree lumbar spondylolisthesis and all received bilateral vertebral lamina fenestration for posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC), which maintains the three-column...

Estado de las enfermedades raras que cursan con discapacidad intelectual en Colombia

OpenAIRE

Hurtado Sánchez, Johan Sebastián

2016-01-01

Las enfermedades raras o huérfano son una problemática que ha tomado mucha importancia en el contexto mundial del presente siglo, estas se han definido como crónicas, de difícil tratamiento de sus síntomas y con baja prevalencia en la población; muchas de estas enfermedades cursan con varios tipos de discapacidad, siendo el objetivo del presente trabajo el enfocarse en aquellas enfermedades raras que cursan con discapacidad intelectual. Para poder profundizar en estas enfermedades se realizó ...

Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Fixation for Degenerative Lumbar Disease.

Science.gov (United States)

Wang, Hui-Wang; Hu, Yong-Cheng; Wu, Zhan-Yong; Wu, Hua-Rong; Wu, Chun-Fu; Zhang, Lian-Suo; Xu, Wei-Kun; Fan, Hui-Long; Cai, Jin-Sheng; Ma, Jian-Qing

2017-08-01

To evaluate the clinical effect of the minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation using a tubular retractor in the management of degenerative lumbar disease. A retrospective analysis was conducted to analyze the clinical outcome of 58 degenerative lumbar disease patients who were treated with minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation during December 2012 to January 2015. The spine was unilaterally approached through a 3.0-cm skin incision centered on the disc space, located 2.5 cm lateral to the midline, and the multifidus muscles and longissimus dorsi were stripped off. After transforaminal lumbar interbody fusion and posterolateral fusion the unilateral pedicle screw fixation was performed. The visual analogue scale (VAS) for back and leg pain, the Oswestry disability index (ODI), and the MacNab score were applied to evaluate clinical effects. The operation time, peri-operative bleeding, postoperative time in bed, hospitalization costs, and the change in the intervertebral height were analyzed. Radiological fusion based on the Bridwell grading system was also assessed at the last follow-up. The quality of life of the patients before and after the operation was assessed using the short form-36 scale (SF-36). Fifty-eight operations were successfully performed, and no nerve root injury or dural tear occurred. The average operation time was 138 ± 33 min, intraoperative blood loss was 126 ± 50 mL, the duration from surgery to getting out of bed was 46 ± 8 h, and hospitalization cost was 1.6 ± 0.2 ten thousand yuan. All of the 58 patients were followed up for 7-31 months, with an average of 14.6 months. The postoperative VAS scores and ODI score were significantly improved compared with preoperative data (P degenerative lumbar disease, and the short-term clinical outcome is satisfactory

Measurements of the lumbar spinal canal by computed tomography in lumbar diseases

International Nuclear Information System (INIS)

Kido, Kenji; Kawai, Shinya; Oda, Hirotane; Saika, Minoru; Uminaga, Yasuo; Takano, Shinichi; Akiho, Yasushi

1986-01-01

To assess the significance of computed tomography (CT) in the elucidation of morphology of the lumbar spinal canal (LSC), the antero-posterior (AP) and transverse (T) diameter, and T area of the soft and bony LSC, and dural canal (DC) were measured by CT in 15 patients with lumbar canal stenosis, 45 patient with spondylosis, and 33 control subjects. The AP diameter failed to indicate the degree of stenosis because it was independent of morphology of the LSC. The T area of the LSC did not always help to determine the degree of DC compression, but showed some degree of stenosis. The T area of the DC was useful in determining the degree of stenosis and morphology of the stenosed site. With the use of the T area of the DC, the upper margin of articular segment was found to be most stenosed in patients with lumbar canal stenosis. (Namekawa, K.)

Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion.

Science.gov (United States)

Rothenfluh, Dominique A; Mueller, Daniel A; Rothenfluh, Esin; Min, Kan

2015-06-01

Several risk factors and causes of adjacent segment disease have been debated; however, no quantitative relationship to spino-pelvic parameters has been established so far. A retrospective case-control study was carried out to investigate spino-pelvic alignment in patients with adjacent segment disease compared to a control group. 45 patients (ASDis) were identified that underwent revision surgery for adjacent segment disease after on average 49 months (7-125), 39 patients were selected as control group (CTRL) similar in the distribution of the matching variables, such as age, gender, preoperative degenerative changes, and numbers of segments fused with a mean follow-up of 84 months (61-142) (total n = 84). Several radiographic parameters were measured on pre- and postoperative radiographs, including lumbar lordosis measured (LL), sacral slope, pelvic incidence (PI), and tilt. Significant differences between ASDis and CTRL groups on preoperative radiographs were seen for PI (60.9 ± 10.0° vs. 51.7 ± 10.4°, p = 0.001) and LL (48.1 ± 12.5° vs. 53.8 ± 10.8°, p = 0.012). Pelvic incidence was put into relation to lumbar lordosis by calculating the difference between pelvic incidence and lumbar lordosis (∆PILL = PI-LL, ASDis 12.5 ± 16.7° vs. CTRL 3.4 ± 12.1°, p = 0.001). A cutoff value of 9.8° was determined by logistic regression and ROC analysis and patients classified into a type A (∆PILL lordosis mismatch. In type A spino-pelvic alignment, 25.5 % of patients underwent revision surgery for adjacent segment disease, whereas 78.3 % of patients classified as type B alignment had revision surgery. Classification of patients into type A and B alignments yields a sensitivity for predicting adjacent segment disease of 71 %, a specificity of 81 % and an odds ratio of 10.6. In degenerative disease of the lumbar spine a high pelvic incidence with diminished lumbar lordosis seems to predispose to adjacent segment disease. Patients with such pelvic incidence-lumbar

Remote cerebellar hemorrhage after lumbar spinal surgery

International Nuclear Information System (INIS)

Cevik, Belma; Kirbas, Ismail; Cakir, Banu; Akin, Kayihan; Teksam, Mehmet

2009-01-01

Background: Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH. Methods: Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery. Results: The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery. Conclusion: RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.

Enfermedad Diverticular del Colon

Directory of Open Access Journals (Sweden)

Gonzalo López Escobar

1991-06-01

Full Text Available

Los divertículos del colon han sido reconocidos por varios observadores desde hace más de un siglo, pero en su mayor parte se trataba de casos aislados, hoy se la considera como la enfermedad del siglo XX, la de la era moderna y de los países industrializados y de avanzada tecnología (5,18,33.

Según el diccionario de la Real Academia Española (11, divertículo, del latín, diverticulum, quiere decir desviación de un camino; y desde el punto de vista anatómico, apéndice hueco y terminado en fondo de saco. (Gráfica No. 1.

Goligher (17 lo define como la “posada al borde del camino, probablemente un lugar, a menudo, de mala reputación”.

Historia

Según Hackford (18, el proceso fué descrito brevemente por Littre a comienzos del siglo XVIII; pero se le atribuye a Cruveilhier la primera descripción como proceso patológico en 1849, quien, además, mencionó: “encontramos, no rara vez, en el sigmoide, entre las bandas de fibras musculares longitudinales, una serie de pequeños tumores piriformes oscuros, que están formados por hernias de la mucosa a través de brechas en la capa muscular” (17.

Fleischman en 1815 hizo la primera observación de la enfermedad y empleó el término divertículo (45.

Rokitansky en 1.849, habló de una enfermedad adquirida y consideró que su causa consistía en la constipación (45.

Virchowen 1853 describió la perisigmoiditis (45.

En 1859 Sidney Jones informó de una fístula colo-vesical debida a diverticulitis (5,45.

Loomis en 1870 describe una peritonitis como resultante de una diverticulitis (45.

En 1877 Ball describió la anatomía patológica de la enfermedad y presentó dos casos de fístula colovesical debidas a diverticulitis (9. Cripps en 1.888 popularizó la colostomía de desviación como tratamiento para la fístula colovesical(18...

Lumbar dorsal ramus syndrome.

Science.gov (United States)

Bogduk, N

1980-11-15

Low back pain, referred pain in the lower limbs, and spasm of the back, gluteal, and hamstring muscles are clinical features which can be induced in normal volunteers by stimulating structures which are innervated by the lumbar dorsal rami. Conversely, they can be relieved in certain patients by selective interruption of conduction along dorsal rami. These facts permit the definition of a lumbar dorsal ramus syndrome, which can be distinguished from the intervertebral disc syndrome and other forms of low back pain. The distinguishing feature is that, in lumbar dorsal ramus syndrome, all the clinical features are exclusively mediated by dorsal rami and do not arise from nerve-root compression. The pathophysiology, pathology, and treatment of this syndrome are described. Recognition of this syndrome, and its treatment with relatively minor procedures, can obviate the need for major surgery which might otherwise be undertaken.

La enfermedad de Alzheimer y los inhibidores de la colinesterasa

OpenAIRE

Carlos Luis Alpízar-Quesada; Catalina Morales-Alpízar

2003-01-01

La enfermedad de alzheimer (EA), es muy frecuente en la vejez donde se pierden, en forma lenta y progresiva, capacidades cognoscitivas y motoras. Esta enfermedad ha ido en aumento conforme se incrementa la expectativa de vida de la población. En los últimos años, descubrir un tratamiento efectivo para esta enfermedad ha sido un verdadero reto científico. A pesar de que su patología fue descrita hace algunos años, no hubo tratamiento disponible hasta hace poco tiempo. Desde principios de los n...

Manejo del síndrome doloroso lumbar Management of lumbar syndrome

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Rafael Rivas Hernández

2010-03-01

Full Text Available Se realizó una revisión bibliográfica del síndrome doloroso lumbar y se seleccionaron los artículos relacionados con este síndrome publicados desde 1991 hasta 2009. Se hizo hincapié en la búsqueda de guías para el manejo del dolor lumbar en la práctica clínica, y sus criterios fueron revisados por el equipo de especialistas en Ortopedia y Traumatología del Servicio de columna vertebral del Hospital Ortopédico Docente "Fructuoso Rodríguez" y adaptados a las condiciones del Sistema Nacional de Salud cubano.A bibliographic review on painful syndrome was made selecting the articles published from 1991 to 2009 related to this syndrome. Authors emphasize in the search of guides for management of lumbar pain in the clinical practice, whose criteria were analyzed by the team Orthopedics and Traumatology team of the spinal column service from the "Fructuoso Rodríguez" Hospital and adjusted to conditions of the Cuban Health System.

Tratamiento de la enfermedad de Graves Basedow

OpenAIRE

Hernando Vargas-Uricoechea; Carlos Hernán Sierra-Torres; Ivonne Alejandra Meza-Cabrera

2014-01-01

Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroid...

Disfagia asociada a la enfermedad de Parkinson

OpenAIRE

Rodríguez Alonso, Alexandra

2017-01-01

La disfagia orofaríngea es un síntoma que se asocia a la enfermedad de Parkinson, se define como la dificultad o el impedimento al avance normal del bolo alimenticio desde la cavidad oral hasta el estómago, contribuyendo a una deglución ineficaz e insegura. Este proyecto de investigación tiene como objetivo principal detectar disfagia en pacientes con Enfermedad de Parkinson. Se realizó una encuesta que fue distribuida entre los EP que acuden a rehabilitación a la Asociación de Parkinson V...

El timerosal y las enfermedades del neurodesarrollo infantil

Directory of Open Access Journals (Sweden)

Luis Maya

2006-09-01

Full Text Available Se evalúa la relación causal entre el timerosal (etilmercurio, como preservante en las vacunas pediátricas, y el incremento de casos de enfermedades del neurodesarrollo infantil, como consecuencia de la ampliación de los esquemas de inmunización. Se revisó la información científica, relacionando el timerosal y las evidencias que permitan evaluar una posible asociación causal, con estudios epidemiológicos, ecológicos, biomoleculares y toxicológicos, de bioseguridad, toxicológicos fetales y sobre salud reproductiva. Se encontró múltiples asociaciones entre la exposición a timerosal y las enfermedades del neurodesarrollo infantil. Tal neurotoxicidad ocurre en los infantes y fetos de gestantes vacunadas por dosis acumulativa de mercurio. Las diversas evidencias implican al timerosal como el agente causante, agravante o disparador de las enfermedades del neurodesarrollo infantil. La toxicidad del mercurio obligó al retiro progresivo del timerosal de los medicamentos. Lamentablemente, en las vacunas, ha habido una sustancial demora en la demostración de su impacto negativo. Actualmente, existen vacunas sin timerosal, cuyo uso está ocasionando la disminución de la incidencia de las enfermedades del neurodesarrollo infantil.

Enfermedad, lenguaje y vida animal

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Miguel Martínez García

2017-07-01

Full Text Available En este artículo planteamos una aproximación crítica a la «cuestión animal» desde la perspectiva de la enfermedad. El problema de la «animalidad», en efecto, y de su relación con lo humano, constituye un problema clave en las experiencias modernas de «lo patológico». Es frecuente, ciertamente, que en un contexto de enfermedad grave o ante un proceso patológico agudo se produzca un efecto de acercamiento o de asimilación entre el sujeto enfermo y el animal. En la mayoría de los casos, dicha animalización está íntimamente relacionada con el discurso y la práctica médica. Sin embargo, creemos que «lo animal» está irrumpiendo también de otro modo en nuestras experiencias de enfermedad. Para entender esta irrupción, creemos que es adecuado volver a recurrir a la idea del «devenir animal» de Deleuze. Con esta herramienta, nos enfrentamos a un corpus de textos literarios recientes en los se aprecia un «devenir animal» del enfermo que contesta a los procesos de animalización ligados a la clínica. El «devenir animal» del enfermo se materializa específicamente, en estos casos, en relación con un particular «devenir animal de la lengua».

Errores innatos del metabolismo: Enfermedades lisosomales

Directory of Open Access Journals (Sweden)

Caridad Menéndez Saínz

2002-03-01

Full Text Available Dentro de los errores innatos del metabolismo se encuentran las enfermedades de almacenamiento lisosomal o enzimopatías lisosomales, las cuáles se caracterizan por un déficit enzimático específico, la excreción de metabolitos por la orina y la acumulación de los compuestos no degradados en diferentes órganos y tejidos que ocasionan la disfución de éstos. Tienen un patrón de herencia autosómico recesivo, excepto para la enfermedad de Fabry y la enfermedad de Hunter en las que el patrón de herencia está ligado al cromosoma X. Estas enfermedades tienen una baja incidencia en general, aunque hay poblaciones donde algunas de ellas tienen una alta incidencia. Su importancia radica en la magnitud que representan como problema de salud, por la pobre calidad de vida de esos pacientes, así como su fallecimiento prematuro, motivo por el cual hay que evitar los nacimientos de nuevos niños afectados.Among the metabolism inborn errors, there are the lysosomal storage diseases or lysosomal enzymopathies that are characterized by an specific enzymatic deficiency, excretion of metabollites in urine and accumulation of non-degraded compounds in various organs and tissues causing their dysfunction. These diseases have a recessive autosomal heredity, except for Fabry´s disease and Hunter’s disease in which the pattern of heredity is chromosome X-linked. These diseases have a low incidence in general although there are populations where they show a high incidence. Their importance lies in what they represent as a health problem because of the poor quality of life of these patients and their early death, therefore, it is necessary to prevent the birth of new infants affected with these diseases.

PREVALENCIA Y MORTALIDAD DE LA ENFERMEDAD DE HUNTINGTON A PARTIR DEL REGISTRO POBLACIONAL DE ENFERMEDADES RARAS DE LAS ISLAS BALEARES DURANTE EL PERÍODO 2010-2013

Directory of Open Access Journals (Sweden)

Mercedes Cáffaro Rovira

2017-01-01

Full Text Available La enfermedad de Huntington (EH es una enfermedad hereditaria de baja prevalencia, por lo que se incluye en los registros de enfermedades raras. El registro poblacional de enfermedades raras de las Islas Baleares se inició en el año 2010. Previamente no existían datos de prevalencia y mortalidad de la EH en las Islas Baleares. El objetivo de este estudio fue determinar la prevalencia y la mortalidad de la enfermedad de Huntington en las Islas Baleares durante el periodo 2010-2013. Métodos: Se utilizaron como fuentes de información el registro poblacional de enfermedades raras de las Islas Baleares, del que se obtuvieron los casos diagnosticados, el Registro de mortalidad de las Islas Baleares, del que se obtuvieron los casos fallecidos, el registro del Servicio de Salud de las Islas Baleares del que se obtuvieron el número de tarjetas sanitarias y del Instituto Nacional de Estadística se obtuvieron los datos de población. Se calcularon las tasas de prevalencia y de mortalidad. Resultados: El registro poblacional de enfermedades raras de las Islas Baleares durante el periodo 2010-2013 registró 27 casos de EH. El 63% fueron mujeres. La tasa de prevalencia fue de 2,6 por 105 y la tasa de mortalidad de 1,1 por 105. La isla de Menorca fue la más afectada con una prevalencia de 5,9 por 105 y una mortalidad de 2,1 por 105. Conclusiones: La prevalencia y mortalidad de la EH en las Islas Baleares son bajas en comparación con zonas del entorno.

La legionelosis como enfermedad profesional: metodología de valoración

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Marta Dorronsoro Dorronsoro

2014-06-01

Full Text Available La Legionella es una enfermedad bacteriana producida por la Legionella Pneumofila, patógeno oportunista que para causar una enfermedad debe estar presente en el lugar (reservorio, debe alcanzar un número suficiente para causar la infección (amplificación y debe pasar al ambiente en estado infectivo (diseminación los focos de contaminación que con mayor frecuencia han sido relacionados con los brotes epidémicos son instalaciones de suministro de agua y de acondicionamiento del aire de los edificios como: circuitos de distribución de agua caliente sanitaria, sistemas de climatización, aguas termales de centros de rehabilitación y recreo, equipos de aerosolterapia. El desarrollo de la enfermedad depende de la exposición al microorganismo patógeno, de la virulencia y de la inmunidad del huésped. La enfermedad puede ser asumida como enfermedad profesional cuando su aparición va ligada a la exposición al agente patógeno, demostrada su presencia en el medio de trabajo y realizando tareas en las que es posible su infección. En este artículo a propósito de un caso se establecen los pasos para la determinación de la contingencia profesional de una enfermedad causada por exposición a agentes biológicos Material y método: Se han revisado hasta mayo de 2013 las siguientes bases de datos bibliográficas: SciELO, y PUBMED. Así como la Bibliografía y documentos de consulta citados en la misma Conclusiones: la neumonía por legionella puede contraerse tanto con carácter ocupacional ligado al trabajo como ambiental. Como toda enfermedad profesional, la diferencia no está en los signos o síntomas de la enfermedad, que no difieren en la neumonía por legionella ni en la clínica ni en la analítica, ni en las pruebas de imagen en cuanto al origen causal, sea este ambiental o de ocio o en la práctica laboral, sino que su adscripción diferencial causal ligada al trabajo viene definida por cumplir con los requisitos legales que dotan a

Sensitivity of lumbar spine loading to anatomical parameters

DEFF Research Database (Denmark)

Putzer, Michael; Ehrlich, Ingo; Rasmussen, John

2016-01-01

Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the in uence of dened geometrical parameters on lumbar spine loading utilizing ve parametrized musculoskeletal lumbar spine ...... lumbar spine model for a subject-specic approach with respect to bone geometry. Furthermore, degeneration processes could lead to computational problems and it is advised that stiffness properties of discs and ligaments should be individualized....

ENFERMEDAD, MUERTE Y MEMORIA LA EXPERIENCIA FUNERARIA COMO INSTANCIA DEL RECUERDO (UNA LECTURA DE LA ENFERMEDAD, DE ALBERTO BARRERA TYSZKA

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José Javier Franco

2016-01-01

Full Text Available Experiencia y memoria dicen de una vida en común; ambas son, esencialmente, colectivas. Vivir y recordar nos comprometen con el otro, porque incluso la experiencia más íntima está mediada por su presencia; o por su ausencia, que es otra forma de estar juntos. La muerte augura no sólo el fin de la experiencia, sino también su carácter irrecuperable, irreversible. La enfermedad es el aviso, la antesala de la muerte. Enfermedad y muerte convocan el pasado, lo instan a hacerse (en el presente, aunque toda restitución sea imposible. Pero la muerte, al menos la propia, es inenarrable. No hay un discurso pos mortem que no provenga del otro, de los otros. La enfermedad y la muerte del prójimo, del otro próximo, activan la memoria y el discurso funerarios. Los vivos recuerdan al muerto y hablan en su nombre. La enfermedad, de Alberto Barrera Tyszka, ficciona ese doble proceso de recordación y pérdida: la muerte del padre signa no sólo el pasado, sino el futuro del hijo, que ve en el presente tanto la repetición traumática del pasado, como el proceso de duelo que inaugura. Estas líneas proponen una lectura de esa puesta en escena.

Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

OpenAIRE

Alberto Mendoza-Ticona

2012-01-01

Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis ...

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

Science.gov (United States)

2010-10-01

...-Year-Old Child § 572.19 Lumbar spine, abdomen and pelvis. (a) The lumbar spine, abdomen, and pelvis... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen and pelvis. 572.19 Section..., the lumbar spine assembly shall flex by an amount that permits the rigid thoracic spine to rotate from...

Lumbar Vertebral Canal Diameters in Adult Ugandan Skeletons ...

African Journals Online (AJOL)

Background: Normal values of lumbar vertebral canal diameters are useful in facilitating diagnosis of lumbar vertebral canal stenosis. Various studies have established variation on values between different populations, gender, age, and ethnic groups. Objectives: To determine the lumbar vertebral canal diameters in adult ...

A reappraisal of the anatomy of the human lumbar erector spinae.

OpenAIRE

Bogduk, N

1980-01-01

In the lumbar region the longissimus thoracis and iliocostalis lumborum are separated by the erector spinae aponeurosis and its ventral reflection--the lumbar intermuscular aponeurosis. Lumbar fibres of the longissimus arise from the ilium and the lumbar intermuscular aponeurosis and insert into the accessory processes and proximal ends of the transverse processes of the lumbar vertebrae. Lumbar fibres of iliocostalis insert into the costal elements of the first four lumbar vertebrae. The lum...

FERTILIDAD Y EMBARAZO EN PACIENTES CON ENFERMEDADES INFLAMATORIAS INTESTINALES

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ANDRÉS YARUR U., DR.

2015-09-01

Full Text Available Las Enfermedades Inflamatorias Intestinales (EII son entidades crónicas del tracto digestivo, que afectan frecuentemente a pacientes en edad reproductiva. Debido a las características de estas enfermedades y su tratamiento, existen múltiples desafíos. En este artículo, revisamos la evidencia más reciente con respecto a fertilidad y embarazo en pacientes con EII. En general, existe evidencia de que pacientes con EII tienen una mayor tasa de complicaciones durante el embarazo con respecto a pacientes sin EII. Sin embargo, esta diferencia está directamente asociada al grado de actividad de la enfermedad. La mayor parte de los fármacos hoy usados en el tratamiento de EII son considerados seguros durante el embarazo y se recomienda continuarlos, sobre todo considerando que el mayor riesgo de complicaciones está asociado a una enfermedad activa. Sin embargo es importante considerar las opciones caso a caso. Las dos grandes excepciones son metotrexato y talidomida que están completamente contraindicadas. La recomendación más importante es educar a toda paciente con EII en edad reproductiva, explicando que el embarazo debe llevarse a cabo cuando la enfermedad esté controlada y que la probabilidad de complicaciones está relacionada con el grado de actividad y severidad de la EII. Los médicos tratantes deben educar a las pacientes, enfatizando el seguimiento de los controles y tratamiento.

Enfermedad de Tay-Sachs

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Albia Josefina Pozo Alonso

Full Text Available La enfermedad de Tay-Sachs es un trastorno neurodegenerativo progresivo de herencia autosómica recesiva. Se debe a la deficiencia de la enzima β-hexosaminidasa A, que provoca una acumulación de gangliósidos GM2 en los lisosomas. Se incluye dentro de las esfingolipidosis. De las esfingolipidosis que presentan mancha rojo cereza en la mácula, la enfermedad de Tay-Sachs es la única en la que no se evidencia hepatoesplenomegalia. La variante más frecuente se inicia en la lactancia. Se presenta un lactante del sexo masculino al que se le realizó el diagnóstico de esta entidad a los 8 meses de edad. A partir de los 4 meses comenzó a presentar una reacción de sobresalto. A los 6 meses comenzó a perder habilidades previamente adquiridas y crisis epilépticas mioclónicas. Se constató una disminución de la actividad específica de la enzima hexosaminidasa A en leucocitos.

The shape of the human lumbar vertebral canal

OpenAIRE

Zarzur,Edmundo

1996-01-01

Literature on the anatomy of the human vertebral column characterizes the shape of the lumbar vertebral canal as triangular. The purpose of the present study was to determine the precise shape of the lumbar vertebral canal. Ten lumbar vertebral columns of adult male cadavers were dissected. Two transverse sections were performed in the third lumbar vertebra. One section was performed at the level of the lower border of the ligamenta flava, and the other section was performed at the level of t...

Las enfermedades de Ludwing Van Beethoven

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Osvaldo Llanos López

2007-08-01

Full Text Available La extraordinaria genialidad y productividad musical de Beethoven no fue disminuida por la influencia de sus múltiples dolencias, sino que por el contrario, en períodos críticos, esta se vio incluso exacerbada. A la sordera, su enfermedad más conocida, pero de causa todavía no precisada, se agregaron otras enfermedades, algunas demostradas en la autopsia, como la cirrosis hepática, la nefropatía, la pancreatitis crónica y otros síndromes sin etiología demostrada, como sus alteraciones gastrointestinales, bronquiales, articulares y oculares. Estas enfermedades, que mortificaron seriamente su vida, pero que no frenaron su creatividad, no pudieron ser controladas por los mejores médicos de la época, con los limitados tratamientos disponibles. Los estudios y especulaciones acerca de su historia médica son abundantes en la literatura y no logran establecer tampoco una patología sistémica que explique al menos la mayoría de sus síndromes. El conocimiento más preciso apunta a que su sordera era de causa mixta, que su cirrosis hepática fue provocada por exceso de alcohol y que la causa de su muerte fue una insuficiencia hepática.

Una lengua común: poéticas y políticas de la enfermedad

OpenAIRE

Martínez García, Miguel Ángel

2015-01-01

La tesis "Una lengua común: poéticas y políticas de la enfermedad" analiza un corpus de textos literarios recientes (publicados en su mayoría después del año 2000) en los que se tematiza el motivo de la enfermedad. La tesis interroga la dimensión social y política de las formas actuales de la enfermedad a partir de sus representaciones literarias. El punto de partida de la tesis consiste en la constatación de que algunas enfermedades (como el cáncer o las llamadas "enfermedades del vacío" o "...

Enfermedades y Geopolítica en Colombia

OpenAIRE

Hugo Armando Sotomayor Tribin

1997-01-01

El presente artículo “Enfermedades y geopolítica en Colombia” relacionará las enfermedades con dos fenómenos sociales y políticos que han pesado grandemente en la conformación histórica de nuestro país: el acento político y el progreso económico para algunas regiones, al tiempo que el descuido y abandono para otra, y el racismo.

El primero, el relacionado con la asignación de una mayor importancia en un momento dado a algunas regiones y su contrapartida, el descuido...

Úvea y enfermedades sistémicas

OpenAIRE

Pablo Sabat, O.; Víctor Velásquez, R.

2010-01-01

El ojo, además de entregarnos el sentido de la visión, también nos permite conocer la salud general del organismo. Muchas enfermedades sistémicas se manifiestan en el órgano visual antes, durante o después del debut de ellas a nivel sistémico. Este compromiso visual es variado y depende de la enfermedad en cuestión, destacando la escleritis, uveítis y vasculitis retinales. Conocer el estado ocular permitirá al clínico realizar diagnósticos más asertivos y oportunos, realizar el tratamiento má...

El dolor en la enfermedad de Parkinson. Implicaciones autonómicas y afectivas

OpenAIRE

Camacho Conde, José

2016-01-01

Introducción y objetivo: La enfermedad de Parkinson (EP) es una enfermedad neurodegenerativa, la segunda con mayor prevalencia, después de la enfermedad de Alzheimer (EA). La enfermedad presenta tanto síntomas motores como “no motores”, entre los que se encuentra disfunción autonómica, dolor, deterioro cognitivo, ansiedad, depresión, entre otros. El dolor en la EP, a pesar de su frecuencia, sigue siendo un síntoma infravalorado, infradiagnosticado e infratratado. Nuestro objetivo principal es...

PARAMETRIC MODEL OF LUMBAR VERTEBRA

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CAPPETTI Nicola

2010-11-01

Full Text Available The present work proposes the realization of a parametric/variational CAD model of a normotype lumbar vertebra, which could be used for improving the effectiveness of actual imaging techniques in informational augmentation of the orthopaedic and traumatological diagnosis. In addition it could be used for ergonomic static and dynamical analysis of the lumbar region and vertebral column.

Comparison Between Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Lan, Tao; Hu, Shi-Yu; Zhang, Yuan-Tao; Zheng, Yu-Chen; Zhang, Rui; Shen, Zhe; Yang, Xin-Jian

2018-04-01

To compare the efficacy and safety in the management of lumbar diseases performed by either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). Interbody fusion is considered the "gold standard" in the treatment of lumbar degenerative diseases. Both PLIF and TLIF have been advocated, and it remains controversial as to the best operative technique. The electronic databases including Embase, PubMed, and Cochrane library were searched to identify relevant studies up to September 2017. The primary outcomes were fusion rate, complications, and clinical satisfaction. The secondary outcomes were length of hospitalization, operation time, blood loss, postoperative visual analog scale, Oswestry Disability Index, and Japanese Orthopaedic Association Score. Data analysis was conducted with RevMan 5.3 software. A total of 16 studies involving 1502 patients (805 patients in PLIF group and 697 in TLIF group) were included in the meta-analysis. The pooled analysis showed that there was no significant difference in terms of fusion rate (P > 0.05) and clinical satisfaction (P > 0.05) between the 2 groups. TLIF was superior to PLIF with significantly lower incidence of nerve root injury (P 0.05) and graft malposition (P > 0.05). PLIF required significant longer operation time (P degenerative lumbar diseases. However, TLIF was superior to PLIF with shorter operation time, less blood loss, and lower incidence of nerve root injury and dural tear. There is no significant difference between both groups regarding wound infection and graft malposition. Copyright © 2018 Elsevier Inc. All rights reserved.

Enfermedad de Hashimoto

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Hernando Latorre

1956-01-01

Full Text Available Se describe un caso de enfermedad de hashimoto en una enferma de 47 años y se hacen algunos comentarios sobre la interpretación y relaciones de esta entidad con el coto de riedel y el coto linfadenoide. La lesión al examen clínico simuló un tumor maligno de tiroides, diagnóstico con el cual fue remitido el órgano al laboratorio de anatomía patológica.

Enfermedad de Gaucher en Latinoamérica: Un informe del Registro Internacional y del Grupo Latinoamericano para la Enfermedad de Gaucher

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Guillermo Drelichman

2012-08-01

Full Text Available La enfermedad de Gaucher, por su escasa frecuencia, está incluida dentro de las llamadas enfermedades huérfanas. En 1991 se creó el Registro Internacional de Gaucher y en 1992 se incorporaron los primeros pacientes de Latinoamérica. En el año 2008 se creó el Grupo Latinoamericano para la Enfermedad de Gaucher (GLAEG cuyos principales objetivos son fomentar la realización de consensos regionales, difundir el ingreso de pacientes al registro internacional y aumentar el conocimiento sobre la enfermedad para lograr mejorar la atención y la calidad de vida de los pacientes. Hasta abril del 2010 ingresaron 5828 pacientes de todo el mundo, 911 (15.6% son de Latinoamérica. Este es el primer informe global de la enfermedad en la Región: hay un predominio del sexo femenino, la forma clínica más frecuente es el tipo I (95%; al diagnóstico la mayoría son <20 años (68%. Las manifestaciones clínicas más frecuentes al diagnóstico son esplenomegalia (96% y anemia (49%, el 80% presentó hallazgos radiológicos de compromiso óseo. En nuestra Región, la gran mayoría de los pacientes (89% ha recibido alguna vez terapia de reemplazo enzimática con imiglucerasa logrando, con un seguimiento prolongado (hasta10 años, las metas terapéuticas que muestran la gran eficacia de la terapia. Si bien el porcentaje de pacientes con terapia es alto, las suspensiones de tratamiento son frecuentes. Las principales deficiencias en nuestra Región son: la carencia de evaluaciones viscerales volumétricas, de densitometría y de estudios moleculares en algunos pacientes. El principal problema es el subdiagnóstico.

Reporte de familias con neurofibromatosis y otras enfermedades genéticas

OpenAIRE

Orraca Castillo, Miladys; Licourt Otero, Deysi; Sánchez Álvarez de La Campa, Ana Isabel

2011-01-01

La neurofibromatosis tipo 1, es una enfermedad genética que primariamente afecta el desarrollo y crecimiento celular del sistema nervioso, clínicamente se caracteriza por máculas café con leche, neurofibromas, pecas en regiones no expuestas al sol, nódulos de Lisch, lesiones óseas y glioma óptico. En el presente trabajo se describen dos familias, en las cuales algunos individuos padecen esta enfermedad y otros miembros de la misma familia muestran una diferente enfermedad genética. La coexist...

Obesidad y enfermedad renal: consecuencias ocultas de la epidemia

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Csaba P. Kovesdy

2017-07-01

Full Text Available La obesidad se ha convertido en una epidemia mundial, y se ha proyectado que su prevalencia se incrementrá en un 40% en la próxima década. Esta creciente prevalencia supone implicaciones tanto para el riesgo de desarrollo de diabetes y enfermedades cardiovasculares como para el desarrollo de enfermedad renal crónica. Un elevado índice de masa corporal es uno de los factores de riesgo más importantes para el desarrollo de enfermedad renal crónica. En individuos afectados por la obesidad, tiene lugar una hiperfiltración compensatoria necesaria para alcanzar la alta demanda metabólica secundaria al aumento del peso corporal. El incremeno de la presión intraglomerular puede generar daño renal y elevar el riesgo de desarrollar enfermedad renal crónica a largo plazo. La incidencia de glomerulopatía asociada a obesidad se ha incrementado 10 veces en los últimos años. Así mismo se ha demostrado que la obesidad es un factor de riesgo para el desarrollo de nefrolitiasis y un número de neoplasias, incluyendo cáncer renal. Este año, el Día Mundial del Riñón promueve la educación acerca de las consecuencias nocivas de la obesidad y su asociación con la enfermedad renal, abogando por un estilo de vida saludable y la implementación de políticas publicas de salud que promuevan medidas preventivas alcanzables.

Management of Lumbar Conditions in the Elite Athlete.

Science.gov (United States)

Hsu, Wellington K; Jenkins, Tyler James

2017-07-01

Lumbar disk herniation, degenerative disk disease, and spondylolysis are the most prevalent lumbar conditions that result in missed playing time. Lumbar disk herniation has a good prognosis. After recovery from injury, professional athletes return to play 82% of the time. Surgical management of lumbar disk herniation has been shown to be a viable option in athletes in whom nonsurgical measures have failed. Degenerative disk disease is predominately genetic but may be accelerated in athletes secondary to increased physiologic loading. Nonsurgical management is the standard of care for lumbar degenerative disk disease in the elite athlete. Spondylolysis is more common in adolescent athletes with back pain than in adult athletes. Nonsurgical management of spondylolysis is typically successful. However, if surgery is required, fusion or direct pars repair can allow the patient to return to sports.

Enfermedad de Hirschsprung

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Gonzalo López Escobar

1990-04-01

ática, efectuaron simpa tectomías lumbares en pacientes con Enfermedad de Hirschsprung, con resultados exitosos. Este procedimiento fue adoptado por Adson en Estados Unidos, y luego por Rankin y Learmonth en Inglaterra...

Estudo clínico da eficácia do bloqueio anestésico radicular transforaminal no tratamento da radiculopatia lombar Estudio clínico de la eficacia del bloqueo anestésico radicular transforaminal en el tratamiento de la radiculopatía lumbar Clinical study on the efficacy of transforaminal radicular block in lumbar radiculopathy treatment

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Fabiano Fonseca Rodrigues de Souza

2011-01-01

Full Text Available OBJETIVO: O objetivo deste estudo é avaliar a eficácia da injeção transforaminal nos pacientes com dor radicular devido à hérnia de disco ou estenose foraminal lombar por meio de estudo prospectivo randomizado. MÉTODOS: Foram avaliados 61 pacientes com quadro de radiculopatia nos membros inferiores. Esses pacientes foram divididos em dois grupos escolhidos aleatoriamente. Desses, 32 foram submetidos à injeção de corticosteroides e 29 foram submetidos à injeção salina. O período de acompanhamento foi de 12 meses. Para avaliar os resultados aplicamos a Escala Analógica Visual de Dor (EAV e o Índice Oswestry (ODI. RESULTADOS: Houve melhora significativa da intensidade de dor (p OBJETIVO: El presente estudio tuvo como objetivo evaluar la eficacia de la inyección transforaminal en pacientes con dolor radicular, debido a la hernia discal lumbar o estenosis foraminal, mediante un estudio prospectivo y aleatorizado. MÉTODOS: Se analizó un total de 61 pacientes con cuadro de radiculopatía en miembros inferiores. Estos pacientes fueron divididos en dos grupos seleccionados al azar. De ellos, 31 fueron sometidos a inyecciones de corticoides y a 29 se les aplicaron inyecciones de suero fisiológico. El período de seguimiento fue de 12 meses. Para evaluar los resultados se les aplicó la Escala Visual Analógica del dolor (EAV y el Índice de Oswestry (ODI, sigla en inglés. RESULTADOS: Hubo una mejora significativa en la intensidad del dolor (p OBJECTIVE: To assess the efficacy of corticosteroid injections in patients with sciatica due to lumbar disc herniation or lumbar foraminal stenosis by a prospective randomized study. METHODS: There were analyzed 61 patients with sciatica due to lumbar disc degeneration. These patients were divided into two groups randomly chosen to radicular blocks with saline solution or corticosteroids. Thirty-one of these patients were submitted to corticosteroids radicular block and 29 patients were submitted

Uso de derivados de quinazollnas y sus composiciones farmacéuticas en enfermedades neurodegenerativas

OpenAIRE

Martínez, Ana; Redondo, Miriam; Sanz-SanCristóbal, Marina; Gil, Carmen; Morales-García, José A.; Pérez Castillo, Ana; Pérez Martín, María Concepción

2009-01-01

Uso de derivados de quinazolinas y sus composiciones farmacéuticas en enfermedades neurodegenerativas. La invención se refiere a derivados heterocíclicos de quinazolinas y a su potencial para el tratamiento de enfermedades neurodegenerativas y/o neurológicas, entre otras la enfermedad de Parkinson, enfermedad de Alzheimer o esclerosis. Además, la invención se refiere a composiciones farmacéuticas que comprenden dichos compuestos derivados de quinazolinas.

Manifestaciones neuroftalmológicas en la enfermedad de Parkinson

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Yoel Nicomedes Rodríguez Martín

Full Text Available La enfermedad de Parkinson es un desorden neurodegenerativo progresivo provocado por un déficit de dopamina que desencadena importantes alteraciones motoras y no motoras. Dentro de estas, un considerable grupo constituye motivo de interés para el neuroftalmólogo. La enfermedad ha sido siempre más reconocida por sus alteraciones motoras. El objetivo fundamental de esta revisión es hacer énfasis en el diagnóstico de las afectaciones visuales en la enfermedad de Parkinson y de esta forma mejorar en lo posible la calidad de vida de los pacientes. Se realizó una amplia búsqueda en PUBMED y se revisaron 60 artículos relacionados con el tema, publicados entre los años 1984 y 2012.

Preliminary experience with lumbar facet distraction and fixation as treatment for lumbar spinal stenosis

OpenAIRE

Grasso, Giovanni; Landi, Alessandro

2017-01-01

Objectives: To assess the properties of facet fixation with the Facet Wedge system in patients affected by lumbar spinal stenosis (LSS). Summary of Background Data: Implant of intra-articular spacers is an emerging technique for lumbar degenerative disease. Methods: This study included forty patients (Group 1) with symptomatic LSS in whom intra-articular spacers have been implanted along with microdecompression (MD) of the neural structures. Group 1 has been compared with a homogeneous ...

Weightlifter Lumbar Physiology Health Influence Factor Analysis of Sports Medicine.

Science.gov (United States)

Zhang, Xiangyang

2015-01-01

Chinese women's weightlifting project has been in the advanced world level, suggests that the Chinese coaches and athletes have many successful experience in the weight lifting training. Little weight lifting belongs to high-risk sports, however, to the lumbar spine injury, some young good athletes often due to lumbar trauma had to retire, and the national investment and athletes toil is regret things. This article from the perspective of sports medicine, weightlifting athletes training situation analysis and put forward Suggestions, aimed at avoiding lumbar injury, guarantee the health of athletes. In this paper, first of all to 50 professional women's weightlifting athletes doing investigation, found that 82% of the athletes suffer from lumbar disease symptoms, the reason is mainly composed of lumbar strain, intensity is too large, motion error caused by three factors. From the Angle of sports medicine and combined with the characteristics of the structure of human body skeleton athletes lumbar structural mechanics analysis, find out the lumbar force's two biggest technical movement, study, and regulate the action standard, so as to minimize lumbar force, for athletes to contribute to the health of the lumbar spine.

Post-surgical functional recovery, lumbar lordosis, and range of motion associated with MR-detectable redundant nerve roots in lumbar spinal stenosis.

Science.gov (United States)

Chen, Jinshui; Wang, Juying; Wang, Benhai; Xu, Hao; Lin, Songqing; Zhang, Huihao

2016-01-01

T1- and T2-weighted magnetic resonance images (MRI) can reveal lumbar redundant nerve roots (RNRs), a result of chronic compression and nerve elongation associated with pathogenesis of cauda equina claudication (CEC) in degenerative lumbar canal stenosis (DLCS). The study investigated effects of lumbar lordosis angle and range of motion on functional recovery in lumbar stenosis patents with and without RNRs. A retrospective study was conducted of 93 lumbar spinal stenosis patients who underwent decompressive surgery. Eligible records were assessed by 3 independent blinded radiologists for presence or absence of RNRs on sagittal T2-weighted MR (RNR and non-RNR groups), pre- and post-operative JOA score, lumbar lordosis angle, and range of motion. Of 93 total patients, the RNR group (n=37, 21/37 female) and non-RNR group (n=56; 31/56 female) had similar preoperative conditions (JOA score) and were not significantly different in age (mean 64.19 ± 8.25 vs. 62.8 ± 9.41 years), symptom duration (30.92 ± 22.43 vs. 28.64 ± 17.40 months), or follow-up periods (17.35 ± 4.02 vs. 17.75 ± 4.29 mo) (all p>0.4). The non-RNR group exhibited significantly better final JOA score (p=0.015) and recovery rate (p=0.002). RNR group patients exhibited larger lumbar lordosis angles in the neutral position (p=0.009) and extension (p=0.021) and larger range of motion (p=0.008). Poorer surgical outcomes in patients with RNRs indicated that elevated lumbar lordosis angle and range of motion increased risks of RNR formation, which in turn may cause poorer post-surgical recovery, this information is possibly useful in prognostic assessment of lumbar stenosis complicated by RNRs. Copyright © 2015 Elsevier B.V. All rights reserved.

La enfermedad periodontal asociada al paciente con Síndrome de Down

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Rubens Demicheri A.

Full Text Available Resumen: El Síndrome de Down es una de las condiciones de discapacidad más comunes. Dentro de las patologías bucales más prevalentes, la enfermedad periodontal es una de las asociadas con este síndrome. Se considera que la persona con Síndrome de Down presenta una mayor susceptibilidad a contraer esta enfermedad. En este artículo se describen los factores etiológicos y las características clínicas de la enfermedad en pacientes portadores del síndrome

La enfermedad de manos, pies y boca (Hand, Foot, and Mouth Disease)

Centers for Disease Control (CDC) Podcasts

La enfermedad de manos, pies y boca es una enfermedad contagiosa que afecta principalmente a niños menores de cinco años. En este podcast, la doctora Eileen Schneider habla de los síntomas de la enfermedad de manos, pies y boca, cómo se propaga y cómo protegerse y proteger a sus hijos para que no se infecten con el virus.

Effect of Lumbar Disc Degeneration and Low-Back Pain on the Lumbar Lordosis in Supine and Standing

DEFF Research Database (Denmark)

Hansen, Bjarke B; Bendix, Tom; Grindsted, Jacob

2015-01-01

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To examine the influence of low-back pain (LBP) and lumbar disc degeneration (LDD) on the lumbar lordosis in weight-bearing positional magnetic resonance imaging (pMRI). SUMMARY OF BACKGROUND DATA: The lumbar lordosis increases with a change...... of position from supine to standing and is known as an essential contributor to dynamic changes. However, the lordosis may be affected by disc degeneration and pain. METHODS: Patients with LBP >40 on a 0 to 100 mm Visual Analog Scale (VAS) both during activity and rest and a sex and age-decade matching...... control group without LBP were scanned in the supine and standing position in a 0.25-T open MRI unit. LDD was graded using Pfirrmann's grading-scale. Subsequently, the L2-to-S1 lumbar lordosis angle (LA) was measured. RESULTS: Thirty-eight patients with an average VAS of 58 (±13.8) mm during rest and 75...

Retroperitoneal hemorrhage from an unrecognized puncture of the lumbar right segmental artery during lumbar chemical sympathectomy: diagnosis and management.

Science.gov (United States)

Shin, Ho-Jin; Choi, Yun-Mi; Kim, Hye-Jin; Lee, Sun-Jae; Yoon, Seok-Hyun; Kim, Kyung-Hoon

2014-12-01

Lumbar chemical sympathectomy has been performed using fluoroscopic guidance for needle positioning. An 84 year old woman with atherosclerosis obliterans was referred to the pain clinic for intractable cold allodynia of her right foot. A thermogram showed decreased temperature of both feet compared with temperatures above both ankles. The patient agreed to undergo lumbar chemical sympathectomy using fluoroscopy after being informed of the associated risks of nerve injury, hemorrhage, infection, transient back pain, and transient hypotension. During the procedure and three hours afterward, no abnormal signs or symptoms were found except an increase in right leg temperature. The patient was ambulatory after the procedure. However, one day after undergoing lumbar chemical sympathectomy, she visited our emergency department for abdominal discomfort and postural dizziness. Her blood pressure was 80/50 mmHg, and flank tenderness was noted. Retroperitoneal hemorrhage from the second right lumbar segmental artery was shown on computed tomography and angiography. Vital signs were stabilized immediately after embolization into the right lumbar segmental artery. Copyright © 2014 Elsevier Inc. All rights reserved.

Radiographic Results of Single Level Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease: Focusing on Changes of Segmental Lordosis in Fusion Segment

OpenAIRE

Kim, Sang-Bum; Jeon, Taek-Soo; Heo, Youn-Moo; Lee, Woo-Suk; Yi, Jin-Woong; Kim, Tae-Kyun; Hwang, Cheol-Mog

2009-01-01

Background To assess the radiographic results in patients who underwent transforaminal lumbar interbody fusion (TLIF), particularly the changes in segmental lordosis in the fusion segment, whole lumbar lordosis and disc height. Methods Twenty six cases of single-level TLIF in degenerative lumbar diseases were analyzed. The changes in segmental lordosis, whole lumbar lordosis, and disc height were evaluated before surgery, after surgery and at the final follow-up. Results The segmental lordosi...

Influences of posterior-located center of gravity on lumbar extension strength, balance, and lumbar lordosis in chronic low back pain.

Science.gov (United States)

Kim, Dae-Hun; Park, Jin-Kyu; Jeong, Myeong-Kyun

2014-01-01

In patients with chronic low back pain, the center of gravity (COG) is abnormally located posterior to the center in most cases. The purpose of this study was to examine the effects of posterior-located COG on the functions (lumbar extension strength, and static and dynamic balance) and structure (lumbar lordosis angle and lumbosacral angle) of the lumbar spine. In this study, the COG of chronic low back pain patients who complained of only low back pain were examined using dynamic body balance equipment. A total of 164 subjects participated in the study (74 males and 90 females), and they were divided into two groups of 82 patients each. One group (n=82) consisted of patients whose COG was located at the center (C-COG); the other group (n=82) consisted of patients whose COG was located posterior to the center (P-COG). The following measures assessed the lumber functions and structures of the two groups: lumbar extension strength, moving speed of static and dynamic COGs, movement distance of the static and dynamic COGs, lumbar lordosis angle, and lumbosacral angle. The measured values were analyzed using independent t-tests. The group of patients with P-COG showed more decreases in lumbar extension strength, lumbar lordosis angle, and lumbosacral angle compared to the group of patients with C-COG. Also this group showed increases in moving speed and movement distance of the static COG. However, there were no differences in moving speed and movement distance of the dynamic COG between the two groups. These findings suggest that chronic LBP patients with P-COG have some disadvantages to establish lumbar extension strength and static and dynamic balance, which require specific efforts to maintain a neutral position and to control posture.

Pelvic Hydatid Disease: CT and MRI Findings Causing Sciatica

Energy Technology Data Exchange (ETDEWEB)

Sanal, Hatice Tuba; Kocaoglu, Murat; Bulakbasi, Nail; Yildirim, Duzgun [Gulhane Military Medical School, Department of Radiology, 06018, Ankara (Turkmenistan)

2007-12-15

Pelvic masses, especially hydatid disease, rarely present with sciatica. We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings. isc herniation in the lumbar spine is a well-known etiology of back pains and sciatica, but whenever disc herniation of the lumbar spine is excluded by the employed imaging modalities, then the pelvis should be examined for other possible etiologies of nerve compression. We describe here a patient, who was complaining of sciatica, with no abnormal findings in her lumbar spinal magnetic resonance imaging (MRI). The cause of her sciatica was found to be associated with a pelvic hydatid cyst compressing the lumbosacral nerve plexus. In conclusion, if no pathology is evident for the lumbar discal structures, in connection with the cause of sciatica and lumbar back pains, then the pelvis should also be examined for the possible etiologies of compression of the lumbosacral nerve plexus. Whenever a multiseptated cyst is come across in a patient of an endemic origin with a positive history for hydatid disease like surgery, indicating recurrence, hydatid cyst is the most likely diagnosis.

Pelvic Hydatid Disease: CT and MRI Findings Causing Sciatica

International Nuclear Information System (INIS)

Sanal, Hatice Tuba; Kocaoglu, Murat; Bulakbasi, Nail; Yildirim, Duzgun

2007-01-01

Pelvic masses, especially hydatid disease, rarely present with sciatica. We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings. isc herniation in the lumbar spine is a well-known etiology of back pains and sciatica, but whenever disc herniation of the lumbar spine is excluded by the employed imaging modalities, then the pelvis should be examined for other possible etiologies of nerve compression. We describe here a patient, who was complaining of sciatica, with no abnormal findings in her lumbar spinal magnetic resonance imaging (MRI). The cause of her sciatica was found to be associated with a pelvic hydatid cyst compressing the lumbosacral nerve plexus. In conclusion, if no pathology is evident for the lumbar discal structures, in connection with the cause of sciatica and lumbar back pains, then the pelvis should also be examined for the possible etiologies of compression of the lumbosacral nerve plexus. Whenever a multiseptated cyst is come across in a patient of an endemic origin with a positive history for hydatid disease like surgery, indicating recurrence, hydatid cyst is the most likely diagnosis

Enfermedad periodontal inflamatoria asociada a un absceso pulmonar. Presentación de un caso

OpenAIRE

López Rodríguez, Vania Julexis; Garcías Rodríguez, Marisel; Gómez Martínez, Ana Iris; Díaz Gonzáles, Gabriela

2015-01-01

Fundamento: A pesar, de que hay reportes de casos en la literatura internacional, que asocian la enfermedad periodontal con enfermedades respiratorias y medidas para la prevención de la enfermedad periodontal inflamatoria, sino se establece un adecuado manejo de esta última, puede evolucionar con una complicación sistémica como es el absceso pulmonar. Objetivo: Ilustrar cómo la enfermedad periodontal inflamatoria puede asociarse a un absceso pulmonar como complicación sistémica en su evolució...

El desafío de la gestión de las enfermedades profesionales: solvitas perambulum

Directory of Open Access Journals (Sweden)

Clara Guillén Subirán

2014-01-01

Full Text Available Los cambios que tienen lugar en el entorno laboral repercuten en la naturaleza de las enfermedades profesionales planteando cada vez más desafíos. Este artículo se centra en ellos: el concepto enfermedad profesional tiene un carácter legal y no médico, las nuevas patologías y las enfermedades emergentes, las enfermedades profesionales con largos periodos de latencia, las posibles causas de las enfermedades profesionales que son incluso más complejas que la definición, porque, en muchos casos, los factores relacionados con el trabajo aumentan el riesgo de sufrir una enfermedad junto con otros factores extralaborales. Es precisamente esta compleja multicasualidad de las enfermedades profesionales la que no solo dificulta su reconocimiento y registro sino también su prevención y aseguramiento. En definitiva, se deberían desarrollar algunos métodos y realizar prácticas adecuadas para proponer estrategias,que respondan a estos retos: aseguramiento de una notificación fiable y motivación para que se notifique, fortalecimiento de la calidad del diagnóstico, seguimiento de los trabajadores expuestos, revisión y actualización de las listas de enfermedades profesionales y promoción de la prevención de las enfermedades profesionales.

LA TERAPIA DE REMPLAZO ENZIMÁTICO ENZIMÁTICO TRATAMIENTO ENFERMEDADES EN EL TRATAMIENTO DE ENFERMEDADES GENÉTICAS

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Homero Sáenz

2003-12-01

Full Text Available La terapia de remplazo enzimático (TRE, consiste en suministrarle a un paciente una proteína exógena, que en su organismo está siendo sintetizada anormalmente. La proteína puede provenir de tejidos y fluidos humanos, ser sintetizada en bacterias, células de mamífero o levaduras, a las cuales se les ha introducido el gen correspondiente. Actualmente son tratadas con TRE las enfermedades de Gaucher, Fabry y la inmunodeficiencia humana combinada. Además existen avanzados estudios en las enfermedades de Hurler, Hunter, Pompe, Niemann-Pick tipo B, Morquio A, angioderma hereditario y pénfigo vulgar. Una de las limitantes de la TRE ha sido sus altos costos, debido al relativamente pequeño número de pacientes que se tratan a nivel mundial y a que el sistema usado hasta ahora, es decir, la expresión en células de mamífero, requiere procedimientos muy costosos. La expresión en bacterias o levaduras sería mucho más barato, pero las primeras no expresan proteínas glicosiladas que constituyen el 91% del total de proteínas y la mayoría de las levaduras tienen sistemas de glicosilación, distintos a los de mamíferos.Sin embargo, Pichia pastoris y Hansenula polymorpha parecen producir proteínas muy similares a las humanas, con lo cual se evitan los problemas de rechazo por parte del organismo humano. En el Instituto de Errores Innatos del Metabolismo (IEIM de la Pontificia Universidad Javeriana se adelantan estudios conducentes a la implementación de un sistema de expresión de proteínas recombinantes en levaduras para uso clínico en enfermedades lisosomales como los síndromes de Hunter y Morquio A. Este modelo, si funciona a cabalidad, podría emplearse para la mayoría de las enfermedades lisosomales (42 en total y para otros errores innatos del metabolismo.

Enfermedad de Pompe de inicio temprano. A propósito de un caso

OpenAIRE

Grandez-Urbina, J. Antonio; Bustamante-Ubillus, Claudio; Farro-Calderon, Rossy; Linares-Alarcon, Ismael; Goyzueta-Knox, Silvana

2013-01-01

La enfermedad de Pompe es una enfermedad inusual de presentación temprana, causada por el déficit de la síntesis de α 1-4 glucosidasa ácida. Presentamos un caso de inicio insidioso descompensado evidenciándose dificultad respiratoria y cardiomiopatía. La enfermedad de Pompe es muy infrecuente, siendo el primer caso reportado en nuestro medio.

Palabras impertinentes. Contra el concepto de enfermedad mental.

OpenAIRE

Yolanda Gómez Fontanil; Esteban Coto Ezama

1986-01-01

Señalamos la existencia ineludible de un aspecto organizacional en toda situación, persistente e indeseable, etiquetada como de «enfermedad mental». Ese aspecto es traducible en un hacer discursivo de un colectivo de personas. Denunciamos el carácter metafórico del término «enfermedad mental» que atenúa, pero también perpetúa, la convención social de la locura: una estrategia socialmente destructora para resolver y ganar conflictos sin reconocerlos. Encontramos un campo no metafórico para la ...

Outcome after surgical treatment for lumbar spinal stenosis: the lumbar extension test is not a predictive factor

DEFF Research Database (Denmark)

Westergaard, Lars; Hauerberg, John; Springborg, Jacob B

2009-01-01

STUDY DESIGN: A prospective clinical study. OBJECTIVES: To investigate the predictive value of the lumbar extension test for outcome after surgical treatment of lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: Studies have indicated that aggravation of the symptoms from LSS by extension...... of the lumbar spine has predictive value for the outcome after decompression. The aim of this study was to investigate this theory in a larger group of patients. METHODS: One hundred forty-six consecutive patients surgically treated for LSS were included in the study. The clinical condition was recorded before...... has no predictive value for the outcome after surgical treatment of LSS....

Interventional Radiology Management of a Ruptured Lumbar Artery Pseudoaneurysm after Cryoablation and Vertebroplasty of a Lumbar Metastasis

Energy Technology Data Exchange (ETDEWEB)

Giordano, Aldo Victor; Arrigoni, Francesco, E-mail: arrigoni.francesco@gmail.com [Ospedale San Salvatore, Department of Radiology (Italy); Bruno, Federico [University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences (Italy); Carducci, Sergio; Varrassi, Marco; Zugaro, Luigi [Ospedale San Salvatore, Department of Radiology (Italy); Barile, Antonio; Masciocchi, Carlo [University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences (Italy)

2017-05-15

We describe the management of a complication (a lumbar artery pseudoaneurysm and its rupture) after combined procedure (cryoablation and vertebroplasty) on a lumbar (L2) metastasis from renal cell carcinoma. Review of the literature is also presented with discussion about the measures to be taken to prevent these types of complications.

ISASS Policy Statement – Lumbar Artificial Disc

Science.gov (United States)

Garcia, Rolando

2015-01-01

Purpose The primary goal of this Policy Statement is to educate patients, physicians, medical providers, reviewers, adjustors, case managers, insurers, and all others involved or affected by insurance coverage decisions regarding lumbar disc replacement surgery. Procedures This Policy Statement was developed by a panel of physicians selected by the Board of Directors of ISASS for their expertise and experience with lumbar TDR. The panel's recommendation was entirely based on the best evidence-based scientific research available regarding the safety and effectiveness of lumbar TDR. PMID:25785243

Gonadal dose reduction in lumbar spine radiography

International Nuclear Information System (INIS)

Moilanen, A.; Kokko, M.L.; Pitkaenen, M.

1983-01-01

Different ways to minimize the gonadal dose in lumbar spine radiography have been studied. Two hundred and fifty lumbar spine radiographs were reviewed to assess the clinical need for lateral L5/S1 projection. Modern film/screen combinations and gonadal shielding of externally scattered radiation play a major role in the reduction of the genetic dose. The number of exposures should be minimized. Our results show that two projections, anteroposterior (AP) and lateral, appear to be sufficient in routine radiography of the lumbar spine. (orig.)

Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

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Koshi Ninomiya

2014-01-01

Full Text Available A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI showed a large L2/3 disc hernia descending to the L3/4 level. Compared to the initial MRI, this hernia occurred in an “intact” disc among multilevel severely degenerated discs. Right leg paresis and bladder dysfunction appeared a few days after admission. Microscopic lumbar disc herniotomy was performed. The right leg motor weakness improved just after the operation, but the moderate left leg motor weakness and difficulty in urination persisted.

General practitioners' willingness to request plain lumbar spine radiographic examinations

International Nuclear Information System (INIS)

Ryynaenen, Olli-Pekka; Lehtovirta, Jukka; Soimakallio, Seppo; Takala, Jorma

2001-01-01

Objectives: To examine general practitioners' attitudes to plain lumbar spine radiographic examinations. Design: A postal questionnaire consisting of questions on background data and doctors' opinions about plain lumbar spine radiographic examinations, as well as eight vignettes (imaginary patient cases) presenting indications for lumbar radiography, and five vignettes focusing on the doctors' willingness to request lumbar radiography on the basis of patients' age and duration of symptoms. The data were analysed according to the doctor's age, sex, workplace and the medical school of graduation. Setting: Finland. Subjects: Six hundred and fifteen randomly selected physicians working in primary health care (64% of original target group). Results: The vignettes revealed that the use of plain lumbar radiographic examination varied between 26 and 88%. Patient's age and radiation protection were the most prominent factors influencing doctors' decisions to request lumbar radiographies. Only slight differences were observed between the attitudes of male and female doctors, as well as between young and older doctors. Doctors' willingness to request lumbar radiographies increased with the patient's age in most vignettes. The duration of patients' symptoms had a dramatic effect on the doctor's decision: in all vignettes, doctors were more likely to request lumbar radiography when patient's symptoms had exceeded 4 weeks. Conclusions: General practitioners commonly use plain lumbar spine radiographic examinations, despite its limited value in the diagnosis of low back pain. Further consensus and medical education is needed to clarify the indications for plain lumbar radiographic examination

Enfermedad de Hirschsprung

OpenAIRE

K A Santos-Jasso

2017-01-01

Definición
La enfermedad de Hirschsprung, megacolon congénito o agangliónico, o Aganglionosis Intestinal Congénita, es una anomalía caracterizada por la ausencia congénita de células ganglionares del sistema parasimpático de los piejos intermientéricos de Auerbach, situado entre las capas musculares, circular y longitudinal, y el submucoso de Meissner; con conducción inefectiva del peristaltismo, ocasionando obstrucción funcional (24, 37, 65, 8...

con enfermedad crónica

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María del Refugio Zavala Rodríguez

2007-01-01

Full Text Available El propósito del estudio fue determinar el grado de correlación entre los niveles de fortaleza para la salud y de ansiedad-rasgo, en unamuestra de 200 pacientes integrada por medio de muestreo no probabilístico; los criterios de inclusión fueron: adultos de ambos génerosdiagnosticados con enfermedad crónica, con estudios de enseñanza básica y orientada. El marco teórico que guió la investigación es elModelo de Adaptación de Roy. El diseño fue descriptivo, transversal, correlacional. Se utilizó el cuestionario de fortaleza de S. Pollock y laescala de autoevaluación de ansiedad-rasgo de Spielberger; los instrumentos presentaron una consistencia interna aceptable con unAlpha de Cronbach de ,852 y ,813 respectivamente. La información se recabó de cuatro instituciones de salud ubicadas en los municipiosde Tampico-Cd. Madero Tamaulipas, México. El análisis de los datos se efectuó mediante estadística descriptiva e inferencial, se utilizó elpaquete estadístico SPSS versión 13. El rango de edad que predominó fue de 45 a 64 años (54%; el 55% fue del sexo femenino, el 48%cuenta con estudios de primaria, cerca del 90% padece de una enfermedad metabólica. El coeficiente de correlación de Spearman entrela fortaleza para la salud y la ansiedad-rasgo fue significativo (Œ,570, valor Œp,000. En la mayoría de la población participante se encontróun nivel moderado tanto de fortaleza (83% como de ansiedad (73%. El análisis de regresión múltiple indicó que la relación significativaentre estas dos variables no es afectada por la edad, el género o los años de evolución de la enfermedad crónica. Los datos de este estudiomuestran evidencia de que en los pacientes con enfermedades crónicas a mayor nivel de fortaleza menor nivel de ansiedad-rasgo. Estasituación invita a desarrollar más estudios de estos fenómenos, en la disciplina de enfermería, que sirvan como sustento teórico-prácticopara el diseño o la mejora de

Tractography of lumbar nerve roots: initial results

Energy Technology Data Exchange (ETDEWEB)

Balbi, Vincent; Budzik, Jean-Francois; Thuc, Vianney le; Cotten, Anne [Hopital Roger Salengro, Service de Radiologie et d' Imagerie musculo-squelettique, Lille Cedex (France); Duhamel, Alain [Universite de Lille 2, UDSL, Lille (France); Bera-Louville, Anne [Service de Rhumatologie, Hopital Roger Salengro, Lille (France)

2011-06-15

The aims of this preliminary study were to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and fibre tracking (FT) of the lumbar nerve roots, and to assess potential differences in the DTI parameters of the lumbar nerves between healthy volunteers and patients suffering from disc herniation. Nineteen patients with unilateral sciatica related to posterolateral or foraminal disc herniation and 19 healthy volunteers were enrolled in this study. DTI with tractography of the L5 or S1 nerves was performed. Mean fractional anisotropy (FA) and mean diffusivity (MD) values were calculated from tractography images. FA and MD values could be obtained from DTI-FT images in all controls and patients. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (p=0.0001) and of the nerve roots of volunteers (p=0.0001). MD was significantly higher in compressed nerve roots than in the contralateral nerve root (p=0.0002) and in the nerve roots of volunteers (p=0.04). DTI with tractography of the lumbar nerves is possible. Significant changes in diffusion parameters were found in the compressed lumbar nerves. (orig.)

Tractography of lumbar nerve roots: initial results

International Nuclear Information System (INIS)

Balbi, Vincent; Budzik, Jean-Francois; Thuc, Vianney le; Cotten, Anne; Duhamel, Alain; Bera-Louville, Anne

2011-01-01

The aims of this preliminary study were to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and fibre tracking (FT) of the lumbar nerve roots, and to assess potential differences in the DTI parameters of the lumbar nerves between healthy volunteers and patients suffering from disc herniation. Nineteen patients with unilateral sciatica related to posterolateral or foraminal disc herniation and 19 healthy volunteers were enrolled in this study. DTI with tractography of the L5 or S1 nerves was performed. Mean fractional anisotropy (FA) and mean diffusivity (MD) values were calculated from tractography images. FA and MD values could be obtained from DTI-FT images in all controls and patients. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (p=0.0001) and of the nerve roots of volunteers (p=0.0001). MD was significantly higher in compressed nerve roots than in the contralateral nerve root (p=0.0002) and in the nerve roots of volunteers (p=0.04). DTI with tractography of the lumbar nerves is possible. Significant changes in diffusion parameters were found in the compressed lumbar nerves. (orig.)

El concepto general de enfermedad: revisión, crítica y propuesta Tercera parte: un modelo teórico de enfermedad

Directory of Open Access Journals (Sweden)

Adolfo Peña

2003-03-01

Full Text Available Se plantea el concepto de enfermedad como modelo teórico, es decir, como una representación conceptual esquemática, la cual representará la enfermedad en términos teóricos de alto grado de abstracción. Nos serviremos de conceptos matemáticos tales como los de conjunto y función, y de teorías muy generales, como la teoría general de sistemas y el materialismo emergentista.

Enfermedad de Pompe de inicio temprano: A propósito de un caso

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J. Antonio Grandez-Urbina

2013-10-01

Full Text Available La enfermedad de Pompe es una enfermedad inusual de presentación temprana, causada por el déficit de la síntesis de α 1-4 glucosidasa ácida. Presentamos un caso de inicio insidioso descompensado evidenciándose dificultad respiratoria y cardiomiopatía. La enfermedad de Pompe es muy infrecuente, siendo el primer caso reportado en nuestro medio.

Side effects after lumbar iohexol myelography

International Nuclear Information System (INIS)

Sand, T.; Stovner, L.J.; Myhr, G.; Dale, L.G.

1990-01-01

Side effects of iohexol lumbar myelography have been analyzed with respect to the influence of the type of radiological abnormality, sex and age in a group of 200 patients. Headache, postural headache, nausea and back/leg pain were significantly more frequent in patients without definite radiological abnormalities. Postural headache, nausea, dizziness and mental symptoms were more frequent in women, while headache, postural headache, nausea, dizziness, minor mental symptoms (i.e. anxiety or depression) and pain became less frequent with age. This pattern is similar to that reported after lumbar puncture. Young women without definite clinical signs of nerve root lesions probably have the greatest risk of experiencing side effects after iohexol lumbar myelography. (orig.)

ASSOCIATION OF SPINOPELVIC PARAMETERS WITH THE LOCATION OF LUMBAR DISC HERNIATION

OpenAIRE

Léo, Jefferson Coelho de; Léo, Álvaro Coelho de; Cardoso, Igor Machado; Jacob Júnior, Charbel; Batista Júnior, José Lucas

2015-01-01

Objective:To associate spinopelvic parameters, pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with the axial location of lumbar disc herniation.Methods:Retrospective study, which evaluated imaging and medical records of 61 patients with lumbar disc herniation, who underwent surgery with decompression and instrumented lumbar fusion in only one level. Pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with simple lumbopelvic lateral radiographs, which included the ...

Comparison of erector spinae and hamstring muscle activities and lumbar motion during standing knee flexion in subjects with and without lumbar extension rotation syndrome.

Science.gov (United States)

Kim, Si-hyun; Kwon, Oh-yun; Park, Kyue-nam; Kim, Moon-Hwan

2013-12-01

The aim of this study was to compare the activity of the erector spinae (ES) and hamstring muscles and the amount and onset of lumbar motion during standing knee flexion between individuals with and without lumbar extension rotation syndrome. Sixteen subjects with lumbar extension rotation syndrome (10 males, 6 females) and 14 healthy subjects (8 males, 6 females) participated in this study. During the standing knee flexion, surface electromyography (EMG) was used to measure muscle activity, and surface EMG electrodes were attached to both the ES and hamstring (medial and lateral) muscles. A three-dimensional motion analysis system was used to measure kinematic data of the lumbar spine. An independent-t test was conducted for the statistical analysis. The group suffering from lumbar extension rotation syndrome exhibited asymmetric muscle activation of the ES and decreased hamstring activity. Additionally, the group with lumbar extension rotation syndrome showed greater and earlier lumbar extension and rotation during standing knee flexion compared to the control group. These data suggest that asymmetric ES muscle activation and a greater amount of and earlier lumbar motion in the sagittal and transverse plane during standing knee flexion may be an important factor contributing to low back pain. Copyright © 2013 Elsevier Ltd. All rights reserved.

Representación de la Enfermedad, Afrontamiento y Ajuste en los Trastornos Alimentarios

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Yolanda Quiles Marcos

2009-01-01

Full Text Available El objetivo de esta investigación es evaluar la representación de la enfermedad en pacientes con un trastorno alimentario (TA, así como su relación con el afrontamiento y el ajuste, utilizando como marco teórico el Modelo del Sentido Común de Leventhal. Método: Participaron 98 mujeres diagnosticadas de un TA. La media de edad fue 20.8 años (dt=5.61. Para evaluar la representación de la enfermedad se administró la adaptación española para los TA del Cuestionario de Percepción de la Enfermedad Revisado (IPQ-R. Resultados: Respecto a la identidad, los síntomas más señalados fueron la "pérdida de peso" (89.8% y las "alteraciones en la menstruación" (81.6%. Consideran que su enfermedad tiene una larga duración y serias consecuencias, así como que tienen control y siguiendo un tratamiento es posible su curación. El 21% de la varianza de las estrategias evitativas fue explicado por diferentes dimensiones de la representación de la enfermedad. Se confirman los efectos directos de la representación de la enfermedad sobre el ajuste, pero no los del afrontamiento. Conclusiones: Los resultados apoyan la necesidad de intervenir sobre las creencias que tienen estas pacientes sobre su enfermedad con el fin de mejorar su ajuste psicosocial.

High-Force Versus Low-Force Lumbar Traction in Acute Lumbar Sciatica Due to Disc Herniation: A Preliminary Randomized Trial.

Science.gov (United States)

Isner-Horobeti, Marie-Eve; Dufour, Stéphane Pascal; Schaeffer, Michael; Sauleau, Erik; Vautravers, Philippe; Lecocq, Jehan; Dupeyron, Arnaud

This study compared the effects of high-force versus low-force lumbar traction in the treatment of acute lumbar sciatica secondary to disc herniation. A randomized double blind trial was performed, and 17 subjects with acute lumbar sciatica secondary to disc herniation were assigned to high-force traction at 50% body weight (BW; LT50, n = 8) or low force traction at 10% BW (LT10, n = 9) for 10 sessions in 2 weeks. Radicular pain (visual analogue scale [VAS]), lumbo-pelvic-hip complex motion (finger-to-toe test), lumbar-spine mobility (Schöber-Macrae test), nerve root compression (straight-leg-raising test), disability (EIFEL score), drug consumption, and overall evaluation of each patient were measured at days 0, 7, 1, 4, and 28. Significant (P sciatica secondary to disc herniation who received 2 weeks of lumbar traction reported reduced radicular pain and functional impairment and improved well-being regardless of the traction force group to which they were assigned. The effects of the traction treatment were independent of the initial level of medication and appeared to be maintained at the 2-week follow-up. Copyright © 2016. Published by Elsevier Inc.

Método de diagnóstico y/o pronóstico de enfermedades neurodegenerativas

OpenAIRE

Trullás Oliva, Ramón; Figueiro-Silva, Joana; Mihaylovich Podlesniy, Petar

2012-01-01

La presente invención se refiere al uso del ADN mitocondrial como biomarcador cuantitativo de enfermedades neurodegenerativas, preferiblemente de la enfermedad de Alzheimer, así como a un método y a un kit diagnóstico y/o pronóstico de dichas enfermedades mediante el uso de dicho biomarcador

Therapeutic efficacy of hydro-kinesiotherapy Programs in lumbar spondylosis

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Ana-Maria BOTEZAN

2015-12-01

Full Text Available Lumbar spondylarthrosis is a degenerative disease that affects the joint structures of the lumbar spine. In the course of time, numerous studies on the role of hydro-kinesiotherapy in the treatment of lumbar spondylosis have been conducted. The aim of this research is motivated by the significantly high number of patients with chronic pain in the lumbar spine due to lumbar spondylosis, as well as by the negative impact on their quality of life through the impairment of the activities of daily living. The prospective longitudinal study was carried out at the Clinical Rehabilitation Hospital Cluj-Napoca. The study included 35 patients with chronic low back pain and mobility limitation in the lumbar spine. The patients were assigned to two groups: the study group formed by 20 patients and the control group consisting of 15 patients aged between 40-70 years. The treatment of the patients included in the study was performed over a two week period and consisted of a hydro-kinesiotherapy program, for the patients of the study group, the duration of a treatment session being 40 minutes. Both the subjects of the study group and of the control group also benefited from sedative massage of the lumbosacral spine, kinesiotherapy, laser therapy of the lumbar spine. The patients were evaluated using Schober’s test, the Visual Analogue Scale, the Oswestry index. These evaluation methods were applied to the patients of both groups at the beginning of the rehabilitation programs and after two weeks. The results of the study demonstrated the therapeutic efficacy of the medical rehabilitation programs that included hydro-kinesiotherapy programs. The patients of both groups had improvements through a decrease of lumbar pain, an increase in lumbar spine mobility, as well as in the patients’ ability to organize themselves in the activities of daily living. However, the patients of the study group, with a hydro-kinesiotherapy program performed for two weeks, had

New physical examination tests for lumbar spondylolisthesis and instability: low midline sill sign and interspinous gap change during lumbar flexion-extension motion.

Science.gov (United States)

Ahn, Kang; Jhun, Hyung-Joon

2015-04-22

Lumbar spondylolisthesis (LS) and lumbar instability (LI) are common disorders in patients with low back or lumbar radicular pain. However, few physical examination tests for LS and LI have been reported. In the study described herein, new physical examination tests for LS and LI were devised and evaluated for their validity. The test for LS was designated "low midline sill sign", and that for LI was designated "interspinous gap change" during lumbar flexion-extension motion. The validity of the low midline sill sign was evaluated in 96 patients with low back or lumbar radicular pain. Validity of the interspinous gap change during lumbar flexion-extension motion was evaluated in 73 patients with low back or lumbar radicular pain. The sensitivity, specificity, and positive and negative predictive values of the two tests were also investigated. The sensitivity and specificity of the low midline sill sign for LS were 81.3% and 89.1%, respectively. Positive and negative predictive values of the test were 78.8% and 90.5%, respectively. The sensitivity and specificity of the interspinous gap change test for LI were 82.2% and 60.7%, respectively. Positive and negative predictive values of the test were 77.1% and 68.0%, respectively. The low midline sill sign and interspinous gap change tests are effective for the detection of LS and LI, and can be performed easily in an outpatient setting.

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis

OpenAIRE

Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Zhang, Yupeng; Liu, Zheng

2015-01-01

Objective: The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.Methods: Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reco...

Método de diagnóstico y/o pronóstico de enfermedades neurodegenerativas

OpenAIRE

Trullás Oliva, Ramón; Figueiro-Silva, Joana; Mihaylovich Podlesniy, Petar

2012-01-01

[ES] La presente invención se refiere al uso del ADN mitocondrial como biomarcador cuantitativo de enfermedades neurodegenerativas, preferiblemente de la enfermedad de Alzheimer, así como a un método y a un kit diagnóstico y/o pronóstico de dichas enfermedades mediante el uso de dicho biomarcador

Intervertebral Fusion with Mobile Microendoscopic Discectomy for Lumbar Degenerative Disc Disease.

Science.gov (United States)

Xu, Bao-Shan; Liu, Yue; Xu, Hai-Wei; Yang, Qiang; Ma, Xin-Long; Hu, Yong-Cheng

2016-05-01

The aim of this article is to introduce a technique for lumbar intervertebral fusion that incorporates mobile microendoscopic discectomy (MMED) for lumbar degenerative disc disease. Minimally invasive transforaminal lumbar interbody fusion is frequently performed to treat degenerative diseases of the lumbar spine; however, the scope of such surgery and vision is limited by what the naked eye can see through the expanding channel system. To expand the visual scope and reduce trauma, we perform lumbar intervertebral fusion with the aid of a MMED system that provides a wide field through freely tilting the surgical instrument and canals. We believe that this technique is a good option for treating lumbar degenerative disc disease that requires lumbar intervertebral fusion. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

OpenAIRE

Lee, Su-Keon; Lee, Seung-Hwan; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

2016-01-01

Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondyloli...

Contribución Colombiana al Conocimiento de la Enfermedad de Morquio A

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Carlos Javier Alméciga Díaz

2012-07-01

Full Text Available La enfermedad de Morquio A o Mucopolisacaridosis IV A es un trastorno de depósito lisosomal producidapor alteración en la actividad de la enzima N-acetilgalactosamina-6-sulfato sulfatasa (GALNS encargada de la degradación de queratán y condroitin-6- sulfato. La enfermedad se caracteriza por alteraciones óseas, cardiacas y pulmonares. Aunque esta enfermedad es rara, algunos trabajos sugieren que Colombia puede ser uno de los países con mayor número de pacientes. En el presente artículo se revisará el estado actual de la enfermedad de Morquio A, haciendo especial énfasis en los aportes realizados por investigadores colombianos para su avance. Progresos importantes se han realizado en el desarrollo de nuevas técnicas de diagnóstico, modelos animales, terapia de reemplazo enzimático y terapia génica. En este último aspecto, el Instituto de Errores Innatos del Metabolismoha jugado un papel importante en el diseño y evaluación de vectores derivados de virus adenoasociados, para el desarrollo de una estrategia de terapia génica para la enfermedad de Morquio A.

The top 100 classic papers in lumbar spine surgery.

Science.gov (United States)

Steinberger, Jeremy; Skovrlj, Branko; Caridi, John M; Cho, Samuel K

2015-05-15

Bibliometric review of the literature. To analyze and quantify the most frequently cited papers in lumbar spine surgery and to measure their impact on the entire lumbar spine literature. Lumbar spine surgery is a dynamic and complex field. Basic science and clinical research remain paramount in understanding and advancing the field. While new literature is published at increasing rates, few studies make long-lasting impacts. The Thomson Reuters Web of Knowledge was searched for citations of all papers relevant to lumbar spine surgery. The number of citations, authorship, year of publication, journal of publication, country of publication, and institution were recorded for each paper. The most cited paper was found to be the classic paper from 1990 by Boden et al that described magnetic resonance imaging findings in individuals without back pain, sciatica, and neurogenic claudication showing that spinal stenosis and herniated discs can be incidentally found when scanning patients. The second most cited study similarly showed that asymptomatic patients who underwent lumbar spine magnetic resonance imaging frequently had lumbar pathology. The third most cited paper was the 2000 publication of Fairbank and Pynsent reviewing the Oswestry Disability Index, the outcome-measure questionnaire most commonly used to evaluate low back pain. The majority of the papers originate in the United States (n=58), and most were published in Spine (n=63). Most papers were published in the 1990s (n=49), and the 3 most common topics were low back pain, biomechanics, and disc degeneration. This report identifies the top 100 papers in lumbar spine surgery and acknowledges those individuals who have contributed the most to the advancement of the study of the lumbar spine and the body of knowledge used to guide evidence-based clinical decision making in lumbar spine surgery today. 3.

Single photon emission computed tomography in lumbar degenerative spondylolisthesis

International Nuclear Information System (INIS)

Ito, S.; Muro, T.; Eisenstein, S.

1998-01-01

Analysis of single photon emission computed tomographic images and plain X-ray films of the lumbar vertebrae was performed in 15 patients with lumbar spondylosis and 15 patients with lumbar degenerative spondylolisthesis. The facet joint and osteophyte images were observed in particular, and the slipping ratio of spondylolisthetic vertebrae was determined. The slipping ratio of degenerative spondylolisthesis ranged from 11.8 % to 22.3 %. Hot uptake of 99mTc-HMDP by both L4-5 facet joints was significantly greater in the patients with degenerative spondylolisthesis than in those with lumbar spondylosis. The hot uptake by the osteophytes in lumbar spondylosis was nearly uniform among the three inferior segments, L3-4, L4-5 and L5-S, but was localized to the spondylolisthetic vertebrae, L4-5, or L5-S, in the patients with spondylolisthesis. Half of the osteophytes with hot uptake were assigned to the 3rd degree of Nathan's grading. It was suggested that stress was localized to the slipping vertebrae and their facet joints in patients with lumbar degenerative spondylolisthesis. (author)

Optimizing Residents' Performance of Lumbar Puncture

DEFF Research Database (Denmark)

Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle

2018-01-01

Background: Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given...... to whether the design of the videos impacts on subsequent performance. Objective: To investigate the effect of different preparatory interventions on learner performance and self-confidence regarding lumbar puncture (LP). Design: Randomized controlled trial in which participants were randomly assigned to one...... of three interventions as preparation for performing lumbar puncture: 1) goal- and learner-centered video (GLV) presenting procedure-specific process goals and learner-centered information; 2) traditional video (TV) providing expert-driven content, but no process goals; and 3) written text (WT...

La enfermedad periodontal como riesgo de enfermedades sistémicas The periodontal disease as a risk for systemic diseases

Directory of Open Access Journals (Sweden)

Maritza Peña Sisto

2008-03-01

Full Text Available Se realizó una revisión bibliográfica exhaustiva acerca de la presencia de enfermedad periodontal como factor de riesgo asociado con diversas enfermedades sistémicas. Algunos autores han propuesto el nacimiento de la medicina periodontal, como nueva disciplina, para explicar estas asociaciones. Las evidencias que emergieron en el último decenio arrojaron luz sobre el lado inverso de la relación entre salud general y salud bucal, o sea, los efectos potenciales de la enfermedad periodontal sobre una amplia variedad de sistemas de órganos. En los últimos años han surgido numerosos informes basados en estudios epidemiológicos en los que las infecciones buco-dentales se asocian con enfermedades sistémicas, entre ellas alteraciones cerebrovasculares, respiratorias, diabetes mellitus y resultados adversos del embarazo, debido a los lipopolisacáridos, las bacterias gramnegativas viables del biofilm y citoquinas proinflamatorias que pueden ingresar al torrente sanguíneo e influir en la salud general y susceptibilidad a ciertas enfermedades. Se reúnen los modelos de interacción y mecanismos propuestos, además de evidencias que sustentan las teorías proclamadas, prestando especial interés a la causalidad entre ambos procesos.An exhaustive bibliographic review of the presence of the periodontal disease as a risk factor associated with diverse systemic diseases was made. Some authors have proposed the emergence of periodontal medicine as a new discipline to explain these associations. The evidences that appeared in the last decade shed light on the opposite side of the relation between general health and oral health, that is, the potential effects of the periodontal diseases on a wide range of organ systems. In the last years, several reports have been based on epidemiological studies in which the oro-dental diseases are associated with systemic diseases, such as cerebrovascular and respiratory disorders, diabetes mellitus and adverse

Terapia génica de la enfermedad de Stargardt

OpenAIRE

Martín Nieto, José

2015-01-01

El gen humano ABCA4 (=ABCR) se caracterizó en 1997 como el principal causante de la enfermedad de Stargardt, una distrofia macular hereditaria generalmente autosómica recesiva. Poco tiempo después se encontraron otras enfermedades asociadas a mutaciones en este gen, como son distrofia de conos y bastones, determinados casos de retinosis pigmentaria y un aumento de la susceptibilidad a la degeneración macular asociada a la edad. No existen tratamientos curativos para ninguna de estas distrofia...

Enfermedad de pompe: presentación de un caso

OpenAIRE

Azrak, M. Angeles; Fernández, Zulma; Peruffo, M.Virginia; Specola, Norma; Nuñez, M.; Pardo, A.

2009-01-01

Presentamos el caso de una niña de 6 meses de ascendencia china con enfermedad de Pompe diagnosticada a partir de una miocardiopatía hipertrófica biventricular e hipotonía global. En esta enfermedad el acúmulo de glucógeno lisosomal principalmente en el corazón y músculo esquelético ocasiona la mayoría de la sintomatología clínica. En esta paciente la hipotonía generalizada, macroglosia, debil...

El rol del fisioterapeuta en el manejo de la Enfermedad de Pompe

OpenAIRE

Rocío del Pilar Ruiz Agudelo; Laura Lorena Alba; Rosmary Martínez-Rueda

2015-01-01

Antecedentes: La enfermedad de Pompe está catalogada dentro del grupo de enfermedades huérfanas.  A pesar de existir tratamiento, quienes la padecen pueden sufrir secuelas relacionadas con la misma, en parte por la dificultad de un diagnóstico temprano y adecuado de la patología. Objetivo: Describir las diferentes alternativas de tratamiento fisioterapéutico para la enfermedad de Pompe. Metodología: Se realizó una revisión bibliométrica. Se consultaron en bases de datos y portales científicos...

Axial loaded MRI of the lumbar spine

Energy Technology Data Exchange (ETDEWEB)

Saifuddin, A. E-mail: asaifuddin@aol.com; Blease, S.; MacSweeney, E

2003-09-01

Magnetic resonance imaging is established as the technique of choice for assessment of degenerative disorders of the lumbar spine. However, it is routinely performed with the patient supine and the hips and knees flexed. The absence of axial loading and lumbar extension results in a maximization of spinal canal dimensions, which may in some cases, result in failure to demonstrate nerve root compression. Attempts have been made to image the lumbar spine in a more physiological state, either by imaging with flexion-extension, in the erect position or by using axial loading. This article reviews the literature relating to the above techniques.

Lumbar supports for prevention and treatment of low back pain

DEFF Research Database (Denmark)

Van Tulder, M W; Jellema, P; van Poppel, M N

2000-01-01

BACKGROUND: Lumbar supports are used in the treatment of low back pain patients to make the impairment and disability vanish or decrease. Lumbar supports are also used to prevent the onset of low back pain (primary prevention) or to prevent recurrences of a low back pain episode (secondary...... 1999, and the Embase database up to September 1998. We also screened references given in relevant reviews and identified controlled trials, and used Science Citation Index to identify additional controlled trials. SELECTION CRITERIA: Controlled clinical trials that reported on any type of lumbar...... types of treatment or no intervention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, while it is still unclear if lumbar...

Magnetic Resonance Imaging (MRI): Lumbar Spine (For Parents)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Magnetic Resonance Imaging (MRI): Lumbar Spine KidsHealth / For Parents / Magnetic Resonance Imaging (MRI): Lumbar Spine What's in this article? ...

Tuberculosis, una Enfermedad de Ayer, de Hoy y del Futuro

Directory of Open Access Journals (Sweden)

Rafael Vargas

2013-09-01

Full Text Available La tuberculosis es una enfermedad tan antigua como la humanidad. A pesar de los avances en el conocimiento de su fisiopatología y en el desarrollo de medicamentos antituberculosos, todavía es una enfermedad común que afecta a una gran proporción de la población mundial. En los últimos años han aumentado los problemas relacionados con la morbi-mortalidad, lo cual se refleja en el incremento de la coinfección con VIH, el aumento de casos de neurotuberculosis y la mayor mortalidad en pacientes con tuberculosis. En el presente artículo se presenta una revisión de aspectos microbiológicos, epidemiológicos y clínico-terapéuticos de la enfermedad.

[Quality of life of neurological patients during therapy and rehabilitation].

Science.gov (United States)

Musaev, A V; Guseĭnova, S G; Imamverdieva, S S; Mustafaeva, E E; Musaeva, I R

2006-01-01

A total of 198 neurological patients on physiotherapeutic rehabilitation participated in a questionnaire survey on their quality of life. The patients had diabetic polyneuropathy (n = 86), disorders in spinal blood circulation (n = 65), 47 patients were operated for discal hernia of the lumbar spine. It was found that all the responders suffer from physical, psychological, emotional and social sequelae of their diseases which deteriorate their quality of life. The severity of this deterioration depends on the form and stage of the disease, motor and sensitive disturbances. Rehabilitation improved subjective response, social, psychological and emotional parameters. Thus, the proposed questionnaires proved valid for assessment of physiotherapy efficacy in neurological patients.

Treatment and outcome of herniated lumbar intervertebral disk in a ...

African Journals Online (AJOL)

The goal of treatment in cases of lumbar disk herniation is to return the patient to .... instability during surgery on the lumbar spine for the treatment of reherniation ... H. H. Failure within one year following subtotal lumbar discectomy. J Bone ...

LUMBAR LORDOSIS IN ASYMPTOMATICS SUBJECTS AND PATIENTS WITH CHRONIC LOW BACK PAIN

Directory of Open Access Journals (Sweden)

S.J MOUSAVI

2003-12-01

Full Text Available Introduction: The relationship between the degree of lumbar lordosis and chronic and purpose low back pain (LBP has long been speculated, but there is discrepancy in findings of previous researchers. The purpose of this of this study was to drtermin differences between lumbar lordosis in asymptomatic and LBP subjects. Matherials: Lumbar lordosis of 420 patients with chronic LBP and 420 asymptomatic subjects was measured by two examiner. A flexible ruler was used to measure lumbar lodosis in all subjects. Results: The averagr degree of lumbar lordosis for all subjects was 37±13°. Females had greater lumbar lordosis (42 ±15° than males (32±100 and elderly subjects had lesser lumbar lordosis than younger and middle aged subjects. Conclussoion: The degree of lumbar lordosis was not differet between normal subjects and those with LBP. It seems that effects of lumbar lordosis on LBP and treatment programs need to be reevaluated.

[A woman with a postoperative lumbar swelling].

Science.gov (United States)

Hulshof, Hanna M; Elsenburg, Patric H J M; Frequin, Stephan T F M

2013-01-01

A 65-year-old woman had developed a large lumbar swelling in a period of four weeks following lumbar laminectomy. An MRI-scan revealed a large fluid collection, which had formed from the spinal canal. The diagnosis 'liquorcele', a rare complication of spine surgery, was established.

Analysis of Patients with Myelopathy due to Benign Intradural Spinal Tumors with Concomitant Lumbar Degenerative Diseases Misdiagnosed and Erroneously Treated with Lumbar Surgery.

Science.gov (United States)

Lu, Kang; Wang, Hao-Kuang; Liliang, Po-Chou; Yang, Chih-Hui; Yen, Cheng-Yo; Tsai, Yu-Duan; Chen, Po-Yuan; Chye, Cien-Leong; Wang, Kuo-Wei; Liang, Cheng-Loong; Chen, Han-Jung

2017-09-01

When a cervical or thoracic benign intradural spinal tumor (BIST) coexists with lumbar degenerative diseases (LDD), diagnosis can be difficult. Symptoms of BIST-myelopathy can be mistaken as being related to LDD. Worse, an unnecessary lumbar surgery could be performed. This study was conducted to analyze cases in which an erroneous lumbar surgery was undertaken in the wake of failure to identify BIST-associated myelopathy. Cases were found in a hospital database. Patients who underwent surgery for LDD first and then another surgery for BIST removal within a short interval were studied. Issues investigated included why the BISTs were missed, how they were found later, and how the patients reacted to the unnecessary lumbar procedures. Over 10 years, 167 patients received both surgeries for LDD and a cervical or thoracic BIST. In 7 patients, lumbar surgery preceded tumor removal by a short interval. Mistakes shared by the physicians included failure to detect myelopathy and a BIST, and a hasty decision for lumbar surgery, which soon turned out to be futile. Although the BISTs were subsequently found and removed, 5 patients believed that the lumbar surgery was unnecessary, with 4 patients expressing regrets and 1 patient threatening to take legal action against the initial surgeon. Concomitant symptomatic LDD and BIST-associated myelopathy pose a diagnostic challenge. Spine specialists should refrain from reflexively linking leg symptoms and impaired ability to walk to LDD. Comprehensive patient evaluation is fundamental to avoid misdiagnosis and wrong lumbar surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Las enfermedades vasculares del clavel en Colombia y en el mundo

Directory of Open Access Journals (Sweden)

Arbeláez Torres Germán

1993-06-01

Full Text Available El clavel es atacado por un gran número de enfermedades
causadas por hongos, bacterias, nemátodos, virus y micoplasmas, las cuales se presentan afectando diferentes partes de la planta. Dentro de esas enfermedades, las más importantes son las enfermedades vasculares por las altas
perdidas que ocasionan, por la facilidad de propagación
a través de los esquejes, por su alta persistencia en el suelo y por el alto costo de algunas de las medidas de control utilizadas. Las enfermedades vasculares del clavel son ocasionadas por hongos y bacterias y, hasta el momento,
se han reconocido las siguientes: 1. Marchitamiento bacterial, causado por Pseudomonas caryophylli (Burkh Starr et Burkh. 2. Enanismo bacterial, causado por Erwinia chrysanthemi Burkh. pv. dianthicola. 3. Marchitamiento lento, causado por una raza del hongo Rhizoctonia solani Kuhn. 4. Marchitamiento vascular, causado por el hongo Phialophora cinerescens (wollenw van Beyma. 5. Marchitamiento vascular, causado por el hongo Fusarium oxysporum Schlecht f.sp. dianthi (Prill et Dei. Snyder et Hansen.

Diabetes mellitus en el paciente con enfermedad renal avanzada

OpenAIRE

R. Verner Codoceo, Dr.

2010-01-01

La diabetes mellitus 2 (DM 2) y la enfermedad renal crónica (ERC) son considerados problemas de salud pública a nivel mundial. Los pronósticos de ambas enfermedades están estrechamente relacionados, por lo que las acciones terapéuticas son complementarias. Un buen control glicémico revierte las alteraciones renales en sus etapas iniciales disminuyendo el deterioro microangiopático ya su vez el intento de obtener un control óptimo de glicemias requiere conocer y tratar las alteraciones provoca...

Magnetic resonance imaging of normal lumbar intervertebral discs

International Nuclear Information System (INIS)

Al-Hadidi, Maher T.; Badran, Darwish H.; Abu-Ghaida, Jamal H.; Al-Hadidi, A.

2001-01-01

Objective was to study changes in midpoint lumbar disc heights in an asymptomatic Jordanian sample relative to age, sex, lumbar level and midvertebral heights. A total of 153 asymptomatic patients (87 males, age range 20-65 years; mean 43+/-12.1 and 66 females, age range 22-68 years; mean 47+/-13.7) were selected during the study period. All underwent midsagittal magnetic resonance imaging to measure the midpoint disc height and midvertebral height of all lumbar spines. Values were statistically analyzed to obtain the significance of differences in the means of midpoint disc heights at different levels in every age group and among other age groups. The relative height indices for every lumbar level in each age group for both males and females were determined. The results showed that a highly significant sex-independent cephalocaudal increase sequence of midpoint disc heights is evident, where maximum values are reached at lumbar 3/4 level in the younger age groups and at lumbar 5/sacral 1 level in older ones. In relation to age, midpoint disc heights displayed a non-linear, alternating increase/decrease pattern, which was of higher magnitude and statistically significant in males, but less evident and statistically insignificant in females. Maximum values were reached during the 6th decade in males while during the 5th decade in females. The relative height indices were similar in both sexes and remained fairly constant between age groups at all levels. The craniocaudal and age-dependent patterns could be termed physiological and interpreted as adaptation of the lumbar spine to changing functional demands. The utility of the relative height index is discussed. (author)

49 CFR 572.85 - Lumbar spine flexure.

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine flexure. 572.85 Section 572.85... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.85 Lumbar spine flexure. (a) When subjected to continuously applied force in accordance with paragraph (b...

Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion--systematic review and meta-analysis.

Science.gov (United States)

Phan, Kevin; Thayaparan, Ganesha K; Mobbs, Ralph J

2015-01-01

To assess the clinical and radiographic outcomes and complications of anterior lumbar interbody fusion (ALIF) versus transforaminal lumbar interbody fusion (TLIF). A systematic literature search was conducted from six electronic databases. The relative risk and weighted mean difference (WMD) were used as statistical summary effect sizes. Fusion rates (88.6% vs. 91.9%, P = 0.23) and clinical outcomes were comparable between ALIF and TLIF. ALIF was associated with restoration of disk height (WMD, 2.71 mm, P = 0.01), segmental lordosis (WMD, 2.35, P = 0.03), and whole lumbar lordosis (WMD, 6.33, P = 0.03). ALIF was also associated with longer hospitalization (WMD, 1.8 days, P = 0.01), lower dural injury (0.4% vs. 3.8%, P = 0.05) but higher blood vessel injury (2.6% vs. 0%, P = 0.04). ALIF and TLIF appear to have similar success and clinical outcomes, with different complication profiles. ALIF may be associated with superior restoration of disk height and lordosis, but requires further validation in future studies.

Predictors of clinical outcome following lumbar disc surgery

DEFF Research Database (Denmark)

Hebert, Jeffrey J; Fritz, Julie; Koppenhaver, S.L.

2016-01-01

scheduled for first time, single-level lumbar discectomy. Participants underwent a standardized preoperative evaluation including real-time ultrasound imaging assessment of lumbar multifidus function, and an 8-week postoperative rehabilitation programme. Clinical outcome was defined by change in disability....... CONCLUSIONS: Information gleaned from the clinical history and physical examination helps to identify patients more likely to succeed with lumbar disc surgery. While this study helps to inform clinical practice, additional research confirming these results is required prior to confident clinical...

Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

Directory of Open Access Journals (Sweden)

Alberto Mendoza-Ticona

2012-06-01

Full Text Available Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto.There is enough evidence to declare tuberculosis as an occupational disease among healthcare workers. In Peru, there are regulations granting employment rights regarding tuberculosis as an occupational disease, such as healthcare coverage for temporary or permanent disability. However, these rights have not been sufficiently socialized. This study presents information on the risk of acquiring tuberculosis in the workplace, and a review of the evidence to declare tuberculosis as an occupational disease among health care workers, presenting the current Peruvian law related.

Pruebas diagnósticas en la enfermedad por reflujo gastroesofágico

OpenAIRE

Remes-Troche, José María

2013-01-01

En la actualidad la enfermedad por reflujo gastro esofágico (ERGE) no es una enfermedad simple y se tiene que considerar como una enfermedad heterogénea y multi-sintomática por lo que no hay una prueba estándar de oro. La decisión de que prueba utilizar, cuando utilizarla y cuál será su ganancia en el diagnóstico depende de varios factores. Para la evaluación estructural, la videoendoscopia se considera la prueba ideal ya que permite establecer la ausencia o presencia de erosiones y de compli...

Cardiopatías y enfermedades periodontales: ¿existen evidencias de asociación?

OpenAIRE

Jiménez Beato, Gema; Machuca Portillo, Guillermo

2005-01-01

Las enfermedades cardiovasculares representan una de las principales causas de muerte en las sociedades desarrolladas. Estas enfermedades no sólo son importantes por la mortalidad que generan, sino por la gran cantidad de individuos afectados y en tratamiento que han de soportar los sistemas de salud de los distintos países. De ahí que la detección precoz de los factores de riesgo conducentes a desencadenar estas enfermedades haya sido vista como el mecanismo más eficaz p...

Enfermedad inflamatoria intestinal y celiaquía : componente genético y farmacogenética

OpenAIRE

Medrano de Dios, Luz María

2014-01-01

La enfermedad inflamatoria intestinal (EII) y la enfermedad celiaca (ECe) son dos enfermedades mediadas por el sistema inmunológico con afectación intestinal crónica. En los últimos años los avances en los estudios genéticos (GWAS) han permitido identificar un amplio número de variantes asociadas a estas enfermedades (163 loci en EII y 40 en ECe). A pesar de ello, existe un porcentaje de heredabilidad aún por descubrir (“heredabilidad perdida”) en la que hemos centrado este trabajo. Comenzamo...

La enfermedad de Graves, signos y síntomas

OpenAIRE

Young, P.; Finn, B. C.; Bruetman, J. E.

2007-01-01

La enfermedad de Graves es la causa más común de hipertiroidismo, es de patogenia autoinmune. Se distingue clínicamente de otras formas de hipertiroidismo por la presencia de bocio difuso, oftalmopatía y ocasionalmente mixedema pretibial. En este artículo describimos la vida y obra de Robert Graves, realizando posteriormente una revisión de los signos y síntomas de la enfermedad. En el mundo de la medicina actual, en donde la tecnología juega un rol preponderante, queremos recordar la importa...

Atrofia muscular espinal tipo 1: enfermedad de Werdnig-Hoffmann

OpenAIRE

Zárate-Aspiros, Romeo; Rosas-Sumano, Ana Beatriz; Paz-Pacheco, Alberto; Fenton-Navarro, Patricia; Chinas-López, Silvet; López-Ríos, José Antonio

2013-01-01

Introducción. Las atrofias musculares espinales de la infancia son enfermedades neuromusculares hereditarias, autosómicas, recesivas, caracterizadas por la degeneración de las neuronas motoras del asta anterior de la médula espinal. La atrofia muscular espinal tipo I (enfermedad de Werdnig-Hoffmann) es la forma más severa. Se inicia in útero o durante los primeros meses de vida. La muerte suele ocurrir antes de los dos años de edad. Caso clínico. Lactante de 6 meses de edad que ingresa al Ser...

Leopoldo María Panero: enfermedad mental y literatura

OpenAIRE

Sánchez Bustos, Sergio Augusto

2012-01-01

Un estudio de la vida y obra del poeta Leopoldo María Panero, ha sido realizado, acentuando la búsqueda de caracterizaciones, textos, representaciones y su devenir biográfico de manera de configurar un discurso y una biografía de Leopoldo María Panero, enfatizando en sus textos la búsqueda de relaciones con la enfermedad mental. Mediante el estudio de la vida y obra del poeta se pretende contribuir a comprender sin prejuicios y críticamente los usos sociales del concepto de enfermedad mental ...

Morphometric study of the lumbar spinal canal in the Korean population.

Science.gov (United States)

Lee, H M; Kim, N H; Kim, H J; Chung, I H

1995-08-01

The anatomic dimensions of the vertebral body and spinal canal of the lumbar spine were analyzed in Koreans. To determine the normal dimension of the lumbar spinal canal in Koreans, to determine whether there are any racial differences in the morphometry of the lumbar spinal canal, and to provide criteria for diagnosing spinal stenosis in the Far Eastern Asian. Some radiologic and anatomic studies have been conducted regarding the size of the lumbar spinal canal of whites and blacks in western and African countries. One-thousand-eight-hundred measurements were performed on the transverse and sagittal diameters of vertebral bodies and spinal canals using complete sets of 90 lumbar vertebrae. The mean mid-sagittal diameter of the lumbar spinal canal in the Korean population was less than that measured in white and African populations, but there was no significant differences between the Korean, white, and African populations regarding the transverse diameter of the lumbar spinal canal. The mid-sagittal diameter of the lumbar spinal canal is narrowest in the Far Eastern Asian population; the radiologic criteria of spinal stenosis should be reconsidered for these people.

The role of cumulative physical work load in lumbar spine disease: risk factors for lumbar osteochondrosis and spondylosis associated with chronic complaints

OpenAIRE

Seidler, A; Bolm-Audorff, U; Heiskel, H; Henkel, N; Roth-Kuver, B; Kaiser, U; Bickeboller, R; Willingstorfer, W; Beck, W; Elsner, G

2001-01-01

OBJECTIVES—To investigate the relation with a case-control study between symptomatic osteochondrosis or spondylosis of the lumbar spine and cumulative occupational exposure to lifting or carrying and to working postures with extreme forward bending.
METHODS—From two practices and four clinics were recruited 229 male patients with radiographically confirmed osteochondrosis or spondylosis of the lumbar spine associated with chronic complaints. Of these 135 had additionally had acute lumbar disc...

Clinical tests to diagnose lumbar spondylolysis and spondylolisthesis: A systematic review.

Science.gov (United States)

Alqarni, Abdullah M; Schneiders, Anthony G; Cook, Chad E; Hendrick, Paul A

2015-08-01

The aim of this paper was to systematically review the diagnostic ability of clinical tests to detect lumbar spondylolysis and spondylolisthesis. A systematic literature search of six databases, with no language restrictions, from 1950 to 2014 was concluded on February 1, 2014. Clinical tests were required to be compared against imaging reference standards and report, or allow computation, of common diagnostic values. The systematic search yielded a total of 5164 articles with 57 retained for full-text examination, from which 4 met the full inclusion criteria for the review. Study heterogeneity precluded a meta-analysis of included studies. Fifteen different clinical tests were evaluated for their ability to diagnose lumbar spondylolisthesis and one test for its ability to diagnose lumbar spondylolysis. The one-legged hyperextension test demonstrated low to moderate sensitivity (50%-73%) and low specificity (17%-32%) to diagnose lumbar spondylolysis, while the lumbar spinous process palpation test was the optimal diagnostic test for lumbar spondylolisthesis; returning high specificity (87%-100%) and moderate to high sensitivity (60-88) values. Lumbar spondylolysis and spondylolisthesis are identifiable causes of LBP in athletes. There appears to be utility to lumbar spinous process palpation for the diagnosis of lumbar spondylolisthesis, however the one-legged hyperextension test has virtually no value in diagnosing patients with spondylolysis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lumbar spinal stenosis

DEFF Research Database (Denmark)

Lønne, Greger; Fritzell, Peter; Hägg, Olle

2018-01-01

BACKGROUND: Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains con...

General practitioners' willingness to request plain lumbar spine radiographic examinations

Energy Technology Data Exchange (ETDEWEB)

Ryynaenen, Olli-Pekka E-mail: ollipekka.ryynanen@uku.fi; Lehtovirta, Jukka; Soimakallio, Seppo; Takala, Jorma

2001-01-01

Objectives: To examine general practitioners' attitudes to plain lumbar spine radiographic examinations. Design: A postal questionnaire consisting of questions on background data and doctors' opinions about plain lumbar spine radiographic examinations, as well as eight vignettes (imaginary patient cases) presenting indications for lumbar radiography, and five vignettes focusing on the doctors' willingness to request lumbar radiography on the basis of patients' age and duration of symptoms. The data were analysed according to the doctor's age, sex, workplace and the medical school of graduation. Setting: Finland. Subjects: Six hundred and fifteen randomly selected physicians working in primary health care (64% of original target group). Results: The vignettes revealed that the use of plain lumbar radiographic examination varied between 26 and 88%. Patient's age and radiation protection were the most prominent factors influencing doctors' decisions to request lumbar radiographies. Only slight differences were observed between the attitudes of male and female doctors, as well as between young and older doctors. Doctors' willingness to request lumbar radiographies increased with the patient's age in most vignettes. The duration of patients' symptoms had a dramatic effect on the doctor's decision: in all vignettes, doctors were more likely to request lumbar radiography when patient's symptoms had exceeded 4 weeks. Conclusions: General practitioners commonly use plain lumbar spine radiographic examinations, despite its limited value in the diagnosis of low back pain. Further consensus and medical education is needed to clarify the indications for plain lumbar radiographic examination.

Enfermedades Autoinmunes, tratamiento con Trichuris suis y otros helmintos

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Iñigo Pallardo Fernández

2015-01-01

Full Text Available Objetivos: La "Hipótesis de la Higiene" postula sobre los efectos inmunomoduladores inducidos por agentes infecciosos en los seres humanos. El objetivo principal de este trabajo es indagar sobre las evidencias de esa hipótesis y sobre sus aplicaciones en el campo del tratamiento de las enfermedades autoinmunes, haciendo especial hincapié tanto en los mecanismos de acción en los que se basan estas aplicaciones como en los resultados reales obtenidos. Además analizará la posible evolución de estas terapias, especialmente a la sombra de las controversias éticas que surgen de la aplicación de estos tratamientos en relación a si es lícito causar una infección para curar otra patología, como es el caso que nos ocupa. Resultados: Actualmente existen resultados prometedores de ensayos clínicos sobre terapias helmínticas aplicadas al tratamiento de enfermedades autoinmunes como son la enfermedad de Crohn y la colitis ulcerosa, resumidos en el apartado de resultados de este artículo. Igualmente prometedora es la gran variedad de ensayos clínicos que actualmente están en curso sobre la aplicación de la terapia helmíntica al tratamiento de diversas patologías en las que está involucrado el sistema inmunológico, como son: asma, rinitis alérgica, artritis reumatoide, esclerosis múltiple, diabetes Mellitus tipo I, encefalomielitis autoinmune, obesidad, autismo, etc que han llevado a identificar cuáles son los parásitos indicados en el tratamiento de este amplio espectro de enfermedades. Sin embargo es necesario indicar que no todos los helmintos son inmunorreguladores y, por lo tanto útiles en el tratamiento de estas enfermedades y que, los que lo son, no son útiles en el tratamiento de todas las enfermedades de origen inmunológico sino que presentan una marcada especificidad. Es más, la utilidad de éstos presenta una variabilidad importante, no sólo dependiente de la enfermedad de origen inmunológico a tratar, sino tambi

Hepatocellular Carcinoma Supplied by the Right Lumbar Artery

International Nuclear Information System (INIS)

Miyayama, Shiro; Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Sugimori, Natsuki; Igarashi, Saya; Nakashima, Yoshiko; Matsui, Osamu

2010-01-01

This study evaluated the clinical features of hepatocellular carcinoma (HCC) supplied by the right lumbar artery. Eleven patients with HCC supplied by the right lumbar artery were treated with chemoembolization. The patients' medical records were retrospectively analyzed. All patients underwent 6.7 ± 3.7 (mean ± SD) chemoembolization sessions, and the hepatic arterial branches were noted as being attenuated. The right inferior phrenic artery (IPA) was also embolized in 10 patients. The interval between initial chemoembolization and chemoembolization of the lumbar artery supply was 53.2 ± 26.9 months. Mean tumor diameter was 3.1 ± 2.4 cm and was located at the surface of S7 and S6. The feeding-branch arose proximal to the bifurcation of the dorsal ramus and muscular branches (n = 8) or from the muscular branches (n = 3) of the right first (n = 10) or second lumbar artery (n = 1). The anterior spinal artery originated from the tumor-feeding lumbar artery in one patient. All feeders were selected, and embolization was performed after injection of iodized oil and anticancer drugs (n = 10) or gelatin sponge alone in a patient with anterior spinal artery branching (n = 1). Eight patients died from tumor progression 10.1 ± 4.6 months later, and two patients survived 2 and 26 months, respectively. The remaining patient died of bone metastases after 32 months despite liver transplantation 10 months after chemoembolization. The right lumbar artery supplies HCC located in the bare area of the liver, especially in patients who undergo repeated chemoembolization, including chemoembolization by way of the right IPA. Chemoembolization by way of the right lumbar artery may be safe when the feeder is well selected.

Physiological pattern of lumbar disc height

International Nuclear Information System (INIS)

Biggemann, M.; Frobin, W.; Brinckmann, P.

1997-01-01

Purpose of this study is to present a new method of quantifying objectively the height of all discs in lateral radiographs of the lumbar spine and of analysing the normal craniocaudal sequence pattern of lumbar disc heights. Methods: The new parameter is the ventrally measured disc height corrected for the dependence on the angle of lordosis by normalisation to mean angles observed in the erect posture of healthy persons. To eliminate radiographic magnification, the corrected ventral height is related to the mean depth of the cranially adjoining vertebra. In this manner lumbar disc heights were objectively measured in young, mature and healthy persons (146 males and 65 females). The craniocaudal sequence pattern was analysed by mean values from all persons and by height differences of adjoining discs in each individual lumbar spine. Results: Mean normative values demonstrated an increase in disc height between L1/L2 and L4/L5 and a constant or decreasing disc height between L4/L5 and L5/S1. However, this 'physiological sequence of disc height in the statistical mean' was observed in only 36% of normal males and 55% of normal females. Conclusion: The radiological pattern of the 'physiological sequence of lumbar disc height' leads to a relevant portion of false positive pathological results especially at L4/L5. An increase of disc height from L4/L5 to L5/S1 may be normal. The recognition of decreased disc height should be based on an abrupt change in the heights of adjoining discs and not on a deviation from a craniocaudal sequence pattern. (orig.) [de

Return to Golf After Lumbar Fusion.

Science.gov (United States)

Shifflett, Grant D; Hellman, Michael D; Louie, Philip K; Mikhail, Christopher; Park, Kevin U; Phillips, Frank M

Spinal fusion surgery is being increasingly performed, yet few studies have focused on return to recreational sports after lumbar fusion and none have specifically analyzed return to golf. Most golfers successfully return to sport after lumbar fusion surgery. Case series. Level 4. All patients who underwent 1- or 2-level primary lumbar fusion surgery for degenerative pathologies performed by a single surgeon between January 2008 and October 2012 and had at least 1-year follow-up were included. Patients completed a specifically designed golf survey. Surveys were mailed, given during follow-up clinic, or answered during telephone contact. A total of 353 patients met the inclusion and exclusion criteria, with 200 responses (57%) to the questionnaire producing 34 golfers. The average age of golfers was 57 years (range, 32-79 years). In 79% of golfers, preoperative back and/or leg pain significantly affected their ability to play golf. Within 1 year from surgery, 65% of patients returned to practice and 52% returned to course play. Only 29% of patients stated that continued back/leg pain limited their play. Twenty-five patients (77%) were able to play the same amount of golf or more than before fusion surgery. Of those providing handicaps, 12 (80%) reported the same or an improved handicap. More than 50% of golfers return to on-course play within 1 year of lumbar fusion surgery. The majority of golfers can return to preoperative levels in terms of performance (handicap) and frequency of play. This investigation offers insight into when golfers return to sport after lumbar fusion surgery and provides surgeons with information to set realistic expectations postoperatively.

Revisión actualizada sobre enfermedad cerebrovascular: estudio de un caso

OpenAIRE

Bardají Fandos, Teodosia

2003-01-01

La enfermedad cerebrovascular (ECV), también denominada accidente cerebrovascular (ACV)o ictus, representa el 90% de las enfermedades neurológicas y constituye la tercera causa de muerte en la mayoría de los países desarrollados; en España representa la primera causa de muerte en mujeres de 75 años o más de edad.

Partial Facetectomy for Lumbar Foraminal Stenosis

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Kevin Kang

2014-01-01

Full Text Available Background. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms. Methods. Partial facetectomy was performed by removal of the medial portion of the superior facet in patients with lumbar foraminal stenosis. 47 patients underwent the procedure from 2001 to 2010. Those who demonstrated neurogenic claudication without spinal instability or central canal stenosis and failed conservative management were eligible for the procedure. Functional level was recorded for each patient. These patients were followed for an average of 3.9 years to evaluate outcomes. Results. 27 of 47 patients (57% reported no back pain and no functional limitations. Eight of 47 patients (17% reported moderate pain, but had no limitations. Six of 47 patients (13% continued to experience degenerative symptoms. Five of 47 patients (11% required additional surgery. Conclusions. Partial facetectomy is an effective means to decompress the lumbar nerve root foramen without causing spinal instability.

Cirugía de la columna lumbar degenerativa

OpenAIRE

López-Sastre Núñez, Antonio; Menéndez Díaz, D.; Vaquero Morillo, F.

1998-01-01

En una realidad la gran demanda actual de fusiones de la columna lumbar. Los resultados clínicos obtenidos con la fusión posterolateral se ven claramente superados con las fusiones anteroposteriores. Se realiza una revisión bibliográfica de las diferentes formas de fusión de la columna lumbar y la reaparición del concepto de soporte de columna anterior. Se establecen las indicaciones y las ventajas de la fusión anteroposterior lumbar, describiéndose las posibles vías de abordaje posterior y a...

PSA (:30) Enfermedades diarreicas (Diarrheal Diseases)

Centers for Disease Control (CDC) Podcasts

2017-10-25

Este anuncio de servicio público de 30 segundos habla sobre cómo prevenir las enfermedades diarreicas después de una emergencia.  Created: 10/25/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/25/2017.

Biomarcadores en enfermedades relacionadas con el sistema nervioso

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Elso Manuel Cruz Cruz

2014-12-01

Full Text Available El estudio de biomarcadores, o marcadores biológicos para el diagnóstico y seguimiento al tratamiento de enfermedades, constituye referente frecuente en la literatura científica biomédica actual. Se realizó una revisión bibliográfica empleando los recursos disponibles en la red Infomed, específicamente Ebsco, The Cochrane Librery, PubMed, Hinari y SciELO, a través de los cuales se accedieron a las bases de datos: MEDLINE, Academic Search Premier, MedicLatina y Scopus. Se recopilaron varios artículos científicos, donde se hace referencia al empleo de biomarcadores en el diagnóstico de enfermedades relacionadas con el sistema nervioso. El factor de crecimiento endotelial, la inmunoglobulina G (IgG y el sistema arginina - óxido nítrico - citrulina, se refieren como indicadores prematuros de la hemorragia subaracnoidea. La disminución del amiloide beta y el aumento de las concentraciones de proteína tau en el líquido cefalorraquídeo, se cuentan entre los biomarcadores más prometedores e informativos que indiquen precozmente el Alzheimer y otras enfermedades neurodegenerativas. Estos mismos marcadores se comportan de manera contraria a nivel plasmático. La copeptina es un biomarcador fácilmente medible, que refleja la situación de estrés a la que está sometido el organismo y se propone su uso en el diagnóstico del síndrome de Burnout; además, niveles aumentados de α-amilasa y cromogranina A (CgA salivales pueden también ser utilizadas como indicadores de este síndrome. Se logró recoger en este artículo un compendio de ejemplos de marcadores biológicos, utilizados en el diagnóstico de enfermedades relacionadas de alguna forma con el sistema nervioso

Morphometric and Histological Study of Osteophytes in Human Cadaveric Lumbar Vertebrae

OpenAIRE

Ashwini Aithal Padur; Naveen Kumar; Swamy Ravindra Shanthakumar; Arijit Bishnu

2017-01-01

Introduction: Osteophytes are bony outgrowth on the vertebral column. Its prevalence in the lumbar region and clinical importance mandates to conduct a detailed study of lumbar osteophytes in the cadaveric vertebral column. Aim: The present study was conducted to study the detailed features of lumbar osteophytes and document its prevalence, morphometric and histological structure. Materials and Methods: This was an observational study in which frequency of occurrence of lumbar osteophyt...

Lumbar disc excision through fenestration

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Sangwan S

2006-01-01

Full Text Available Background : Lumbar disc herniation often causes sciatica. Many different techniques have been advocated with the aim of least possible damage to other structures while dealing with prolapsed disc surgically in the properly selected and indicated cases. Methods : Twenty six patients with clinical symptoms and signs of prolapsed lumbar intervertebral disc having radiological correlation by MRI study were subjected to disc excision by interlaminar fenestration method. Results : The assessment at follow-up showed excellent results in 17 patients, good in 6 patients, fair in 2 patients and poor in 1 patient. The mean preoperative and postoperative Visual Analogue Scores were 9.34 ±0.84 and 2.19 ±0.84 on scale of 0-10 respectively. These were statistically significant (p value< 0.001, paired t test. No significant complications were recorded. Conclusion : Procedures of interlaminar fenestration and open disc excision under direct vision offers sufficient adequate exposure for lumbar disc excision with a smaller incision, lesser morbidity, shorter convalescence, early return to work and comparable overall results in the centers where recent laser and endoscopy facilities are not available.

Miopericarditis en enfermedad de Still del adulto: Reporte de un caso

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Carmen Eliana Peralta Vargas

2008-10-01

Full Text Available Varón de 22 años, admitido en el Hospital Nacional Cayetano Heredia, con un tiempo de enfermedad de diez días, manifestando fiebre, malestar general y diaforesis nocturna; se añade astenia, disnea a moderados esfuerzos y tos productiva. No tenía antecedentes personales ni familiares de enfermedad previa. En el Hospital, desarrolla Insuficiencia Cardiaca Aguda y efusión pericárdica, el estudio del líquido y la biopsia del pericardio fueron de tipo inflamatorio inespecífico. El paciente, inicialmente recibió antibióticos, sin mejoría de cuadro clínico; desarrolló rash dérmico y oligoartritis, con estudio de líquido articular no inflamatorio, con cultivos negativos. Se solicita ferritina sérica, resultado 95 873 ng/mL. Se obtuvo mejoría en el estado general y caída de la fiebre con prednisona 60mg/d. Al excluirse otras enfermedades, se sugiere el diagnóstico de enfermedad de Still de inicio del adulto, con miopericarditis como manifestación inicial. (Rev Med Hered 2008; 19:167-170.

La actuación de enfermería ante las enfermedades infecciosas en la urgencias hospitalarias

OpenAIRE

Suárez Domínguez, Sara

2017-01-01

[EN] Una enfermedad infecciosa se define como aquella enfermedad producida por microorganismos patógenos como bacterias, hongos, virus o parásitos, la cual puede contagiarse por contacto con animales, insectos o de una persona a otra. A lo largo de este trabajo estudiaremos las Enfermedades Infecciosas Hospitalarias, concretamente en la enfermedad por virus Ébola y en las diferentes actuaciones de enfermería ante la misma. Para ello, se realizará un repaso en la historia y el desarrollo de...

Enfermedades emergentes y reemergentes: factores causales y vigilancia

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Carmen Luisa Suárez Larreinaga

2000-12-01

Full Text Available Este artículo tiene como objetivo exponer los conceptos y algunos de los factores causales más importantes en la aparición y diseminación de las enfermedades emergentes y reemergentes, así como presentar brevemente algunas de las actividades de vigilancia epidemiológica y su importancia en la detección y control de estas enfermedadesThe objective of this paper is to expound the concepts and some of the most important causal factors in the appearance and spreading of emergent and reemergent diseases, as well as to make a brief presentation of some of the epidemiological surveillance activities and their importance in the detection and control of these diseases

Caudal lumbar vertebral fractures in California Quarter Horse and Thoroughbred racehorses.

Science.gov (United States)

Collar, E M; Zavodovskaya, R; Spriet, M; Hitchens, P L; Wisner, T; Uzal, F A; Stover, S M

2015-09-01

To gain insight into the pathophysiology of equine lumbar vertebral fractures in racehorses. To characterise equine lumbar vertebral fractures in California racehorses. Retrospective case series and prospective case-control study. Racehorse post mortem reports and jockey injury reports were retrospectively reviewed. Vertebral specimens from 6 racehorses affected with lumbar vertebral fractures and 4 control racehorses subjected to euthanasia for nonspinal fracture were assessed using visual, radiographic, computed tomography and histological examinations. Lumbar vertebral fractures occurred in 38 Quarter Horse and 29 Thoroughbred racehorses over a 22 year period, primarily involving the 5th and/or 6th lumbar vertebrae (L5-L6; 87% of Quarter Horses and 48% of Thoroughbreds). Lumbar vertebral fractures were the third most common musculoskeletal cause of death in Quarter Horses and frequently involved a jockey injury. Lumbar vertebral specimens contained anatomical variations in the number of vertebrae, dorsal spinous processes and intertransverse articulations. Lumbar vertebral fractures examined in 6 racehorse specimens (5 Quarter Horses and one Thoroughbred) coursed obliquely in a cranioventral to caudodorsal direction across the adjacent L5-L6 vertebral endplates and intervertebral disc, although one case involved only one endplate. All cases had evidence of abnormalities on the ventral aspect of the vertebral bodies consistent with pre-existing, maladaptive pathology. Lumbar vertebral fractures occur in racehorses with pre-existing pathology at the L5-L6 vertebral junction that is likely predisposes horses to catastrophic fracture. Knowledge of these findings should encourage assessment of the lumbar vertebrae, therefore increasing detection of mild vertebral injuries and preventing catastrophic racehorse and associated jockey injuries. © 2014 EVJ Ltd.

Transforaminal Lumbar Puncture: An Alternative Technique in Patients with Challenging Access.

Science.gov (United States)

Nascene, D R; Ozutemiz, C; Estby, H; McKinney, A M; Rykken, J B

2018-05-01

Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1. The L1-2 level was used in 2; the L2-3 level, in 10; the L3-4 level, in 12; and the L4-5 level, in 2 procedures. Post-lumbar puncture headache was observed on 4 occasions, which resolved without blood patching. One patient felt heat and pain at the injection site that resolved spontaneously within hours. One patient had radicular pain that resolved with conservative treatment. Transforaminal lumbar puncture may become an effective alternative to classic interlaminar lumbar puncture or cervical puncture. © 2018 by American Journal of Neuroradiology.

Lumbar lordosis and sacral slope in lumbar spinal stenosis: standard values and measurement accuracy.

Science.gov (United States)

Bredow, J; Oppermann, J; Scheyerer, M J; Gundlfinger, K; Neiss, W F; Budde, S; Floerkemeier, T; Eysel, P; Beyer, F

2015-05-01

Radiological study. To asses standard values, intra- and interobserver reliability and reproducibility of sacral slope (SS) and lumbar lordosis (LL) and the correlation of these parameters in patients with lumbar spinal stenosis (LSS). Anteroposterior and lateral X-rays of the lumbar spine of 102 patients with LSS were included in this retrospective, radiologic study. Measurements of SS and LL were carried out by five examiners. Intraobserver correlation and correlation between LL and SS were calculated with Pearson's r linear correlation coefficient and intraclass correlation coefficients (ICC) were calculated for inter- and intraobserver reliability. In addition, patients were examined in subgroups with respect to previous surgery and the current therapy. Lumbar lordosis averaged 45.6° (range 2.5°-74.9°; SD 14.2°), intraobserver correlation was between Pearson r = 0.93 and 0.98. The measurement of SS averaged 35.3° (range 13.8°-66.9°; SD 9.6°), intraobserver correlation was between Pearson r = 0.89 and 0.96. Intraobserver reliability ranged from 0.966 to 0.992 ICC in LL measurements and 0.944-0.983 ICC in SS measurements. There was an interobserver reliability ICC of 0.944 in LL and 0.990 in SS. Correlation between LL and SS averaged r = 0.79. No statistically significant differences were observed between the analyzed subgroups. Manual measurement of LL and SS in patients with LSS on lateral radiographs is easily performed with excellent intra- and interobserver reliability. Correlation between LL and SS is very high. Differences between patients with and without previous decompression were not statistically significant.

Enfermedad poliquística autosómica recesiva Recessive autosomal polycystic disease

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Sandalio Durán Álvarez

2007-06-01

Full Text Available Como enfermedades renales poliquísticas hereditarias se describen clásicamente la autosómica recesiva y la autosómica dominante, mal llamadas enfermedad poliquística de tipo infantily de;tipo adulto, respectivamente, pues ambas pueden verse tanto en una como en otra edad. Los conceptos cambiantes en cuanto a la enfermedad autosómica recesiva, dados por los progresos en el tratamiento de los recién nacidos con la enfermedad, y la localización del gen, que por su mutación la produce, nos motivan hacer esta breve revisión con la finalidad de contribuir a la comprensión de la enfermedad por los estudiantes de medicina y el médico general básico.Recessive autosomal and dominant autosomal polycystic kidney diseases are classically described as hereditary illnesses; they are also called polycystic disease of child type” and of adult typerespectively since both may be seen in any of these two life stages. The changing concepts of recessive autosomal disease, given the advances made in the treatment of newborns with this disease, and the location of the gen, the mutation of which causes it, encouraged us to make a brief literature review to help medical students and general practitioners to understand this disease.

Enfermedades laborales, una pandemia que requiere prevención

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Joaquín Nieto

2014-03-01

Full Text Available Las enfermedades relacionadas con el trabajo constituyen una pandemias por la que cada año mueren 2.350.000 personas, de las que unas 340.000 se corresponden con accidentes de trabajo y el resto, unos 2.020.000 por enfermedad laboral, la mayor parte de ellas invisibles porque en muchas ocasiones ni se reconocen ni se registran. OIT se marca desde su nacimiento el principal objetivo de la mejora de las condiciones de trabajo El derecho a la salud y seguridad en el trabajo como principal compromiso, desarrollando normas internacionales para garantizar los derechos laborales en todo el mundo con el compromiso de mejorar el derecho a la salud y la seguridad en el trabajo. Así, de casi 200 convenios internacionales adoptados por la OIT, 40 van dedicados a esta materia, y desarrolla el Programa de Seguridad y Salud en el Trabajo y Medio Ambiente, SafeWork, al objeto de promover la conciencia mundial sobre la magnitud y las consecuencias de los accidentes, las lesiones y las enfermedades relacionadas con el trabajo. Afrontar el problema de las enfermedades laborales en España, requiere 5 líneas de actuación: 1 Desarrollo de normas, 2 contar con mecanismos y recursos humanos que permitan el cumplimiento de la normativa, 3 investigación, estudio y generar conocimiento, 4 cooperación entre Gobierno, empresa, sindicatos y trabajadores y 5 coherencia de políticas y adecuada colaboración entre las distintas Administraciones, principalmente de la Administración Laboral y Sanitaria.

La fragilidad en el anciano con enfermedad renal crónica

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Maria Eugenia Portilla Franco

2016-11-01

La fragilidad puede ser una situación reversible, por lo que su estudio en el paciente con enfermedad renal crónica es de especial interés. Este artículo tiene por objeto describir las interrelaciones existentes entre envejecimiento, fragilidad y enfermedad renal crónica a la luz de la bibliografía pertinente más relevante y reciente publicada.

Enfermedades genéticas del ADN mitocondrial humano

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Solano Abelardo

2001-01-01

Full Text Available Las enfermedades mitocondriales son un grupo de trastornos que están producidos por un fallo en el sistema de fosforilación oxidativa (sistema Oxphos, la ruta final del metabolismo energético mitocondrial, con la consiguiente deficiencia en la biosíntesis del trifosfato de adenosina (ATP, por sus siglas en inglés. Parte de los polipéptidos que componen este sistema están codificados en el ácido desoxirribonucleico (DNA mitocondrial y, en los últimos años, se han descrito mutaciones que se han asociado con síndromes clínicos bien definidos. Las características genéticas del DNA mitocondrial, herencia materna, poliplasmia y segregación mitótica, confieren a estas enfermedades propiedades muy particulares. Las manifestaciones clínicas de estas enfermedades son muy heterogéneas y afectan a distintos órganos y tejidos por lo que su correcto diagnóstico implica la obtención de datos clínicos, morfológicos, bioquímicos y genéticos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

Clinical outcomes of two minimally invasive transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative diseases.

Science.gov (United States)

Tian, Yonghao; Liu, Xinyu

2016-10-01

There are two modified TLIF, including MIS-TLIF and TLIF through Wiltse approach (W-TLIF). Although both of the two minimally invasive surgical procedures can be effective in the treatment for lumbar degenerative diseases, no comparative analysis has been made so far regarding their clinical outcomes. To compare the clinical outcomes of MIS-TLIF and W-TLIF for the treatment for single-segment degenerative lumbar diseases. Ninety-seven patients with single-segment degenerative lumbar disorders were included in this study. Forty-seven underwent MIS-TLIF surgery (group A). For group B, fifty patients underwent W-TLIF. The Japanese Orthopedic Association (JOA) score, the visual analog scale (VAS) of low back pain (LBP) and leg pain, MRI score and atrophy rate of CSA, interbody fusion rate were assessed during the postoperative follow-up. Incision length, blood loss, operative time, CPK, and postoperative incision pain VAS were better in group A (P degenerative disease. MIS-TLIF has less blood loss, shorter surgical incision, and less lower postoperative back pain, while W-TLIF is less expensive for hospital stay with lower exposure to X-rays.

[THE ALTERNATIVE MODEL IN TRAINING FOR OPERATION MANAGEMENT ON LUMBAR SPINE].

Science.gov (United States)

Zakondyrin, D E

2015-01-01

The authors proposed to use a lumbar part of calf carcass as a new biological model for training of basic practical skills in order to perform the neurosurgical operative interventions on the spine. The proximity of anatomico-surgical parameters of given model and human cavader lumbar spine was estimated. The study proved the possibility of use of lumbar part of calf carcass for training techniques of transpedicular fixation and microdiskectomy in lumbar part.

Guía clínica de la enfermedad de Pompe de inicio tardío

OpenAIRE

Barba-Romero, Miguel A.; Barrot, Emilia; Bautista-Lorite, Juan; Gutiérrez-Rivas, Eduardo; Illa, Isabel; Jiménez, Luis M.; Ley-Martos, Myriam; López de Munain, Adolfo; Pardo, Julio; Pascual-Pascual, Samuel I.; Pérez-López, Jordi; Solera, Jesús; Vílchez-Padilla, Juan J.

2012-01-01

English version available at www.neurologia.com Hasta 2006, la enfermedad de Pompe o glucogenosis tipo II era una enfermedad incurable y con tratamiento meramente paliativo. El desarrollo de la terapia de sustitución con la enzima α-glucosidasa recombinante humana ha constituido el primer tratamiento específico para esta enfermedad. El objetivo de esta guía es servir de referencia en el manejo de la variedad de inicio tardío de la enfermedad de Pompe, es decir, la que aparece d...

Didactopatogenia (Enfermedades generadas por la mala enseñanza

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José Cukier

1996-12-01

Full Text Available Se plantea el desarrollo de enfermedades generadas por la mala enseñanza. Se cuestiona el papel que cumplen las instituciones educativas al avalar a educadores con personalidad narcisista que inducen a estas enfermedades. Se describen las características de estos educadores, sus principales defensas y las interacciones didactopatogénicas que se establecen entre el educador y el educando, generando transformación pasivo/activo, tabú del pensamiento, saber enciclopédico, recuerdos póstumos, trastornos de conducta, distracción, y agresividad marcada. Se discute, también, el concepto del educador y sus dobles.

Conceptos actuales sobre el envejecimiento y la enfermedad cardiovascular

OpenAIRE

Carolina Pemberthy López; Nicolás Jaramillo-Gómez; Camilo Andrés Velásquez Mejía; Jonathan Cardona-Vélez; Heidy Contreras-Martínez; Valentina Jaramillo-Restrepo

2016-01-01

En los últimos años se ha presentado un notable incremento en la proporción de población mayor de 65 años de edad, de la mano con el incremento de las enfermedades cardiovasculares, específicamente la enfermedad coronaria. No obstante, los mecanismos fisiopatológicos del envejecimiento y su relación con la salud cardiovascular son un campo de reciente investigación. Resulta fundamental conocer aspectos como: la teoría del acortamiento de telómeros, el papel de la actividad física, el endoteli...

Correcção de escoliose lombar degenerativa por técnica minimamente invasiva Corrección de escoliosis lumbar degenerativa por técnica mínimamente invasiva Correction of degenerative lumbar scoliosis by minimally invasive technique

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Pedro Santos Silva

2012-12-01

Full Text Available A terapêutica cirúrgica da escoliose degenerativa consiste habitualmente em instrumentações e fusões mais ou menos extensas e associa-se a morbilidade significativa. A evolução tecnológica tem aberto caminho a técnicas menos invasivas que permitem obter resultados sobreponíveis aos das técnicas tradicionais minimizando a agressão cirúrgica. Descreve-se o caso de uma paciente do sexo feminino, de 63 anos, submetida a descompressão lombar posterior, em Janeiro de 2009, por alterações degenerativas marcadas. Poucos meses após a cirurgia a paciente referiu aumento das lombalgias e ciatalgia direita. O estudo imagiológico demonstrou agravamento de escoliose degenerativa L2-L5 associada a extrusão discal L2-L3 direita calcificada, fractura bilateral dos pedículos de L3 e espondilolistese degenerativa grau 1 L5-S1. Foi submetida a reintervenção cirúrgica por técnica minimamente invasiva consistindo em TLIF's L2-L3, L3-L4, L4-L5 e L5-S1 e fixação transpedicular L2-S1 bilateral, com correcção da deformidade no plano sagital e coronal. O caso clínico apresentado ilustra o potencial das abordagens minimamente invasivas no tratamento cirúrgico de escolioses degenerativas, devendo ser uma opção sempre presente considerando os benefícios potenciais para o paciente.El tratamiento quirúrgico de la escoliosis degenerativa consiste habitualmente en instrumentaciones y fusiones más o menos extensas, asociadas a morbilidad significativa. La evolución tecnológica ha abierto el camino para técnicas menos invasivas que permiten obtener resultados comparables a los de las técnicas tradicionales, minimizando el trauma de la cirugía. Presentamos el caso de paciente de sexo femenino, de 63 años de edad, sometida a descompresión lumbar posterior en enero de 2009, debido a marcadas alteraciones degenerativas. Pocos meses después del procedimiento, la paciente refirió agravamiento de la lumbalgia y ciática derecha. El estudio de

Fem Modelling of Lumbar Vertebra System

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Rimantas Kačianauskas

2014-02-01

Full Text Available The article presents modeling of human lumbar vertebra and it‘sdeformation analysis using finite elements method. The problemof tissue degradation is raised. Using the computer aided modelingwith SolidWorks software the models of lumbar vertebra(L1 and vertebra system L1-L4 were created. The article containssocial and medical problem analysis, description of modelingmethods and the results of deformation test for one vertebramodel and for model of 4 vertebras (L1-L4.

COLOFONIA DE PINÁCEAS CUBANAS PARA EL CONTROL DE ENFERMEDADES TROPICALES TRANSMITIDAS POR MOLUSCOS

OpenAIRE

Y. Arteaga-Crespo; L. R. Carballo-Abreu; R. Sotolongo-Sospedra; Y. Hevia-Jiménez; J. E. Tacoronte-Morales

2010-01-01

La esquistosomiasis, enfermedad tropical transmitida por molusco, ocupa el segundo lugar en enfermedades parasitarias después de la malaria. En Cuba no existe la esquistosomiasis aunque sí el riesgo a contraerla, puesto que en nuestra fauna se encuentran especies que pueden actuar como hospederos intermediarios del tremátodo causante de la enfermedad. El objetivo del trabajo fue evaluar el polvo de colofonia sobre larvas de Biomphalaria havanensis para el control de vectores que propagan la e...

Application of percutaneous endoscopic RF/holmium laser lumbar discectomy in the lumbar disc herniation (attach 160 cases reported)

International Nuclear Information System (INIS)

Zhao Zhengxu; Hu Tongzhou; He Jun; Jiang Zenghui; Wang Weiqi; Lin Hang

2010-01-01

Objective: To evaluate the efficacy of endoscopic discectomy for the lumbar disc herniation and to determine the prognostic factors affecting surgical outcome. Methods: In the group of 160 cases, posterolateral and trans-interlaminar endoscopic Ho: YAG laser and radio frequency-assisted disc excisions were performed under local anesthesia. Results: In 160 patients with post-surgical follow-up period was 15 months on average (7 ∼ 24 months). Based on the MacNab criteria, there were 117 cases in which result was excellent, in 19 cases good, in 12 cases fair, and in 12 cases poor, and successful rate was 85%. Conclusion: Percutaneous endoscopy lumbar discectomy is effective for recurrent disc herniation in the selected. In applies in particular to the traditional open surgery of lumbar disc herniation in patients with recurrent. (authors)

Coexisting lumbar spondylosis in patients undergoing TKA: how common and how serious?

Science.gov (United States)

Chang, Chong Bum; Park, Kun Woo; Kang, Yeon Gwi; Kim, Tae Kyun

2014-02-01

Information on the coexistence of lumbar spondylosis and its influence on overall levels of pain and function in patients with advanced knee osteoarthritis (OA) undergoing total knee arthroplasty (TKA) would be valuable for patient consultation and management. The purposes of this study were to document the prevalence and severity of coexisting lumbar spondylosis in patients with advanced knee OA undergoing TKA and to determine whether the coexisting lumbar spondylosis at the time of TKA adversely affects clinical scores in affected patients before and 2 years after TKA. Radiographic lumbar spine degeneration and lumbar spine symptoms including lower back pain, radiating pain at rest, and radiating pain with activity were assessed in 225 patients undergoing TKA. In addition, the WOMAC score and the SF-36 scores were evaluated before and 2 years after TKA. Potential associations of radiographic lumbar spine degeneration and lumbar spine symptom severities with pre- and postoperative WOMAC subscales and SF-36 scores were examined. All 225 patients had radiographic degeneration of the lumbar spine, and the large majority (89% [200 of 225]) had either moderate or severe spondylosis (72% and 17%, respectively). A total of 114 patients (51%) had at least one moderate or severe lumbar spine symptom. No association was found between radiographic severity of lumbar spine degeneration and pre- and postoperative clinical scores. In terms of lumbar spine symptoms, more severe symptoms were likely to adversely affect the preoperative WOMAC and SF-36 physical component summary (PCS) scores, but most of these adverse effects improved by 2 years after TKA with the exception of the association between severe radiating pain during activity and a poorer postoperative SF-36 PCS score (regression coefficient = -5.41, p = 0.015). Radiographic lumbar spine degeneration and lumbar spine symptoms are common among patients with advanced knee OA undergoing TKA. Severe lumbar spine symptoms

Angiogenesis in the degeneration of the lumbar intervertebral disc

OpenAIRE

David, Gh; Ciurea, AV; Iencean, SM; Mohan, A

2010-01-01

The goal of the study is to show the histological and biochemical changes that indicate the angiogenesis of the intervertebral disc in lumbar intervertebral disc hernia and the existence of epidemiological correlations between these changes and the risk factors of lumbar intervertebral disc hernia, as well as the patient's quality of life (QOL). We have studied 50 patients aged between 18 and 73 years old, who have undergone lumbar intervertebral disc hernia surgery, making fibroblast growth ...

Critical analysis of extra peritoneal antero-lateral approach for lumbar plexus

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Roberto Sérgio Martins

2011-08-01

Full Text Available Lesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. METHOD: The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. RESULTS: An exposure of all distal elements of lumbar plexus was possible, but a cranial extension of the incision was needed to reach the iliohypogastric nerve in all cases. Ligation of vessels derived from common iliac artery was necessary for genitofemoral and obturator nerves exposure in two cases. The most proximal part of the lumbar roots could be identified only after dissection and clipping of most lumbar vessels. CONCLUSION: The extraperitoneal anterolateral approach allows appropriate exposure of terminal nerves of lumbar plexus laterallly to psoas major muscle. Cranial extension of the cutaneous incision may be necessary for exposure of iliohypogastric nerve. Roots exposure increases the risk of vascular damage.

FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

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Luis Muñiz Luna

2016-03-01

Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

Percepciones de salud-enfermedad y trayectorias de cuidado en familias afrocolombianas vulnerables

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Alba Idaly Muñoz Sánchez

2014-12-01

Full Text Available Acercarse al proceso salud-enfermedad es un paso inicial para el fortalecimiento del cuidado propio de los colectivos. Así, se describieron las percepciones de salud-enfermedad y las trayectorias de cuidado de las familias afrocolombianas en situación de pobreza de la zona urbana de Tumaco-región del Pacífico colombiano. Mediante un enfoque cualitativo etnográfico, se abordaron familias extensas afrocolombianas en situación de pobreza de la ciudad de Tumaco-Nariño, seleccionadas mediante un muestreo por conveniencia. Se utilizaron la entrevista etnográfica y la observación participante como instrumentos. La enfermedad emergió como el deterioro del cuerpo y estar sano, como su vitalidad. Las trayectorias de cuidado evidenciaron las alteraciones de salud prioritarias y diferentes rutas y agentes de salud para su cuidado. Acercarse a los significados del proceso salud-enfermedad y a las trayectorias de cuidado brindan elementos para orientar intervenciones en salud sensibles a la cultura y direccionar las acciones de investigación y docencia de enfermería.

Morphometric and Histological Study of Osteophytes in Human Cadaveric Lumbar Vertebrae

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Ashwini Aithal Padur

2017-10-01

Full Text Available Introduction: Osteophytes are bony outgrowth on the vertebral column. Its prevalence in the lumbar region and clinical importance mandates to conduct a detailed study of lumbar osteophytes in the cadaveric vertebral column. Aim: The present study was conducted to study the detailed features of lumbar osteophytes and document its prevalence, morphometric and histological structure. Materials and Methods: This was an observational study in which frequency of occurrence of lumbar osteophytes was studied in 40 cadaveric vertebral columns over a period of four years. The lumbar part of the vertebral columns was dissected and examined meticulously. The occurrence of lumbar osteophytes with their vertebral levels and morphometric measurements were recorded. A small excision of the osteophyte was processed histologically to study its microscopic details using routine Haematoxylin & Eosin stain. Results: Lumbar osteophytes were present in 4 specimens (10%. They were mostly found on the right side of the vertebral bodies. Histopathological examination of the osteophytes revealed degenerative osteophytic cartilage and fibrillation overlying the trabecular bone enclosing fatty marrow spaces containing haematopoietic elements. Conclusion: Lumbar osteophytes were found in 10% of the specimens studied and it is assumed that these cadaveric reports deserve further attention given their potential clinical implications. Knowledge regarding occurrence and incidence of osteophytes is essential for management of common degenerative changes of the vertebral column.

ASSOCIATION OF SPINOPELVIC PARAMETERS WITH THE LOCATION OF LUMBAR DISC HERNIATION

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Jefferson Coelho de Léo

2015-09-01

Full Text Available Objective:To associate spinopelvic parameters, pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with the axial location of lumbar disc herniation.Methods:Retrospective study, which evaluated imaging and medical records of 61 patients with lumbar disc herniation, who underwent surgery with decompression and instrumented lumbar fusion in only one level. Pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis with simple lumbopelvic lateral radiographs, which included the lumbar spine, the sacrum and the proximal femur. The affected segment was identified as the level and location of lumbar disc herniation in the axial plane with MRI scans.Results:Of 61 patients, 29 (47.5% had low lumbar lordosis; in this group 24 (82.8% had central disc herniation, 4 (13.8% had lateral recess disc herniation and 1 (3.4% had extraforaminal disc herniation (p<0.05. Of the 61 patients, 18 (29.5% had low sacral slope; of this group 15 (83.3% had central disc herniation and 3 (16.7% had disc herniation in lateral recess (p<0.05.Conclusions:There is a trend towards greater load distribution in the anterior region of the spine when the spine has hypolordotic curve. This study found an association between low lordosis and central disc herniation, as well as low sacral slope and central disc herniation.

Síndrome de apnea-hipopnea obstructiva del sueño y enfermedades respiratorias

OpenAIRE

Londoño-Palacio, Natalia; Machado, Carlos

2017-01-01

Resumen El síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) es una enfermedad sistémica con afectación de múltiples órganos. El presente artículo trata la relación que existe entre el SAHOS y algunas enfermedades que comprometen el sistema respiratorio como son la enfermedad pulmonar obstructiva crónica, el asma, la tos crónica, el síndrome de hipoventilación alveolar y la fibrosis pulmonar. Por lo general, cada una de estas afectaciones se diagnostica por separado, pero es importante...

Fusão intersomática lombar transforaminal: experiência de uma instituição Fusión intersomática lumbar transforaminal: la experiencia de una institución Transforaminal lumbar interbody fusion: a single-center experience

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Vinicius de Meldau Benites

2012-12-01

del dolor y/o claudicación neurogénicas en comparación con el status preoperatorio. Solamente cinco pacientes continuaron usando alguna medicación analgésica. Cinco pacientes presentaran alguna complicación, pero sólo dos de ellas están relacionadas directamente al procedimiento. CONCLUSIONES: Es una técnica segura, posible de ser realizada en todos los niveles de la columna lumbar y es aplicable a la mayoría de las enfermedades que afectan a esta región de la columna.OBJECTIVE: Describe the early results and experience from a reference center in spine surgery in São Paulo, Brazil with transforaminal lumbar interbody fusion (TLIF technique in its various indications. METHODS: We retrospectively reviewed the medical records of 25 patients who underwent surgery with TLIF technique in 2011. One patient was excluded because we considered that TLIF was not the most important technique used. The indications were 9 lumbar disc herniations, 7 spondylolistheses, 4 revision surgeries of which 2 were for pseudoarthroses and 2 for low back pain, and finally, 4 lumbar spinal stenoses. RESULTS: All the patients reported low back pain and/or neurologic claudication improvement when comparing to preoperative status. Only five patients continued using analgesics. Five patients presented some complication, but only two of them were related to the procedure. CONCLUSIONS: TLIF is a safe technique which can be performed at any lumbar level of the lumbar spine and is applicable to the majority of diseases that affect this region.

Kinematics of the lumbar spine : clinical significance of lateral X-rays of the lumbar spine in anteflexion and retroflexion in healthy individuals, in cases of symptomatic herniated lumbar disc diseases and of spondylolisthesis

NARCIS (Netherlands)

M.W. Berfelo

1989-01-01

textabstractAbout half of the population of the Netherlands suffers at some stage in their life from low back pain (Haanen, 1984) ; clinical examination of the lumbar spine is a matter of daily routine. X-Rays of the lumbar spine are taken in order to detect morphological changes that may be

A lumbar body support (KBS 2000) alters lumbar muscle recruitment ...

African Journals Online (AJOL)

random order) either a flat conventional mattress or a LBS placed on top of the ... mirrored these changes and were higher in patients only when lying on the flat ... While studies have examined the effect of lumbar support on LBP during sitting ... measured using a 4-channel EMG and customised software programme (EM8 ...

NONFUSION STABILIZATION IN THE DEGENERATIVE LUMBAR SPINE DISEASES

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Matjaž Voršič

2009-04-01

Conclusions Cosmic is a posterior dynamic nonfusion pedicle screw-rod system for the stabilization of the lumbar vertebral column. It represents the new step in the development of the spinal instrumentation and can efficiently replace the spondylodesis in the treatment of painful degenerative diseases of the lumbar spine.

Enfermedad periodontal en adolescentes

OpenAIRE

Navarro Napóles, Josefa

2017-01-01

Introducción: durante mucho tiempo se creyó que la enfermedad periodontal era una afección de la adultez, sin embargo la falta de motivación en la práctica de la higiene oral en la etapa de la adolescencia condiciona su aparición. Objetivo: identificar el estado periodontal en adolescentes de la escuela Secundaria Básica Urbana ¨Raúl Pujols¨, en la ciudad de Santiago de Cuba, en el periodo de septiembre 2014 hasta marzo 2015. Materiales y Métodos: se realizó un estudio observacional, descript...

Acromegalia y enfermedad cardiovascular

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Perel, Cecilia; Echin, Mónica

2011-01-01

La acromegalia es producida por un adenoma hipofisario en más del 99% de los casos. Es una enfermedad desfigurante e inhabilitante, que al no ser tratada adecuadamente reduce la expectativa de vida en un promedio de diez años. Las complicaciones son secundarias al aumento de la hormona de crecimiento (GH: growth hormone) y del factor de crecimiento insulínico tipo 1 (IGF-1: insulin-like growth factor 1). Tanto la GH como la IGF-1 tienen receptores a nivel del miocito cardíaco, por el cual el ...

Diabetes y enfermedad ocular

OpenAIRE

Flores Ojeda, Desireé

2016-01-01

En el presente trabajo se lleva a cabo una revisión bibliográfica de la diabetes en relación con las diferentes patologías oculares a las que está asociada. La diabetes, es una enfermedad crónica que comporta un importante problema sanitario y social, que afecta a muchos órganos. De entre todos ellos, el ojo parece afectarse especialmente por los cambios de glucosa en sangre. Una vez entendida la estructura del ojo humano, el trabajo estudia las partes especialmente afectadas en pacientes ...

The Influence of Pelvic Incidence and Lumbar Lordosis Mismatch on Development of Symptomatic Adjacent Level Disease Following Single-Level Transforaminal Lumbar Interbody Fusion.

Science.gov (United States)

Tempel, Zachary J; Gandhoke, Gurpreet S; Bolinger, Bryan D; Khattar, Nicolas K; Parry, Philip V; Chang, Yue-Fang; Okonkwo, David O; Kanter, Adam S

2017-06-01

Annual incidence of symptomatic adjacent level disease (ALD) following lumbar fusion surgery ranges from 0.6% to 3.9% per year. Sagittal malalignment may contribute to the development of ALD. To describe the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and the development of symptomatic ALD requiring revision surgery following single-level transforaminal lumbar interbody fusion for degenerative lumbar spondylosis and/or low-grade spondylolisthesis. All patients who underwent a single-level transforaminal lumbar interbody fusion at either L4/5 or L5/S1 between July 2006 and December 2012 were analyzed for pre- and postoperative spinopelvic parameters. Using univariate and logistic regression analysis, we compared the spinopelvic parameters of those patients who required revision surgery against those patients who did not develop symptomatic ALD. We calculated the predictive value of PI-LL mismatch. One hundred fifty-nine patients met the inclusion criteria. The results noted that, for a 1° increase in PI-LL mismatch (preop and postop), the odds of developing ALD requiring surgery increased by 1.3 and 1.4 fold, respectively, which were statistically significant increases. Based on our analysis, a PI-LL mismatch of >11° had a positive predictive value of 75% for the development of symptomatic ALD requiring revision surgery. A high PI-LL mismatch is strongly associated with the development of symptomatic ALD requiring revision lumbar spine surgery. The development of ALD may represent a global disease process as opposed to a focal condition. Spine surgeons may wish to consider assessment of spinopelvic parameters in the evaluation of degenerative lumbar spine pathology. Copyright © 2017 by the Congress of Neurological Surgeons

The association of spinal osteoarthritis with lumbar lordosis

Science.gov (United States)

2010-01-01

Background Careful review of published evidence has led to the postulate that the degree of lumbar lordosis may possibly influence the development and progression of spinal osteoarthritis, just as misalignment does in other joints. Spinal degeneration can ensue from the asymmetrical distribution of loads. The resultant lesions lead to a domino- like breakdown of the normal morphology, degenerative instability and deviation from the correct configuration. The aim of this study is to investigate whether a relationship exists between the sagittal alignment of the lumbar spine, as it is expressed by lordosis, and the presence of radiographic osteoarthritis. Methods 112 female subjects, aged 40-72 years, were examined in the Outpatients Department of the Orthopedics' Clinic, University Hospital of Heraklion, Crete. Lumbar radiographs were examined on two separate occasions, independently, by two of the authors for the presence of osteoarthritis. Lordosis was measured from the top of L1 to the bottom of L5 as well as from the top of L1 to the top of S1. Furthermore, the angle between the bottom of L5 to the top of S1was also measured. Results and discussion 49 women were diagnosed with radiographic osteoarthritis of the lumbar spine, while 63 women had no evidence of osteoarthritis and served as controls. The two groups were matched for age and body build, as it is expressed by BMI. No statistically significant differences were found in the lordotic angles between the two groups Conclusions There is no difference in lordosis between those affected with lumbar spine osteoarthritis and those who are disease free. It appears that osteoarthritis is not associated with the degree of lumbar lordosis. PMID:20044932

Lumbar disc herniation in patients with chronic backache.

Science.gov (United States)

Ali, Asghar; Khan, Shahbaz Ali; Aurangzeb, Ahsan; Ahmed, Ehtisham; Ali, Gohar; Muhammad, Gul; Mehmood, Shakir

2013-01-01

Low back pain with or without lower extremity pain is the most common problem among chronic pain disorders with significant economic, social, and health impact. This study was conducted to determine the frequency of lumbar disc herniation and its different levels, among patients with chronic backache. This cross sectional study was conducted in the department of Neurosurgery, Ayub Medical College Abbottabad from January 2011 to January 2013. All the patients presenting with chronic low backache of either gender above the age 14 years were included in the study. Magnetic resonance imaging (MRI) was done in all the patients included in the study to look for lumbar disc herniation. A total of 477 patients with chronic low backache were included in the study out of which 274 (57.4%) were males. Age of the patients ranged from 19 to 75 (39.92 +/- 12.31) years. Out of 477 patients 38 (7.9%) had significant radiological evidence of disc prolapse at lumbar vertebral levels, with 26 (9.5%) males and 12 (5.9%) females. Among these 38 patients with inter-vertebral disc, 20 (52.6%) of patients had disc herniation at L5-S1, 15 (39.5%) at L4-L5, 2 (5.26%) cases at L3-L4 level and only one case (2.6%) had the involvement of L2-L3 level. No cases of L1-L2 disc prolapse were found. Patients with chronic backache can have inter-vertebral lumbar disc prolapsed disease. Middle age group are more affected by lumbar disc disease especially at the lower lumbar regions.

Diagnóstico precoz de enfermedades pulmonares por tabaquismo

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Dr. D. Rodrigo Gil

2010-09-01

Full Text Available El tabaquismo es una epidemia y en Chile la prevalencia no ha disminuido. Entre las causas más importantes de muerte por tabaquismo están el cáncer pulmonar y la enfermedad pulmonar obstructiva crónica (EPOC. La erradicación del tabaquismo es la mejor estrategia de prevención de estas enfermedades. La segunda estrategia es la detección precoz de ellas. Sin embargo la EPOC está sub diagnosticada en todo el mundo. No está claro si la solución es hacer más espirometrías en población de riesgo. Es posible que otros métodos diagnósticos como la tomografía axial computada de tórax (TAC y la difusión pulmonar, puedan mejorar la capacidad de diagnóstico precoz de esta enfermedad. El cáncer pulmonar es el más mortal de los cánceres. El diagnóstico en etapas tempranas mejora significativamente su pronóstico. Hay varios estudios en curso que evalúan el beneficio de hacer pesquisa de cáncer pulmonar con TAC.

An empirical study of preferred settings for lumbar support on adjustable office chairs.

Science.gov (United States)

Coleman, N; Hull, B P; Ellitt, G

1998-04-01

The preferred settings for lumbar support height and depth of 43 male and 80 female office workers were investigated. All subjects were equipped with identical modern office chairs with foam-padded backrests adjustable in both height and depth. Measurements of lumbar support settings were recorded in the workplace, outside of working hours, on four different occasions, over a 5 week period. Preferred lumbar support height and depth settings extended to both extremes of the adjustment range. The mean preferred height setting was 190 mm above the compressed seat surface. The mean depth setting (horizontal distance from front of seat to lumbar support point) was 387 mm. A regression model examining the effects of standing height, Body Mass Index (BMI) and gender on mean preferred lumbar support height showed a significant relationship between preferred height and BMI. Higher lumbar supports were chosen by subjects with greater BMIs. Gender and standing height were not associated with preferred lumbar support height settings. Preferred lumbar support depth was not significantly associated with standing height, gender or BMI. Older subjects were more likely to readjust their lumbar support from a disrupted position than younger subjects, indicating that older users are more sensitive to the position of their lumbar support. Subjects who reported recent back pain or discomfort that they believed to be associated with their chair or office work were found to set their lumbar support significantly closer to the front of the seat, probably to ensure greater support for their back. Based on the evidence that a high proportion of users do make adjustments to the height and depth of their lumbar support, and the finding that different groups of users, with different physical characteristics, adjust the position of their lumbar support in distinct and predictable ways, the researchers conclude that office chairs with traditional padded fixed-height lumbar supports are unlikely

Enfermedades profesionales en la industria del cobre: extracción, manufactura y reciclaje

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C.D. Cabrera-Marutz

2014-12-01

Full Text Available Introducción: El cobre por sus características se utiliza en una gran variedad de aplicaciones en la industria energética, sus múltiples usos unidos a la expansión y evolución de los diversos sectores industriales lo hacen una pieza fundamental para lograr el desarrollo sostenible de la sociedad actual. La minería, procesamiento, reciclaje y su transformación genera riqueza, crea puestos de trabajo y a su vez puede suponer un riesgo potencial para el desarrollo de enfermedades profesionales. Objetivo: Realizar una revisión bibliográfica que permita identificar las principales enfermedades profesionales que desarrollan los trabajadores de la industria de cobre. Metodología: Se realizó búsqueda bibliográfica en las siguientes bases de datos: MEDLINE (PUBMED, OSH UPDATE, IBECS, LILACS. Se revisó la literatura científica en busca de posibles enfermedades profesionales en la industria del cobre. Resultados: Se incluyeron en el estudio un total de 16 artículos científicos que cumplían los criterios de inclusión, agrupándolos en 4 categorías: cáncer de pulmón y vías respiratorias 10; 6 describían enfermedades respiratorias crónicas (neumoconiosis, EPOC; 5 se referían a otros tipos de cánceres (urotelial, Linfoma No Hodking, de estómago, de vejiga, de colon, de hueso, de hígado y 2 reportaron alergias de contacto. Conclusiones: Las principales enfermedades detectadas en los trabajadores de la industria del cobre fueron cáncer de pulmón y vías respiratorias y en segundo lugar enfermedades respiratorias crónicas. La minería fue el sector más afectado. Existe escasa literatura científica que identifique la aparición de enfermedades profesionales relacionadas con el reciclaje de cobre.

Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.

Science.gov (United States)

Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J

2018-06-01

Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.

Contribution of hamstring fatigue to quadriceps inhibition following lumbar extension exercise.

Science.gov (United States)

Hart, Joseph M; Kerrigan, D Casey; Fritz, Julie M; Saliba, Ethan N; Gansneder, Bruce; Ingersoll, Christopher D

2006-01-01

The purpose of this study was to determine the contribution of hamstrings and quadriceps fatigue to quadriceps inhibition following lumbar extension exercise. Regression models were calculated consisting of the outcome variable: quadriceps inhibition and predictor variables: change in EMG median frequency in the quadriceps and hamstrings during lumbar fatiguing exercise. Twenty-five subjects with a history of low back pain were matched by gender, height and mass to 25 healthy controls. Subjects performed two sets of fatiguing isometric lumbar extension exercise until mild (set 1) and moderate (set 2) fatigue of the lumbar paraspinals. Quadriceps and hamstring EMG median frequency were measured while subjects performed fatiguing exercise. A burst of electrical stimuli was superimposed while subjects performed an isometric maximal quadriceps contraction to estimate quadriceps inhibition after each exercise set. Results indicate the change in hamstring median frequency explained variance in quadriceps inhibition following the exercise sets in the history of low back pain group only. Change in quadriceps median frequency explained variance in quadriceps inhibition following the first exercise set in the control group only. In conclusion, persons with a history of low back pain whose quadriceps become inhibited following lumbar paraspinal exercise may be adapting to the fatigue by using their hamstring muscles more than controls. Key PointsA neuromuscular relationship between the lumbar paraspinals and quadriceps while performing lumbar extension exercise may be influenced by hamstring muscle fatigue.QI following lumbar extension exercise in persons with a history of LBP group may involve significant contribution from the hamstring muscle group.More hamstring muscle contribution may be a necessary adaptation in the history of LBP group due to weaker and more fatigable lumbar extensors.

Patogenia y tratamientos actuales de la enfermedad de Alzheimer

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Marco J Albert Cabrera

Full Text Available El Alzheimer es una enfermedad neurodegenerativa que se manifiesta como deterioro cognitivo y trastornos conductuales. En Cuba, junto a la demencia, ocupa el lugar número 6 en el cuadro de principales causas de muerte. No hay tratamiento eficaz para detener la progresión del Alzheimer. Sin embargo, algunas terapias detienen o ralentizan temporalmente el deterioro cognitivo, funcional y conductual de la enfermedad. En el trabajo se presenta una revisión actualizada a partir de la base de datos MEDLINE (2008-2013 sobre los mecanismos patológicos y los medicamentos usados en el tratamiento de los pacientes con la referida afección.

Guía clínica de la enfermedad de Pompe de inicio tardío

OpenAIRE

Barba-Romero, Miguel A.; Barrot, Emilia; Bautista-Lorite, Juan; Gutiérrez-Rivas, E.; Illa, Isabel; Jiménez, Luis M.; Ley-Martos, Myriam; López de Munain, Adolfo; Pardo, Julio; Pascual-Pascual, Samuel I.; Pérez-López, Jordi; Solera, Jesús; Vílchez-Padilla, Juan J.

2012-01-01

Hasta 2006, la enfermedad de Pompe o glucogenosis tipo II era una enfermedad incurable y con tratamiento meramente paliativo. El desarrollo de la terapia de sustitución con la enzima α-glucosidasa recombinante humana ha constituido el primer tratamiento específico para esta enfermedad. El objetivo de esta guía es servir de referencia en el manejo de la variedad de inicio tardío de la enfermedad de Pompe, es decir, la que aparece después del primer año de vida. En la guía, un grupo de exper...

Fine needle diagnosis in lumbar osteomyelitis

International Nuclear Information System (INIS)

Joshi, K.B.; Brinker, R.A.

1983-01-01

Lumbar vertebral body and disk infection, presenting as low back pain, is a relatively uncommon disease but is seen more often in drug addicts. Radiographs show typical changes of infection of the lumbar vertebrae and adjacent disc. Under local anesthesia a fine needle is placed, saline injected, and aspirated. The entire needle-syringe unit is submitted to the bacteriology department. Pseudomonas infection is usually found. This method of diagnosis is simple, cost effective, well accepted by the patients, and can be done on outpatients. (orig.)

Presentación de un paciente con enfermedad de Norrie

OpenAIRE

Santana Hernández, Elayne Esther; Tamayo Chang, Víctor Jesús; Marrero Infante, Juan Miguel; Márquez Ibáñez, Nilson; Artigas Cuenca, Arianne

2013-01-01

La enfermedad de Norrie es un raro trastorno genético ligado al cromosoma X que afecta principalmente a los ojos y casi siempre conduce a la ceguera. Además de los síntomas oculares congénitos, algunos pacientes sufren una pérdida progresiva de la audición sobre todo a partir de su segunda década de vida, mientras que otros afectados pueden tener problemas mentales. Los pacientes con la enfermedad de Norrie pueden desarrollar cataratas y leucocoria, junto con otras afecciones de desarrollo en...

The hybrid assisted limb (HAL) for Care Support, a motion assisting robot providing exoskeletal lumbar support, can potentially reduce lumbar load in repetitive snow-shoveling movements.

Science.gov (United States)

Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Endo, Hirooki; Murakami, Hideki; Doita, Minoru; Kumagai, Hiroshi; Nagashima, Katsuya; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

2018-03-01

An excessive lumbar load with snow-shoveling is a serious problem in snowfall areas. Various exoskeletal robots have been developed to reduce lumbar load in lifting work. However, few studies have reported the attempt of snow-shoveling work using exoskeletal robots. The purpose of the present study was to test the hypothesis that the HAL for Care Support robot would reduce lumbar load in repetitive snow-shoveling movements. Nine healthy male volunteers performed repetitive snow-shoveling movements outdoors in a snowfall area for as long as possible until they were fatigued. The snow-shoveling trial was performed under two conditions: with and without HAL for Care Support. Outcome measures were defined as the lumbar load assessed by the VAS of lumbar fatigue after the snow-shoveling trial and the snow-shoveling performance, including the number of scoops, and snow shoveling time and distance. The mean of VAS of lumbar fatigue, the number of scoops, and snow-shoveling time and distance without HAL for Care Support were 75.4 mm, 50.3, 145 s, and 9.6 m, while with HAL for Care Support were 39.8 mm, 144, 366 s, and 35.4 m. The reduction of lumbar fatigue and improvement of snow-shoveling performance using HAL for Care Support were statistically significant. There was no adverse event during snow-shoveling with HAL for Care Support. In conclusion, the HAL for Care Support can reduce lumbar load in repetitive snow-shoveling movements. Copyright © 2017 Elsevier Ltd. All rights reserved.

Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis.

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Gao, Tian; Lai, Qi; Zhou, Song; Liu, Xuqiang; Liu, Yuan; Zhan, Ping; Yu, Xiaolong; Xiao, Jun; Dai, Min; Zhang, Bin

2017-11-22

The aim of this study was to investigate the correlation between facet tropism and spinal degenerative diseases, such as degenerative lumbar spondylolisthesis, degenerative lumbar scoliosis, and lumbar disc herniation. This study retrospectively analysed clinical data from the Department of Orthopaedics at The First Affiliated Hospital of Nanchang University. Ninety-two patients were diagnosed with lumbar spondylolisthesis, 64 patients with degenerative scoliosis, and 86 patients with lumbar disc herniation between 1 October 2014 and 1 October 2016. All patients were diagnosed using 3.0 T magnetic resonance imaging and underwent conservative or operative treatment. Facet tropism was defined as greater than a ten degree between the facet joint angles on both sides. For L3-L4 degenerative lumbar spondylolisthesis, one out of six cases had tropism compared to seven out of the 86 controls (p = 0.474). At the L4-L5 level, 17/50 cases had tropism compared to 4/42 cases in the control group (p = 0.013). At the L5-S1 level, 18/36 cases had tropism compared to 7/56 controls (p = 0.000). For degenerative lumbar scoliosis at the L1-L5 level, 83/256 cases had tropism as compared to 36/256 controls (p = 0.000). For L3-L4 lumbar disc herniation two out of eight cases had tropism compared to 14/78 controls (p = 0.625). At the L4-L5 level, 19/44 cases had tropism compared to four out of 42 controls (p = 0.001). At the L5-S1 level, 24/34 cases had tropism compared to 10/52 controls (p = 0.000). At the L4-5 and L5-S1 levels, facet tropism is associated with degenerative spondylolisthesis. In the degenerative lumbar scoliosis group, the number of case with facet tropism was significantly higher than that of the control group. Facet tropism was associated with lumbar disc herniation at the L4-5 and L5-S1 levels. Overall, in these three lumbar degenerative diseases, facet tropism is a common phenomenon.

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Science.gov (United States)

2010-10-01

...) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine, abdomen, and pelvis consist of... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis assembly and...

Intracranial haemorrhage following lumbar myelography: case report and review of the literature

International Nuclear Information System (INIS)

Suess, O.; Stendel, R.; Baur, S.; Schilling, A.; Brock, M.

2000-01-01

We describe a subacute intracranial subdural haematoma following lumbar myelography. This rare but potentially life-threatening complication has been reported both after lumbar myelography and following lumbar puncture for spinal anaesthesia. We review 16 previously reported cases of intracranial haemorrhage following lumbar myelography, and discuss the pathogenesis. In all reported cases post-puncture headache was the leading symptom and should therefore be regarded as a warning sign. (orig.)

Clostridium difficile colitis in patients undergoing lumbar spine surgery.

Science.gov (United States)

Skovrlj, Branko; Guzman, Javier Z; Silvestre, Jason; Al Maaieh, Motasem; Qureshi, Sheeraz A

2014-09-01

Retrospective database analysis. To investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after lumbar spine surgery. C. difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on estimates of C. difficile infection rates and its consequences on patient outcomes and health care resources among patients undergoing lumbar spine surgery. The Nationwide Inpatient Sample was examined from 2002 to 2011. Patients were included for study based on International Classification of Diseases, Ninth Revision, Clinical Modification, procedural codes for lumbar spine surgery for degenerative diagnoses. Baseline patient characteristics were determined and multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. The incidence of C. difficile infection in patients undergoing lumbar spine surgery is 0.11%. At baseline, patients infected with C. difficile were significantly older (65.4 yr vs. 58.9 yr, Pinfection. Small hospital size was associated with decreased odds (odds ratio [OR], 0.5; Pinfection. Uninsured (OR, 1.62; Pinfection. C. difficile increased hospital length of stay by 8 days (Pdifficile infection after lumbar spine surgery carries a 36.4-fold increase in mortality and costs approximately $10,658,646 per year to manage. These data suggest that great care should be taken to avoid C. difficile colitis in patients undergoing lumbar spine surgery because it is associated with longer hospital stays, greater overall costs, and increased inpatient mortality. 3.

Regional differences in lumbar spinal posture and the influence of low back pain

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Burnett Angus F

2008-11-01

Full Text Available Abstract Background Spinal posture is commonly a focus in the assessment and clinical management of low back pain (LBP patients. However, the link between spinal posture and LBP is not fully understood. Recent evidence suggests that considering regional, rather than total lumbar spine posture is important. The purpose of this study was to determine; if there are regional differences in habitual lumbar spine posture and movement, and if these findings are influenced by LBP. Methods One hundred and seventy female undergraduate nursing students, with and without LBP, participated in this cross-sectional study. Lower lumbar (LLx, Upper lumbar (ULx and total lumbar (TLx spine angles were measured using an electromagnetic tracking system in static postures and across a range of functional tasks. Results Regional differences in lumbar posture and movement were found. Mean LLx posture did not correlate with ULx posture in sitting (r = 0.036, p = 0.638, but showed a moderate inverse correlation with ULx posture in usual standing (r = -0.505, p Conclusion This study supports the concept of regional differences within the lumbar spine during common postures and movements. Global lumbar spine kinematics do not reflect regional lumbar spine kinematics, which has implications for interpretation of measures of spinal posture, motion and loading. BMI influenced regional lumbar posture and movement, possibly representing adaptation due to load.

Lumbar puncture in patients using anticoagulants and antiplatelet agents

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Renan Domingues

2016-08-01

Full Text Available ABSTRACT The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

Multiple-level lumbar spondylolysis and spondylolisthesis.

Science.gov (United States)

Liu, Xinyu; Wang, Lianlei; Yuan, Suomao; Tian, Yonghao; Zheng, Yanping; Li, Jianmin

2015-03-01

Lumbar spondylolysis and isthmic spondylolisthesis occur most commonly at only one spinal level. The authors report on 13 cases of lumbar spondylolysis with spondylolisthesis at multiple levels. During July 2007-March 2012, multiple-level spondylolysis associated with spondylolisthesis was diagnosed in 13 patients (10 male, 3 female) at Qilu Hospital of Shandong University. The mean patient age was 43.5 ± 14.6 years. The duration of low-back pain was 11.7 ± 5.1 months. Spondylolysis occurred at L-2 in 2 patients, L-3 in 4 patients, L-4 in all patients, and L-5 in 5 patients. Spondylolysis occurred at 3 spinal levels in 3 patients and at 2 levels in 10 patients. All patients had spondylolisthesis at 1 or 2 levels. Japanese Orthopaedic Association and visual analog scale scores were used to evaluate preoperative and postoperative neurological function and low-back pain. All patients underwent pedicle screw fixation and interbody fusion or direct pars interarticularis repair. Both low-back pain scores improved significantly after surgery (p spondylolysis and spondylolisthesis occurred more often in men. Most multiplelevel lumbar spondylolysis occurred at 2 spinal levels and was associated with sports, trauma, or heavy labor. Multiplelevel lumbar spondylolysis occurred mostly at L3-5; associated spondylolisthesis usually occurred at L-4 and L-5, mostly at L-4. The treatment principle was the same as that for single-level spondylolisthesis.

Aspectos determinantes en la presentación de la enfermedad infecciosa de la bursa

OpenAIRE

Jaimes-Olaya, Javier Andrés; Álvarez Espejo, Diana Claudia; Correa, Jairo Jaime; Vera Alfonso, Víctor Julio

2009-01-01

La enfermedad infecciosa de la bursa, o enfermedad de Gumboro, es una patología inmunosupresiva de las aves de gran importancia en la industria avícola, debido a las grandes pérdidas económicas que produce no sólo por su efecto directo, sino por la predisposición a infecciones secundarias y a la interferencia con las vacunas comerciales, disminuyendo la eficacia de éstas. Es producida por el virus de la enfermedad infecciosa de la bursa (IBDV), el cual es un birnavirus de genoma RNA, con alta...

Amiloidosis secundaria en la enfermedad inflamatoria intestinal Secondary amyloidosis in Chrohn's disease

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S. Seijo Ríos

2008-12-01

Full Text Available La amiloidosis es una entidad clínica que se produce a consecuencia del depósito a nivel extracelular de un material proteico amorfo, causando una desorganización de la arquitectura normal de múltiples órganos y tejidos y, por tanto, una alteración funcional de los mismos. La amiloidosis secundaria es una complicación infrecuente pero muy grave que aparece en el contexto de neoplasias, enfermedades infecciosas e inflamatorias de curso crónico, como es el caso de la enfermedad inflamatoria intestinal, principalmente enfermedad de Crohn, ensombreciendo el pronóstico de estos pacientes. A continuación presentamos dos casos clínicos correspondientes a dos pacientes con enfermedad de Crohn que desarrollaron amiloidosis secundaria.Amyloidosis is a clinical entity that results from the deposition of an extracellular protein material that causes disruption in the normal architecture of multiple organs and tissues, and impairs their function. Secondary amyloidosis is a rare but serious complication that may worsen the prognosis of patients with cancer, infection or chronic inflammatory disease, including inflammatory bowel disease, particularly Crohn's disease. We report two cases of Crohn's disease associated with secondary amyloidosis.

Las enfermedades infecciosas y su importancia en el sector avícola

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Javier Andrés Jaimes Olaya

2010-12-01

Full Text Available Dentro del contexto de un país cuyas mejores capacidades se encuentran en el sector agropecuario, la industria avícola se ha convertido en uno de los sectores más promisorios y de mayor crecimiento en Colombia. Por esta razón, actualmente se vienen implementando programas para el mejoramiento de la calidad de los productos avícolas, con el objetivo no solo de mantener el crecimiento de la industria,sino de poder expandir las fronteras de exportación. Sin embargo, la avicultura enfrenta un gran reto encuanto a su producción, debido a que las enfermedades infecciosas que afectan a las aves continúan siendo una problemática importante del sector, aun por encima de la alimentación y la genética. En este artículo se presentan elementos de relevancia referentes a la industria avícola, así como en relación con las enfermedades de control oficial y algunas de las enfermedades infecciosas que más la aquejan, enfatizando en la importancia de la intervención en el manejo y control de dichas enfermedades.

Differences between clinical "snap-shot" and "real-life" assessments of lumbar spine alignment and motion - What is the "real" lumbar lordosis of a human being?

Science.gov (United States)

Dreischarf, Marcel; Pries, Esther; Bashkuev, Maxim; Putzier, Michael; Schmidt, Hendrik

2016-03-21

The individual lumbar lordosis and lumbar motion have been identified to play an important role in pathogenesis of low back pain and are essential references for preoperative planning and postoperative evaluation. The clinical "gold-standard" for measuring lumbar lordosis and its motion are radiological "snap-shots" taken while standing and during upper-body flexion and extension. The extent to which these clinically assessed values characterise lumbar alignment and its motion in daily life merits discussion. A non-invasive measurement-system was employed to measure lumbar lordosis and lumbar motion in 208 volunteers (age: 20-74yrs; ♀/♂: 115/93). For an initial short-term measurement, comparable with the clinical "snap-shot", lumbar lordosis and its motion were assessed while standing and during flexion and extension. Subsequently, volunteers were released to their daily lives while wearing the device, and measurements were performed during the following 24h. The average lumbar lordosis during 24h (8.0°) differed significantly from the standardised measurement while standing (33.3°). Ranges of motion were significantly different throughout the day compared to standing measurements. The influence of the factors age and gender on lordosis and its motion resulted in conflicting results between long- and short-term-measurements. In conclusion, results of short-term examinations differ considerably from the average values during real-life. These findings might be important for surgical planning and increase the awareness of the biomechanical challenges that spinal structures and implants face in real-life. Furthermore, long-term assessments of spinal alignment and motion during daily life can provide valid data on spinal function and can reveal the importance of influential factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Radiographic Morphometry of the Lumbar Spine in Munich Miniature Pigs†

Science.gov (United States)

Engelke, Elisabeth C; Post, Christina; Pfarrer, Christiane D; Sager, Martin; Waibl, Helmut R

2016-01-01

The incidence of human spinal column disease remains high, and animal models still play important roles in prophylactic, diagnostic, and therapeutic research. Because of their similar size to humans, pigs remain an important spine model. For pigs to serve as a model for the human spine, basic similarities and differences must be understood. In this study, morphometric data of the lumbar spine of Munich miniature pigs (Troll) were recorded radiologically, evaluated, and compared with recorded human data. Whereas humans have a constant number of 5 lumbar vertebrae, Munich minipigs had 5 or 6 lumbar vertebrae. Compared with their human counterparts, the lumbar vertebral bodies of the minipigs were remarkably larger in the craniocaudal (superior–inferior) direction and considerably smaller in the dorsoventral and laterolateral directions. The porcine vertebral canal was smaller than the human vertebral canal. The spinal cord extended into the caudal part of the porcine lumbar vertebral canal and thus did not terminate as cranial, as seen in humans. The lumbar intervertebral spaces of the pig were narrower in craniocaudal direction than human intervertebral spaces. These differences need to be considered when planning surgical actions, not only to avoid pain and irreversible damage to the minipigs but also to achieve accurate scientific results. PMID:27177570

Sobre la terapia génica para enfermedades de la retina.

Science.gov (United States)

Fischer, M Dominik

2017-07-11

Las mutaciones en un gran número de genes provocan degeneración de la retina y ceguera sin que exista actualmente cura alguna. En las últimas décadas, la terapia génica para enfermedades de la retina ha evolucionado y se ha convertido en un nuevo y prometedor paradigma terapéutico para estas enfermedades poco comunes. Este artículo refleja las ideas y los conceptos que parten de la ciencia básica hacia la aplicabilidad de la terapia génica en el ámbito clínico. Se describen los avances y las reflexiones actuales sobre la eficacia de los ensayos clínicos en la actualidad y se discuten los posibles obstáculos y soluciones de cara al futuro de la terapia génica para enfermedades de la retina. © 2017 S. Karger AG, Basel.

Frecuencia de algunas enfermedades genéticas en Neuropediatría

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Tatiana Zaldívar Vaillant

2012-12-01

Full Text Available Introducción: las enfermedades neurológicas en Pediatría son diversas y obedecen a un gran número de causas: infecciosas, genéticas, metabólicas y degenerativas, entre otras. El diagnóstico genético, dentro del método clínico en Neurología, está relacionado con el diagnóstico etiológico. Existen muy pocas publicaciones que reflejen la frecuencia de las enfermedades neurogenéticas como grupo etiológico. Objetivo: describir la frecuencia de algunas enfermedades neuropediátricas en la Consulta de Neurogenética del Instituto de Neurología y Neurocirugía. Métodos: se realizó una investigación descriptiva y prospectiva en el periodo 2008-2010. Se clasificó a los pacientes por grupos etarios, y se calculó el porcentaje de frecuencia para la atrofia muscular espinal de la infancia, la distrofia muscular tipo Duchenne/Becker, las lesiones estáticas del sistema nervioso central de causa prenatal genética, y para la clasificación de los grupos según tipo de herencia. Resultados: el universo de estudio estuvo conformado por 161 pacientes, 72,6 % del sexo masculino, para una razón de la variable sexo de 2,5. Los escolares fueron mayoría (37,8 %, y la edad promedio 5 años. La distrofia muscular tipo Duchenne fue la enfermedad más frecuente (24,8 %. El 41,40 % clasificó en la herencia autosómica recesiva. Los resultados coinciden con lo reportado en la literatura. Conclusiones: las enfermedades neuromusculares hereditarias, y las lesiones estáticas del sistema nervioso central de causa prenatal genética, son las más frecuentes de solicitud de asesoramiento genético en un servicio de Neurogenética.

Lumbar hernia: A commonly misevaluated condition of the bilateral costoiliac spaces

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Yiji Suh

2017-09-01

Full Text Available Lumbar hernias develop through the weakening of the posterolateral abdominal wall associated with the Petit's triangle or the Grynfeltt-Lesshaft triangle. Clinicians are generally unfamiliar with the presentation of lumbar hernias, which frequently leads to misdiagnosis and delay of treatment. Prompt failure to diagnose and surgically correct lumbar hernias have resulted in increased morbidity. This review addresses the anatomical and clinical concepts associated with the bilateral costoiliac spaces, which may be implicated in the increased prevalence of left-sided hernias. Knowledge of the contents and boundaries of this enclosure can aid the physician in diagnosis. We explore the intraperitoneal and retroperitoneal diseases that present at the lumbocostal space, including lumbar hernias, which can be classified as congenital, acquired, traumatic, or iatrogenic in origin. In an evaluation, imaging is crucial for assessing musculofascial layer disruptions and hernia contents. Open and laparoscopic surgery, as well retromuscular lumbar hernia repair, are options to explore in surgical intervention, particularly if there are challenges in preliminary pain management. Keywords: Lumbar hernia, Costoiliac spaces, Petit's triangle, Grvnfeltt-lesshaft triangle, Lumbocostovertebral syndrome

[Discarthrosis with hyperalgic lumbar multileveled radicular syndrome].

Science.gov (United States)

Sardaru, D; Tiţu, Gabriela; Pendefunda, L

2012-01-01

The problems at the level of intervertebral discs are producing dysfunctions and important functional regression at the level of lumbar column, at a stage at which the patient could remain blocked in an anterior or lateral flexion position or producing an antalgic position of scoliosis that could incapacitate the patient to perform activities of daily living. The medical rehabilitation, in such cases, must seek not only the relief of local pain through different methods of obtaining it, but also the functional reeducation of the intervertebral articulations through specific analytical mobilization in order to achieve the biomechanical harmonization of the rachis. We report the case study of a 66 year-old patient who presented to our clinic for medical consult and physical therapy when he was diagnosed with discharthrosis, hyperalgic lumbar multileveled radiculopathy at L4-L5 and L5-S1. The lumbar x-ray showed osteophytes, disc narrowing at the level of L5-S1 and inter-apophysis arthrosis. The clinical examination revealed difficulty walking with pain in the right sacroiliac articulations and right sciatic emergence with plantar paraesthesia. The patient developed pain induced scoliosis on the right side that restricted the lumbar range of motion and prevented the right flexion blocking him into an left flexion, any attempt of straightening inducing pain. The condition was treated using specific analytical lumbar mobilization for the realignment of the vertebrae complex. In this case study, we found that functional reeducation in cases of pain induced deviations of the rachis of the column should be centered on the harmonization of inadequate pressure and position of the complex intervertebral articulations.

Congenital absence of the lumbar facet joint associated with bilateral spondylolysis of the fifth lumbar vertebra.

Science.gov (United States)

Wang, Zhuo; Sakakibara, Toshihiko; Kasai, Yuichi

2013-01-01

A 14-year-old boy presented with a rare case of congenital absence of lumbar facet joint manifesting as low back pain. Physical examination showed no neurological or hematologic abnormalities. Radiography revealed absence of a facet joint on the right side of L4-5. Computed tomography and three-dimensional computed tomography revealed absence of the facet joint on the right side of L4-5 and spondylolysis on both sides of L5. Pain subsided after conservative treatment. This is an extremely rare case of congenital absence of lumbar facet joint associated with bilateral spondylolysis.

Calidad de vida en adultos del Paraguay con enfermedad celiaca

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Raúl Emilio Real-Delor

2018-01-01

Full Text Available La enfermedad celiaca altera el estado emocional, las relaciones sociales, la autonomía y la percepción de la salud, afectando la calidad de vida relacionada a la salud. Los objetivos fueron determinar la calidad de vida relacionada a la salud en adolescentes y adultos con enfermedad celiaca e investigar los factores que la afectan. Se realizó un estudio observacional, prospectivo, realizado en adolescentes y adultos del Paraguay portadores de enfermedad celiaca con al menos 6 meses en dieta sin gluten. Se aplicó el cuestionario CD-QOL. Fueron incluidos 114 sujetos, con edad media 30±10 años, siendo 58% del sexo femenino. La calidad de vida fue buena en 25%, regular en 49% y mala en 26%. Los factores asociados significativamente a mejor calidad de vida fueron el sexo femenino, el grupo etario >30 años y realizar actividades fuera del hogar. Se concluye que la calidad de vida de los celiacos adolescentes y adultos es regular en 49% de los encuestados.

La sospecha de enfermedad profesional: programas de vigilancia epidemiológica laboral

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Montserrat García Gómez

2014-01-01

Full Text Available El desconocimiento de la realidad de las enfermedades profesionales (EP supone uno de los principales déficits de la prevención de riesgos laborales. El conocimiento del número de las enfermedades profesionales que realmente sufren los trabajadores, así como en qué actividades y lugares de trabajo ocurren, permitiría elaborar acciones preventivas más eficaces y promover el diagnóstico precoz para favorecer su tratamiento en el momento más efectivo, esto es, cuando se manifiestan los primeros síntomas, fase en la que, con frecuencia, un buen número de las afecciones todavía son reversibles. Tras la aprobación de la Ley de Prevención de Riesgos Laborales, han tenido lugar iniciativas relevantes de las administraciones y los agentes sociales con la finalidad de hacer aflorar enfermedades profesionales ocultas y evitar la infradeclaración de tales enfermedades. La más reciente, el Real Decreto 1299/2006, por el que se establecía un nuevo procedimiento de notificación y registro, que incorporó la comunicación de sospecha de enfermedad profesional por parte de los facultativos del SNS y de los servicios de prevención de riesgos laborales. Son ya 9 las Comunidades Autónomas que han desarrollado el procedimiento e iniciado los trabajos de declaración de la sospecha de EP. Se describen las iniciativas correspondientes a Navarra, Comunidad Valenciana y Asturias.

Plan integral de enfermería para la atención domiciliaria de pacientes con enfermedad neuromuscular e insuficiencia respiratoria

OpenAIRE

Terán Pérez, Jimena

2013-01-01

Las enfermedades neuromuscualres son enfermedades neurológicas, de naturaleza progresiva, normalmente hereditarias cuya principal característica clínica es la debilidad muscular. Dentro de las enfermedades que causan problemas respiratorios, existen una gran variedad de enfermedades neuromusculares que comprometen la función respiratoria, las cuales pueden dividirse en enfermedades neuromusculares neuropaticas y miopáticas, además de poder clasificarlas según la evolución. Las ENM pueden c...

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis.

Science.gov (United States)

Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Liu, Zheng; Zhang, Yupeng

2015-01-01

The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. The mean follow-up was 36.9 months (range: 24-62 months). The kyphotic angle ranged from 15.2-35.1° preoperatively, with an average measurement of 27.8°. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocyte sedimentation rate (ESR) used to judge the activity of TB. Spinal TB was completely cured in all 17 patients. There was no recurrent TB infection. The postoperative kyphotic angle was 6.6-10.2°, 8.1° in average, and there was no significant loss of the correction at final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation can be a feasible and effective method the in treatment of single-segment lumbar spinal TB.

Moving back: The radiation dose received from lumbar spine quantitative fluoroscopy compared to lumbar spine radiographs with suggestions for dose reduction.

Science.gov (United States)

Mellor, F E; Thomas, P; Breen, A

2014-08-01

Quantitative fluoroscopy is an emerging technology for assessing continuous inter-vertebral motion in the lumbar spine, but information on radiation dose is not yet available. The purposes of this study were to compare the radiation dose from quantitative fluoroscopy of the lumbar spine with lumbar spine radiographs, and identify opportunities for dose reduction in quantitative fluoroscopy. Internationally reported dose area product (DAP) and effective dose data for lumbar spine radiographs were compared with the same for quantitative fluoroscopy and with data from a local hospital for functional radiographs (weight bearing AP, lateral, and/or flexion and extension) ( n  = 27). The effects of procedure time, age, weight, height and body mass index on the fluoroscopy dose were determined by multiple linear regression using SPSS v19 software (IBM Corp., Armonck, NY, USA). The effective dose (and therefore the estimated risk) for quantitative fluoroscopy is 0.561 mSv which is lower than in most published data for lumbar spine radiography. The dose area product (DAP) for sagittal (flexion + extension) quantitative fluoroscopy is 3.94 Gy cm 2 which is lower than local data for two view (flexion and extension) functional radiographs (4.25 Gy cm 2 ), and combined coronal and sagittal dose from quantitative fluoroscopy (6.13 Gy cm 2 ) is lower than for four view functional radiography (7.34 Gy cm 2 ). Conversely DAP for coronal and sagittal quantitative fluoroscopy combined (6.13 Gy cm 2 ) is higher than that published for both lumbar AP or lateral radiographs, with the exception of Nordic countries combined data. Weight, procedure time and age were independently positively associated with total dose, and height (after adjusting for weight) was negatively associated, thus as height increased, the DAP decreased.

Moving back: The radiation dose received from lumbar spine quantitative fluoroscopy compared to lumbar spine radiographs with suggestions for dose reduction

International Nuclear Information System (INIS)

Mellor, F.E.; Thomas, P.; Breen, A.

2014-01-01

Purpose: Quantitative fluoroscopy is an emerging technology for assessing continuous inter-vertebral motion in the lumbar spine, but information on radiation dose is not yet available. The purposes of this study were to compare the radiation dose from quantitative fluoroscopy of the lumbar spine with lumbar spine radiographs, and identify opportunities for dose reduction in quantitative fluoroscopy. Methods: Internationally reported dose area product (DAP) and effective dose data for lumbar spine radiographs were compared with the same for quantitative fluoroscopy and with data from a local hospital for functional radiographs (weight bearing AP, lateral, and/or flexion and extension) (n = 27). The effects of procedure time, age, weight, height and body mass index on the fluoroscopy dose were determined by multiple linear regression using SPSS v19 software (IBM Corp., Armonck, NY, USA). Results and conclusion: The effective dose (and therefore the estimated risk) for quantitative fluoroscopy is 0.561 mSv which is lower than in most published data for lumbar spine radiography. The dose area product (DAP) for sagittal (flexion + extension) quantitative fluoroscopy is 3.94 Gy cm 2 which is lower than local data for two view (flexion and extension) functional radiographs (4.25 Gy cm 2 ), and combined coronal and sagittal dose from quantitative fluoroscopy (6.13 Gy cm 2 ) is lower than for four view functional radiography (7.34 Gy cm 2 ). Conversely DAP for coronal and sagittal quantitative fluoroscopy combined (6.13 Gy cm 2 ) is higher than that published for both lumbar AP or lateral radiographs, with the exception of Nordic countries combined data. Weight, procedure time and age were independently positively associated with total dose, and height (after adjusting for weight) was negatively associated, thus as height increased, the DAP decreased

LUMBAR LORDOSIS IN ASYMPTOMATICS SUBJECTS AND PATIENTS WITH CHRONIC LOW BACK PAIN

OpenAIRE

S.J MOUSAVI; MOHAMMAD REZA NOURBAKHSH

2003-01-01

Introduction: The relationship between the degree of lumbar lordosis and chronic and purpose low back pain (LBP) has long been speculated, but there is discrepancy in findings of previous researchers. The purpose of this of this study was to drtermin differences between lumbar lordosis in asymptomatic and LBP subjects. Matherials: Lumbar lordosis of 420 patients with chronic LBP and 420 asymptomatic subjects was measured by two examiner. A flexible ruler was used to measure lumbar l...

Influence of lumbar curvature and rotation on forward flexibility in idiopathic scoliosis

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Feng-Chun Kao

2014-04-01

Full Text Available Background: Lumbar spine facet joints are arranged sagittally and mainly provide forward flexibility. Rotation of the lumbar vertebral body and coronal plane deformity may influence the function of lumbar forward flexibility. We hypothesize that the more advanced axial and coronal plane deformity could cause more limitation on forward flexibility in patients with idiopathic scoliosis. Methods: Between January 2011 and August 2011, 85 patients with adolescent idiopathic scoliosis were enrolled in this study. The proximal thoracic, major thoracic, thoracolumbar/lumbar (TL/L, and lumbar (L1/L5 curves were measured by Cobb's method. Lumbar apical rotation was graded using the Nash-Moe score. Lumbar forward flexibility was measured using the sit and reach (S and R test. Statistical analysis was performed using one-way analysis of variance (ANOVA, Spearman's and Pearson's correlation coefficients. Results: The mean age was 16.1 ± 2.84 years. The mean proximal thoracic, major thoracic, TL/L, and L1/L5 curves were 17.61° ± 8.92, 25.56° ± 11.61, 26.09° ± 8.6, and 15.10° ± 7.85, respectively. The mean S and R measurement was 25.56 ± 12.33 cm. The magnitude of the TL/L and L1/L5 curves was statistically positively related to vertebral rotation (rs = 0.580 and 0.649, respectively. The correlation between the S and R test and both the TL/L and L1/L5 curves was negative (rp = –0.371 and –0.595, respectively. Besides, the S and R test also demonstrated a significant negative relationship with vertebral rotation (rs = –0.768. Conclusion: In patients with idiopathic scoliosis, spinal deformity can diminish lumbar forward flexibility. Higher lumbar curvature and rotation lead to greater restriction of lumbar flexion.

Diagnosis of Lumbar Foraminal Stenosis using Diffusion Tensor Imaging.

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Eguchi, Yawara; Ohtori, Seiji; Suzuki, Munetaka; Oikawa, Yasuhiro; Yamanaka, Hajime; Tamai, Hiroshi; Kobayashi, Tatsuya; Orita, Sumihisa; Yamauchi, Kazuyo; Suzuki, Miyako; Aoki, Yasuchika; Watanabe, Atsuya; Kanamoto, Hirohito; Takahashi, Kazuhisa

2016-02-01

Diagnosis of lumbar foraminal stenosis remains difficult. Here, we report on a case in which bilateral lumbar foraminal stenosis was difficult to diagnose, and in which diffusion tensor imaging (DTI) was useful. The patient was a 52-year-old woman with low back pain and pain in both legs that was dominant on the right. Right lumbosacral nerve compression due to a massive uterine myoma was apparent, but the leg pain continued after a myomectomy was performed. No abnormalities were observed during nerve conduction studies. Computed tomography and magnetic resonance imaging indicated bilateral L5 lumbar foraminal stenosis. DTI imaging was done. The extraforaminal values were decreased and tractography was interrupted in the foraminal region. Bilateral L5 vertebral foraminal stenosis was treated by transforaminal lumbar interbody fusion and the pain in both legs disappeared. The case indicates the value of DTI for diagnosing vertebral foraminal stenosis.

Overpowering posterior lumbar instrumentation and fusion with hyperlordotic anterior lumbar interbody cages followed by posterior revision: a preliminary feasibility study.

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Kadam, Abhijeet; Wigner, Nathan; Saville, Philip; Arlet, Vincent

2017-12-01

OBJECTIVE The authors' aim in this study was to evaluate whether sagittal plane correction can be obtained from the front by overpowering previous posterior instrumentation and/or fusion with hyperlordotic anterior lumbar interbody fusion (ALIF) cages in patients undergoing revision surgery for degenerative spinal conditions and/or spinal deformities. METHODS The authors report their experience with the application of hyperlordotic cages at 36 lumbar levels for ALIFs in a series of 20 patients who underwent revision spinal surgery at a single institution. Included patients underwent staged front-back procedures: ALIFs with hyperlordotic cages (12°, 20°, and 30°) followed by removal of posterior instrumentation and reinstrumentation from the back. Patients were divided into the following 2 groups depending on the extent of posterior instrumentation and fusion during the second stage: long constructs (≥ 6 levels with extension into thoracic spine and/or pelvis) and short constructs (lumbar lordosis increased from 44.3° to 59.8° (p lumbar levels that have pseudarthrosis from the previous posterior spinal fusion. Meticulous selection of levels for ALIF is crucial for safely and effectively performing this technique.

[Lumbar spinal angiolipoma].

Science.gov (United States)

Isla, Alberto; Ortega Martinez, Rodrigo; Pérez López, Carlos; Gómez de la Riva, Alvaro; Mansilla, Beatriz

2016-01-01

Spinal angiolipomas are fairly infrequent benign tumours that are usually located in the epidural space of the thoracic column and represent 0.14% to 1.3% of all spinal tumours. Lumbar angiolipomas are extremely rare, representing only 9.6% of all spinal extradural angiolipomas. We report the case of a woman who complained of a lumbar pain of several months duration with no neurological focality and that had intensified in the last three days without her having had any injury or made a physical effort. The MR revealed an extradural mass L1-L2, on the posterior face of the medulla, decreasing the anteroposterior diameter of the canal. The patient symptoms improved after surgery. Total extirpation of the lesion is possible in most cases, and the prognosis is excellent even if the lesion is infiltrative. For this reason, excessively aggressive surgery is not necessary to obtain complete resection. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

MRI of the lumbar spine. Technical aspect. T2-weighted fat saturation coronal dynamic MRI of the lumbar spine

International Nuclear Information System (INIS)

Clarisse, J.; Francke, J.P.; Leclet, H.; Bourgeois, Ph.; Chastanet, P.; Cotten, A.

1998-01-01

Assess the feasibility of 'dynamic' MRI of the lumbar spine and study the parameters of a single MRI sequence favorable for simultaneous imaging of the meningeal space and the epidural and foraminal venous system. Favor a decline in the number of sacco-radiculograms. Clinical assessment in the following circumstances: discordant clinical and and radiographic findings, difficulty in interpreting single or multiple disc-root conflicts, preoperative work-up in cases of narrow or stenotic lumbar canal. Dynamic MRI of the lumbar spine is possible if the hypothesis that the hyper-lordosis obtained in the supine position creates an anatomic and radiographic situation identical to the hyper-lordosis induced by the upright position is accepted. The 'radiculo-phlebographic' sequence gives images of the root sheaths and the epidural, foraminal and extra-foraminal veins simultaneously, particularly in the coronal plane. (authors)

A Narrative Review of Lumbar Fusion Surgery With Relevance to Chiropractic Practice.

Science.gov (United States)

Daniels, Clinton J; Wakefield, Pamela J; Bub, Glenn A; Toombs, James D

2016-12-01

The purpose of this narrative review was to describe the most common spinal fusion surgical procedures, address the clinical indications for lumbar fusion in degeneration cases, identify potential complications, and discuss their relevance to chiropractic management of patients after surgical fusion. The PubMed database was searched from the beginning of the record through March 31, 2015, for English language articles related to lumbar fusion or arthrodesis or both and their incidence, procedures, complications, and postoperative chiropractic cases. Articles were retrieved and evaluated for relevance. The bibliographies of selected articles were also reviewed. The most typical lumbar fusion procedures are posterior lumbar interbody fusion, anterior lumbar interbody fusion, transforaminal interbody fusion, and lateral lumbar interbody fusion. Fair level evidence supports lumbar fusion procedures for degenerative spondylolisthesis with instability and for intractable low back pain that has failed conservative care. Complications and development of chronic pain after surgery is common, and these patients frequently present to chiropractic physicians. Several reports describe the potential benefit of chiropractic management with spinal manipulation, flexion-distraction manipulation, and manipulation under anesthesia for postfusion low back pain. There are no published experimental studies related specifically to chiropractic care of postfusion low back pain. This article describes the indications for fusion, common surgical practice, potential complications, and relevant published chiropractic literature. This review includes 10 cases that showed positive benefits from chiropractic manipulation, flexion-distraction, and/or manipulation under anesthesia for postfusion lumbar pain. Chiropractic care may have a role in helping patients in pain who have undergone lumbar fusion surgery.

3-dimensional reconstructions of computer tomograms of the lumbar spine

International Nuclear Information System (INIS)

Kern, A.; Waggershauser, T.; Zendel, W.; Astinet, A.; Felix, R.; Hansen, K.; Lanksch, W.R.

1991-01-01

In this study, 50 patients were examined by a Siemens 'Somatom Plus'; continuous 2 mm sections between the third lumbar and first sacral vertebra were obtained. All these imaging procedures were suitable for the diagnosis of osteochondrosis and chondrosis. Spondylosis was diagnosed more frequently on 3-D CT. Spondyloarthrosis, with narrowing of the invertebral foramina and root canals is shown particularly well by 3-D CT, since the entire extent of these structures can be seen. 3-D surface reconstruction of the lumbar spine is useful in the diagnosis of lumbar spondyloarthrosis with narrowing of the root canals and of the spinal canal. This method of axial CT is superior to conventional radiography of the lumbar spine in the usual two planes. (orig./GDG) [de

Influence of age, BMI, gender and lumbar level on T1ρ magnetic resonance imaging of lumbar discs in healthy asymptomatic adults

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Guebitz, Raphael [Asklepios Hospital Altona, Hamburg (Germany). Dept. of Radiology and Neuroradiology; Lange, Tobias; Gosheger, Georg [University Hospital Muenster (Germany). Dept. of Orthopaedics and Tumor Orthopaedics; Heindel, Walter; Allkemper, Thomas [University Hospital Muenster (Germany). Dept. of Clinical Radiology; Stehling, Christoph [Sankt-Barbara Hospital Ham-Heessen, Hamm (Germany). Clinic for Radiology and Neuroradiology; Gerss, Joachim [Muenster Univ. (Germany). Inst. of Biostatistics and Clinical Research; Kanthak, Christian [Fraunhofer MEVIS, Bremen (Germany). Inst. for Medical Image Computing; Schulte, Tobias L. [Bochum Univ. St. Josef Hospital (Germany). Dept. of Orthopaedics and Trauma Surgery

2018-02-15

To assess the T1ρ range of lumbar intervertebral discs in healthy asymptomatic individuals at 1.5 T and to investigate the influence of age, body mass index (BMI), gender, and lumbar level on T1ρ relaxation. In a prospective study, a total of 81 volunteers aged 20 - 80 years were included in this study and divided into three age groups (A: 20 - 39y; B: 40 - 59y; C: 60 - 80y). All of the volunteers underwent magnetic resonance imaging (MRI) at 1.5 T with acquisition of sagittal T1ρ images. The calculated T1ρ relaxation times were correlated with age, BMI, gender, and lumbar level relative to the total disc, the annulus fibrosus, and the nucleus pulposus. Age had a significant influence on T1ρ relaxation times at all lumbar levels, with increasing age being associated with reduced relaxation times. There was also a significant difference between age groups A vs. C and B vs. C (P = 0.0008 and P = 0.0149, respectively). No significant differences in T1ρ relaxation time were observed between men and women (P > 0.05). BMI showed a significant negative correlation with T1ρ relaxation times (P < 0.0001). Analysis of the lumbar level revealed a significant decrease in relaxation times from L1/2 to L5 / S1 (P = 0.0013). Increasing age correlated significantly with advanced lumbar disc degeneration in asymptomatic individuals, particularly in those aged 60 or older. Increasing BMI correlated significantly with increasing degeneration. The lower discs showed more degeneration than the upper ones.

Influence of age, BMI, gender and lumbar level on T1ρ magnetic resonance imaging of lumbar discs in healthy asymptomatic adults

International Nuclear Information System (INIS)

Guebitz, Raphael; Lange, Tobias; Gosheger, Georg; Heindel, Walter; Allkemper, Thomas; Stehling, Christoph; Gerss, Joachim; Kanthak, Christian; Schulte, Tobias L.

2018-01-01

To assess the T1ρ range of lumbar intervertebral discs in healthy asymptomatic individuals at 1.5 T and to investigate the influence of age, body mass index (BMI), gender, and lumbar level on T1ρ relaxation. In a prospective study, a total of 81 volunteers aged 20 - 80 years were included in this study and divided into three age groups (A: 20 - 39y; B: 40 - 59y; C: 60 - 80y). All of the volunteers underwent magnetic resonance imaging (MRI) at 1.5 T with acquisition of sagittal T1ρ images. The calculated T1ρ relaxation times were correlated with age, BMI, gender, and lumbar level relative to the total disc, the annulus fibrosus, and the nucleus pulposus. Age had a significant influence on T1ρ relaxation times at all lumbar levels, with increasing age being associated with reduced relaxation times. There was also a significant difference between age groups A vs. C and B vs. C (P = 0.0008 and P = 0.0149, respectively). No significant differences in T1ρ relaxation time were observed between men and women (P > 0.05). BMI showed a significant negative correlation with T1ρ relaxation times (P < 0.0001). Analysis of the lumbar level revealed a significant decrease in relaxation times from L1/2 to L5 / S1 (P = 0.0013). Increasing age correlated significantly with advanced lumbar disc degeneration in asymptomatic individuals, particularly in those aged 60 or older. Increasing BMI correlated significantly with increasing degeneration. The lower discs showed more degeneration than the upper ones.

Computed tomography as the primary radiological examination of lumbar spine

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Ilkko, E.; Laehde, S.

1988-10-01

A series of 235 patients examined by lumbar CT because of sciatica or other low back disorder was studied. The need of additional examinations and correlations to surgical findings were evaluated. Inadequate information was the cause of additional examination, mostly myelography in 20 patients (8,5%). It was concluded that lumbar CT is a suitable first examination of the lumbar spine in sciatica and low back pain. The indications to complementary myelography and its benefit are discussed.

Computed tomography as the primary radiological examination of lumbar spine

International Nuclear Information System (INIS)

Ilkko, E.; Laehde, S.

1988-01-01

A series of 235 patients examined by lumbar CT because of sciatica or other low back disorder was studied. The need of additional examinations and correlations to surgical findings were evaluated. Inadequate information was the cause of additional examination, mostly myelography in 20 patients (8,5%). It was concluded that lumbar CT is a suitable first examination of the lumbar spine in sciatica and low back pain. The indications to complementary myelography and its benefit are discussed. (orig.) [de

Las enfermedades reumáticas: de la teoría a la realidad

Directory of Open Access Journals (Sweden)

Miguel Ángel Serra Valdés

2013-12-01

Full Text Available Las enfermedades reumáticas constituyen un reconocido problema de salud a nivel mundial; por su morbilidad, por la discapacidad que provocan, por su repercusión en el plano económico debido a los altos costos ocasionados a las instituciones sanitarias así como a las personas aquejadas. Las enfermedades reumáticas debieran estar incluidas dentro de las crónicas no trasmisibles si se tienen en cuenta en su definición aspectos como: factores de riesgo, curso crónico, repercusión en la calidad de vida, incidencia y prevalencia en la población general, mortalidad, etc., aspectos que en las enfermedades reumáticas coexisten.

Estatinas en prevención de enfermedad cardiovascular y cerebrovascular ¿Dónde estamos?

Directory of Open Access Journals (Sweden)

Iván Dario Sierra Ariza

2006-04-01

Full Text Available La enfermedad cardiovascular, incluyendo la enfermedad coronaria, es la causa más importante de muerte tanto en hombres como en mujeres en los países desarrollados y también en muchos de los en vías de desarrollo

Las enfermedades de transmisión sexual en embarazadas

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Denis Berdasquera Corcho

Full Text Available Se realizó una investigación descriptiva de corte transversal en la que se estudiaron 351 embarazadas captadas entre el 1ro de enero y el 31 de diciembre de 1998 en el municipio Guanajay. Para la recogida de la información se utilizó un formulario, donde se estudiaron variables biológicas y socioculturales obtenidas de las historias clínicas de las gestantes. Predominaron las embarazadas en edades de 20 a 34 años, un alto nivel de escolaridad, más de 55 % de amas de casa, con pareja estable y más del 90 % habían comenzado sus relaciones sexuales antes de cumplir los 20 años. La moniliasis y la trichomoniasis fueron las enfermedades que mayores prevalencias presentaron, seguidas en orden decreciente de la blenorragia, el herpes simple, el condiloma acuminado, la hepatitis B, la sífilis, y el VIH/SIDA. La vigilancia de la blenorragia en la población estudiada no fue adecuada por una deficiente pesquisa de esta enfermedad. La distribución de gestantes con enfermedades de transmisión sexual, según variables socioculturales, tuvo un comportamiento similar a la distribución general de estas en el total de las embarazadas.

Mechanisms of action of lumbar supports : a systematic review

NARCIS (Netherlands)

van Poppel, M N; de Looze, M P; Koes, B W; Smid, T; Bouter, L M

2000-01-01

STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports. SUMMARY OF BACKGROUND DATA: A restriction of trunk

Mechanisms of action of lumbar supports: a sytematic review

NARCIS (Netherlands)

van Poppel-Bruinvels, M.N.M.; de Looze, M.P.; Koes, B.W.; Smid, T.; Bouter, L.M.

2000-01-01

Study Design. A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. Objective. To summarize the evidence bearing on the putative mechanisms of action of lumbar supports. Summary of Background Data. A restriction of trunk

Is it possible to preserve lumbar lordosis after hybrid stabilization? Preliminary results of a novel rigid-dynamic stabilization system in degenerative lumbar pathologies.

Science.gov (United States)

Formica, Matteo; Cavagnaro, Luca; Basso, Marco; Zanirato, Andrea; Felli, Lamberto; Formica, Carlo

2015-11-01

To evaluate the results of a novel rigid-dynamic stabilization technique in lumbar degenerative segment diseases (DSD), expressly pointing out the preservation of postoperative lumbar lordosis (LL). Forty-one patients with one level lumbar DSD and initial disc degeneration at the adjacent level were treated. Circumferential lumbar arthrodesis and posterior hybrid instrumentation were performed to preserve an initial disc degeneration above the segment that has to be fused. Clinical and spino-pelvic parameters were evaluated pre- and postoperatively. At 2-year follow-up, a significant improvement of clinical outcomes was reported. No statistically significant difference was noted between postoperative and 2-year follow-up in LL and in disc/vertebral body height ratio at the upper adjacent fusion level. When properly selected, this technique leads to good results. A proper LL should be achieved after any hybrid stabilization to preserve the segment above the fusion.

Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

International Nuclear Information System (INIS)

Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang

2009-01-01

Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

2009-12-15

Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

RELIABILITY AND VALIDITY OF SUBJECTIVE ASSESSMENT OF LUMBAR LORDOSIS IN CONVENTIONAL RADIOGRAPHY.

Science.gov (United States)

Ruhinda, E; Byanyima, R K; Mugerwa, H

2014-10-01

Reliability and validity studies of different lumbar curvature analysis and measurement techniques have been documented however there is limited literature on the reliability and validity of subjective visual analysis. Radiological assessment of lumbar lordotic curve aids in early diagnosis of conditions even before neurologic changes set in. To ascertain the level of reliability and validity of subjective assessment of lumbar lordosis in conventional radiography. A blinded, repeated-measures diagnostic test was carried out on lumbar spine x-ray radiographs. Radiology Department at Joint Clinical Research Centre (JCRC), Mengo-Kampala-Uganda. Seventy (70) lateral lumbar x-ray films were used for this study and were obtained from the archive of JCRC radiology department at Butikiro house, Mengo-Kampala. Poor observer agreement, both inter- and intra-observer, with kappa values of 0.16 was found. Inter-observer agreement was poorer than intra-observer agreement. Kappa values significantly rose when the lumbar lordosis was clustered into four categories without grading each abnormality. The results confirm that subjective assessment of lumbar lordosis has low reliability and validity. Film quality has limited influence on the observer reliability. This study further shows that fewer scale categories of lordosis abnormalities produce better observer reliability.

Embolization of Isolated Lumbar Artery Injuries in Trauma Patients

International Nuclear Information System (INIS)

Sofocleous, Constantinos T.; Hinrichs, Clay R.; Hubbi, Basil; Doddakashi, Satish; Bahramipour, Philip; Schubert, Johanna

2005-01-01

Purpose. The purpose of the study was to evaluate the angiographic findings and results of embolotherapy in the management of lumbar artery trauma. Methods. All patients with lumbar artery injury who underwent angiography and percutaneous embolization in a state trauma center within a 10-year period were retrospectively reviewed. Radiological information and procedural reports were reviewed to assess immediate angiographic findings and embolization results. Long-term clinical outcome was obtained by communication with the trauma physicians as well as with chart review. Results. In a 10-year period, 255 trauma patients underwent abdominal aortography. Eleven of these patients (three women and eight men) suffered a lumbar artery injury. Angiography demonstrated active extravasation (in nine) and/or pseudoaneurysm (in four). Successful selective embolization of abnormal vessel(s) was performed in all patients. Coils were used in six patients, particles in one and gelfoam in five patients. Complications included one retroperitoneal abscess, which was treated successfully. One patient returned for embolization of an adjacent lumbar artery due to late pseudoaneurysm formation. Conclusions. In hemodynamically stable patients, selective embolization is a safe and effective method for immediate control of active extravasation, as well as to prevent future hemorrhage from an injured lumbar artery

Differences of Sagittal Lumbosacral Parameters between Patients with Lumbar Spondylolysis and Normal Adults.

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Yin, Jin; Peng, Bao-Gan; Li, Yong-Chao; Zhang, Nai-Yang; Yang, Liang; Li, Duan-Ming

2016-05-20

Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Han Chinese people concerning the normal range of spinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population. A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group. All the 52 patients were divided into two subgroups, Subgroup A: 36 patients with simple lumbar spondylolysis, and Subgroup B: 16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis (slip percentage spondylolysis group and the control group with independent-sample t- test. There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B. PI, PT, SS, and LL were higher (P spondylolysis group than those in the control group, but STA was lower (P spondylolysis group. Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population.

Overload pain but root differentiation discomfort in the lumbar spine

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Joanna Siminska

2017-06-01

Full Text Available Lumbar pain syndromes of the spine can also be referred to as the pain of the cross. These ailments have now become epidemics of our time. In literature, these pain are referred to as localized ailments that are located in the lumbar, lumbosacral, and cross-iliac areas. Cross pains are a very general term because there are a multitude of factors that cause lumbar disc herniation. This problem poses great diagnostic difficulties. [4]. The nature of these ailments is often difficult to pinpoint by the patient, but it can be the pain that describes patients from blunt, piercing, biting, baking, to those that are termed cold feeling. Keep in mind that the location of the lumbar pain symptoms varies. Patients report pain that is located throughout the lumbar-sacral area or only on one side of the spine, or occurs only in the area of the hip joints. These complaints often radiate along the lower limb. They are often the result of a lack of proper spine prevention: they contribute to this poor body posture, improper sleep positioning, as well as lack of coping skills, as well as a bad diet. In daily life, it is important to remember to do your daily activities in the correct position as well as to use prevention to avoid pain in the lumbar area.

Does change in isolated lumbar extensor muscle function correlate with good clinical outcome? A secondary analysis of data on change in isolated lumbar extension strength, pain, and disability in chronic low back pain.

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Steele, James; Fisher, James; Perrin, Craig; Conway, Rebecca; Bruce-Low, Stewart; Smith, Dave

2018-01-12

Secondary analysis of data from studies utilising isolated lumbar extension exercise interventions for correlations among changes in isolated lumbar extension strength, pain, and disability. Studies reporting isolated lumbar extension strength changes were examined for inclusion criteria including: (1) participants with chronic low back pain, (2) intervention ≥ four weeks including isolated lumbar extension exercise, (3) outcome measures including isolated lumbar extension strength, pain (Visual Analogue Scale), and disability (Oswestry Disability Index). Six studies encompassing 281 participants were included. Correlations among change in isolated lumbar extension strength, pain, and disability. Participants were grouped as "met" or "not met" based on minimal clinically important changes and between groups comparisons conducted. Isolated lumbar extension strength and Visual Analogue Scale pooled analysis showed significant weak to moderate correlations (r = -0.391 to -0.539, all p Disability Index pooled analysis showed significant weak correlations (r = -0.349 to -0.470, all p disability, isolated lumbar extension strength changes were greater for those "met" compared with those "not met" (p disability. This study shows significant correlations between increases in isolated lumbar extension strength and reductions in pain and disability. Strengthening of the lumbar extensor musculature could be considered an important target for exercise interventions.

AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion.

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Rapp, Steven M; Miller, Larry E; Block, Jon E

2011-01-01

Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF) system is a minimally invasive fusion device that accesses the lumbar (L4-S1) intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date.

Does team lifting increase the variability in peak lumbar compression in ironworkers?

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Faber, Gert; Visser, Steven; van der Molen, Henk F; Kuijer, P Paul F M; Hoozemans, Marco J M; Van Dieën, Jaap H; Frings-Dresen, Monique H W

2012-01-01

Ironworkers frequently perform heavy lifting tasks in teams of two or four workers. Team lifting could potentially lead to a higher variation in peak lumbar compression forces than lifts performed by one worker, resulting in higher maximal peak lumbar compression forces. This study compared single-worker lifts (25-kg, iron bar) to two-worker lifts (50-kg, two iron bars) and to four-worker lifts (100-kg, iron lattice). Inverse dynamics was used to calculate peak lumbar compression forces. To assess the variability in peak lumbar loading, all three lifting tasks were performed six times. Results showed that the variability in peak lumbar loading was somewhat higher in the team lifts compared to the single-worker lifts. However, despite this increased variability, team lifts did not result in larger maximum peak lumbar compression forces. Therefore, it was concluded that, from a biomechanical point of view, team lifting does not result in an additional risk for low back complaints in ironworkers.

Enfermedades hereditarias monogénicas y multifactoriales

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Cruz Cubas, Antonio

2007-01-01

En el lenguaje de la genética, es corriente distinguir según sus causas- dos grandes grupos de patologías hereditarias: las “monogénicas” y las “multifactoriales Las enfermedades monogénicas son provocadas por mutacion(es) génica(s) necesaria(s) y suficiente(s)

Lumbar punction: comparison between an atraumatic and a traumatic punction needle

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Tina Bregant

2017-03-01

Full Text Available Background: Lumbar puncture is a standardized, routine diagnostic procedure in the diagnosis of neurological diseases. Post-duarl puncture headache (PDPH is a common complication which occurs in 10 to 30 % of patients. Although the incidence of PDPH is much lower with the use of small, non-cutting needles, neurologists in Slovenia routinely use the classical traumatic spinal needles.Methods: In the article we provide an overview of a research concerned with the use of traumatic and atraumatic needles in the procedure with the emphasis on complications of the lumbar puncture. We present American and European recommendations for lumbar puncture procedure.Conclusions: International recommendations for neurologists advise the use of atraumatic spinal needles for lumbar puncture. We recommend to Slovenian neurologists to start using the atraumatic needles for elective lumbar punctures and hence provide neurological patients with better quality and cheaper long-term care.

Prevalencia de enfermedad celíaca en pacientes con hepatopatías crónicas

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Crivelli, Adriana N.

2016-01-01

La enfermedad celíaca (EC) es definida como una enteropatía crónica del intestino delgado mediada por mecanismos inmunes, precipitada por la exposición al gluten y prolaminas relacionadas de la dieta, en individuos genéticamente predispuestos. Diversas enfermedades hepáticas pueden asociarse a la EC. El espectro del compromiso hepático en la EC es muy amplio e incluye, entre otros, enfermedad hepática criptogenética (desde leve a severa), hepatitis autoinmune, colangitis esclerosante primaria...

Medium-term effects of Dynesys dynamic stabilization versus posterior lumbar interbody fusion for treatment of multisegmental lumbar degenerative disease.

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Wu, Haiting; Pang, Qingjiang; Jiang, Guoqiang

2017-10-01

Objective To compare the medium-term clinical and radiographic outcomes of Dynesys dynamic stabilization and posterior lumbar interbody fusion (PLIF) for treatment of multisegmental lumbar degenerative disease. Methods Fifty-seven patients with multisegmental lumbar degenerative disease underwent Dynesys stabilization (n = 26) or PLIF (n = 31) from December 2008 to February 2010. The mean follow-up period was 50.3 (range, 46-65) months. Clinical outcomes were evaluated using a visual analogue scale (VAS) and the Oswestry disability index (ODI). Radiographic evaluations included disc height and range of motion (ROM) of the operative segments and proximal adjacent segment on lumbar flexion-extension X-rays. The intervertebral disc signal change was defined by magnetic resonance imaging, and disc degeneration was classified by the Pfirrmann grade. Results The clinical outcomes including the VAS score and ODI were significantly improved in both groups at 3 months and the final follow-up, but the difference between the two was not significant. At the final follow-up, the disc height of stabilized segments in both groups was significantly increased; the increase was more notable in the Dynesys than PLIF group. The ROM of stabilized segments at the final follow-up decreased from 6.20° to 2.76° and 6.56° to 0.00° in the Dynesys and PLIF groups, respectively. There was no distinct change in the height of the proximal adjacent segment in the two groups. The ROM of the proximal adjacent segment in both groups increased significantly at the final follow-up; the change was significantly greater in the PLIF than Dynesys group. Only one case of adjacent segment degeneration occurred in the PLIF group, and this patient underwent a second operation. Conclusions Both Dynesys stabilization and PLIF can improve the clinical and radiographic outcomes of multisegmental lumbar degenerative disease. Compared with PLIF, Dynesys stabilization can maintain the mobility of the

Análisis estadístico multivariante de las principales enfermedades gastroéntericas en el cantón Guayaquil

OpenAIRE

Romero Saltos, Cristina Marisela; Ramirez Figueroa, John Alex

2009-01-01

La presente investigación desarrolla el Análisis Multivariado de las principales enfermedades gastroéntericas que afectan a la ciudad de Guayaquil. Consideramos que las principales enfermedades gastroéntericas son: Fiebre Tifoidea, Salmonelosis y Enfermedades Diarreicas Agudas. En el primer capítulo se enfoca la problemática de las enfermedades gastroéntericas en el Ecuador y en la ciudad de Guayaquil, de la misma manera se presenta la descripción de las principales enfermedades gastroént...

Enfermedad de creutzfeldt-jakob en el Perú: reporte de once casos

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Luis Torres-Ramírez

Full Text Available La enfermedad de Creutzfeldt-Jakob (ECJ es una enfermedad neurológica fatal producida por la isoforma patológica de la proteína priónica humana. Se reporta las características clínicas de seis casos de la forma esporádica de ECJ con diagnóstico definitivo por histopatología, y cinco casos con diagnóstico probable, en pacientes atendidos en el Instituto Nacional de Ciencias Neurológicas del Perú. La edad de inicio en los casos definitivos fue de 55,8 años y, en los probables, de 59,6 años, con predominio del sexo masculino. El tiempo de enfermedad fue de 8,8 meses. Se encontró un EEG típico en 50% de los casos definitivos y 80% de los probables. La proteína 14-3-3 en líquido cefalorraquídeo fue positiva en un caso probable y los hallazgos típicos en resonancia magnética se observaron en dos casos probables. Todos los casos cursaron con una evolución clínica típica de la enfermedad, y se considera el primer reporte de ECJ en el Perú

Is lumbar lordosis related to low back pain development during prolonged standing?

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Sorensen, Christopher J; Norton, Barbara J; Callaghan, Jack P; Hwang, Ching-Ting; Van Dillen, Linda R

2015-08-01

An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain during prolonged standing. The purposes of this study were to (1) compare baseline lumbar lordosis in back-healthy participants who do (Pain Developers) and do not (Non-Pain Developers) develop low back pain during 2 h of standing, and (2) examine the relationship between lumbar lordosis and low back pain intensity. Cross-sectional. First, participants stood while positions of markers placed superficial to the lumbar vertebrae were recorded using a motion capture system. Following collection of marker positions, participants stood for 2 h while performing light work tasks. At baseline and every 15 min during standing, participants rated their low back pain intensity on a visual analog scale. Lumbar lordosis was calculated using marker positions collected prior to the 2 h standing period. Lumbar lordosis was compared between pain developers and non-pain developers. In pain developers, the relationship between lumbar lordosis and maximum pain was examined. There were 24 (42%) pain developers and 33 (58%) non-pain developers. Lumbar lordosis was significantly larger in pain developers compared to non-pain developers (Mean difference = 4.4°; 95% Confidence Interval = 0.9° to 7.8°, Cohen's d = 0.7). The correlation coefficient between lumbar lordosis and maximum pain was 0.46 (P = 0.02). The results suggest that standing in more lumbar lordosis may be a risk factor for low back pain development during prolonged periods of standing. Identifying risk factors for low back pain development can inform preventative and early intervention strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Metabolismo de los hidratos de carbono en los enterocitos de sujetos con enfermedad de Crohn y colitis ulcerosa.

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Estada Gimeno, Úrsula

2007-01-01

RESUMEN Introducción: Los pacientes con enfermedad inflamatoria crónica intestinal (EII), enfermedad de Crohn y colitis ulcerosa presentan lesiones en el epitelio intestinal de carácter inflamatorio. Estas lesiones afectan al intestino grueso en la colitis ulcerosa y a cualquier parte del tracto digestivo en la enfermedad de Crohn. En este tipo de enfermos se ha visto que existe una menor absorción de nutrientes, sobre todo en la enfermedad de Crohn, entre ellos la lactosa (el azúcar de la...

[Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy].

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Çetin, Mehmet Fatih; Karaman, Haktan; Ölmez Kavak, Gönül; Tüfek, Adnan; Baysal Yildirim, Zeynep

2012-01-01

This study looks into the efficacy and safety of the transforaminal lumbar epidural steroid injection (TLESI) applied to patients with radiculopathy due to lumbar disk herniation. The patients' files which were applied TLESI, were retrospectively scanned. Patients who did not respond to one-month conservative treatment and who were detected to have bulging or protruding lumbar disk herniation as a result of imaging methods were included in the study. All applications were performed with C-arm fluoroscopy under local anesthesia by outpatient method. In all cases, a mix of 80 mg triamsinolone and 0.25% bupivacaine, was transforaminally injected to the anterior epidural area. Initial VAS pain scores were compared with the values of the 1, 3 and 6th months after the application. Patient satisfaction was determined through scoring. Furthermore, early and late term complications were collected for evaluation. A total of 222 patients were administered TLESI 460 times (average: 2.1, repeat interval: 1-6 times). The applications were carried out most frequently at the levels of L4-L5 and L5-S1. While the initial VAS score average was 8.2±0.7, after TLESI, it was 5.0±1.6, 4.8±1.5 and 5.1±1.5 in the 1, 3 and 6th months, respectively. 63.9% of the patients (n=142) defined the treatment as 'good and excellent'. No major complications were experienced and the overall minor complication rate was 11.1%. It was seen that TLESI was an efficient and safe method in the short and medium term.

Enfermedad de Von Gierke: Reporte de tres casos

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E. Espinosa

2001-07-01

Full Text Available La enfermedad de Von Gierke es un defecto en la glucosa 6 fosfatasa, degrada el glucógeno en el hígado, riñón e intestino. Asociada con hipoglicemia, acidosis láctica e hiperuricemia.

Síntesis y evaluación farmacológica de nuevas entidades moleculares con aplicación a enfermedades neurodegenerativas

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Rincón Arias, Ángela

2016-01-01

La prevalencia de las enfermedades neurodegenerativas aumenta con el envejecimiento de la población. La Organización Mundial de la Salud estima que, para el año 2040, estas enfermedades serán la segunda causa de muerte por delante del cáncer. Por tanto, comprender los fundamentos fisiopatológicos y desarrollar nuevos métodos de diagnóstico y agentes terapéuticos, hacen de las enfermedades neurodegenerativas un área de gran interés científico. La enfermedad de Alzheimer (EA) y la enfermedad de...

Enfermedad por el virus del Chikungunya: historia y epidemiología

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Jorge Acosta-Reyes

2015-01-01

Full Text Available El 9 de diciembre de 2013 la Organización Panamericana de la Salud emitió una alerta epidemiológica debido a la detección de los primeros casos autóctonos de fiebre del Chikun-gunya en el continente americano; desde entonces este se ha convertido en un problema de salud pública. El primer reporte de un brote por el virus del Chikungunya se presentó en 1952-1953 en Tanzania. Las experiencias en epidemias en otros países han centrado la atención en que la presentación clínica no siempre tiene un comportamiento similar. Hasta 2005 todos los reportes mencionaban la presentación de la enfermedad como benigna y con cuadros clínicos bastantes similares, sin embargo, la aparición de epidemias después de ese año en las Islas Reunión y en la India describieron la presencia de cuadros graves, atípicos y un aumento de la mortalidad relacionados con la enfermedad. La región de las Américas debe prepararse para esta nueva epidemia. Esto hace necesario mejorar los conocimientos sobre la enfermedad; y un primer abordaje es a través de una descripción de la historia y epidemiología de la enfermedad por el virus del Chikungunya en el mundo.

LA INFLAMACIÓN COMO FACTOR CAUSAL EMERGENTE DE LA ENFERMEDAD CARDIOVASCULAR

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T. Fernández-Mora

2007-06-01

Full Text Available La ateroesclerosis está involucrada en el desarrollo de la enfermedad cardiovascular, una de las principales enfermedades de morbimortalidad en el mundo. Se han determinado una serie de factores de riesgo, tanto clásicos como emergentes, implicados en el desarrollo de esta enfermedad. Recientes investigaciones han demostrado que la inflamación juega un papel clave en el desarrollo de la ateroesclerosis. Las células del sistema inmune se encuentran presentes en todos los estadios de las lesiones arterioescleróticasy sus moléculas efectoras pueden acelerar la progresión de las lesiones y orquestar los mecanismos de inflamación inducidos en los síndromes coronarios agudos. La evidencia crítica implica a mediadores de la inmunidad tanto innata como adquirida en los diferentes estados de la ateroesclerosis. Dentro de loscomponentes inmunes involucrados en el proceso de la ateroesclerosis se encuentran componentes celulares como macrófagos, linfocitos, células dendríticas, mastocitos, células NK; componentes humoralescomo anticuerpos, citocinas proinflamatorias y moduladoras de la respuesta inmune, complemento, proteínas de fase aguda; y otros componentes como moléculas de adhesión y de choque térmico. A partirdel esclarecimiento del papel del sistema inmune en el desarrollo de la arterioesclerosis, han surgido una serie de perspectivas diagnósticas y terapéuticas para la enfermedad cardiovascular.

Organización cultural de la enfermedad y estructuras semánticas: Enfermedades músculo-esqueléticas de la población Mapuche de Chile

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Aldo Vidal Herrera

2014-01-01

Full Text Available Se presentan resultados etnosemánticos de una investigación antropológica multimétodo de enfermedades músculo-esqueléticas en la población Mapuche de Chile. Desde la antropología lingüística se describen los hallazgos respecto a los mecanismos y estructuras semánticas de identificación y organización de los lexemas de las entidades patológicas reconocidas por la lengua mapuche, el mapudungun, así como sus aspectos culturales y cognitivos. Los resultados muestran: a la existencia de una estructura semántica formal taxonómica para la clasificación y organización de las unidades relativas a enfermedades; b la existencia de estructuras semánticas tipológicas y paradigmáticas, para dimensiones semiológicas de las enfermedades; c la presencia de fenómenos de polisemia y homonimia, relacionados, entre otros, con una pérdida considerable del stock lingüístico en este campo semántico del mapudungun.

Historia breve de las enfermedades tropicales en América

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Dulce María Delgadillo Álvarez

2016-02-01

Full Text Available La región tropical de la Tierra comprende la zona entre los trópicos de Cáncer y de Capricornio y es en esta franja en donde se localizan países con grandes riquezas naturales pero con economías de ingresos bajos o medios-bajos. Aunado a esto, las características climatológicas de la región son propicias para el desarrollo de organismos patógenos que causan enfermedades graves en la población humana. El término enfermedad tropical, es resultado de un proceso histórico social observado por los europeos durante la conquista y la colonia pues, en el trópico americano, las enfermedades tropicales no existían antes de la llegada de los españoles. Cuando los conquistadores llegaron llevaron consigo patógenos que causaron la muerte de casi el 90 % de la población original siendo las epidemias de viruela, sarampión y gripe las más devastadoras. La conquista del continente fue posible en gran medida por el intercambio biológico entre conquistadores y conquistados y estuvo acompañada de la destrucción de las dos civilizaciones americanas más avanzadas, la azteca en México y la inca en Perú. Durante los siguientes siglos, el intercambio biológico ha sido más amplio; las enfermedades tropicales están ahora presentes en todo el mundo y deben ser atendidas no importando la región del mundo en la que se manifiesten.

PREVALENCIA DE ENFERMEDAD PERIODONTAL (E. P.) EN INDIVIDUOS CON SÍNDROME DE DOWN (S. D.).

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Maita Véliz, Luis; Casteñeda Mosto, María

2014-01-01

Los niños disminuidos requieren recibir una adecuada evaluación de su estado de salud periodontal. Es necesario investigar en esta población la prevalenciada enfermedad periodontal (E. P.) siendo escasos los trabajos en el país. La literatura de otros países reporta una prevalencia y severidad alta de E. P. en individuos con síndrome de Down. Los objetivos de la investigación están referidos a conocer la prevalencia de enfermedad periodontal: las áreas periodontales con mayor enfermedad perio...

Incidencia de enfermedades en pejibaye (bactris gasipaes kunth para palmito

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Carlos Arroyo

2004-01-01

Full Text Available Incidencia de enfermedades en pejibaye (Bactris gasipaes Kunth para palmito. Se determinó la incidencia de enfermedades en cuatro variedades de palmito de pejibaye (Bactris gasipaes Kunth, durante los 12 primeros meses de desarrollo. Tres de ellas sin espinas (Diamantes-1, Diamantes- 10 y Diamantes-20 y una con espinas (Utilis-Tucurrique. El ensayo se efectuó en la región de Guápiles, Costa Rica, de mayo del 2000 a abril del 2001. Los patógenos que se encontraron en las plantas de pejibaye fueron: Colletotrichum sp., (mancha negra de las hojas; Phytophthora palmivora, (pudrición cogollo u hoja guía; Drechslera setariae, (mancha de anillo; Lasiodiplodia theobromae (hoja deshilachada y Erwinia sp., (pudrición del tallo, quema de hojas y hoja guía. La variedad Utilis-Tucurrique, presentó la mayor susceptibilidad a todas las enfermedades, pero en ningún caso éstas llegaron a un nivel de importancia económica. La incidencia de Erwinia sp. y Phytophothora palmivora mostró mayor relación con la precipitación y alta temperatura.

AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion

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Rapp SM

2011-08-01

Full Text Available Steven M Rapp1, Larry E Miller2,3, Jon E Block31Michigan Spine Institute, Waterford, MI, USA; 2Miller Scientific Consulting Inc, Biltmore Lake, NC, USA; 3Jon E. Block, Ph.D., Inc., San Francisco, CA, USAAbstract: Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF system is a minimally invasive fusion device that accesses the lumbar (L4–S1 intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date.Keywords: AxiaLIF, fusion, lumbar, minimally invasive, presacral

La artritis idiopática juvenil y su relevancia dentro de las enfermedades reumatologicas de la infancia

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Dr. González M. Benito

2012-07-01

Full Text Available El dolor y la inflamación que afecta a las articulaciones o tejidos periarticulares son motivo frecuente de consulta a nivel pediátrico. Dentro de los diagnósticos diferenciales se encuentran las enfermedades reumatológicas. En los últimos años ha cambiado el pronóstico y visión que se tenía de estas enfermedades gracias a los nuevos conocimientos sobre la patogenia y a la incorporación de nuevas terapias con agentes biológicos, basados en anticuerpos monoclonales y que se ha traducido en un cambio en los tratamientos convencionales de estas enfermedades. La Artritis Reumatoidea Juvenil, actualmente denominada Artritis Idiopática Juvenil (AIJ, constituye la enfermedad más frecuente dentro del espectro de estos cuadros autoinmunes. El objetivo de esta presentación es dar a conocer las diversas formas de AIJ y los principales hallazgos clínicos y de laboratorio que pueden orientar al clínico acerca de estas enfermedades y así iniciar un tratamiento oportuno que asegure un buen pronóstico de la enfermedad.

Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

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Adam D.

2015-03-01

Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

Enfermedad celíaca. Alteraciones neurológicas y psiquiátricas Celiac disease. Neurological and psychiatric alterations

OpenAIRE

A. Martínez Bermejo

2009-01-01

Otra manifestación de enfermedad celiaca silente es la asociación con otras enfermedades bien definidas que tengan una base inmunológica o no. La enfermedad celiaca ha sido asociada con diversos procesos, tanto generales como neurológicos. Al menos el 10% de los niños con enfermedad celiaca presentan de forma asociada otras alteraciones entre las que destacan de forma especial la deficiencia en IgA, dermatitis herpetiforme, anomalías del esmalte dental y la diabetes mellitus tipo I. También s...

Costes no sanitarios ocasionados por las enfermedades isquémicas del corazón en España

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Oliva Moreno, Juan; Lobo Aleu, José Félix; López Bastida, Julio; Duque González, Beatriz; Osuna Guerrero, Rubén

2004-01-01

Además de los costes que originan su tratamiento y prevención, las enfermedades generan otro tipo de costes que no siempre se tienen en cuenta. El objetivo del presente trabajo es identificar, medir y valorar una parte de estos últimos costes en el caso de una de las enfermedades que más muertes causan en España, las enfermedades isquémicas del corazón. Por una parte, se estimaron los costes indirectos (pérdidas de productividad laboral) ocasionados por esta enfermedad, utilizando tanto el en...

Las enfermedades neoplásicas como causa de la incapacidad permanente

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Ares Camerino, A.; Sainz Vera, B.; Marchena Aparicio, J.C.; Soto Pino, M.L.

2008-01-01

El cáncer es la primera causa de mortalidad en hombres y la segunda en mujeres, tras las enfermedades cardiovasculares. Desde el punto de vista económico, los costes atribuibles a las enfermedades neoplásicas son principalmente indirectos (pérdida de productividad asociada a la mortalidad o a la incapacidad permanente). Analizando las incapacidades permanentes producidas en la Diputación Provincial de Cádiz en el período 1990-2005, que fueron un total de 208, se concluye, por orden de frecuen...

Colectomía parcial laparoscópica electiva por enfermedad diverticular

OpenAIRE

MELKONIAN T, ERNESTO; RODRÍGUEZ G, MARCELO; CONTRERAS F, DAVID; OPAZO S, PATRICIO; ROBLES G, IGNACIO; BRAVO H, MAGDALENA

2011-01-01

La cirugía laparoscópica colorrectal, aunque de desarrollo lento, ha presentado en los últimos años ventajas con respecto a la cirugía abierta. Hay escasas publicaciones nacionales sobre esta técnica en enfermedad diverticular. Objetivo: Presentar nuestra experiencia en enfermedad diverticular en una serie consecutiva de pacientes con indicación quirúrgica electiva resueltos por vía laparoscópica. Material y Método: Se analizan los protocolos prospectivos de cirugía laparoscópica de colon con...

Enfermedad gingival asociada al paciente pediátrico asmático

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Carfi Marin, Indhira Del Valle; Alarcón Palacios, Marco

2014-01-01

El asma es una enfermedad infl amatoria crónica del sistema respiratorio, caracterizada por ser hipersensible y episódica, reversible y con síntomas de abstracción del fl ujo de aire. La prevalencia del asma ha ido en aumento a través de todas las edades, sexo y grupos raciales; y resulta ser mayor entre los niños que en adultos. Últimamente ha sido asociada en numerosas investigaciones a la prevalencia de caries y enfermedad periodontal, donde diversos factores y la respuesta inmune actúan d...

Congenital lumbar vertebrae agenesis in a lamb.

Science.gov (United States)

Farajli Abbasi, Mohammad; Shojaei, Bahador; Azari, Omid

2017-01-01

Congenital agenesis of lumbar vertebrae was diagnosed in a day-old female lamb based on radiology and clinical examinations. There was no neurological deficit in hindlimb and forelimb associated with standing disability. Radiography of the abdominal region revealed absence of lumbar vertebrae. Necropsy confirmed clinical and radiographic results. No other anomaly or agenesis was seen macroscopically in the abdominal and thoracic regions as well as vertebral column. Partial absence of vertebral column has been reported in human and different animal species, as an independent occurrence or associated with other organs anomalies. The latter has been designated as caudal regression syndrome. Vertebral agenesis may arise from irregularity in the differentiation of somites to the sclerotome or sclerotome to the vertebral primordium. Most of the previously reported cases of agenesis were related to the lumbosacral region, lonely or along with other visceral absences. This case was the first report of congenital agenesis of lumbar vertebrae in a lamb.

Biomechanical implications of lumbar spinal ligament transection.

Science.gov (United States)

Von Forell, Gregory A; Bowden, Anton E

2014-11-01

Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.

Enfermedades del tejido conectivo: Importancia del diagnóstico precoz

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G. Patricia Abumohor, Dra.

2012-07-01

Full Text Available Las Enfermedades del Tejido Conectivo (ETC son entidades de baja prevalencia en la población general. Son de naturaleza inflamatoria y autoinmune, tienden a la cronicidad y al compromiso de muchos parénquimas, órganos y tejidos, dejando en ellos daño estructural y funcional. Dado lo anterior, amenazan la vida o disminuyen la expectativa y calidad de vida. El diagnóstico y tratamiento precoz de estas entidades, permite cambiar su curso y muchas veces lograr remisión. Es por lo tanto de suma importancia tenerlas en mente y sospecharlas como entidades de enfermedad e iniciar un tratamiento oportuno.

Enfermedad de Hirschsprung y apendicitis. Una asociación rara

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C Baeza-Herrera

2016-05-01

Full Text Available La enfermedad de Hirschsprung asociada con apendicitis es una condición poco usual; suman 15 los reportados en la literatura, ya incluido este caso. Se informa el caso de un lactante de 12 meses de edad que ingresó con fiebre, anorexia, distensión abdominal, vómito, evacuaciones hemáticas y antecedente de estreñimiento. Se realizó laparotomía exploradora que reportó apendicitis y megacolon congénito o enfermedad de Hirschsprung. El reporte histopatológico reveló periapendicitis, huevecillos de áscaris lumbricoides, con ausencia de células ganglionares.

Múltiples quistes parapiélicos en la enfermedad de Fabry

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María A. Azancot

2016-05-01

Presentamos un caso de un paciente varón afecto de la enfermedad de Fabry, que presentaba múltiples quistes parapiélicos e insuficiencia renal, sin presentar angioqueratomas. El estudio genético mostró una mutación en el gen de alfa-GLA A que no ha sido descrita previamente en el registro de mutaciones, y de novo, ya que no se encontró en otros familiares, además que no fue trasmitida a la descendencia. La presencia de múltiples quistes parapiélicos y su peculiar aspecto fue lo que hizo sospechar el diagnóstico de la enfermedad.

Enfermedad periodontal en pacientes infectados por el VIH

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Caridad Nazco Ríos

2002-04-01

Full Text Available Se realizó un estudio epidemiológico descriptivo transversal en 22 pacientes seropositivos al VIH ingresados en el Sanatorio Provincial de Villa Clara, con el propósito de determinar la prevalencia y gravedad de la enfermedad periodontal, su relación con las etapas clínicas de la infección por el VIH, la población linfocitaria, la higiene bucal y las infecciones agudas del grupo estudiado. El mayor número de pacientes pertenecían al grupo de edades de 20 a 29 años y el sexo masculino fue el más encontrado; la prevalencia de la enfermedad periodontal fue del 100 %, la destrucción avanzada la lesión más severa (13,6 % en pacientes del grupo II de la enfermedad por VIH, y la gingivitis con bolsa la más frecuente (86,45 %. La higiene bucal fue deficiente en todos los examinados. La estomatitis aftosa fue la infección aguda más frecuente. No se encontraron formas de enfermedad periodontal asociadas con el VIH. La cifra de inmunocompetentes alcanzó el 68,2 % y el 31,8 % presentó una inmunodepresión leve.An epidemiological descriptive cross-sectional study was carried out among 22 HIV seropositive patients admitted at the Provincial Sanatorium of Villa Clara aimed at determining the prevalence and severity of the periodontal disease, its relationship with the clinical stages of the HIV infection, the lymphocitary population, the oral hygiene and the acute infections of the studied group. Most of the patients were between 20 and 29 years old; whereas males were the most affected. There was a prevalence of the periodontal disease of 100 %. The advanced destruction was the most serious lesion (13.6 % in patients from the group II of the disease caused by HIV and the gingivitis with pocket was the most common (86.45 %. Oral hygiene was deficient in all individuals that were examined. The aphthous stomatitis was the most frequent acute infection. There were no forms of periodontal diseases associated with HIV. The figure of

Lower thoracic degenerative spondylithesis with concomitant lumbar spondylosis.

Science.gov (United States)

Hsieh, Po-Chuan; Lee, Shih-Tseng; Chen, Jyi-Feng

2014-03-01

Degenerative spondylolisthesis of the spine is less common in the lower thoracic region than in the lumbar and cervical regions. However, lower thoracic degenerative spondylolisthesis may develop secondary to intervertebral disc degeneration. Most of our patients are found to have concomitant lumbar spondylosis. By retrospective review of our cases, current diagnosis and treatments for this rare disease were discussed. We present a series of 5 patients who experienced low back pain, progressive numbness, weakness and even paraparesis. Initially, all of them were diagnosed with lumbar spondylosis at other clinics, and 1 patient had even received prior decompressive lumbar surgery. However, their symptoms continued to progress, even after conservative treatments or lumbar surgeries. These patients also showed wide-based gait, increased deep tendon reflex (DTR), and urinary difficulty. All these clinical presentations could not be explained solely by lumbar spondylosis. Thoracolumbar spinal magnetic resonance imaging (MRI), neurophysiologic studies such as motor evoked potential (MEP) or somatosensory evoked potential (SSEP), and dynamic thoracolumbar lateral radiography were performed, and a final diagnosis of lower thoracic degenerative spondylolisthesis was made. Bilateral facet effusions, shown by hyperintense signals in T2 MRI sequence, were observed in all patients. Neurophysiologic studies revealed conduction defect of either MEP or SSEP. One patient refused surgical management because of personal reasons. However, with the use of thoracolumbar orthosis, his symptoms/signs stabilized, although partial lower leg myelopathy was present. The other patients received surgical decompression in association with fixation/fusion procedures performed for managing the thoracolumbar lesions. Three patients became symptom-free, whereas in 1 patient, paralysis set in before the operation; this patient was able to walk with assistance 6 months after surgical decompression

Efficacy of different bone volume expanders for augmenting lumbar fusions.

Science.gov (United States)

Epstein, Nancy E

2008-01-01

A wide variety of bone volume expanders are being used in performing posterolateral lumbar noninstrumented and instrumented lumbar fusions. This article presents a review of their efficacy based on fusion rates, complications, and outcomes. Lumbar noninstrumented and instrumented fusions frequently use laminar autografts and different bone graft expanders. This review presents the utility of multiple forms/ratios of DBMs containing allografts. It also discusses the efficacy of artificial bone graft substitutes, including HA and B-TCP. Dynamic x-ray and/or CT examinations were used to document fusion in most series. Outcomes were variously assessed using Odom's criteria or different outcome questionnaires (Oswestry Questionnaire, SF-36, Dallas Pain Questionnaire, and/or Low Back Pain Rating Scale). Performing noninstrumented and instrumented lumbar posterolateral fusions resulted in comparable fusion rates in many series. Similar outcomes were also documented based on Odom's criteria or the multiple patient-based questionnaires. However, in some studies, the addition of spinal instrumentation increased the reoperation rate, operative time, blood loss, and cost. Various forms of DBMs, applied in different ratios to autografts, effectively supplemented spinal fusions in animal models and patient series. beta-Tricalcium phosphate, which is used to augment autograft fusions addressing idiopathic scoliosis or lumbar disease, also proved to be effective. Different types of bone volume expanders, including various forms of allograft-based DBMs, and artificial bone graft substitutes (HA and B-TCP) effectively promote posterolateral lumbar noninstrumented and instrumented fusions when added to autografts.

Lumbar Nerve Root Occupancy in the Foramen in Achondroplasia

Science.gov (United States)

Modi, Hitesh N.; Song, Hae-Ryong; Yang, Jae Hyuk

2008-01-01

Lumbar stenosis is common in patients with achondroplasia because of narrowing of the neural canal. However, it is unclear what causes stenosis, narrowing of the central canal or foramina. We performed a morphometric analysis of the lumbar nerve roots and intervertebral foramen in 17 patients (170 nerve roots and foramina) with achondroplasia (eight symptomatic, nine asymptomatic) and compared the data with that from 20 (200 nerve roots and foramina) asymptomatic patients without achondroplasia presenting with low back pain without neurologic symptoms. The measurements were made on left and right parasagittal MRI scans of the lumbar spine. The foramen area and root area were reduced at all levels from L1 to L5 between the patients with achondroplasia (Groups I and II) and the nonachondroplasia group (Group III). The percentage of nerve root occupancy in the foramen between Group I and Group II as compared with the patients without achondroplasia was similar or lower. This implied the lumbar nerve root size in patients with achondroplasia was smaller than that of the normal population and thus there is no effective nerve root compression. Symptoms of lumbar stenosis in achondroplasia may be arising from the central canal secondary to degenerative disc disease rather than a true foraminal stenosis. Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18259829

La Enfermedad Celíaca

OpenAIRE

Cueto Rua, Eduardo Ángel; Nanfito, Gabriela; Guzmán, Luciana

2006-01-01

La Enfermedad Celíaca (EC) es la intolerancia alimentaria de orden genético más frecuente de la especie humana. En nuestro Servicio de Gastroenterología hemos diagnosticado más de 1900 casos en los últimos 34 años, y 92 y 73 nuevos casos en los años 2004 y 2005, respectivamente. La EC es el resultado de la interacción entre factores genéticos (constante absoluta) expresados en la mucosa intestinal y la respuesta i...

Spinal CT scan, 2. Lumbar and sacral spines

Energy Technology Data Exchange (ETDEWEB)

Nakagawa, Hiroshi (Aichi Medical Univ., Aichi (Japan))

1982-08-01

Plain CT described fairly accurately the anatomy and lesions of the lumbar and sacral spines on their transverse sections. Since hernia of the intervertebral disc could be directly diagnosed by CT, indications of myelography could be restricted. Spinal-canal stenosis of the lumbar spine occurs because of various factors, and CT not only demonstrated the accurate size and morphology of bony canals, but also elucidated thickening of the joints and yellow ligament. CT was also useful for the diagnosis of tumors in the lumbar and sacral spines, visualizing the images of bone changes and soft tissues on the trasverse sections. But the diagnosis of intradural tumors required myelography and metrizamide CT. CT has become important for the diagnosis of spinal and spinal-cord diseases and for selection of the route of surgical arrival.

Anticoagulante lúpico en enfermedades autoinmunes Lupus anticoagulant in autoimmune diseases

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Dunia de la C Castillo González

2004-08-01

Full Text Available El tromboembolismo venoso es una complicación reconocida en diferentes enfermedades autoinmunes. Se ha establecido que la detección del anticoagulante lúpico (AL y posiblemente los anticuerpos anticardiolipina (AAC tipo Ig G en título alto y medio, ayuden a identificar pacientes con riesgo de trombosis. Estudiamos el AL en 81 pacientes con enfermedades autoinmunes: 25 pacientes con lupus eritematoso sistémico (LES, 28 pacientes con púrpura trombocitopénica idiopática (PTI, 15 con anemia hemolítica autoinmune (AHAI y 13 que se incluyeron en el grupo de otras enfermedades, que comprendían vasculitis cutánea de pequeños vasos, enfermedad mixta del tejido conectivo, artritis reumatoidea y esclerodermia. El AL se encontró en el 19,7 % del total de los estudiados: 16 % en pacientes con LES, 21,4 % en pacientes con PTI y 40 % en la AHAI. En el grupo de otras enfermedades no se halló ningún paciente con el AL positivo. El 56,3 % de los pacientes con AL positivo presentaron alguna manifestación atribuible al síndrome antifosfolípido (SAFVenous thromboembolism is a well-known complication in different autoimmune diseases. It has been established that detection of lupus anticoagulant (LA and possibly IgG type anticardiolipin antibodies (AAC in high and medium titers help to identify patients with thrombosis risk. We studied LA in 81 patients with autoimmune erythomatous lupus, 28 patients with idiopathic thrombocytopenic purpura, 15 with autoimmune hemolytic anemia and 13 patients who were included in the group covering other diseases such as small vessel skin vasculitis, combined disease of the connective tissue, rheumatoid arthritis and sclerodermia. LA was found in 19,7 % of the total number of cases, in 16% of patients with LES, 21,4 % of those with ITP and 40 % of cases with AIHA. In the group of other diseases, there was no patient with positive LA. 56,3 % of patients with positive AL showed some manifestations related to

Endoscopic anatomy and features of lumbar discectomy by Destandau technique

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Keyvan Mostofi

2017-03-01

Full Text Available Minimally invasive spine surgery prevents alteration of paraspinal muscles and avoids traditional open surgery, so in the majority of cases, recovery is much quicker and patients have less back pain after surgery. The authors describe an endoscopic approach to lumbar disc herniation by the Destandau's method originated in Bordeaux. Destandau designed ENDOSPINE for discectomy will be inserted, and the procedure will continue using endoscopy. The Endoscopic approach to lumbar disc herniation by Destandau's method offers a convenient access to lumbar disc herniation with less complications and negligible morbidity. It gives maximum exposure to the disc space with maximal angles and minimal cutaneous incision. Contrary to other minimally invasive approaches, the visual field in discectomy by Destandau technique is broad and depending on the workability of ENDOSPINE an adequate access to lumbar disc herniation is possible.

Constipation after thoraco-lumbar fusion surgery.

Science.gov (United States)

Stienen, Martin N; Smoll, Nicolas R; Hildebrandt, Gerhard; Schaller, Karl; Tessitore, Enrico; Gautschi, Oliver P

2014-11-01

Thoraco-lumbar posterior fusion surgery is a frequent procedure used for patients with spinal instability due to tumor, trauma or degenerative disease. In the perioperative phase, many patients may experience vomiting, bowel irritation, constipation, or may even show symptoms of adynamic ileus possibly due to immobilization and high doses of opioid analgesics and narcotics administered during and after surgery. Retrospective single-center study on patients undergoing thoraco-lumbar fusion surgery for degenerative lumbar spine disease with instability in 2012. Study groups were built according to presence/absence of postoperative constipation, with postoperative constipation being defined as no bowel movement on postoperative days 0-2. Ninety-nine patients (39 males, 60 females) with a mean age of 57.1 ± 17.3 years were analyzed, of which 44 patients with similar age, gender, BMI and ASA-grades showed constipation (44.4%). Occurrence of constipation was associated with longer mean operation times (247 ± 62 vs. 214 ± 71 min; p=0.012), higher estimated blood loss (545 ± 316 vs. 375 ± 332 ml; pconstipation. One patient with constipation developed a sonographically confirmed paralytic ileus. Patients with constipation showed a tendency toward longer postoperative hospitalization (7.6 vs. 6.7 days, p=0.136). The rate of constipation was high after thoraco-lumbar fusion surgery. Moreover, it was associated with longer surgery time, higher blood loss, and higher postoperative morphine doses. Further trials are needed to prove if the introduction of faster and less invasive surgery techniques may have a positive side effect on bowel movement after spine surgery as they may reduce operation times, blood loss and postoperative morphine use. Copyright © 2014 Elsevier B.V. All rights reserved.

Imaging of the lumbar spine after diskectomy

International Nuclear Information System (INIS)

Laredo, J.D.; Wybier, M.

1995-01-01

The radiological investigation of persistent or recurrent sciatica after lumbar diskectomy essentially consists of demonstrating recurrent disk herniation. Comparison between plain and contrast enhanced CT or MR examinations at the level of the diskectomy is the main step of the radiological survey. The meanings of the various radiological findings are discussed. Other lesions that may induce persistent sciatica after lumbar diskectomy include degenerative narrowing of the lateral recess, spinal instability, stress fracture of the remaining neural arch, pseudo-meningomyelocele after laminectomy. (authors). 34 refs., 5 tabs

Evaluation of Coflex interspinous stabilization following decompression compared with decompression and posterior lumbar interbody fusion for the treatment of lumbar degenerative disease: A minimum 5-year follow-up study.

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Yuan, Wei; Su, Qing-Jun; Liu, Tie; Yang, Jin-Cai; Kang, Nan; Guan, Li; Hai, Yong

2017-01-01

Few studies have compared the clinical and radiological outcomes between Coflex interspinous stabilization and posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease. We compared the at least 5-year clinical and radiological outcomes of Coflex stabilization and PLIF for lumbar degenerative disease. Eighty-seven consecutive patients with lumbar degenerative disease were retrospectively reviewed. Forty-two patients underwent decompression and Coflex interspinous stabilization (Coflex group), 45 patients underwent decompression and PLIF (PLIF group). Clinical and radiological outcomes were evaluated. Coflex subjects experienced less blood loss, shorter hospital stays and shorter operative time than PLIF (all pdisease was higher in the PLIF group, but this did not achieve statistical significance (11.1% vs. 4.8%, p=0.277). Both groups provided sustainable improved clinical outcomes for lumbar degenerative disease through at least 5-year follow-up. The Coflex group had significantly better early efficacy than the PLIF group. Coflex interspinous implantation after decompression is safe and effective for lumbar degenerative disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lumbar hernia - a case report and review of the literature

International Nuclear Information System (INIS)

D'Ippolito, Giuseppe; Yonamine, Claudia

1999-01-01

The authors present a case of lumbar hernia of inferior right space (Petit's triangle), classified as acquired hernia and diagnosed by clinical history and computed tomography. Lumbar hernia are quite rare. Authors have done a literature review of this disease. (author)

Iliac artery pseudoaneurysm after lumbar disc hernia operation

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Mehmet Atay

2016-03-01

Full Text Available Lumbar disc herniation surgery is usually performed through a posterior approach. Vascular injuries can be counted among the complications. 39 years old male patient had lower extremity pain which has started after lumbar disc herniation surgery and continued for a month. Iliac arterial pseudoaneurysm has been detected in computerized tomography. It was successfully treated with vascular surgery [Cukurova Med J 2016; 41(0.100: 5-7

Enfermedad trofoblástica gestacional

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Ariel Labrada Salas

2014-09-01

Full Text Available Se presenta un caso con enfermedad trofoblástica gestacional de diagnóstico tardío, que debutó con manifestaciones respiratorias, producidas por metástasis pulmonares. Los datos se obtuvieron de la historia clínica de la paciente y, además, se revisó la literatura. Se trata de una paciente de 23 años de edad, con antecedentes de dos abortos espontáneos recientes, que ingresó por manifestaciones clínicas y radiológicas sugestivas de neumonía de la comunidad, con derrame pleural paraneumónico, siendo tratada con antibióticos de amplio espectro sin respuesta adecuada. Después del ingreso apareció dolor en hipogastrio y se le realizó un ultrasonograma ginecológico, que mostró quistes de ovario bilaterales, y una laparoscopía que informó quiste de ovario con compromiso vascular, por lo que se le practicó histerectomía total. Se determinaron niveles elevados de gonadotropina coriónica humana en sangre. En la tomografía axial computarizada de pulmón se observaron imágenes nodulares en ambos campos pulmonares, de aspecto metastásico. El estudio citológico del líquido pleural fue positivo de células neoplásicas. Se planteó el diagnostico de enfermedad trofoblástica con metástasis pulmonares y se inició quimioterapia con metotrexato, con respuesta favorable

Percutaneous endoscopic lumbar discectomy: Results of first 100 cases

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Kanthila Mahesha

2017-01-01

Full Text Available Background: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Percutaneous endoscopic discectomy is the least invasive procedure for lumbar disc prolapse. The aim of this study was to analyze the clinical outcome, quality of life, neurologic function, and complications. Materials and Methods: One hundred patients with lumbar disc prolapse who were treated with percutaneous endoscopic discectomy from May 2012 to January 2014 were included in this retrospective study. Clinical followup was done at 1 month, 3 months, 6 months, 1 year, and at yearly interval thereafter. The outcome was assessed using modified Macnab′s criteria, visual analog scale, and Oswestry Disability Index. Results: The mean followup period was 2 years (range 18 months - 3 years. Transforaminal approach was used in 84 patients, interlaminar approach in seven patients, and combined approach in nine patients. An excellent outcome was noted in ninety patients, good outcome in six patients, fair result in two patients, and poor result in two patients. Minor complications were seen in three patients, and two patients had recurrent disc prolapse. Mean hospital stay was 1.6 days. Conclusions: Percutaneous endoscopic lumbar discectomy is a safe and effective procedure in lumbar disc prolapse. It has the advantage that it can be performed on a day care basis under local anesthesia with shorter length of hospitalization and early return to work thus improving the quality of life earlier. The low complication rate makes it the future of disc surgery. Transforaminal approach alone is sufficient in majority of cases, although 16% of cases required either percutaneous interlaminar approach or combined approach. The procedure definitely has a learning curve, but it is acceptable with adequate preparations.

Effect of Lumbar Lordosis on the Adjacent Segment in Transforaminal Lumbar Interbody Fusion: A Finite Element Analysis.

Science.gov (United States)

Zhao, Xin; Du, Lin; Xie, Youzhuan; Zhao, Jie

2018-06-01

We used a finite element (FE) analysis to investigate the biomechanical changes caused by transforaminal lumbar interbody fusion (TLIF) at the L4-L5 level by lumbar lordosis (LL) degree. A lumbar FE model (L1-S5) was constructed based on computed tomography scans of a 30-year-old healthy male volunteer (pelvic incidence,= 50°; LL, 52°). We investigated the influence of LL on the biomechanical behavior of the lumbar spine after TLIF in L4-L5 fusion models with 57°, 52°, 47°, and 40° LL. The LL was defined as the angle between the superior end plate of L1 and the superior end plate of S1. A 150-N vertical axial preload was imposed on the superior surface of L3. A 10-N/m moment was simultaneously applied on the L3 superior surface along the radial direction to simulate the 4 basic physiologic motions of flexion, extension, lateral bending, and torsion in the numeric simulations. The range of motion (ROM) and intradiscal pressure (IDP) of L3-L4 were evaluated and compared in the simulated cases. In all motion patterns, the ROM and IDP were both increased after TLIF. In addition, the decrease in lordosis generally increased the ROM and IDP in all motion patterns. This FE analysis indicated that decreased spinal lordosis may evoke overstress of the adjacent segment and increase the risk of the pathologic development of adjacent segment degeneration; thus, adjacent segment degeneration should be considered when planning a spinal fusion procedure. Copyright © 2018. Published by Elsevier Inc.

Efecto neuroprotector de los cannabinoides en las enfermedades neurodegenerativas

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Carlos Suero-García

2015-01-01

Full Text Available Objetivos: Se analiza la situación actual de las investigaciones relacionadas con las sustancias cannabinoides, así como su interacción con el organismo, clasificación, efectos terapéuticos y su uso en las enfermedades neurodegenerativas. Métodos: Se realiza una exhaustiva revisión bibliográfica relacionada con las sustancias cannabinoides y sus derivados sintéticos, haciendo especial hincapié en la forma de interactuar con el organismo y los efectos que provocan dichas interacciones. Concretamente, se estudiarán sus efectos neuroantiinflamatorio y analgésico lo que conlleva al efecto neuroprotector en enfermedades neurodegenerativas tales como Alzheimer, Parkinson, Huntington, esclerosis múltiple y esclerosis lateral amiotrófica. Resultados: Desde hace miles de años la planta Cannabis Sativa ha sido utilizada por muchas culturas con distintos fines, de ocio, textiles, analgésicos, pero no es hasta finales del siglo XX cuando se empieza a incentivar los estudios científicos relacionados con ésta. La planta posee una mezcla de unos 400 componentes, de los cuales 60 pertenecen al grupo de los cannabinoides siendo los principales el cannabinol, cannabidiol y tetrahidrocannabinol. Con el descubrimiento de las sustancias cannabinoides, sus derivados, y los receptores que interactúan, se amplían las posibilidades terapéuticas teniendo un especial interés el efecto neuroprotector que estas sustancias contienen. Conclusiones. Se ha demostrado el gran potencial de los cannabinoides como sustancias terapéuticas más allá de su uso analgésico o antiemético, esto es, en enfermedades neurodegenerativas en las que pueden no solo disminuir los síntomas, sino frenar el proceso de la enfermedad. Otra posible aplicación puede ser en el campo oncológico, siendo particularmente intensa la actividad investigadora realizada en los últimos 15 años.

Agresiones físicas en prisión, la enfermedad mental como factor de riesgo asociado

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F. Caravaca-Sánchez

2014-02-01

Full Text Available Objetivos: Analizar la victimización física en la población penitenciaria teniendo en cuenta la existencia de algún tipo de enfermedad mental en el Centro Penitenciario de Albolote (Granada. Material y métodos: 270 personas privadas de libertad realizaron una encuesta anónima y voluntaria sobre victimización. Resultados: Un 36,7% del total de internos sufrió algún tipo de victimización física en prisión. Aproximadamente un 62,2% de los participantes perciben que tienen ansiedad, depresión, enfermedad bipolar, esquizofrenia u otra enfermedad mental, recibiendo la mitad tratamiento para estos problemas. Conclusiones: Las agresiones físicas para personas con enfermedad mental son 2.5 veces superiores respecto los que no tienen ninguna.

Risk factors for acute surgical site infections after lumbar surgery: a retrospective study.

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Lai, Qi; Song, Quanwei; Guo, Runsheng; Bi, Haidi; Liu, Xuqiang; Yu, Xiaolong; Zhu, Jianghao; Dai, Min; Zhang, Bin

2017-07-19

Currently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery. We retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital's spinal surgery unit. Patient demographics, procedures, and wound infection rates were analyzed using descriptive statistics, and risk factors were analyzed using logistic regression analyses. Twenty-six patients (2.81%) experienced acute surgical site infection following lumbar surgery in our study. The patients' mean body mass index, smoking history, operative time, blood loss, draining time, and drainage volume in the acute surgical site infection group were significantly different from those in the non-acute surgical site infection group (p operative type in the acute surgical site infection group were significantly different than those in the non-acute surgical site infection group (p operative type, operative time, blood loss, and drainage time were independent predictors of acute surgical site infection following lumbar surgery. In order to reduce the risk of infection following lumbar surgery, patients should be evaluated for the risk factors noted above.

Lumbar spine chordoma

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M.A. Hatem, M.B.Ch.B, MRes, LMCC

2014-01-01

Full Text Available Chordoma is a rare tumor arising from notochord remnants in the spine. It is slow-growing, which makes it difficult to diagnose and difficult to follow up after treatment. Typically, it occurs in the base of the skull and sacrococcygeal spine; it rarely occurs in other parts of the spine. CT-guided biopsy of a suspicious mass enabled diagnosis of lumbar spine chordoma.

Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

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Lee, Su-Keon; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

2016-01-01

Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. Methods Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°). Results Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). Conclusions Intraoperative lumbar lordosis on the OSI frame with a prone

Trasplante cardíaco en pacientes con enfermedad de Chagas. Experiencia de un único centro

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Alfredo Inácio Fiorelli

2011-07-01

Conclusiones: El trasplante cardíaco es el único tratamiento actual eficaz de tratamiento de la enfermedad de Chagas en fase terminal. La reactivación de la enfermedad es un problema real que es fácilmente revertido con la introducción de la terapéutica farmacológica específica, restaurando los padrones histológicos del miocardio sin dejar secuelas. La inmunosupresión, en especial los corticoides, predisponen al desarrollo de neoplasias y a la reactivación de la enfermedad, exigiendo una atención especial su interrupción o reducción precoz.

Evaluación de la prueba del reloj en el tamizaje de enfermedad de Alzheimer

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Teodoro Oscanoa

2004-03-01

Full Text Available Objetivo: Examinar la capacidad discriminativa de la prueba del reloj con 10 puntos en el tamizaje de trastorno cognoscitivo por enfermedad de Alzheimer. Material y Métodos: Evaluación de una prueba diagnóstica mediante estudio de pacientes con y sin enfermedad de Alzheimer, provenientes del Consultorio Externo del Servicio de Geriatría del Hospital Almenara, Lima, Perú. Participaron 31 pacientes (10 varones y 21 mujeres con enfermedad de Alzheimer y 31 pacientes sin esta enfermedad (21 varones y 10 mujeres. A ambos grupos se les realizó el prueba del reloj. No hubo diferencia significativa entre la edad y grado de instrucción de ambos grupos. La gravedad de la demencia según el Clinical Dementia Ratio de Hughes fue leve en 10 (32,3%, moderada 12 (38,7% y severa en 9 (29%. Resultados: Considerando como punto de corte un valor de 6 en la prueba del reloj, se encontró una sensibilidad de 83,9%, especificidad 93,5%, valor predictivo positivo 92,9 y valor predictivo negativo 85,3%. Conclusión: La prueba del reloj parece ser un examen simple y efectivo para la evaluación inicial de trastornos cognitivos en pacientes adultos mayores con sospecha de demencia por enfermedad de Alzheimer.

The Lumbar Lordosis in Males and Females, Revisited.

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Ori Hay

Full Text Available Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females.Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height.Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined.Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis. The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

The Lumbar Lordosis in Males and Females, Revisited.

Science.gov (United States)

Hay, Ori; Dar, Gali; Abbas, Janan; Stein, Dan; May, Hila; Masharawi, Youssef; Peled, Nathan; Hershkovitz, Israel

2015-01-01

Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females. Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height. Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined). Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis). The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

Atresia biliar: una enfermedad grave

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Ramonet, Margarita; Ciocca, Mirta; Alvarez, Fernando

2014-01-01

La atresia biliar es una grave enfermedad que se manifiesta en los recién nacidos, y se desconoce su causa. La inflamación y destrucciónprogresiva de los conductos biliares conducen a la aparición de ictericia, coluria y acolia entre la segunda y sexta semana de vida. Como existen múltiples causas de colestasis neonatal en esta etapa de la vida, es necesario realizar un diagnóstico y derivación precoz para ofrecer un tratamiento quirúrgico, con el fin de restablecer el flujo biliar. Alrededor...

Principales enfermedades bucodentales en embarazadas

OpenAIRE

Méndez de Varona, Yuliet B; Batista Sánchez, Tamara; Peña Marrero, Yamilet; Torres Acosta, Raúl

2016-01-01

Introducción: el embarazo constituye un proceso natural que provoca una serie de cambios fisiológicos, patológicos y psicológicos que las convierten en pacientes especiales que demandan cuidados exclusivos. Objetivo: determinar las principales enfermedades bucodentales que afectan a las embarazadas del Policlínico Pedro Díaz Coello. Métodos: Se realizó un estudio transversal de enero de 2014 a enero de 2015 en el Policlínico Pedro Díaz Coello de Holguín a un total de 395 embarazadas que acudi...

Radiographic comparison between male and female patients with lumbar spondylolysis.

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Takao, Shoichiro; Sakai, Toshinori; Sairyo, Koichi; Kondo, Tadashi; Ueno, Junji; Yasui, Natsuo; Nishitani, Hiromu

2010-02-01

We studied the lumbar spines of 117 adults (39 women and 78 men) with spondylolysis unrelated to low back pain using multidetector computed tomography (CT). Of the 117 subjects with spondylolysis, including five with multiple-level spondylolysis, there were 124 vertebrae with spondylolysis. In adult lumbar spines with unilateral spondylolysis, there was no significant difference between the incidence of spondylolisthesis in female and male subjects. However, in those with bilateral spondylolysis, there was a significantly higher incidence of spondylolisthesis in female subjects (90.9%) than in males (66.2%). Furthermore, females with bilateral spondylolysis had significant more slippage than males. Lumbar index and lumbar lordosis were not significantly different between male and female subjects, and did not significantly correlate with slippage. In conclusion, to treat acute spondylolysis in adolescents, it is important to obtain bony union at least unilaterally, especially in female subjects, to prevent further slippage.

Mortalidad prematura por enfermedades infecciosas en España, 1908-1995

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Mirón Canelo José Antonio

2002-01-01

Full Text Available Objetivos. Las enfermedades infecciosas han sido tradicionalmente una de las principales causas de muerte en los países desarrollados. Los objetivos del presente trabajo consistieron en cuantificar la importancia de las enfermedades infecciosas como causa de muerte prematura en España entre 1908 y 1995, y conocer la frecuencia y distribución de las enfermedades infecciosas con mayor impacto sobre la mortalidad prematura. Métodos. El estudio se realizó a partir de los datos de mortalidad por causas infecciosas publicados por el Instituto Nacional de Estadística en el Movimiento Natural de la Población para el período en estudio. Se utilizan como indicadores de mortalidad prematura los años de vida potencial perdidos (AVPP, la tasa bruta de AVPP por 1 000 habitantes y el porcentaje y la media de AVPP. Resultados. Entre 1908 y 1995, el número y la tasa de AVPP por causas infecciosas experimentaron una evolución claramente descendente. El descenso fue más acusado a partir de los años 50 y se observó en todos los grupos de edad. La tuberculosis fue la primera causa de muerte prematura desde principios de siglo hasta los años 70. A partir de esta fecha toman el relevo las neumonías y el sida. Conclusiones. El impacto de las enfermedades infecciosas como determinantes de muerte prematura en España ha descendido a lo largo del siglo XX, sobre todo a partir de los años 70.

Surgical management for lumbar disc herniation in pregnancy.

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Kapetanakis, S; Giovannopoulou, E; Blontzos, N; Kazakos, G; Givissis, P

2017-12-01

Lumbar disc herniation is a common surgical spine pathology that may be presented during pregnancy. The state of pregnancy complicates the diagnosis and therapeutical management of this entity. Specific considerations rule the decision for surgical intervention, the optimal timing of it and the type of selected procedure in a pregnant patient, due to the potential risks for the fetus. In the last 30 years, evolution in the field of spine surgery has provided options other than open standard discectomy. The well-established concept of "minimal intervention" has led to the development of microdiscectomy and other innovative, full-endoscopic techniques for lumbar discectomy. The aim of the present study is to review the surgical management of lumbar disc herniation in pregnancy and investigate the potential role of minimally invasive spine surgery in this specific population. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Ocurrencia de enfermedad cerebrovascular en pacientes hipertensos

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María de la Concepción Orbay Araña

2002-10-01

Full Text Available Se realizó un estudio para establecer la relación entre la hipertensión arterial esencial y la enfermedad cerebrovascular, en 19 consultorios del Médico de la Familia del Policlínico Plaza de la Revolución. Se aplicó una encuesta a pacientes reevaluados como hipertensos, confeccionándose una base de datos para tratamiento en el sistema FOXBASE versión 5.0. Aplicamos prueba de asociación entre variables cualitativas que se distribuyen en Chi cuadrado. Se identificó el comportamiento de la hipertensión arterial atendiendo a grados, los grupos etáreos, el sexo, la raza y los factores de riesgo asociados. Se estableció igualmente la relación entre el control de la hipertensión arterial y la aparición de la enfermedad cerebrovascular y encontramos un 15 % de población hipertensa, predominando la moderada (36,88 %, con mayor representación los grupos etáreos de 55 a 64 años (38,29 % y de 45 a 54 (23,16 %, del sexo femenino (55,02 % y de la raza blanca (54,04 %. La ocurrencia de enfermedad cerebrovascular estuvo representada por el 4, 35 %, correspondiente a 71 pacientes, con mayor asociación a la hipertensión arterial severa. No resultó significativamente estadística la relación entre enfermedad cerebrovascular e hipertensión arterial.A study was conducted to establish the relationship between essential arterial hypertension and cerebrovascular disease in 19 family physician offices of "Plaza de la Revolución" Polyclinic. Those patientes reevaluated as hypertensive were surveyed. A database for treatment was created in the FOXBASE system, version 5.0. A Chi square test of association among qualitative variables, which are distributed, was applied. The behavior of arterial hypertension was identified according to degrees, age groups, sex, race and the associated risk factors. The relation between the control of arterial hypertension and the appearance of cerebrovascular disease was also established. It was found a 15 % of

The values of MSCT multi-planar reconstruction in the diagnosis of lumbar spondylolysis

International Nuclear Information System (INIS)

Tan Qixuan; Zhu Gangming; Qian Huirong; Zhong Sheng

2007-01-01

Objective: To study the reasonable schedule and diagnostic values of MSCT multi-planar reconstruction in patients with lumbar spondylolysis. Methods: Volume scan ranging from T12 to S1 was done in 540 cases suffered from backleg pain without definite trauma. The lumbar disc axial and whole lumbar axial, sagital, coronal images were reconstructed from raw data of MSCT. Results: Of the 540 cases, 54 spondylolysis in isthmus of lumbar pedicle were demonstrated in 29 ones (29/540, 5.37%). 20 cases were accompanied with spondylolisthesis. The sagital multi-planar reconstruction was the best way to reveal the fissures of spondylolysis and accompanying abnormalities. The detectable ratio of fissures in lumbar disc with axial, whole lumbar axial, sagital and coronal multi-planer reconstruction images were 7.41%, 100%, 100% and 51.85% respectively. Conclusions: MSCT sagital multi-planar reconstruction is the best images to reveal the fissures of spondylolysis. It should be taken as routine item in MSCT examination for the patients with lower back pain. (authors)

Herpes zoster sciatica mimicking lumbar canal stenosis: a case report.

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Koda, Masao; Mannoji, Chikato; Oikawa, Makiko; Murakami, Masazumi; Okamoto, Yuzuru; Kon, Tamiyo; Okawa, Akihiko; Ikeda, Osamu; Yamazaki, Masashi; Furuya, Takeo

2015-07-29

Symptom of herpes zoster is sometimes difficult to distinguish from sciatica induced by spinal diseases, including lumbar disc herniation and spinal canal stenosis. Here we report a case of sciatica mimicking lumbar canal stenosis. A 74-year-old Chinese male patient visited our hospital for left-sided sciatic pain upon standing or walking for 5 min of approximately 1 month's duration. At the first visit to our hospital, there were no skin lesions. A magnetic resonance imaging showed spinal canal stenosis between the 4th and 5th lumbar spine. Thus, we diagnosed the patient with sciatica induced by spinal canal stenosis. We considered decompression surgery for the stenosis of 4th and 5th lumbar spine because conservative therapy failed to relieve the patient's symptom. At that time, the patient complained of a skin rash involving his left foot for several days. A vesicular rash and erythema were observed on the dorsal and plantar surfaces of the great toe and lateral malleolus. The patient was diagnosed with herpes zoster in the left 5th lumbar spinal nerve area based on clinical findings, including the characteristics of the pain and vesicular rash and erythema in the 5th lumbar spinal dermatome. The patient was treated with famciclovir (1,500 mg/day) and non-steroidal anti-inflammatory drugs. After 1 week of medication, the skin rash resolved and pain relief was obtained. In conclusion, spinal surgeons should keep in mind herpes zoster infection as one of the possible differential diagnoses of sciatica, even if there is no typical skin rash.

Diagnostic method for lumbar foraminal stenosis based on the clinical results of transforaminal lumbar interbody fusion (TLIF). Utility of the foraminal stenosis score

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Yamada, Katsutaka; Nakamura, Jun-ichiro; Mitsugi, Naoto; Sato, Masatsune; Saito, Tomoyuki

2010-01-01

In this study we analyzed 73 cases treated by transforaminal lumbar interbody fusion (TLIF) for lumbar foraminal stenosis or central canal stenosis and foraminal stenosis, and based on the perioperative findings and outcome of treatment, we considered the diagnostic procedure for lumbar foraminal stenosis in the future. In 25 cases (34.2%) cases there was actually no clear perioperative evidence of foraminal stenosis. We compared the preoperative clinical and imaging findings in the group with perioperative findings and the group without perioperative findings performed a multiple logistic regression analysis to identify factors associated with foraminal stenosis. We also calculated the odds ratio for the perioperative findings and proposed a foraminal stenosis scoring system. (author)

Sagittal lumbar and pelvic alignment in the standing and sitting positions.

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Endo, Kenji; Suzuki, Hidekazu; Nishimura, Hirosuke; Tanaka, Hidetoshi; Shishido, Takaaki; Yamamoto, Kengo

2012-11-01

The sitting position has become the most common posture in today's workplace. In relation to this position, kinematic analysis of the lumbar spine is helpful in understanding the causes of low back pain and its prevention. In this study, we investigated the relationship between sagittal lumbar alignment and pelvic alignment in the standing and sitting positions for 50 healthy adults. Lumbar lordotic angle (LLA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) were measured on lateral lumbar spine standing and sitting radiographs. Regarding changes from the standing to sitting positions, average LLA, SS, and PT were -16.6° (-49.8 %), -18.7° (-50.3 %), and 18.3° (284.8 %), respectively (P position, lumbar lordosis was reduced and pelvic rotation became posterior. This study showed that LLA decreased by approximately 50 % and PT increased by approximately 25 % in the sitting position compared with the standing position. No significant gender differences were observed for LLA, SS, and PT in the standing position. In the sitting position, however, LLA and SS were markedly larger for women.

Technological advances and changing indications for lumbar puncture in neurological disorders.

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Costerus, Joost M; Brouwer, Matthijs C; van de Beek, Diederik

2018-03-01

Technological advances have changed the indications for and the way in which lumbar puncture is done. Suspected CNS infection remains the most common indication for lumbar puncture, but new molecular techniques have broadened CSF analysis indications, such as the determination of neuronal autoantibodies in autoimmune encephalitis. New screening techniques have increased sensitvity for pathogen detection and can be used to identify pathogens that were previously unknown to cause CNS infections. Evidence suggests that potential treatments for neurodegenerative diseases, such as Alzheimer's disease, will rely on early detection of the disease with the use of CSF biomarkers. In addition to being used as a diagnostic tool, lumbar puncture can also be used to administer intrathecal treatments as shown by studies of antisense oligonucleotides in patients with spinal muscular atrophy. Lumbar puncture is generally a safe procedure but complications can occur, ranging from minor (eg, back pain) to potentially devastating (eg, cerebral herniation). Evidence that an atraumatic needle tip design reduces complications of lumbar puncture is compelling, and reinforces the need to change clinical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Operative treatment of degenerative diseases of the lumbar spine].

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Czabanka, M; Thomé, C; Ringel, F; Meyer, B; Eicker, S-O; Rohde, V; Stoffel, M; Vajkoczy, P

2018-04-20

Degenerative diseases of the lumbar spine and associated lower back pain represent a major epidemiological and health-related economic challenge. A distinction is made between specific and unspecific lower back pain. In specific lower back pain lumbar disc herniation and spinal canal stenosis with or without associated segment instability are among the most frequent pathologies. Diverse conservative and operative strategies for treatment of these diseases are available. The aim of this article is to present an overview of current data and an evidence-based assessment of the possible forms of treatment. An extensive literature search was carried out via Medline plus an additional evaluation of the authors' personal experiences. Conservative and surgical treatment represent efficient treatment options for degenerative diseases of the lumbar spine. Surgical treatment of lumbar disc herniation shows slight advantages compared to conservative treatment consisting of faster recovery of neurological deficits and a faster restitution of pain control. Surgical decompression is superior to conservative measures for the treatment of spinal canal stenosis and degenerative spondylolisthesis. In this scenario conservative treatment represents an important supporting measure for surgical treatment in order to improve the mobility of patients and the outcome of surgical treatment. The treatment of specific lower back pain due to degenerative lumbar pathologies represents an interdisciplinary challenge, requiring both conservative and surgical treatment strategies in a synergistic treatment concept in order to achieve the best results for patients.

Complications of lumbar puncture in a child treated for leukaemia

International Nuclear Information System (INIS)

Staebler, Melanie; Delpierre, Isabelle; Damry, Nash; Christophe, Catherine; Azzi, Nadira; Sekhara, Tayeb

2005-01-01

Lumbar puncture may lead to neurological complications. These include intracranial hypotension, cervical epidural haematomas, and cranial and lumbar subdural haematomas. MRI is the modality of choice to diagnose these complications. This report documents MRI findings of such complications in a child treated for leukaemia. (orig.)

El papel de la terapia ocupacional en la enfermedad de Huntington

OpenAIRE

Hernández Lozano, David; Fernández Hawrylak, María; Grau Rubio, Claudia

2014-01-01

se analiza el papel del terapeuta ocupacional en el trabajo con las personas afectadas por la enfermedad de Huntington. se realizó una investigación por objetivos a través del diseño y puesta en práctica de un programa de intervención encaminado a mitigar el deterioro producido por la enfermedad mediante el entrenamiento en actividades de la vida diaria y de estimulación cognitiva, y a desarrollar competencias en la familia. la investigación se desarrolló en la Asociación de corea de Huntingt...

Descripción actual de la enfermedad de Durand, Nicolas y Favre

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Laurentino Muñoz

1950-04-01

Full Text Available En los últimos años la ciencia médica logra esclarecer el cuadro de la Enfermedad de Durand, Nicolas y Favre; confundida con las otras enfermedades venéreas y aun con la Tuberculosis en épocas que se van alejando, somos dueños ahora no solo de la enseñanza clínica, de medios de diagnostico y terapéuticos, para apreciar y combatir la primitiva lesión y sus complicaciones, sino que el cuadro de la enfermedad se ensancha y adquiere importancia inusitada, de simple adenitis inguinal con bubón o fistulizada que a pesar de la cronicidad se consideraba como lesión local, llegamos a la realidad de localizaciones del virus paradenico a 10 largo del tubo digestivo, en los vasos sanguíneos y linfáticos (a distancia, en el ojo y oído, en el sistema nervioso, en la piel, en las articulaciones.

Hip and pelvis diseases on lumbar AP radiographs including both hip joints

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Lim, Hyun Soo; Juhng, Seon Kwan; Kim, Eun A; Kim, Jeong Ho; Song, Ha Heon; Shim, Dae Moo [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

2002-12-01

To determine the frequency of disease, and to evaluate the methods used for lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1215 patients, taken using 14x17 inch film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesion, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesion in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 or the 20 hospitals which responded, 14{sup x}17{sup f}ilm was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.

The geometric curvature of the lumbar spine during restricted and unrestricted squats.

Science.gov (United States)

Hebling Campos, Mário; Furtado Alaman, Laizi I; Seffrin-Neto, Aldo A; Vieira, Carlos A; Costa de Paula, Marcelo; Barbosa de Lira, Claudio A

2017-06-01

The main purpose of this study was to analyze the behavior of the geometric curvature of the lumbar spine during restricted and unrestricted squats, using a novel investigative method. The rationale for our hypothesis is that the lumbar curvature has different patterns at different spine levels depending on the squat technique used. Spine motion was collected via stereo-photogrammetric analysis in nineteen participants (11 males, 8 females). The reconstructed spine points at the upright neutral position and at the deepest position of the squat exercise were projected onto the sagittal plane of the trunk, a polynomial was fitted to the data, and were quantified the two-dimensional geometric curvature at lower, central and higher lumbar levels, besides the inclination of trunk and lumbosacral region, the overall geometric curvature and overall angle of the lumbar spine. The mean values for each variable were analysed with paired t-test (Psquat techniques and these effects are also reduced in unrestricted squats. The data collected in the study are evidence that during barbell squats the lumbar curvature has different patterns at different spinal levels depending on the exercise technique. The lower lumbar spine appears to be less overloaded during unrestricted squats.

CHANGES IN RADIOGRAPHIC PARAMETERS AFTER MINIMALLY INVASIVE LUMBAR INTERBODY FUSION

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Emiliano Vialle

2015-12-01

Full Text Available Objective : This study aims to evaluate changes in lumbosacral parameters after minimally invasive lumbar interbody fusion. The secondary aim was to evaluate whether interbody cage shape (crescent shaped or rectangular would influence the results. Method : Retrospective analysis of 70 patients who underwent one or two level lumbar interbody fusion through a minimally invasive posterolateral approach. This included midline preservation and unilateral facetectomy. Pre- and postoperative (three to six months postoperative radiographs were used for measuring lumbar lordosis (LL, segmental lordosis (SL at the level of interbody fusion, and sacral slope (SS. Further analyses divided the patients into Roussouly lumbar subgroups. Results : LL was significantly reduced after surgery (59o:39o, p=0.001 as well as the SS (33.8o:31.2o, p=0.05. SL did not change significantly (11.4:11.06, p=0.85. There were no significant differences when comparing patients who received crescent shaped cage (n=27 and rectangular cage (n=43. Hypolordotic patients (Roussouly types 1 and 2 had radiographic improvement in comparison to normolordotic and hyperlordotic groups (types 3 and 4. Conclusion : Minimally invasive lumbar interbody fusion caused reduction in lumbosacral parameters. Cage shape had no influence on the results.

Design of three-dimensional visualization based on the posterior lumbar pedicle screw fixation

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Kai XU

2011-09-01

Full Text Available Objective To establish a three-dimensional visualization model of posterior lumbar pedicle screw fixation.Methods A patient with lumbar intervertebral disc hernia and another patient with compression fracture of lumbar vertebra were involved in the present study.Both patients underwent multi-slice spiral CT scan before and after lumbar pedicle screw fixation.The degree of preoperative vertebral compression,vertebral morphology before and after surgery,postoperative pedicle screw position,and decompression effects were observed.The original data of the multi-slice spiral CT were inputted into the computer.The three-dimensional reconstructed images of the lumbar and implanted screws were obtained using the software Amira 4.1 to show the three-dimensional shape of the lumbar vertebrae before and after surgery and the location of the implanted screws.Results The morphology and structure of the lumbar vertebrae before and after surgery and of the implanted screws were reconstructed using the digital navigation platform.The reconstructed 3D images could be displayed in multicolor,transparent,or arbitrary combinations.In the 3D surface reconstruction images,the location and structure of the implanted screws could be clearly observed,and the decompression of the spinal cord or nerve roots and the severity of the fracture and the compression of lumbar vertebrae could be fully evaluated.The reconstructed images before operation revealed the position of the vertebral pedicles and provided reference for intraoperative localization.Conclusions The three-dimensional computerized reconstructions of lumbar pedicle screw fixation may be valuable in basic research,clinical experiment,and surgical planning.The software Amira is one of the bases of three-dimensional reconstruction.

Transforaminal lumbar interbody fusion versus posterolateral fusion in degenerative lumbar spondylosis

Science.gov (United States)

Zhang, Bin-Fei; Ge, Chao-Yuan; Zheng, Bo-Long; Hao, Ding-Jun

2016-01-01

Abstract Objective: The aim of the study was to evaluate the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) versus posterolateral fusion (PLF) in degenerative lumbar spondylosis. Methods: A systematic literature review was performed to obtain randomized controlled trials (RCTs) and observational studies (OSs) of TLIF and PLF for degenerative lumbar spondylosis. Trials performed before November 2015 were retrieved from the Medline, EMBASE, Cochrane library, and Chinese databases. Data extraction and quality evaluation of the trials were performed independently by 2 investigators. A meta-analysis was performed using STATA version 12.0. Results: Two RCTs and 5 OSs of 630 patients were included. Of these subjects, 325 were in the TLIF and 305 were in the PLF group. Results showed that TLIF did not increase the fusion rate based on RCTs (relative risk [RR] = 1.06; 95% confidence interval [CI]: 0.95–1.18; P = 0.321), but increased it based on OSs (RR = 1.14; 95% CI: 1.07–1.23; P = 0.000) and overall (RR = 1.11; 95% CI: 1.05–1.18; P = 0.001) as compared with PLF. TLIF was able to improve the clinical outcomes based on 1 RCT (RR = 1.33; 95% CI: 1.11–1.59, P = 0.002) and overall (RR = 1.19; 95% CI: 1.07–1.33; P = 0.001), but not based on OSs (RR = 1.11; 95% CI: 0.97–1.27; P = 0.129) as compared with PLF. There were no differences between TLIF and PLF in terms of visual analogue scale, Oswestry Disability Index, reoperation, complications, duration of surgical procedure, blood loss, and hospitalization. Conclusions: In conclusion, evidence is not sufficient to support that TLIF provides higher fusion rate than PLF, and this poor evidence indicates that TLIF might improve only clinical outcomes. Higher quality, multicenter RCTs are needed to better define the role of TLIF and PLF. PMID:27749558

Enfermedad cardiovascular en pacientes cubanos afectados por Ataxia de Friedreich.

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Tania Cruz Mariño

2010-01-01

Full Text Available Al describir la ataxia de Friedreich, Nicholaus hizo referencia a la patología cardiaca. Esta enfermedad autosómica recesiva se debe a una mutación dinámica en el gen FRDA, codificándose deficientemente la proteína Frataxina, conduciendo a estrés oxidativo y muerte celular cardiaca. La presente investigación se desarrolló con el objetivo de describir las anomalías cardiovasculares presentes en los pacientes cubanos afectados por ataxia de Friedreich. A los individuos con diagnóstico molecular confirmatorio de la enfermedad se les realizó electrocardiograma y ecocardiograma, así como evaluación clínica mediante escalas validadas internacionalmente: ICARS y SARA. Los trastornos de repolarización ventricular difusos, los trastornos de conducción intraauricular, así como los trastornos de la función diastólica resultaron hallazgos frecuentes. El patrón restrictivo apreciado provee evidencia invivo de que la enfermedad conduce a disfunción diastólica del ventrículo izquierdo. La ocurrencia de un Infarto Agudo del Miocardio silente indica la importancia de identificar formas incipientes de afectación miocárdica.

Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures.

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Sabo, Alex; Hatgis, Jesse; Granville, Michelle; Jacobson, Robert E

2017-12-19

Osteoporotic patients can present with either single or multiple fractures secondary to repeated falls and progressive osteoporosis. Multiple fractures often lead to additional spinal deformity and are a sign of more severe osteoporosis. In the thoracic spine, multiple fractures are associated with the development of gradual thoracic kyphosis but neurologic deficits are uncommon. In the lumbar spine, patients with multiple lumbar fractures have more constant lumbar pain, may have symptoms related to concurrent lumbar stenosis or degenerative scoliosis, and may present with radiculopathy, especially with fractures at L4 and L5. In a review of a series of patients with recurrent multiple lumbar fractures or 'cascading' fractures, it was found that all the patients were female, had severe osteoporosis, often untreated, had a previous history of multiple previous thoracic and lumbar fractures, and all had associated scoliotic spinal deformities ranging from 6 o to 50 o . It was found that if the curve progressed and the greater the degree of curvature, the more frequently subsequent multiple fractures developed, leading to recurrent acute episodes of pain. Forty percent also had additional sacral insufficiency fractures, an unusually high percentage. Biomechanically, the lumbar spine is both more mobile and supports a larger portion of the spinal load compared to the thoracic spine. The existence or worsening of a lumbar spinal deformity from degenerative lumbar scoliosis shifts the mechanical forces more to one side on already weakened osteoporotic lumbar vertebrae and sacrum, leading to an increased incidence of these fractures. Because of the chronic and uneven lower lumbar spinal load with severe vertebral osteoporosis in certain patients with repeat lumbar fractures and worsening degenerative lumbar scoliosis, there may be a rationale to add preventive vertebroplasty at adjacent vertebral endplates when treating acute recurrent lumbar fractures to decrease the

The treatment of lumbar disc herniation: a comparison between percutaneous lumbar diskectomy combined with ozone and percutaneous lumbar diskectomy combined with collagenase

International Nuclear Information System (INIS)

Zhong Liming; Wei Xin; Hu Hong; You Jian; Zhao Xiaowei; Hu Kongqiong

2012-01-01

Objective: To evaluate the short-term curative effect and the incidence of postoperative adverse events of percutaneous lumbar diskectomy (PLD) combined with ozone or PLD combined with collagenase in treating lumbar disk herniation. Methods: A total of 223 patients with lumbar disk herniation were enrolled in this study. Patients in the study group (n=108) were treated with PLD combined with ozone, while patients in the control group (n=115) were treated with PLD combined with collagenase. The short-term effectiveness and the incidence of postoperative adverse events were documented. The results were analyzed and compared between the two groups. Results: In the study group, the excellent and good therapeutic results were achieved in 85.18% of the patients (n=92) and the occurrence of adverse events was 5.56%, while in the control group, the excellent and good therapeutic results were achieved in 80.00% of the patients (n=92) and the occurrence of adverse events was 13.04%. No significant difference in the short-term effectiveness existed between the two groups (Pearson Chi-Square =1.038, P=0.308). And the difference in the occurrence of postoperative adverse events was not significant between the two groups (Pearson Chi-Square =3.661, P=0.056). No disc infection occurred in the study group. Conclusion: The short-term curative effect of PLD combined with ozone is not significantly different from that of PLD combined with collagenase. In order to maintain decompression within the disc for a long period and to reduce the incidence of postoperative adverse events PLD combined with ozone ablation is an effective complementary treatment. (authors)

Myelography, CT and MRI in leukaemic infiltration of the lumbar theca

International Nuclear Information System (INIS)

Shen, W.C.; Lee, S.K.; Ho, Y.J.; Lee, K.R.

1993-01-01

A 25-year-old woman with acute lymphoblastic leukaemia, while in remission, developed paraparesis, with faecal and urinary incontinence. CT demonstrated increased density of the lumbar theca and enlargement of the nerve roots. Myelography showed complete obstruction below the L3 level. MRI showed increased signal intensity in the lumbar sac on T1 weighting, and the cauda equina enhanced with gadolinium-DTPA. Lymphoblasts were seen in the lumbar spinal fluid. After chemoterhapy, these abnormalities resolved, as did the paraparesis and incontinence. (orig.)

Las enfermedades crónicas como prioridad de la vigilancia de la salud pública en España

OpenAIRE

José María Mayoral Cortes; Nuria Aragonés Sanz; Pere Godoy; María José Sierra Moros; Rosa Cano Portero; Francisco González Moran; Ánxela Pousa Ortega

2016-01-01

En la actualidad, la vigilancia epidemiológica sigue centrada, en España, en las enfermedades transmisibles incluidas en la lista de enfermedades de declaración obligatoria. Sin embargo, el patrón epidemiológico que dominó hasta las últimas décadas del siglo xx ha cambiado. Las enfermedades infecciosas, que eran las principales causas de morbimortalidad, han dado paso a un predominio de las enfermedades crónicas. En este sentido, se ha avanzado en la redacción y la aprobación de normativa esp...

Intrathecal ligaments and nerve root tension: possible sources of lumbar pain during spaceflight.

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Kershner, David; Binhammer, Robert

2004-04-01

Lumbar intrathecal ligaments have recently been demonstrated to randomly bind dorsal nerve roots to the dura within the lumbar vertebral column. Lengthening of the vertebral column and associated lumbar back pain experienced by astronauts is common in microgravity. This study was designed to investigate the relationship of lumbar intrathecal ligaments in spinal lengthening as a possible mechanism for back pain. A two-part study was designed using 36 vertebral columns from embalmed cadavers. There were 12 vertebral columns studied in mid-sagittal section to demonstrate the possible movement of the spinal cord during lengthening of the vertebral column. The remainder were assessed for the amount of tension placed on a dorsal nerve root by the lumbar intrathecal ligament during lengthening of the vertebral column. The spinal cord moves in a cephalic direction approximately 2.8 mm with 4 cm lengthening of the vertebral column. During lengthening, a loss of thoracic and lordotic curvature was noted with an increase in disk height. Tension was significantly increased on the dorsal nerve roots being tethered by the lumbar intrathecal ligaments in comparison to non-tethered nerve roots during lengthening of the vertebral column. A significant amount of tension is placed on dorsal nerve roots tethered by intrathecal ligaments within the lumbar spine during spinal lengthening. These ligaments randomly bind dorsal nerve roots in the lumbar spine and may be involved in the back pain experienced by astronauts in microgravity.

Lumbar degenerative spinal deformity: Surgical options of PLIF, TLIF and MI-TLIF

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Hey Hwee Weng

2010-01-01

Full Text Available Degenerative disease of the lumbar spine is common in ageing populations. It causes disturbing back pain, radicular symptoms and lowers the quality of life. We will focus our discussion on the surgical options of posterior lumbar interbody fusion (PLIF and transforaminal lumbar interbody fusion (TLIF and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF for lumbar degenerative spinal deformities, which include symptomatic spondylolisthesis and degenerative scoliosis. Through a description of each procedure, we hope to illustrate the potential benefits of TLIF over PLIF. In a retrospective study of 53 ALIF/PLIF patients and 111 TLIF patients we found reduced risk of vessel and nerve injury in TLIF patients due to less exposure of these structures, shortened operative time and reduced intra-operative bleeding. These advantages could be translated to shortened hospital stay, faster recovery period and earlier return to work. The disadvantages of TLIF such as incomplete intervertebral disc and vertebral end-plate removal and potential occult injury to exiting nerve root when under experienced hands are rare. Hence TLIF remains the mainstay of treatment in degenerative deformities of the lumbar spine. However, TLIF being a unilateral transforaminal approach, is unable to decompress the opposite nerve root. This may require contralateral laminotomy, which is a fairly simple procedure.The use of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF to treat degenerative lumbar spinal deformity is still in its early stages. Although the initial results appear promising, it remains a difficult operative procedure to master with a steep learning curve. In a recent study comparing 29 MI-TLIF patients and 29 open TLIF, MI-TLIF was associated with longer operative time, less blood loss, shorter hospital stay, with no difference in SF-36 scores at six months and two years. Whether it can replace traditional TLIF as the surgery of

Urgencia hipertensiva secundaria a enfermedad poliquística renal autosómica recesiva en lactante. Reporte de caso

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Roxana Quisbert-Cruz

2017-06-01

Full Text Available La enfermedad poliquística renal asociada a la fibrosis hepática congénita es una enfermedad hereditaria; se encuentra dentro del espectro de las enfermedades fibroquísticas hepatorrenales. Su frecuencia estimada es de 1 en 20.000 nacidos vivos para la variedad de enfermedad poliquística renal autosómica recesiva y más rara para la variedad autosómica dominante. Se presenta un reporte de caso de un paciente cuyo padecimiento se inició con crisis hipertensiva de difícil control, debido a enfermedad poliquística renal y fibrosis hepática congénita, presentación clínica poco frecuente; cabe mencionar sobre la importancia del control de la tensión arterial para prevenir complicaciones causadas por la hipertensión arterial: hipertrofia cardiaca, falla cardiaca y retinopatía crónica.

The Reliability of Lumbar Lordosis Measurements Using a Flexible-Rule.

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The purpose of this study was to examine the intra-rater and intra-rater reliability of lumbar lordosis measurements taken with a flexible-rule. Two...coefficients (ICC) were used to determine the degree of agreement between measurements. The results suggest that measurements of lumbar lordosis with a

Reliability and validity of subjective assessment of lumbar lordosis in ...

African Journals Online (AJOL)

Radiological assessment of lumbar lordotic curve aids in early diagnosis of conditions even before neurologic changes set in. Objective: To ascertain the level of reliability and validity of subjective assessment of lumbar lordosis in conventional radiography. Design: A blinded, repeated-measures diagnostic test was carried ...

Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain

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Manchikanti L

2012-08-01

Full Text Available Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati,1 Ramsin Benyamin3,41Pain Management Center of Paducah, Paducah, KY; 2University of Louisville, Louisville, KY; 3Millennium Pain Center, Bloomington, IL; 4University of Illinois, Urbana-Champaign, IL, USAAbstract: Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures, the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management

Alteraciones emocionales en la enfermedad de Parkinson idiopático sin demencia

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Hurtado González, Carlos Alberto

2014-01-01

[ES]Actualmente la enfermedad de Parkinson ha comenzado a ser considerada como una patología de carácter neuroconductual cognitivo que se encuentra relacionada con alteraciones emocionales como la depresión, ansiedad y apatía que contribuyen a desmejorar la calidad de vida de los pacientes que padecen esta enfermedad. El objetivo de este trabajo tiene como propósito estudiar y analizar las alteraciones emocionales (depresión, ansiedad y apatía) en pacientes con EP sin demencia en est...

El proceso de la enfermedad desde el enfoque de género

OpenAIRE

González Sanjuán, María Eugenia

2009-01-01

El presente artículo trata de desvelar los condicionantes de género en el estado de salud, en la prevalencia de determinadas patologías y en el propio proceso de enfermedad. A partir, fundamentalmente, de las estadísticas, de una encuesta de salud y de entrevistas, el análisis avanza de las cifras a los discursos, de los indicadores objetivos a las vivencias personales. El estudio de la trayectoria de enfermedad se realiza sobre la fibromialgia, una dolencia muy desconocida, qu...

La legionelosis como enfermedad profesional: metodología de valoración

OpenAIRE

Dorronsoro Dorronsoro, Marta; Vicente Pardo, José Manuel

2014-01-01

La Legionella es una enfermedad bacteriana producida por la Legionella Pneumofila, patógeno oportunista que para causar una enfermedad debe estar presente en el lugar (reservorio), debe alcanzar un número suficiente para causar la infección (amplificación) y debe pasar al ambiente en estado infectivo (diseminación) los focos de contaminación que con mayor frecuencia han sido relacionados con los brotes epidémicos son instalaciones de suministro de agua y de acondicionamiento del aire de los e...

Spinous Process Osteochondroma as a Rare Cause of Lumbar Pain

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Bárbara Rosa

2016-01-01

Full Text Available We present a case of a 5th Lumbar Vertebra (L5 spinous process osteochondroma as a rare cause of lumbar pain in an old patient. A 70-year-old male presented with progressive and disabling lower lumbar pain. Tenderness over the central and left paraspinal area of the lower lumbar region and a palpable mass were evident. CT scan showed a mass arising from the spinous process of L5. Marginal resection of the tumor was performed through a posterior approach. The histological study revealed an osteochondroma. After surgery, pain was completely relieved. After one year there was no evidence of local recurrence or symptoms. Osteochondromas rarely involve the spine, but when they do symptoms like pain, radiculopathy/myelopathy, or cosmetic deformity may occur. The imagiologic exam of election for diagnosis is CT scan. When symptomatic the treatment of choice is surgical resection. The most concerning complication of osteochondromas is malignant transformation, a rare event.

Use of Lumbar Punctures in the Management of Ocular Syphilis.

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Reekie, Ian; Reddy, Yaviche

2018-01-01

Ocular syphilis has become rare in the developed world, but is a common presentation to ophthalmology departments in South Africa. We investigated the proportion of patients diagnosed with ocular syphilis who went on to receive lumbar punctures, and determined the fraction of these who had cerebrospinal fluid findings suggestive of neurosyphilis. We aimed to determine whether the use of lumbar punctures in ocular syphilis patients was beneficial in picking up cases of neurosyphilis. Retrospective study of case notes of patients admitted to two district hospitals in Durban, South Africa, with ocular syphilis over a 20-month period. A total of 31 of 68 ocular syphilis patients underwent lumbar puncture, and of these, eight (25.8%) had findings suggestive of neurosyphilis. Lumbar puncture in ocular syphilis patients should continue to be a routine part of the investigation of these patients; a large proportion of ocular syphilis patients show cerebrospinal fluid findings suggestive of neurosyphilis, are at risk of the complications of neurosyphilis, and should be managed accordingly.

Uso de glucocorticoides en enfermedades alérgicas

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M Rodríguez-González

2017-01-01

Full Text Available Los glucocorticoides son análogos sintéticos de las hormonas adrenocorticales, de uso común, de gran utilidad en la práctica clínica del pediatra y se consideran la piedra angular del tratamiento farmacológico de enfermedades alérgicas.

Complications in lumbar spine surgery: A retrospective analysis

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Luca Proietti

2013-01-01

Full Text Available Background: Surgical treatment of adult lumbar spinal disorders is associated with a substantial risk of intraoperative and perioperative complications. There is no clearly defined medical literature on complication in lumbar spine surgery. Purpose of the study is to retrospectively evaluate intraoperative and perioperative complications who underwent various lumbar surgical procedures and to study the possible predisposing role of advanced age in increasing this rate. Materials and Methods: From 2007 to 2011 the number and type of complications were recorded and both univariate, (considering the patients′ age and a multivariate statistical analysis was conducted in order to establish a possible predisposing role. 133 were lumbar disc hernia treated with microdiscetomy, 88 were lumbar stenosis, treated in 36 cases with only decompression, 52 with decompression and instrumentation with a maximum of 2 levels. 26 patients showed a lumbar fracture treated with percutaneous or open screw fixation. 12 showed a scoliotic or kyphotic deformity treated with decompression, fusion and osteotomies with a maximum of 7.3 levels of fusion (range 5-14. 70 were spondylolisthesis treated with 1 or more level of fusion. In 34 cases a fusion till S1 was performed. Results: Of the 338 patients who underwent surgery, 55 showed one or more complications. Type of surgical treatment ( P = 0.004, open surgical approach (open P = 0.001 and operative time ( P = 0.001 increased the relative risk (RR of complication occurrence of 2.3, 3.8 and 5.1 respectively. Major complications are more often seen in complex surgical treatment for severe deformities, in revision surgery and in anterior approaches with an occurrence of 58.3%. Age greater than 65 years, despite an increased RR of perioperative complications (1.5, does not represent a predisposing risk factor to complications ( P = 0.006. Conclusion: Surgical decision-making and exclusion of patients is not justified only

Bias in the physical examination of patients with lumbar radiculopathy

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Katz Jeffrey N

2010-11-01

Full Text Available Abstract Background No prior studies have examined systematic bias in the musculoskeletal physical examination. The objective of this study was to assess the effects of bias due to prior knowledge of lumbar spine magnetic resonance imaging findings (MRI on perceived diagnostic accuracy of the physical examination for lumbar radiculopathy. Methods This was a cross-sectional comparison of the performance characteristics of the physical examination with blinding to MRI results (the 'independent group' with performance in the situation where the physical examination was not blinded to MRI results (the 'non-independent group'. The reference standard was the final diagnostic impression of nerve root impingement by the examining physician. Subjects were recruited from a hospital-based outpatient specialty spine clinic. All adults age 18 and older presenting with lower extremity radiating pain of duration ≤ 12 weeks were evaluated for participation. 154 consecutively recruited subjects with lumbar disk herniation confirmed by lumbar spine MRI were included in this study. Sensitivities and specificities with 95% confidence intervals were calculated in the independent and non-independent groups for the four components of the radiculopathy examination: 1 provocative testing, 2 motor strength testing, 3 pinprick sensory testing, and 4 deep tendon reflex testing. Results The perceived sensitivity of sensory testing was higher with prior knowledge of MRI results (20% vs. 36%; p = 0.05. Sensitivities and specificities for exam components otherwise showed no statistically significant differences between groups. Conclusions Prior knowledge of lumbar MRI results may introduce bias into the pinprick sensory testing component of the physical examination for lumbar radiculopathy. No statistically significant effect of bias was seen for other components of the physical examination. The effect of bias due to prior knowledge of lumbar MRI results should be considered

Bias in the physical examination of patients with lumbar radiculopathy

Science.gov (United States)

2010-01-01

Background No prior studies have examined systematic bias in the musculoskeletal physical examination. The objective of this study was to assess the effects of bias due to prior knowledge of lumbar spine magnetic resonance imaging findings (MRI) on perceived diagnostic accuracy of the physical examination for lumbar radiculopathy. Methods This was a cross-sectional comparison of the performance characteristics of the physical examination with blinding to MRI results (the 'independent group') with performance in the situation where the physical examination was not blinded to MRI results (the 'non-independent group'). The reference standard was the final diagnostic impression of nerve root impingement by the examining physician. Subjects were recruited from a hospital-based outpatient specialty spine clinic. All adults age 18 and older presenting with lower extremity radiating pain of duration ≤ 12 weeks were evaluated for participation. 154 consecutively recruited subjects with lumbar disk herniation confirmed by lumbar spine MRI were included in this study. Sensitivities and specificities with 95% confidence intervals were calculated in the independent and non-independent groups for the four components of the radiculopathy examination: 1) provocative testing, 2) motor strength testing, 3) pinprick sensory testing, and 4) deep tendon reflex testing. Results The perceived sensitivity of sensory testing was higher with prior knowledge of MRI results (20% vs. 36%; p = 0.05). Sensitivities and specificities for exam components otherwise showed no statistically significant differences between groups. Conclusions Prior knowledge of lumbar MRI results may introduce bias into the pinprick sensory testing component of the physical examination for lumbar radiculopathy. No statistically significant effect of bias was seen for other components of the physical examination. The effect of bias due to prior knowledge of lumbar MRI results should be considered when an isolated

Higiene Oral en Enfermedad Periodontal: Consideraciones Históricas, Clínicas y Educativas.

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Jhon Fredy Briceño Castellanos

2012-03-01

Full Text Available Normal 0 21 false false false ES-CO X-NONE X-NONE Históricamente se han discutido diversos modelos de enfermedad periodontal para direccionar su enfoque terapéutico. Actualmente se reconoce que la enfermedad periodontal es de origen bacteriano, su comportamiento puede ser reversible y registra alta prevalencia en países de bajos ingresos. Objetivo: Primero, analizar los diversos abordajes preventivos a través de la historia. Segundo, abordar sus implicaciones clínicas y educativas. Conclusión: La higiene oral ha sido la práctica más evidenciada de prevención en enfermedad periodontal pero se requieren más estudios multidisciplinarios a largo plazo para evaluar su eficacia e impacto real.

Cerebellar Herniation after Lumbar Puncture in Galactosemic Newborn

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Salih Kalay

2011-09-01

Full Text Available Cerebral edema resulting in elevated intracranial pressure is a well-known complication of galactosemia. Lumbar puncture was performed for the diagnosis of clinically suspected bacterial meningitis. Herniation of cerebral tissue through the foramen magnum is not a common problem in neonatal intensive care units because of the open fontanelle in infants. We present the case of a 3-week-old infant with galactosemia who presented with signs of cerebellar herniation after lumbar puncture.

Aspectos jurídicos de la enfermedad profesional: estado de la cuestión y propuestas de reforma

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Faustino Cavas Martínez

Full Text Available Concepto de enfermedad profesional en el ordenamiento español de Seguridad Social. Caracterización de la actual lista de enfermedades profesionales y propuesta de reforma. Infradeclaración de las enfermedades profesionales. Ineficiencia del actual sistema de calificación y notificación de enfermedades profesionales. Conclusiones: - Imprescindible revisión del Real Decreto 1299/2006, con el fin de sustituir el actual sistema de lista cerrada por un sistema mixto que contemple, junto al catálogo de enfermedades profesionales, la posibilidad adicional, para las que no figuren en el mismo, de prueba del nexo o etiología profesional de la enfermedad contraída. - Implementar el cuadro de enfermedades español con la lista de Enfermedades Profesionales que el 25 de marzo de 2010 revisó y aprobó la OIT, entre las que se incluyen los trastornos mentales y del comportamiento. - Urge que los poderes públicos desarrollen los contenidos que en materia de prevención de riesgos laborales. - La formación especializada de los facultativos de atención primaria y una mayor información sobre el trabajo del paciente ayudarían a mejorar la calificación de las enfermedades profesionales, evitando que se traten como comunes genuinas patologías profesionales, y posibilitaría la adopción de medidas preventivas, campo éste el de prevención y en particular el de la vigilancia de la salud que deben reforzarse porque está demostrado que la inversión en prevención se traduce en un ahorro y no en un coste. - Se debe mejorar la interconexión entre los sistemas de información y gestión del Instituto Nacional de Seguridad e Higiene en el Trabajo, los Servicios Públicos de Salud, los Institutos de Seguridad y Salud Laboral de las Comunidades Autónomas, las Mutuas y la Seguridad Social.

Comparison of lumbar discectomy alone and lumbar discectomy with direct repair of pars defect for patients with disc herniation and spondylolysis at the nearby lumbar segment.

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Lee, Gun Woo; Ryu, Ji Hyun; Kim, Jae-Do; Ahn, Myun-Whan; Kim, Ho-Joong; Yeom, Jin S

2015-10-01

It is unknown whether direct repair (DR) of pars defect after lumbar discectomy (LD) for patients with lumbar disc herniation (LDH) and spondylolysis leads to better outcomes than LD alone. The aim was to compare two surgical methods, LD alone and LD with DR, for LDH patients with spondylolysis at a nearby lumbar segment. This was a retrospective comparative study. This study enrolled 89 patients who were diagnosed with LDH and spondylolysis at the same or adjacent lumbar segment and were followed up for at least 1 year. The primary outcome was pain intensity of the lower back and lower extremities as measured with visual analog scale. Secondary outcomes included clinical outcomes as assessed with the Oswestry Disability Index and the 12-item short form health survey, radiologic outcomes as assessed with the gap distance and the union rate at the pars defect, surgical outcomes, and complications. Enrolled patients were classified into two groups: LD alone (Group A, 48 patients) and LD with DR (Group B, 41 patients). Pain intensity of the lower back and lower extremities and clinical outcomes were significantly improved 1 year after surgery compared with preoperative scores. However, the scores in the group receiving LD alone steadily worsened during follow-up, whereas the scores in the group receiving LD with DR did not deteriorate over time. The difference in the gap distance of the pars defect between baseline and 1 year after surgery was significantly different between the groups. The fusion rate of the pars defect was 59% (24/41). With the exception of surgical time, which was longer in Group B, surgical outcomes and complications did not differ significantly between the groups. At the 1-year follow-up, DR after LD was associated with better outcomes for LDH with spondylolysis than LD alone. Copyright © 2015 Elsevier Inc. All rights reserved.

Enfermedad de Niemann Pick tipo-A. Presentación de 12 casos

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Jorge Zarco-Román

2017-05-01

Full Text Available INTRODUCCIÓN: la enfermedad de Niemann Pick tipo A es una enfermedad hereditaria de depósito lisosomal, debida a un déficit de la enzima esfingomielinasa ácida, lo que da lugar a la acumulación de esfingomielina en las células del sistema reticuloendotelial y nervioso central. OBJETIVO: se describe el curso de la enfermedad de Niemann Pick tipo A en 12 pacientes: tres niños y nueve niñas, con edades entre 3 a 33 meses. MATERIAL Y MÉTODOS: estudio retrospectivo efectuado con base en la información de los expedientes de 12 pacientes, evaluados mediante un examen físico completo, oftalmológico, análisis de laboratorio, ultrasonido de abdomen, tomografía axial computarizada o resonancia magnética nuclear cerebral, radiografías de tórax, ecocardiograma, electroencefalograma, potenciales evocados auditivos y visuales, serie esofagogastroduodenal y serie ósea. Se obtuvo información sobre enfermedades intercurrentes y causas de muerte. RESULTADOS: la sintomatología comenzó en promedio a los 5.9 meses (2 a 16 meses y el diagnóstico definitivo se realizó a la edad de los 15.6 meses (3 a 33 meses a través del cuadro clínico sugestivo, con presencia de células espumosas en el aspirado de médula ósea 12/12 (100% y deficiencia de la enzima esfingomielinasa ácida en 12/12 pacientes (100%; la biopsia hepática fue sugestiva de enfermedad por atesoramiento en 5/12 (41.6%. Las manifestaciones clínicas por orden de frecuencia fueron: hepatoesplenomegalia y afección neurológica en 12/12 (100%, alteración pulmonar 11/12 (91.6%, hematológica 9/12 (80%, oftalmológica con mancha rojo cereza 9/12 (75%, ósea 6/12 (50%, y cardiaca 4/12 (33.3%. Únicamente hubo antecedente de consanguinidad en 4 familias (33.3%. CONCLUSIONES: el curso clínico de la enfermedad de Niemann Pick tipo A es muy similar entre los pacientes afectados, el primer dato clínico detectado es la hepatoesplenomegalia. Los pacientes están asintomáticos los primeros

[Feasibility and accuracy of ultrasound-guided methodology in the examination of lumbar spine facet joints].

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Wen, Chuan-Bing; Li, Yong-Zhong; Tang, Qin-Qin; Sun, Lin; Xiao, Hong; Yang, Bang-Xiang; Song, Li; Liu, Hui

2013-03-01

To investigate the feasibility, accuracy of B ultrasound in the examination of joint space of lumbar spine facet joints compared with CT scan. Ten healthy adult volunteers were enrolled. The joint space of lumbar facet joints was measured by ultrasound. To identify the spinal levels, the posterior parasagittal sonograms were obtained at levels L1 to S1. The lumbar facet joints were delineated with the help of transverse sonograms at each level. Meanwhile, the lumbar facet joints were evaluated by spiral CT on the same plane, reformatted to 1-mm axial slices. A total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 volunteers. Both ultrasound and CT measurements showed the same average depth and lateral distance of lumbar facet joint space (P > 0.05). The lumbar facet joint space can be accurately demonstrated by ultrasound.

Transforaminal lumbar interbody fusion using unilateral pedicle screw fixation plus contralateral translaminar facet screw fixation in lumbar degenerative diseases.

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Liu, Fubing; Jiang, Chun; Cao, Yuanwu; Jiang, Xiaoxing; Feng, Zhenzhou

2014-07-01

Transforaminal lumbar interbody fusion (TLIF) has been used in lumbar degenerative diseases. Some researchers have applied unilateral fixation in TLIF to reduce operational trauma without compromising the clinical outcome, but it is always suspected biomechanically unstable. The supplementary contralateral translaminar facet screw (cTLFS) seemed to be able to overcome the inherent drawbacks of unilateral pedicle screw (uPS) fixation theoretically. This study evaluates the safety, feasibility and efficacy of TLIF using uPS with cTLFS fixation in the treatment of lumbar degenerative diseases (LDD). 50 patients (29 male) underwent the aforementioned surgical technique for their LDD between December 2009 and April 2012. The results were evaluated based on visual analogue scale (VAS) of the leg and back, Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were recorded. The radiographic examinations in form of X-ray, computed tomography (CT) or magnetic resonance imaging was done preoperatively and 1 week, 3 months, 6 months, 12 months and 24 months postoperatively. The student t-test was used for comparison between the preoperative values and postoperative counterparts. P degenerative diseases short termly.

Flexion relaxation of the hamstring muscles during lumbar-pelvic rhythm.

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Sihvonen, T

1997-05-01

This study investigated the simultaneous activity of back muscles and hamstring muscles during sagittal forward body flexion and extension in healthy persons. The study was cross-sectional. A descriptive study of paraspinal and hamstring muscle activity in normal persons during lumbar-pelvic rhythm. A university hospital. Forty healthy volunteers (21 men, 19 women, ages 17 to 48 years), all without back pain or other pain syndromes. Surface electromyography (EMG) was used to follow activities in the back and the hamstring muscles. With movement sensors, real lumbar flexion was separated from simultaneous pelvic motion by monitoring the components of motion with a two-inclinometer method continuously from the initial upright posture into full flexion. All signals were sampled during real-time monitoring for off-line analyses. Back muscle activity ceased (ie, flexion relaxation [FR] occurred) at lumbar flexion with a mean of 79 degrees. Hamstring activity lasted longer and EMG activity ceased in the hamstrings when nearly full lumbar flexion (97%) was reached. After this point total flexion and pelvic flexion continued further, so that the last part of lumbar flexion and the last part of pelvic flexion happened without back muscle activity or hamstring bracing, respectively. FR of the back muscles during body flexion has been well established and its clinical significance in low back pain has been confirmed. In this study, it was shown for the first time that the hip extensors (ie, hamstring muscles) relax during forward flexion but with different timing. FR in hamstrings is not dependent on or coupled firmly with back muscle behavior in spinal disorders and the lumbar pelvic rhythm can be locally and only partially disturbed.

Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis: Clinical article.

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Gologorsky, Yakov; Skovrlj, Branko; Steinberger, Jeremy; Moore, Max; Arginteanu, Marc; Moore, Frank; Steinberger, Alfred

2014-10-01

Transforaminal lumbar interbody fusion (TLIF) with segmental pedicular instrumentation is a well established procedure used to treat lumbar spondylosis with or without spondylolisthesis. Available biomechanical and clinical studies that compared unilateral and bilateral constructs have produced conflicting data regarding patient outcomes and hardware complications. A prospective cohort study was undertaken by a group of neurosurgeons. They prospectively enrolled 80 patients into either bilateral or unilateral pedicle screw instrumentation groups (40 patients/group). Demographic data collected for each group included sex, age, body mass index, tobacco use, and Workers' Compensation/litigation status. Operative data included segments operated on, number of levels involved, estimated blood loss, length of hospital stay, and perioperative complications. Long-term outcomes (hardware malfunction, wound dehiscence, and pseudarthrosis) were recorded. For all patients, preoperative baseline and 6-month postoperative scores for Medical Outcomes 36-Item Short Form Health Survey (SF-36) outcomes were recorded. Patient follow-up times ranged from 37 to 63 months (mean 52 months). No patients were lost to follow-up. The patients who underwent unilateral pedicle screw instrumentation (unilateral cohort) were slightly younger than those who underwent bilateral pedicle screw instrumentation (bilateral cohort) (mean age 42 vs. 47 years, respectively; p = 0.02). No other significant differences were detected between cohorts with regard to demographic data, mean number of lumbar levels operated on, or distribution of the levels operated on. Estimated blood loss was higher for patients in the bilateral cohort, but length of stay was similar for patients in both cohorts. The incidence of pseudarthrosis was significantly higher among patients in the unilateral cohort (7 patients [17.5%]) than among those in the bilateral cohort (1 patient [2.5%]) (p = 0.02). Wound dehiscence occurred for

Clinical And Surgical Anatomy Of Lumbar Hernia: A Review

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João Victor Souza Sanders

2017-10-01

Full Text Available Lumbar hernia is defined as the presence of failure in the transverse fascia or in the aponeurosis of the transverse abdominal muscle that results in the extrusion of intra or extra peritoneal organs through the discontinuity of the postero lateral abdominal wall. The aim of this study was to conduct a methodical review of the anatomy of the hernia form grynfelt dated from 2006 to 2017. For this, we performed a bibliographic review by means of electronic databases like SciELO, PubMed, Science Direct, LILACS and Bireme to get better approach to the subject. It has been found that the lumbar hernia is a disease little known by doctors whose diagnostics are often performed in the wrong way and for surgical correction needs a good anatomical knowledge. Lumbar hernias, although rare, must be taken into account, since ischemia of herniated intestinal segments can lead to the death of the patient, especially in the elderly. Knowledge about the anatomy of the lumbar region is of vital importance because it makes surgery safe and reduces risks of complications and recidivating of the hernia.

Enfermedad hipertensiva gestacional, algunos factores de riesgo

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Karen Luz Torres Rojas

2015-11-01

Full Text Available Se realizó un estudio descriptivo de corte transversal, con el objetivo de describir  algunos factores de riesgo asociados a la Enfermedad Hipertensiva Gestacional (EHG, en la Clínica Comoro, del distrito  Dili,  en el período comprendido del 1 de junio de 2006 al 31 de mayo de 2007.  La muestra quedó constituida por 99 embarazadas  con diagnóstico  de hipertensión gestacional. Las variables estudiadas fueron: edad, paridad, factores de riesgo (antecedentes  familiares de  hipertensión arterial,  pielonefritis, obesidad, antecedentes de eclampsia, alcoholismo y tabaquismo, enfermedades crónicas asociadas y formas clínicas presentadas.  La EHG se presentó con más frecuencia en las pacientes del grupo de edad de 35 años y más, seguido por el grupo de 15-19 años. La nuliparidad predominó en las gestantes estudiadas. El factor de riesgo más frecuente fue el antecedente familiar de hipertensión arterial. La forma clínica que prevaleció fue la pre eclampsia-eclampsia.

Tophaceous gout causing lumbar stenosis: A case report.

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Lu, Huigen; Sheng, Jianming; Dai, Jiaping; Hu, Xuqi

2017-08-01

Gout in the spine is very rare. The clinical symptoms of the spinal gout are various and lack of specificity. The authors report a case of spinal gout causing lumbar stenosis. We never find such wide-invasive spinal gouty lesion in the published studies. A 68-year-old male had low back pain radiating to bilateral lower limbs, accompanying with intermittent claudication that lasted for 3 months and aggravated 5 days ago. Spinal gout, lumbar stenosis. The patient underwent L2-L4 laminectomy, L2/3 L3/4 an d L4/5 discectomy and transforaminal lumbar interbody fusion with pedicle screw fixation. Dual-energy computed tomography detected extensive tophaceous deposits in L1/2 L2/3 L3/4 and L4/5 lumbar discs as well as the posterior column, especially L2-L3 and L4-L5 facet joints. During the surgery, we found a mass of chalky white material at the posterior column of L3 to L5 vertebral bodies, which also involved the intervertebral discs. Pathological examination confirmed the diagnosis of spinal gout. Although spinal gout is thought to be rare, the diagnosis should be considered if the patient had severe back pain and a history of gout. Dual-energy computed tomography is highly recommended for these patients.

Lumbar Posterior Apophyseal Ring Fracture Combined with Spondylolysis in Pediatric Athletes: A Report of Three Cases.

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Tamaki, Shunsuke; Yamashita, Kazuta; Higashino, Kosaku; Sakai, Toshinori; Takata, Yoichiro; Sairyo, Koichi

2016-01-01

Lumbar posterior apophyseal ring fracture is an uncommon finding in children, but lumbar spondylolysis is a common disorder. Both disorders are prevalent in young athletes. We describe 3 adolescent athletes who showed both lumbar spondylolysis and lumbar posterior apophyseal ring fracture. Because lumbar spondylolysis is comparatively easy to diagnose, a concurrent posterior lumbar apophyseal ring fracture is likely to be overlooked. In patients with severe low back and radicular pain in whom spondylolysis is suspected, it is important to perform not only magnetic resonance imaging and radiography but also computed tomography for identifying posterior apophyseal ring fractures.

Adjacent Lumbar Disc Herniation after Lumbar Short Spinal Fusion

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Ninomiya, Koshi; Iwatsuki, Koichi; Ohnishi, Yu-ichiro; Ohkawa, Toshika; Yoshimine, Toshiki

2014-01-01

A 70-year-old outpatient presented with a chief complaint of sudden left leg motor weakness and sensory disturbance. He had undergone L4/5 posterior interbody fusion with L3–5 posterior fusions for spondylolisthesis 3 years prior, and the screws were removed 1 year later. He has been followed up for 3 years, and there had been no adjacent segment problems before this presentation. Lumbar magnetic resonance imaging (MRI) showed a large L2/3 disc hernia descending to the L3/4 level. Compared to...

Solitary osteochondroma arising in lumbar spinous process: Case report

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Khaled Hadhri

2016-12-01

Full Text Available Solitary osteochondromas rarely occur in the axial skeleton. Those tumors mostly arise on the posterior elements of the cervical column causing various symptoms especially when developing within the spinal canal. Exophytic lumbar variety is uncommon presenting with palpable mass or spinal deformity. We report a 20-year-old man presenting with a solid painless mass at the lower lumbar region. Radiological examinations revealed an exophytic lesion arising in the third lumbar spinous process appearing to be a solitary osteochondroma. The lesion was treated by en-bloc resection; histopathological examination confirmed the diagnosis of osteochondroma with no evidence of recurrence at the end of 2-year follow up.

Analysis and treatment of surgical complications after percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis

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Guang HAN

2016-04-01

Full Text Available Objective To analyze the causes of surgical complications after treatment of lumbar disc herniation (LDH and lumbar intervertebral foraminal stenosis by percutaneous transforaminal endoscopic discectomy (PTED.  Methods From December 2009 to December 2014, 286 patients with LDH (N = 201 and lumbar intervertebral foraminal stenosis (N = 85 were confirmed by X-ray, CT or MRI and treated by PTED in our hospital. Visual Analogue Scale (VAS was used to evaluate the degree of pain in each paitent before and after operation. The curative effect was evaluated by Macnab score. Surgical complications were recorded to find out the causes and methods to prevent them.  Results All cases were followed up for 3 months, and the VAS score decreased significantly compared with preoperation [1.00 (0.00, 1.05 vs 8.50 (7.75, 9.25; Z = 2.825, P = 0.050]. According to Macnab score, the rate of excellent and good functional recovery was 95.45% (273/286. Procedure-related complications included nerve injury in 8 cases (2.80%, hemorrhage at the operation site and hematoma formation around nerve root in 6 cases (2.10%, rupture of dural sac in one case (0.35%, muscle cramps in 3 cases (1.05%, surgical infection in one case (0.35%, postoperative recurrence in 4 cases (1.40%. All patients with complications were cured after symptomatic treatment. Conclusions The overall effect of percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis is satisfactory, which has a low incidence rate of postoperative complications. Some tips can effectively reduce the rate of surgical complications such as preoperative evaluation, precise performance, careful hemostasis, shortening the operation time and postoperatively symptomatic treatment, etc. DOI: 10.3969/j.issn.1672-6731.2016.04.007

A propósito de las enfermedades de transmisión sexual

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Tamara González Gutiérrez

2015-01-01

Sr. Editor: Las Infecciones de Transmisión Sexual (ITS) son un conjunto de infecciones que se transmiten fundamentalmente a través del contacto con sangre, de la madre infectada a su hijo y de las relaciones sexuales vaginales, anales o durante el sexo oral. Ejemplo de ellas es la sífilis, enfermedad que puede causar complicaciones a largo plazo o la muerte si no se sospecha y se trata de manera adecuada. Los Centros de Control de Enfermedades Infecciosas calculan que 55,400 personas en los E...

Programa nutricional dirigido a personas con riesgo cardiovascular para prevenir enfermedades cardiovasculares

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Cano Herrero, Cristina

2013-01-01

El sistema cardiovascular está constituido por el corazón y los vasos sanguíneos. Su función principal es la de bombear la sangre para transportar el oxigeno y otras sustancias nutritivas hacia los tejidos y eliminar los productos residuales. Cualquier alteración del corazón y de los vasos sanguíneos conlleva a lo que se denomina enfermedades cardiovasculares (ECV). Dentro de esta gran variedad de patologías, las más comunes son la isquemia cardiaca y la enfermedad vasculocerebral (EVC) (1-3)...

Estudio de nuevos marcadores de inflamación en enfermedades del intestino

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Olmos Juste, Raquel

2017-01-01

La enfermedad celiaca (EC) se define como un proceso autoinmune multisistémico debido a una pérdida de tolerancia frente a proteínas de la dieta como al gluten de cereales. Las proteínas que causan esta enfermedad reciben el nombre de prolaminas y están presentes en el trigo (gliadinas), cebada (hordeínas), centeno (secalinas) y avena (aveínas). El único tratamiento que actualmente existe se basa en realizar una dieta libre de gluten (DSG), que da lugar a la desaparición de los...

Imagen, artista y enfermedad en la creación plástica

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Sánchez García, Nieves

2013-01-01

NOTA 520 8 La Tesis Doctoral, titulada “Imagen, artista y enfermedad en la creación plástica“, tiene como objetivo investigar y establecer la relación entre el arte, - como proceso creativo- y la enfermedad, entendida esta como un factor importante e, incluso, decisivo en la propia configuración de la imagen y de la personalidad del artista. Como punto de partida, se procede a analizar diacrónicamente y con profundidad el concepto de “la leyenda del artista” y la consideración social de la...

Tratamiento farmacológico específico en la Enfermedad de Alzheimer

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Simón Marrodán, Roberto

2016-01-01

La Enfermedad de Alzheimer es un proceso neurodegenerativo que conlleva un deterioro progresivo de la memoria y de otras funciones superiores. Es el tipo de demencia más común. En el 95% de los casos afecta a personas mayores de 65 años. Se ha realizado una revisión bibliográfica narrativa utilizando bases de datos, buscadores y páginas web, con el objetivo de conocer cuál es el tratamiento farmacológico específico en la Enfermedad de Alzheimer. Las palabras clave utiliza...

Auditoria clínica para el diagnóstico de la enfermedad celiaca

Directory of Open Access Journals (Sweden)

Marco Antonio Zúñiga Montero