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Sample records for sciatica bothersomeness index

  1. The bothersomeness of sciatica: patients’ self-report of paresthesia, weakness and leg pain

    Science.gov (United States)

    Haugen, Anne Julsrud; Keller, Anne; Natvig, Bård; Brox, Jens Ivar; Grotle, Margreth

    2009-01-01

    The objective of the study was to investigate how patients with sciatica due to disc herniation rate the bothersomeness of paresthesia and weakness as compared to leg pain, and how these symptoms are associated with socio-demographic and clinical characteristics. A cross-sectional study was conducted on 411 patients with clinical signs of radiculopathy. Items from the Sciatica Bothersomeness Index (0 = none to 6 = extremely) were used to establish values for paresthesia, weakness and leg pain. Associations with socio-demographic and clinical variables were analyzed by multiple linear regression. Mean scores (SD) were 4.5 (1.5) for leg pain, 3.4 (1.8) for paresthesia and 2.6 (2.0) for weakness. Women reported higher levels of bothersomeness for all three symptoms with mean scores approximately 10% higher than men. In the multivariate models, more severe symptoms were associated with lower physical function and higher emotional distress. Muscular paresis explained 19% of the variability in self-reported weakness, sensory findings explained 10% of the variability in paresthesia, and straight leg raising test explained 9% of the variability in leg pain. In addition to leg pain, paresthesia and weakness should be assessed when measuring symptom severity in sciatica. PMID:19488793

  2. The bothersomeness of sciatica: patients' self-report of paresthesia, weakness and leg pain.

    Science.gov (United States)

    Grøvle, Lars; Haugen, Anne Julsrud; Keller, Anne; Natvig, Bård; Brox, Jens Ivar; Grotle, Margreth

    2010-02-01

    The objective of the study was to investigate how patients with sciatica due to disc herniation rate the bothersomeness of paresthesia and weakness as compared to leg pain, and how these symptoms are associated with socio-demographic and clinical characteristics. A cross-sectional study was conducted on 411 patients with clinical signs of radiculopathy. Items from the Sciatica Bothersomeness Index (0 = none to 6 = extremely) were used to establish values for paresthesia, weakness and leg pain. Associations with socio-demographic and clinical variables were analyzed by multiple linear regression. Mean scores (SD) were 4.5 (1.5) for leg pain, 3.4 (1.8) for paresthesia and 2.6 (2.0) for weakness. Women reported higher levels of bothersomeness for all three symptoms with mean scores approximately 10% higher than men. In the multivariate models, more severe symptoms were associated with lower physical function and higher emotional distress. Muscular paresis explained 19% of the variability in self-reported weakness, sensory findings explained 10% of the variability in paresthesia, and straight leg raising test explained 9% of the variability in leg pain. In addition to leg pain, paresthesia and weakness should be assessed when measuring symptom severity in sciatica.

  3. The prognosis of self-reported paresthesia and weakness in disc-related sciatica.

    Science.gov (United States)

    Grøvle, L; Haugen, A J; Natvig, B; Brox, J I; Grotle, M

    2013-11-01

    To explore how patients with sciatica rate the 'bothersomeness' of paresthesia (tingling and numbness) and weakness as compared with leg pain during 2 years of follow-up. Observational cohort study including 380 patients with sciatica and lumbar disc herniation referred to secondary care. Using the Sciatica Bothersomeness Index paresthesia, weakness and leg pain were rated on a scale from 0 to 6. A symptom score of 4-6 was defined as bothersome. Along with leg pain, the bothersomeness of paresthesia and weakness both improved during follow-up. Those who received surgery (n = 121) reported larger improvements in both symptoms than did those who were treated without surgery. At 2 years, 18.2% of the patients reported bothersome paresthesia, 16.6% reported bothersome leg pain, and 11.5% reported bothersome weakness. Among patients with no or little leg pain, 6.7% reported bothersome paresthesia and 5.1% bothersome weakness. During 2 years of follow-up, patients considered paresthesia more bothersome than weakness. At 2 years, the percentage of patients who reported bothersome paresthesia was similar to the percentage who reported bothersome leg pain. Based on patients' self-report, paresthesia and weakness are relevant aspects of disc-related sciatica.

  4. Measuring bothersome menopausal symptoms

    DEFF Research Database (Denmark)

    Lund, Kamma Sundgaard; Siersma, Volkert Dirk; Christensen, Karl Bang

    2018-01-01

    BACKGROUND: The experience of menopausal symptoms is common and an adequate patient-reported outcome measure is crucial in studies where women are treated for these symptoms. The aims of this study were to identify a patient-reported outcome measure for bothersome menopausal symptoms and, in the ...

  5. Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure.

    Science.gov (United States)

    Haugen, Anne Julsrud; Grøvle, Lars; Brox, Jens Ivar; Natvig, Bård; Keller, Anne; Soldal, Dag; Grotle, Margreth

    2011-10-01

    The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much better on a 7-point global change scale as external criterion for success. The cut-off values (references in brackets) at 12 months were leg pain VAS 17.5 (0-100), back pain VAS 22.5 (0-100), Sciatica Bothersomeness Index 6.5 (0-24), Maine-Seattle Back Questionnaire 4.5 (0-12), and the SF-36 subscales bodily pain 51.5, and physical functioning 81.7 (0-100, higher values indicate better health). In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies.

  6. Prognostic factors for return to work in patients with sciatica.

    Science.gov (United States)

    Grøvle, Lars; Haugen, Anne J; Keller, Anne; Ntvig, Bård; Brox, Jens I; Grotle, Margreth

    2013-12-01

    Little is known about the prognostic factors for work-related outcomes of sciatica caused by disc herniation. To identify the prognostic factors for return to work (RTW) during a 2-year follow-up among sciatica patients referred to secondary care. Multicenter prospective cohort study including 466 patients. Administrative data from the National Sickness Benefit Register were accessed for 227 patients. Two samples were used. Sample A comprised patients who at the time of inclusion in the cohort reported being on partial sick leave or complete sick leave or were undergoing rehabilitation because of back pain/sciatica. Sample B comprised patients who, according to the sickness benefit register, at the time of inclusion received sickness benefits or rehabilitation allowances because of back pain/sciatica. In Sample A, the outcome was self-reported return to full-time work at the 2-year follow-up. In Sample B, the outcome was time to first sustained RTW, defined as the first period of more than 60 days without receiving benefits from the register. Significant baseline predictors of self-reported RTW at 2 years (Analysis A) were identified by multivariate logistic regression. Significant predictors of time to sustained RTW (Analysis B) were identified by multivariate Cox proportional hazard modeling. Both analyses included adjustment for age and sex. To assess the effect of surgery on the probability of RTW, analyses similar to A and B were performed, including the variable surgery (yes/no). One-fourth of the patients were still out of work at the 2-year follow-up. In Sample A (n=237), younger age, better general health, lower baseline sciatica bothersomeness, less fear-avoidance work, and a negative straight-leg-raising test result were significantly associated with a higher probability of RTW at the 2-year follow-up. Surgery was not significantly associated with the outcome. In Sample B (n=125), history of sciatica, duration of the current sciatica episode more than 3

  7. Prognostic factors for non-success in patients with sciatica and disc herniation.

    Science.gov (United States)

    Haugen, Anne Julsrud; Brox, Jens Ivar; Grøvle, Lars; Keller, Anne; Natvig, Bård; Soldal, Dag; Grotle, Margreth

    2012-09-22

    Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2 years of follow-up and to test the prognostic value of surgical treatment for sciatica. The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine-Seattle Back Questionnaire score of ≥5 (0-12) (primary outcome) and Sciatica Bothersomeness Index ≥7 (0-24) (secondary outcome). Rates of non-success were at 1 and 2 years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1 year was significantly associated with being male (OR 1.70 [95% CI; 1.06 - 2.73]), smoker (2.06 [1.31 - 3.25]), more back pain (1.0 [1.01 - 1.02]), more comorbid subjective health complaints (1.09 [1.03 - 1.15]), reduced tendon reflex (1.62 [1.03 - 2.56]), and not treated surgically (2.97 [1.75 - 5.04]). Further, factors significantly associated with non-success at 2 years were duration of back problems >; 1 year (1.92 [1.11 - 3.32]), duration of sciatica >; 3 months (2.30 [1.40 - 3.80]), more comorbid subjective health complaints (1.10 [1.03 - 1.17]) and kinesiophobia (1.04 [1.00 - 1.08]). For the secondary outcome variable

  8. Diagnosis and Prognosis of Sciatica

    NARCIS (Netherlands)

    A.J.H. Verwoerd (Annemieke)

    2015-01-01

    markdownabstract__Abstract__ Sciatica is one of the most common lumbar spine disorders with a life time incidence of 12 to 40%. The most common cause of sciatica is a herniated disc. Sciatica is associated with significant morbidity. Back problems rank, certainly in the industrialized countries,

  9. Imaging of sciatica

    International Nuclear Information System (INIS)

    Anda, S.

    1993-01-01

    Cotugno described the clinical entity of sciatica in 1764. However, the association between sciatica and compression of lumbar nerve roots was not realized until the 1920s. Back surgery for herniated nucleus pulposus then became fashionable, and plain radiography and myelography enabled preoperative mapping. Recently other imaging techniques have emerged, such as computerized tomography and magnetic resonance imaging. This has increased the knowledge of the etiology of lumbar root compressions, and invasive therapies for sciatica have become more diversified. It is easy to lose perspective among the available imaging procedures and therapeutic techniques. The aim of this paper is to present the current status from a historical point of view, with special emphasis on the most common imaging methods for the investigation of lumbosacral radiculopathies. 48 refs., 4 figs

  10. Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies.

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    Shiri, Rahman; Euro, Ulla; Heliövaara, Markku; Hirvensalo, Mirja; Husgafvel-Pursiainen, Kirsti; Karppinen, Jaro; Lahti, Jouni; Rahkonen, Ossi; Raitakari, Olli T; Solovieva, Svetlana; Yang, Xiaolin; Viikari-Juntura, Eira; Lallukka, Tea

    2017-12-01

    The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica. We included 4 Finnish prospective cohort studies (Health 2000 Survey, Mobile Clinic Survey, Helsinki Health Study, and Young Finns Study) consisting of 34,589 participants and 1259 hospitalizations for sciatica during 12 to 30 years of follow-up. Sciatica was based on hospital discharge register data. We conducted a random-effects individual participant data meta-analysis. After adjustment for confounding factors, current smoking at baseline increased the risk of subsequent hospitalization for sciatica by 33% (95% confidence interval [CI], 13%-56%), whereas past smokers were no longer at increased risk. Obesity defined by body mass index increased the risk of hospitalization for sciatica by 36% (95% CI 7%-74%), and abdominal obesity defined by waist circumference increased the risk by 41% (95% CI 3%-93%). Walking or cycling to work reduced the risk of hospitalization for sciatica by 33% (95% CI 4%-53%), and the effect was independent of body weight and other leisure activities, while other types of leisure activities did not have a statistically significant effect. Smoking and obesity increase the risk of hospitalization for sciatica, whereas walking or cycling to work protects against hospitalization for sciatica. Walking and cycling can be recommended for the prevention of sciatica in the general population. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Subcutaneous Injection of Adalimumab Trial compared with Control (SCIATiC): a randomised controlled trial of adalimumab injection compared with placebo for patients receiving physiotherapy treatment for sciatica.

    Science.gov (United States)

    Williams, Nefyn H; Jenkins, Alison; Goulden, Nia; Hoare, Zoe; Hughes, Dyfrig A; Wood, Eifiona; Foster, Nadine E; Walsh, David A; Carnes, Dawn; Sparkes, Valerie; Hay, Elaine M; Isaacs, John; Konstantinou, Kika; Morrissey, Dylan; Karppinen, Jaro; Genevay, Stephane; Wilkinson, Clare

    2017-10-01

    Biological treatments such as adalimumab (Humira ® ; AbbVie Ltd, Maidenhead, UK) are antibodies targeting tumour necrosis factor alpha, released from ruptured intervertebral discs, which might be useful in sciatica. Recent systematic reviews concluded that they might be effective, but that a definitive randomised controlled trial was needed. Usual care in the NHS typically includes a physiotherapy intervention. To test whether or not injections of adalimumab plus physiotherapy are more clinically effective and cost-effective than injections of saline plus physiotherapy for patients with sciatica. Pragmatic, parallel-group, randomised controlled trial with blinded participants and clinicians, and an outcome assessment and statistical analysis with concurrent economic evaluation and internal pilot. Participants were referred from primary care and musculoskeletal services to outpatient physiotherapy clinics. Adults with persistent symptoms of sciatica of 1-6 months' duration and with moderate to high levels of disability. Eligibility was assessed by research physiotherapists according to clinical criteria for diagnosing sciatica. After a second eligibility check, trial participants were randomised to receive two doses of adalimumab (80 mg and then 40 mg 2 weeks later) or saline injections. Both groups were referred for a course of physiotherapy. Outcomes were measured at the start, and after 6 weeks' and 6 months' follow-up. The main outcome measure was the Oswestry Disability Index (ODI). Other outcomes: leg pain version of the Roland-Morris Disability Questionnaire, Sciatica Bothersomeness Index, EuroQol-5 Dimensions, 5-level version, Hospital Anxiety and Depression Scale, resource use, risk of persistent disabling pain, pain trajectory based on a single question, Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia and adverse effects. To detect an effect size of 0.4 with 90% power, a 5% significance level for a two-tailed t -test and 80% retention

  12. Conservative treatment of sciatica : A systematic review

    NARCIS (Netherlands)

    Vroomen, PCAJ; de Krom, MCTFM; Slofstra, PD; Knottnerus, JA

    2000-01-01

    Most patients with sciatica (often caused by disc herniations) are managed conservatively at first. The natural course seems to be favorable. The additional value of many conservative therapies remains controversial. Because a systematic review of the conservative treatment of sciatica is lacking,

  13. Paradigm shift in MRI for sciatica

    NARCIS (Netherlands)

    Barzouhi, Abdelilah el

    2013-01-01

    In contrast with the intuitive feeling of physicians many worrisome MRI findings do not correlate with patient outcome in patients with sciatica. Physicians should for example not automatically ascribe persistent or recurrent symptoms of sciatica to the presence of abnormalities visible on MRI. This

  14. Unsuspected reason for sciatica in Bertolotti's syndrome.

    Science.gov (United States)

    Shibayama, M; Ito, F; Miura, Y; Nakamura, S; Ikeda, S; Fujiwara, K

    2011-05-01

    Patients with Bertolotti's syndrome have characteristic lumbosacral anomalies and often have severe sciatica. We describe a patient with this syndrome in whom standard decompression of the affected nerve root failed, but endoscopic lumbosacral extraforaminal decompression relieved the symptoms. We suggest that the intractable sciatica in this syndrome could arise from impingement of the nerve root extraforaminally by compression caused by the enlarged transverse process.

  15. Isthmic lumbar spondylolisthesis with sciatica

    International Nuclear Information System (INIS)

    Annertz, M.; Holtaas, S.; Cronqvist, S.; Joensson, B.; Stroemqvist, B.; Lund Univ. Hospital

    1990-01-01

    Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal. On sagittal MR examinations the neural foramen had an altered shape bilaterally with the long axis horizontal in all cases. In addition to altered shape the following was found in the 33 foramina evaluated. I: Normal nerve (n=8), II: Compressed nerve (n=16); III: Disappearance of fat, nerve not possible to identify (n=9). In patients with unilateral sciatica, the degree of foraminal stenosis correlated well with the side of symptoms. Coronal views showed the course of the nerve and pedicular kinking. Eight patients underwent decompressive surgery which revealed nerve compression by hypertrophic fibrous tissue and pedicular kinking, which correlated well with the findings on MR. Since the site of nerve compression often was peripheral to the root sleeves, myelography did not give complete information. (orig.)

  16. Sciatica due to pelvic hematoma: case report

    Directory of Open Access Journals (Sweden)

    Kocaman Umit

    2016-12-01

    Full Text Available Sciatica is defined as pain in the sciatic nerve distribution. The most common reason of sciatica is radiculopathy due to lumbar disc hernia. Other causes can be congenital, acquired, infectious, neoplastic, or inflammatory. The piriformis syndrome is another cause. The pain starts in an insidious manner when the cause of sciatica is an extraspinal tumor. It is intermittent at first but a constant and progressive pain that does not decrease with position or rest gradually develops in all patients. The possibility of an intraabdominal or pelvic mass should always be considered and the relevant tests requested when the cause of the sciatica cannot be explained. We present an 83-year-old male who presented with non-traumatic and non-vascular lumbosacral plexopathy due to a large hematoma in the left adductor muscle following the use of warfarin sodium.

  17. Sciatica and claudication caused by ganglion cyst.

    Science.gov (United States)

    Yang, Guang; Wen, Xiaoyu; Gong, Yubao; Yang, Chen

    2013-12-15

    Case report. We report a rare case that a ganglion cyst compressed the sciatic nerve and caused sciatica and claudication in a 51-year-old male. Sciatica and claudication commonly occurs in spinal stenosis. To our knowledge, only 4 cases have been reported on sciatica resulting from posterior ganglion cyst of hip. A 51-year-old male had a 2-month history of radiating pain on his right leg. He could only walk 20 to 30 m before stopping and standing to rest for 1 to 3 minutes. Interestingly, he was able to walk longer distances (about 200 m) when walking slowly in small steps, without any rest. He had been treated as a case of lumbar disc herniation, but conservative treatment was ineffective. On buttock examination, a round, hard, and fixative mass was palpated at the exit of the sciatic nerve. MR imaging of hip revealed a multilocular cystic mass located on the posterior aspect of the superior gemellus and obturator internus, compressing the sciatic nerve. On operation, we found that the cyst extended to the superior gemellus and the obturator internus, positioned right at the outlet of the sciatic nerve. At 18 months of follow-up, the patient continued to be symptom free. He returned to comprehensive physical activity with no limitations. For an extraspinal source, a direct compression on the sciatic nerve also resulted in sciatica and claudication. A meticulous physical examination is very important for the differential diagnosis of extraspinal sciatica from spinal sciatica.

  18. Sciatica

    Science.gov (United States)

    ... is required and recovery occurs on its own. Conservative (non-surgical) treatment is best in many cases. ... In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

  19. Piriformis syndrome: a cause of nondiscogenic sciatica.

    Science.gov (United States)

    Cass, Shane P

    2015-01-01

    Piriformis syndrome is a nondiscogenic cause of sciatica from compression of the sciatic nerve through or around the piriformis muscle. Patients typically have sciatica, buttocks pain, and worse pain with sitting. They usually have normal neurological examination results and negative straight leg raising test results. Flexion, adduction, and internal rotation of the hip, Freiberg sign, Pace sign, and direct palpation of the piriformis cause pain and may reproduce symptoms. Imaging and neurodiagnostic studies are typically normal and are used to rule out other etiologies for sciatica. Conservative treatment, including medication and physiotherapy, is usually helpful for the majority of patients. For recalcitrant cases, corticosteroid and botulinum toxin injections may be attempted. Ultrasound and other imaging modalities likely improve accuracy of injections. Piriformis tenotomy and decompression of the sciatic nerve can be done for those who do not respond.

  20. Management of an unusual sciatica.

    Science.gov (United States)

    Bourghli, Anouar; Chaballout, Ahmed; Obeid, Ibrahim; Boissiere, Louis; Vital, Jean-Marc; Khoury, Ghassan

    2016-11-01

    Extraforaminal entrapment of the L5 nerve root is uncommon, and its management can sometimes be very challenging. We present the case of a 57-year-old female, complaining of a sciatica in her left leg, for 3 years, with no response to any kind of conservative treatment. MRI and CT scan revealed the presence of a large L5S1 strictly lateral osteophyte compressing the left L5 root in its extraforaminal path. The patient underwent a left anterior retroperitoneal approach with assistance from a vascular surgeon given the very close relation between the osteophyte and the left common iliac vein, lying just on top of it, osteophyte was removed in one piece with the use of an osteotome after retraction of the vessels. The patient progressively recovered from her left sciatic pain with a satisfactory clinical result at 1 year. Literature is sparse on the treatment of extraforaminal entrapment of the L5 nerve root; the current case shows a successful treatment strategy with the use of an anterior approach for direct vision of the lesion and good control of the vessels.

  1. Granulocytic sarcoma: a rare cause of sciatica.

    Science.gov (United States)

    Valsamis, Epaminondas Markos; Glover, Thomas Edward

    2017-02-15

    We describe a case report of a man aged 56 years with a 4-month history of right-sided sciatica-type pain with subclinical disc prolapse evident on MRI. Worsening pain together with the appearance of a tender mass in his right buttock prompted further imaging, which demonstrated an infiltrative mass engulfing the lumbosacral plexus. This was later shown to be a granulocytic sarcoma on biopsy. Intervertebral disc herniation can be an incidental finding and is not always the cause of sciatica. 2017 BMJ Publishing Group Ltd.

  2. Systematic review of prognostic factors predicting outcome in non-surgically treated patients with sciatica.

    Science.gov (United States)

    Verwoerd, A J H; Luijsterburg, P A J; Lin, C W C; Jacobs, W C H; Koes, B W; Verhagen, A P

    2013-09-01

    Identification of prognostic factors for surgery in patients with sciatica is important to be able to predict surgery in an early stage. Identification of prognostic factors predicting persistent pain, disability and recovery are important for better understanding of the clinical course, to inform patient and physician and support decision making. Consequently, we aimed to systematically review prognostic factors predicting outcome in non-surgically treated patients with sciatica. A search of Medline, Embase, Web of Science and Cinahl, up to March 2012 was performed for prospective cohort studies on prognostic factors for non-surgically treated sciatica. Two reviewers independently selected studies for inclusion and assessed the risk of bias. Outcomes were pain, disability, recovery and surgery. A best evidence synthesis was carried out in order to assess and summarize the data. The initial search yielded 4392 articles of which 23 articles reporting on 14 original cohorts met the inclusion criteria. High clinical, methodological and statistical heterogeneity among studies was found. Reported evidence regarding prognostic factors predicting the outcome in sciatica is limited. The majority of factors that have been evaluated, e.g., age, body mass index, smoking and sensory disturbance, showed no association with outcome. The only positive association with strong evidence was found for leg pain intensity at baseline as prognostic factor for subsequent surgery. © 2013 European Federation of International Association for the Study of Pain Chapters.

  3. Risk factors for first time incidence sciatica: a systematic review.

    Science.gov (United States)

    Cook, Chad E; Taylor, Jeffrey; Wright, Alexis; Milosavljevic, Steven; Goode, Adam; Whitford, Maureen

    2014-06-01

    Characteristically, sciatica involves radiating leg pain that follows a dermatomal pattern along the distribution of the sciatic nerve. To our knowledge, there are no studies that have investigated risk factors associated with first time incidence sciatica. The purpose of the systematic review was to identify the longitudinal risk factors associated with first time incidence sciatica and to report incidence rates for the condition. For the purposes of this review, first time incidence sciatica was defined as either of the following: 1) no prior history of sciatica or 2) transition from a pain-free state to sciatica. Studies included subjects of any age from longitudinal, observational, cohort designs. The study was a systematic review. Eight of the 239 articles identified by electronic search strategies met the inclusion criteria. Risk factors and their respective effect estimates were reported using descriptive analysis and the preferred reporting items for systematic reviews and meta-analyses guidelines. Modifiable risk factors included smoking, obesity, occupational factors and health status. Non-modifiable factors included age, gender and social class. Incidence rates varied among the included studies, in part reflecting the variability in the operationalized definition of sciatica but ranged from sciatica are modifiable, suggesting the potential benefits of primary prevention. In addition, those risk factors are also associated with unhealthy lifestyles, which may function concomitantly toward the development of sciatica. Sciatica as a diagnosis is inconsistently defined among studies. © 2013 John Wiley & Sons, Ltd.

  4. Prognostic value of MRI findings in sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Vroomen, P.C.A.J.; Krom, M.C.T.F.M. de [Department of Neurology, Maastricht University Hospital (Netherlands); Wilmink, J.T. [Division of Neuroradiology, Department of Diagnostic Radiology, Maastricht University Hospital (Netherlands)

    2002-01-01

    The natural course of sciatica due to disc herniation is generally favourable but individually unpredictable. Some patients recover only after prolonged conservative therapy or surgery. This study aims to ascertain whether magnetic resonance (MR) imaging features can be used to predict outcome of sciatica and help to identify patients unlikely to respond to conservative management. For a transversal diagnostic study 274 primary care patients underwent early MR imaging for leg pain. One hundred and thirty-three patients with sciatica were followed for 3 months, both patients and physicians being unaware of MR imaging findings. At 12 weeks a favourable prognosis was indicated by the following features: annular rupture (P=0.02) and nerve root compression on MR imaging (P=0.03). Poor prognosis was indicated by disc herniation in the foramen (P=0.004). Our findings show that early MR imaging features are related to prognosis. However, the associations are not strong enough to justify routine use of early MR imaging to predict the prognosis of sciatica. (orig.)

  5. The bothersomeness of female urinary incontinence and its influencing factors: Study from a Chinese city

    Directory of Open Access Journals (Sweden)

    Xiao-Juan Wan

    2014-03-01

    Conclusion: UI patients should receive individualised intervention. Healthcare workers can provide targeted intervention to patients bothered by UI to alleviate symptoms, decrease the sense of stigma, and increase confidence in coping with symptoms to decrease bothersomeness.

  6. Sciatica caused by lumbar epidural gas.

    Science.gov (United States)

    Belfquih, Hatim; El Mostarchid, Brahim; Akhaddar, Ali; gazzaz, Miloudi; Boucetta, Mohammed

    2014-01-01

    Gas production as a part of disc degeneration can occur but rarely causes nerve compression syndromes. The clinical features are similar to those of common sciatica. CT is very useful in the detection of epidural gas accumulation and nerve root compression. We report a case of symptomatic epidural gas accumulation originating from vacuum phenomenon in the intervertebral disc, causing lumbo-sacral radiculopathy. A 45-year-old woman suffered from sciatica for 9 months. The condition worsened in recent days. Computed tomography (CT) demonstrated intradiscal vacuum phenomenon, and accumulation of gas in the lumbar epidural space compressing the dural sac and S1 nerve root. After evacuation of the gas, her pain resolved without recurrence.

  7. The value of computed tomography in ''sciatica''

    International Nuclear Information System (INIS)

    Boehm-Jurkovic, H.; Hammer, B.

    1981-01-01

    13 cases of therapy-resistant lumboischialgia without herniated disk, caused in 12 cases by a tumour and in 1 case by an abscess, were examined by computed tomography of the lumbar and pelvic region. This method is indicated immediately after insufficient results of conventional X-ray methods (including tomography) and of lumbosacral radiculography. The computed tomography is indispensable also in patients with ''sciatica'' with a known malignoma. The information given by computed tomography is essential for the therapy planning. (author)

  8. Piriformis ganglion: An uncommon cause of sciatica.

    Science.gov (United States)

    Park, J H; Jeong, H J; Shin, H K; Park, S J; Lee, J H; Kim, E

    2016-04-01

    Sciatica can occur due to a spinal lesion, intrapelvic tumor, diabetic neuropathy, and rarely piriformis syndrome. The causes of piriformis syndrome vary by a space-occupying lesion. A ganglionic cyst can occur in various lesions in the body but seldom around the hip joint. In addition, sciatica due to a ganglionic cyst around the hip joint has been reported in one patient in Korea who underwent surgical treatment. We experienced two cases of sciatica from a piriformis ganglionic cyst and we report the clinical characterics and progress after non-operative treatment by ultrasonography-guided aspiration. The two cases were diagnosed by magnetic resonance imaging and were treated by ultrasonography-guided aspiration. We followed the patients for more than 6months. The symptoms of piriformis syndrome from the ganglion improved following aspiration and this conservative treatment is a treatment method that can be used without extensive incision or cyst excision. Level IV historical case. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Sciatica caused by a dilated epidural vein: MR findings

    International Nuclear Information System (INIS)

    Demaerel, P.; Petre, C.; Wilms, G.; Plets, C.

    1999-01-01

    We report the MR imaging findings in a 41-year-old woman presenting with sudden low back pain and sciatica. At surgery a dilated epidural vein was found compressing the nerve root. The MR findings may suggest the diagnosis. Magnetic resonance imaging of a dilated epidural vein or varix causing sciatica has not been reported until now. (orig.) (orig.)

  10. Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment

    Directory of Open Access Journals (Sweden)

    Hong F

    2016-09-01

    Full Text Available Fangxin Hong,1,2 Traci M Blonquist,1 Barbara Halpenny,3 Donna L Berry,3,4 1Department of Biostatistics and Computational Biology, Dana‑Farber Cancer Institute, Boston, MA, USA;2Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA; 3Department of Nursing and Patient Care Services, The Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA; 4Department of Medicine, Harvard Medical School, Boston, MA, USA Introduction: Frequently reported symptoms and treatment side effects may not be the most bothersome issues to patients with cancer. The purpose of this study was to investigate patient-reported symptom distress and bothersome issues among participants with cancer. Methods: Participants completed the Symptom Distress Scale-15 before treatment (T1 and during cancer treatment (T2 and reported up to two most bothersome issues among symptoms rated with moderate-to-severe distress. We compared symptom ratings and perceived bother and explored two approaches predicting patients’ most bothersome issues: worst absolute symptom score or worst change from pretreatment. Results: Significantly, (P≤0.0002 more patients reported moderate-to-severe distress at T2 for eight of 13 symptoms. At T1, 81% of patients reported one and 56% reported multiple symptoms with moderate-to-severe distress, while at T2, 89% reported one and 69% reported multiple symptoms with moderate-to-severe distress. Impact on sexual activity/interest, pain, fatigue, and insomnia were the most prevalent symptoms with moderate-to-severe distress. Fatigue, pain, and insomnia were perceived most often as bothersome. When one symptom was rated moderate-to-severe, predictive accuracy of the absolute score was 46% and 48% (T1 & T2 and 38% with the change score (T2–T1. When two or more symptoms were rated moderate-to-severe, predictive accuracy of the absolute score was 76% and 79% (T1 & T2 and 70% with the change score (T2–T1. Conclusion: More

  11. Bothersome Tics in Patients with Chronic Tic Disorders: Characteristics and Individualized Treatment Response to Behavior Therapy

    Science.gov (United States)

    McGuire, Joseph F.; Piacentini, John; Scahill, Lawrence; Woods, Douglas W.; Villarreal, Robert; Wilhelm, Sabine; Walkup, John T.; Peterson, Alan L.

    2015-01-01

    This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. PMID:25988365

  12. Bothersome tics in patients with chronic tic disorders: Characteristics and individualized treatment response to behavior therapy.

    Science.gov (United States)

    McGuire, Joseph F; Piacentini, John; Scahill, Lawrence; Woods, Douglas W; Villarreal, Robert; Wilhelm, Sabine; Walkup, John T; Peterson, Alan L

    2015-07-01

    This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. CLINICALTRIALS. NCT00218777; NCT00231985. Published by Elsevier Ltd.

  13. Sciatica caused by a dilated epidural vein: MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Petre, C.; Wilms, G. [Dept. of Radiology, Catholic University of Leuven (Belgium); Plets, C. [Dept. of Neurosurgery, Catholic University of Leuven (Belgium)

    1999-02-01

    We report the MR imaging findings in a 41-year-old woman presenting with sudden low back pain and sciatica. At surgery a dilated epidural vein was found compressing the nerve root. The MR findings may suggest the diagnosis. Magnetic resonance imaging of a dilated epidural vein or varix causing sciatica has not been reported until now. (orig.) (orig.) With 1 fig., 4 refs.

  14. Sciatica due to Schwannoma at the Sciatic Notch

    Directory of Open Access Journals (Sweden)

    Yavuz Haspolat

    2013-01-01

    Full Text Available Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery.

  15. Sciatica due to Schwannoma at the Sciatic Notch

    Science.gov (United States)

    Haspolat, Yavuz; Ozkan, Feyza Unlu; Turkmen, Ismail; Kemah, Bahattin; Turhan, Yalcin; Sarar, Serhan; Ozkan, Korhan

    2013-01-01

    Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery. PMID:23762699

  16. Cervical cord compression presenting with sciatica-like leg pain

    OpenAIRE

    Chan, Chee Keong; Lee, Ho-Yeon; Choi, Won-Chul; Cho, Ji Young; Lee, Sang-Ho

    2010-01-01

    Sciatica-like leg pain can be the main presenting symptom in patients with cervical cord compression. It is a false localizing presentation, which may lead to missed or delayed diagnosis, resulting in the wrong plan of management, especially in the presence of concurrent lumbar lesions. Medical history, physical findings and the results of imaging studies were reviewed in two cases of cervical cord compressions, which presented with sciatica-like leg pain. There was multi-level cervical spond...

  17. 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.

  18. 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

  19. Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis

    NARCIS (Netherlands)

    Visser, L.H.; Nijssen, P.G.; Tijssen, C.C.; Middendorp, J.J. van; Schieving, J.H.

    2013-01-01

    PURPOSE: To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. METHODS:

  20. Myositis ossificans circumscripta, secondary to high-velocity gunshot and fragment wound that causes sciatica.

    Science.gov (United States)

    Gokkus, Kemal; Sagtas, Ergin; Suslu, Feride Ekimler; Aydin, Ahmet Turan

    2013-10-17

    This report concerns an unusual cause of sciatica. The case presented is of a young man with myositis ossificans that resulted in sciatica and was treated with en bloc excision and low-dose radiotherapy and indomethacine. The aim of this study was to explain the different diagnostic properties of myositis ossificans around the hip and non-classic causes of sciatica.

  1. Percutaneous Endoscopic Lumbar Reoperation for Recurrent Sciatica Symptoms: A Retrospective Analysis of Outcomes and Prognostic Factors in 94 Patients.

    Science.gov (United States)

    Wu, Junlong; Zhang, Chao; Lu, Kang; Li, Changqing; Zhou, Yue

    2018-01-01

    Recurrent symptoms of sciatica after previous surgical intervention is a relatively common and troublesome clinical problem. Percutaneous endoscopic lumbar decompression has been proved to be an effective method for recurrent lumbar disc herniation. However, the prognostic factors and outcomes of percutaneous endoscopic lumbar reoperation (PELR) for recurrent sciatica symptoms were still unknown. The purpose of this study was to evaluate the outcomes and prognostic factors of patients who underwent PELR for recurrent sciatica symptoms. From 2009 to 2015, 94 patients who underwent PELR for recurrent sciatica symptoms were enrolled. The primary surgeries include transforaminal lumbar interbody fusion (n = 16), microendoscopic discectomy (n = 31), percutaneous endoscopic lumbar decompression (PELD, n = 17), and open discectomy (n = 30). The mean follow-up period was 36 months, and 86 (91.5%) patients had obtained at least 24 months' follow-up. Of the 94 patients with adequate follow-up, 51 (54.3%) exhibited excellent improvement, 23 (24.5%) had good improvement, and 7 (7.4%) had fair improvement according to modified Macnab criteria. The average re-recurrence rate was 9.6%, with no difference among the different primary surgery groups (PELD, 3/17; microendoscopic discectomy, 2/31; open discectomy, 3/30; transforaminal lumbar interbody fusion, 1/16). There was a trend toward greater rates of symptom recurrence in the primary group of PELD who underwent percutaneous endoscopic lumbar reoperation compared with other groups, but this did not reach statistical significance (P > 0.05). Multivariate analysis suggested that age, body mass index, and surgeon level was independent prognostic factors. Obesity (hazard ratio 13.98, 95% confidence interval 3.394-57.57; P sciatica symptoms regardless of different primary operation type. Obesity, inferior surgeon level, and patient age older than 40 years were associated with a worse prognosis. Obesity was also a strong and

  2. CT and MRI in the evaluation of extraspinal sciatica

    Science.gov (United States)

    Ergun, T; Lakadamyali, H

    2010-01-01

    Sciatica is the most frequently encountered symptom in neurosurgical practice and is observed in 40% of adults at some point in their lives. It is described as pain of the hip and the lower extremity secondary to pathologies affecting the sciatic nerve within its intraspinal or extraspinal course. The most frequent cause is a herniating lumbar disc pressing on the neural roots. Extraspinal causes of sciatic pain are usually overlooked because they are extremely rare and due to intraspinal causes (lumbar spinal stenosis, facet joint osteoarthritis, fracture, and tumors of the spinal cord and spinal column) being the main consideration. Early diagnosis of sciatica significantly improves the likelihood of relieving symptoms, as well as avoiding any additional neurologic injury and unnecessary surgery. We evaluate histolopathologically confirmed extraspinal causes of sciatica cases, accompanied by their presented computed tomography and/or magnetic resonance imaging findings. PMID:20647515

  3. [A Randomized Controlled Clinical Trial of Treatment of Lumbar Disc Herniation-induced Sciatica by Acupuncture Stimulation of Sciatic Nerve Trunk].

    Science.gov (United States)

    Qiu, Ling; Hu, Xiao-Li; Zhao, Xue-Yu; Zheng, Xu; Zhang, Ji; Zhang, Min; He, Liu

    2016-10-25

    To observe the efficacy of acupuncture stimulation of the sciatic nerve trunk in the treatment of patients suffering from sciatica induced by lumbar disc herniation (LDH). A total of 60 LDH sciatica patients met the inclusion criteria were randomly divided into treatment group and control group, with 30 cases in each. Patients of the treatment group were treated by directly needling the sciatic nerve and routine acupuncture of Ashi -points, Lumbar Jiaji (EX-B 2), Dachangshu (BL 28), etc., and those of the control group treated by simple routine acupuncture. The treatment was conducted once a day, 5 times a week, 4 weeks altogether. The clinical effect was evaluated according to the "Standards for Diagnosis and Therapeutic Effect Evaluation of Syndromes of Chinese Medicine" and the pain intensity was assessed by using simplified Short-Form McGill Pain Questionnaire (SF-MPQ) containing pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI). After the treatment, of the two 30 cases of LDH sciatica patients in the control and treatment groups, 11 and 18 were cured, 7 and 7 experienced marked improvement, 10 and 4 were effective, 2 and 1 was invalid, with the effective rate being 93.3% and 96.7%, respectively. The cured+markedly effective rate of the treatment group was significantly higher than that of the control group ( P sciatica in LDH patients, and is superior to simple routine acupuncture in the clinical efficacy.

  4. Lumbar spinal canal size of sciatica patients

    Energy Technology Data Exchange (ETDEWEB)

    Hurme, M.; Alaranta, H.; Aalto, T.; Knuts, L.R.; Vanharanta, H.; Troup, J.D.G. (Turku City Hospital (Finland). Dept. of Surgery; Social Insurance Institution, Turku (Finland). Rehabilitation Research Centre; Helsinki Univ. (Finland). Dept. of Physical Medicine and Rehabilitation; Liverpool Univ. (UK). Dept. of Orthopaedic and Accident Surgery)

    Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p<0.001) or for cadavers (p<0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment. (orig.).

  5. Lumbar spinal canal size of sciatica patients

    International Nuclear Information System (INIS)

    Hurme, M.; Alaranta, H.; Aalto, T.; Knuts, L.R.; Vanharanta, H.; Troup, J.D.G.; Social Insurance Institution, Turku; Helsinki Univ.; Liverpool Univ.

    1989-01-01

    Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p<0.001) or for cadavers (p<0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment. (orig.)

  6. The Challenges of Treating Sciatica Pain in Older Adults.

    Science.gov (United States)

    Ferreira, Manuela L; McLachlan, Andrew

    2016-11-01

    Sciatica is a debilitating condition affecting approximately 25 % of the population. Typically, the patient will complain of lower limb pain that is more severe than pain in the lower back, usually accompanied by numbness and motor weakness. Most international guidelines recommend pharmacological management for the pain relief of sciatica, including paracetamol, non-steroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants, and corticosteroids, among others. However, the evidence for most of these pharmacological options is scarce, and the majority of clinical trials exclude older patients. There is overall very limited information on the efficacy, safety, and tolerability of these medicines in older patients with sciatica. This review presents a critical appraisal of the existing evidence for the pharmacological treatment of sciatica, with a special focus on the older adult. The age-related changes in the health of older patients, as well as their impact on the response to pharmacological treatment, including polypharmacy, drug interactions, and drug-disease interactions, is also discussed.

  7. Influence of Nerve Flossing Technique on acute sciatica and hip ...

    African Journals Online (AJOL)

    MJP

    2015-08-21

    Aug 21, 2015 ... Physiotherapy treatment of acute sciatica includes cold therapy, rest, manual therapy (spinal manipulation and soft tissue mobilization) and electrotherapy.[9]. Other forms of management include aerobic conditioning, core muscle strengthening, stretching of tight structures, mechanical traction and corsets.

  8. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women.

    Science.gov (United States)

    Agarwal, Arnav; Eryuzlu, Leyla N; Cartwright, Rufus; Thorlund, Kristian; Tammela, Teuvo L J; Guyatt, Gordon H; Auvinen, Anssi; Tikkinen, Kari A O

    2014-06-01

    No study has compared the bothersomeness of all lower urinary tract symptoms (LUTS) using a population-based sample of adults. Despite this lack of evidence, investigators have often cited their LUTS of interest as the "most bothersome" or "one of the most bothersome." To compare the population- and individual-level burden of LUTS in men and women. In this population-based cross-sectional study, questionnaires were mailed to 6000 individuals (18-79 yr of age) randomly identified from the Finnish Population Register. The validated Danish Prostatic Symptom Score questionnaire was used for assessment of bother of 12 different LUTS. The age-standardized prevalence of at least moderate bother was calculated for each symptom (population-level burden). Among symptomatic individuals, the proportion of affected individuals with at least moderate bother was calculated for each symptom (individual-level bother). A total of 3727 individuals (62.4%) participated (53.7% female). The LUTS with the greatest population-level burden were urgency (7.9% with at least moderate bother), stress urinary incontinence (SUI) (6.5%), nocturia (6.0%), postmicturition dribble (5.8%), and urgency urinary incontinence (UUI) (5.0%). Burden from incontinence symptoms was higher in women than men, and the opposite was true for voiding and postmicturition symptoms. At the individual level, UUI was the most bothersome for both genders. Although the response proportion was high, approximately a third did not participate. Both men and women with UUI report moderate or major bother more frequently than individuals with other LUTS. At the population level, the most prevalent bothersome symptoms are urgency, SUI, and nocturia. Urinary urgency was the most common troubling symptom in a large population-based study; however, for individuals, urgency incontinence was the most likely to be rated as bothersome. Copyright © 2014 European Association of Urology. All rights reserved.

  9. Case Report: Sciatic nerve schwannoma - a rare cause of sciatica [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2017-03-01

    Full Text Available Herein we report a rare case of a sciatic nerve schwannoma causing sciatica in a 69-year-old female. Sciatic nerve schwannoma is a rare entity. It should always be considered as a possible cause of sciatica in patients that present with symptoms of sciatica with no prolapsed disc in the lumbar spine and a negative crossed straight leg raise test. Timely diagnosis and complete excision of the lesion leads to complete resolution of the symptoms of such patients.

  10. An Unusual Presentation of Right-Sided Sciatica with Foot Drop.

    Science.gov (United States)

    McCabe, Fergus J; McCabe, John P

    2016-01-01

    Rarely, sciatica is of extraspinal aetiology. By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica. Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect. In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.

  11. Vegans report less bothersome vasomotor and physical menopausal symptoms than omnivores.

    Science.gov (United States)

    Beezhold, Bonnie; Radnitz, Cynthia; McGrath, Robert E; Feldman, Arielle

    2018-06-01

    Lifestyle modifications that may reduce menopausal symptoms have generated much interest. The vegetarian diet has been associated with a lower risk of chronic disease as well as a more healthy hormonal milieu. Our objective in this cross-sectional study was to survey peri- and postmenopausal women to investigate menopausal symptoms and dietary pattern. Survey distribution in 2015-2016 was aimed at female vegans, vegetarians, and omnivores between the ages of 45 and 80 years, who were active on senior and vegetarian social networking websites and at vegan restaurants and events. We investigated vasomotor and physical symptoms as measured by the Menopause-specific Quality of Life Questionnaire (MENQOL) and dietary pattern classified by animal protein intakes reported in response to food frequency questions. Out of 754 participants who completed the survey, 604 reported they were perimenopausal (n = 121) or postmenopausal (n = 483), of whom 539 also completed the food frequency questions. We compared vasomotor and physical symptoms in omnivores (n = 304, consumed meat and/or poultry at least monthly) and vegans (n = 125, abstained from all animal proteins) using general linear models; covariates included age, exercise, hormone replacement therapy, presence of reproductive organs, and age at menopause. Among perimenopausal women, vegans reported less bothersome vasomotor (p < 0.01) and physical symptoms (p < 0.01) than omnivores. For both symptom types, more vegetables and less flesh food were associated with less bothersome symptoms (p values < 0.05). Eating a plant-based diet may be helpful for women in menopausal transition who prefer a natural means to manage their symptoms. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Surgery or physical activity in the management of sciatica

    DEFF Research Database (Denmark)

    Fernandez, Matthew; Ferreira, Manuela L; Refshauge, Kathryn M

    2016-01-01

    PURPOSE: Previous reviews have compared surgical to non-surgical management of sciatica, but have overlooked the specific comparison between surgery and physical activity-based interventions. METHODS: Systematic review using MEDLINE, CINAHL, Embase and PEDro databases was conducted. Randomised...... controlled trials comparing surgery to physical activity, where patients were experiencing the three most common causes of sciatica-disc herniation, spondylolisthesis and spinal stenosis. Two independent reviewers extracted pain and disability data (converted to a common 0-100 scale) and assessed...... than physical activity for disc herniation: disability [WMD -9.00 (95 % CI -13.73, -4.27)], leg pain [WMD -16.01 (95 % CI -23.00, -9.02)] and back pain [WMD -12.44 (95 % CI -17.76, -7.09)]; for spondylolisthesis: disability [WMD -14.60 (95 % CI -17.12, -12.08)], leg pain [WMD -35.00 (95 % CI -39...

  13. Pregabalin and gabapentin for the treatment of sciatica.

    Science.gov (United States)

    Robertson, Kelvin; Marshman, Laurence A G; Plummer, David

    2016-04-01

    Whilst pregabalin (PGB) and gabapentin (GBP) are both used to treat neuropathic pain, their relative role in sciatica is unclear. Our aim was to extensively review the roles of PGB and GBP in treating sciatica. The efficacy, side effects (SE) profile and cost of PGB and GBP in neuropathic pain states were reviewed with special reference to sciatica. Eleven articles matched the criteria: seven systematic reviews, one retrospective cross-sectional study, one placebo-controlled-crossover study, one randomized placebo-controlled double-blind study and one case report. GBP and PGB appeared to demonstrate comparable efficacy and SE. However, the amount and quality of evidence was low, and only indirect comparisons were available. Importantly, no direct "head-to-head" study existed. Globally, costs varied widely (by up to 31 times) and unpredictably (PGB cheaper than GBP, or vice versa). Formulary regulator rulings were globally disparate; however, many exclusively favoured the more expensive drug (whether GBP or PGB). No studies assessed PGB-GBP interchange. Weak evidence suggests that efficacy and SE with GBP and PGB are probably similar; however, firm conclusions are precluded. Despite weak data, and having cited minor titration, but definite cost, advantages, UK National Institute for Health and Clinical Excellence favoured PGB over GBP. Given that no evidence supports unhindered PGB-GBP interchange, neither drug should probably be favoured. Prospective "head-to-head" studies are urgently required to provide robust evidence-based knowledge for choice of GBP or PGB in sciatica. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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.

  15. Timing of surgery for sciatica: Subgroup analysis alongside a randomized trial

    NARCIS (Netherlands)

    W.C. Peul (Wilco); M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart)

    2009-01-01

    textabstractSurgery speeds up recovery for sciatica. Prolonged conservative care with surgery for those patients with persistent sciatica however, yields similar results at 1 year. To investigate whether baseline variables modify the difference in recovery rates between these treatment strategies,

  16. Role of environmental factors and history of low back pain in sciatica symptoms among Finnish adolescents.

    Science.gov (United States)

    Karjalainen, Ulla; Paananen, Markus; Okuloff, Annaleena; Taimela, Simo; Auvinen, Juha; Männikkö, Minna; Karppinen, Jaro

    2013-06-01

    Cross-sectional study in a subcohort of the 1986 Northern Finland Birth Cohort (n = 1987). To investigate the role of environmental factors and LBP history in sciatica symptoms among Finnish young adults. History of low back pain (LBP), smoking, and male sex are associated with sciatica in adult populations. The role of the environmental determinants of sciatica has not been evaluated in populations consisting of only adolescents. Sciatic symptoms and environmental exposures were elicited by a mailed questionnaire and the associations were analyzed using multinomial logistic regression. Female sex was associated with severe sciatica at 18 years (OR, 3.9; 95% confidence interval (CI), 1.6-9.3). Both reported LBP at 16 years and LBP requiring consultation of a health care professional were associated with mild sciatica at 18 years (OR, 2.5; 95% CI, 1.3-4.9; and OR, 3.8; 95% CI, 1.2-11.9). In addition, LBP at 16 years requiring consultation of a health care professional was associated with severe sciatica at 18 years (OR, 5.0; 95% CI, 1.7-15.3). Smoking, obesity, physical workload, and level of physical activity were not associated with sciatica. Females reported sciatic pain more often than males. LBP at 16 years predicted sciatica at 18 years. 2.

  17. Sciatica leading to the discovery of a renal cell carcinoma | Lakmichi ...

    African Journals Online (AJOL)

    Metastatic renal cell cancer is not exceptional in kidney cancer (30% of patients with kidneyl cancer). Its prognosis is particularly severe. However, sciatic neuralgia (sciatica) remains an exceptional revealing clinical sign of this disease. The authors report the case of a patient admitted with right sciatica as chief complain, ...

  18. The most bothersome symptom of vaginal atrophy: Evidence from the observational AGATA study.

    Science.gov (United States)

    Palma, Federica; Xholli, Anjeza; Cagnacci, Angelo

    2018-02-01

    Vaginal atrophy (VA) is a chronic medical condition. It is managed unsatisfactorily, despite its high prevalence and negative impact on female quality of life. In order to meet their needs, it would be useful to know what women perceive to be the most bothersome symptom (MBS) of VA. Cross-sectional, multicenter study of 913 postmenopausal women consulting 22 gynecological outpatient services. Prevalence of the MBS perceived by postmenopausal women of different age and vaginal condition. Vaginal dryness was the most prevalent MBS (54.4%), followed by dyspareunia (17.6%), itching (7.8%), dysuria (5.9%) and burning (2.0%). The prevalence of vaginal dryness as the MBS increased with years since menopause, while that of itching, dysuria and burning remained approximately constant over time. The prevalence of dyspareunia as the MBS was 26.2% in the first 6 years after menopause and declined thereafter, to 8.8%. Among all postmenopausal women vaginal dryness per se, independent of dyspareunia, is the most commonly reported MBS. In each woman, the identification of the MBS may help to define more appropriate VA management. Copyright © 2017. Published by Elsevier B.V.

  19. Impact of identifying factors which trigger bothersome tinnitus on the treatment outcome in tinnitus retraining therapy.

    Science.gov (United States)

    Molini, Egisto; Faralli, Mario; Calzolaro, Lucia; Ricci, Giampietro

    2014-01-01

    The aim of this work was to ascertain any differences in the effectiveness of rehabilitation therapy in relation to the presence or absence of a known negative reinforcement responsible for the tinnitus-related pathology. Between 1 January 2001 and 31 December 2008, we recruited 294 subjects suffering from incapacitating tinnitus and/or hyperacusis. The patients underwent tinnitus retraining therapy (TRT) according to the methods described by Jastreboff and Hazell [Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. Cambridge, Cambridge University Press, 2004, pp 121-133]. We clinically assessed the presence or absence of known phenomena of associative learning, regarding the presence of adverse events temporally correlated with tinnitus and the treatment outcome. The separate analysis of the 2 subgroups shows a statistically significant difference in the improvement rate between the group with a known triggering factor and the group without a triggering factor, with a preponderance of the former with a 91% improvement rate versus approximately 56% for the latter. In our study, the inability to identify factors triggering bothersome tinnitus negatively affected the treatment outcome in TRT. © 2014 S. Karger AG, Basel.

  20. Efficacy and safety of etanercept in the treatment of sciatica: A systematic review and meta-analysis.

    Science.gov (United States)

    Jing, Shangfei; Yang, Chenyuan; Zhang, Xiaofei; Wen, Shuzheng; Li, Yuankui

    2017-10-01

    Etanercept might be promising to alleviate sciatica caused by lumbar disc herniation and spinal stenosis. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy of etanercept in patients with sciatica. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and Controlled clinical trials (CCT) assessing the efficacy of etanercept on sciatica caused by lumbar disc herniation and spinal stenosis were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was leg pain scores. Meta-analysis was performed using random-effect model. Four RCTs and one CCT involving 184 patients were included in the meta-analysis. Overall, compared with placebo, etanercept could significantly reduce leg pain (Std. mean difference=-0.83; 95% CI=-1.59 to -0.06; P=0.03) and back pain (Std. mean difference=-1.89; 95% CI=-3.34 to -0.43; P=0.01). However, when comparing etanercept to steroids there was no significant difference in the relief of leg pain (Std. mean difference=-1.18; 95% CI=-3.21 to 0.84; P=0.25) and back pain (Std. mean difference=-0.29; 95% CI=-1.26 to 0.67; P=0.55). Etanercept showed no increase in Oswestry Disability Index (ODI) compared with placebo (Std. mean difference=-0.83; 95% CI=-2.03 to 0.37; P=0.18) and steroids (Std. mean difference=-0.19; 95% CI=-1.15 to 0.77; P=0.70). Etanercept treatment was associated with a significantly reduced pain in leg and back compared to placebo and may possibly improve leg pain relief compared to steroids, but failed to improve ODI. Etanercept should be recommended for sciatica with caution because of heterogeneity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Tactile allodynia in patients with lumbar radicular pain (sciatica).

    Science.gov (United States)

    Defrin, Ruth; Devor, Marshall; Brill, Silviu

    2014-12-01

    We report a novel symptom in many patients with low back pain (LBP) that sheds new light on the underlying pain mechanism. By means of quantitative sensory testing, we compared patients with radicular LBP (sciatica), axial LBP (LBP without radiation into the leg), and healthy controls, searching for cutaneous allodynia in response to weak tactile and cooling stimuli on the leg and low back. Most patients with radicular pain (~60%) reported static and dynamic tactile allodynia, as well as cooling allodynia, on the leg, often extending into the foot. Some also reported allodynia on the low back. In axial LBP, allodynia was almost exclusively on the back. The degree of dynamic tactile allodynia correlated with the degree of background pain. The presence of allodynia suggests that the peripheral nerve generators of background leg and back pain have also induced central sensitization. The distal (foot) location of the allodynia in patients who have it indicates that the nociceptive drive that maintains the central sensitization arises paraspinally (ectopically) in injured ventral ramus afferents; this is not an instance of somatic referred pain. The presence of central sensitization also provides the first cogent account of shooting pain in sciatica as a wave of activity sweeping vectorially across the width of the sensitized dorsal horn. Finally, the results endorse leg allodynia as a pain biomarker in animal research on LBP, which is commonly used but has not been previously validated. In addition to informing the underlying mechanism of LBP, bedside mapping of allodynia might have practical implications for prognosis and treatment. How can you tell whether pain radiating into the leg in a patient with sciatica is neuropathic, ie, due to nerve injury? Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. Magnetic resonance imaging in follow-up assessment of sciatica.

    Science.gov (United States)

    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Jacobs, Wilco C H; Koes, Bart W; Peul, Wilco C

    2013-03-14

    Magnetic resonance imaging (MRI) is frequently performed during follow-up in patients with known lumbar-disk herniation and persistent symptoms of sciatica. The association between findings on MRI and clinical outcome is controversial. We studied 283 patients in a randomized trial comparing surgery and prolonged conservative care for sciatica and lumbar-disk herniation. Patients underwent MRI at baseline and after 1 year. We used a 4-point scale to assess disk herniation on MRI, ranging from 1 for "definitely present" to 4 for "definitely absent." A favorable clinical outcome was defined as complete or nearly complete disappearance of symptoms at 1 year. We compared proportions of patients with a favorable outcome among those with a definite absence of disk herniation and those with a definite, probable, or possible presence of disk herniation at 1 year. The area under the receiver-operating-characteristic (ROC) curve was used to assess the prognostic accuracy of the 4-point scores regarding a favorable or unfavorable outcome, with 1 indicating perfect discriminatory value and 0.5 or less indicating no discriminatory value. At 1 year, 84% of the patients reported having a favorable outcome. Disk herniation was visible in 35% with a favorable outcome and in 33% with an unfavorable outcome (P=0.70). A favorable outcome was reported in 85% of patients with disk herniation and 83% without disk herniation (P=0.70). MRI assessment of disk herniation did not distinguish between patients with a favorable outcome and those with an unfavorable outcome (area under ROC curve, 0.48). MRI performed at 1-year follow-up in patients who had been treated for sciatica and lumbar-disk herniation did not distinguish between those with a favorable outcome and those with an unfavorable outcome. (Funded by the Netherlands Organization for Health Research and Development and the Hoelen Foundation; Controlled Clinical Trials number, ISRCTN26872154.).

  3. Sonographic evaluation of sciatic nerves in patients with unilateral sciatica.

    Science.gov (United States)

    Kara, Murat; Özçakar, Levent; Tiftik, Tülay; Kaymak, Bayram; Özel, Sumru; Akkuş, Selami; Akinci, Ayşen

    2012-09-01

    To evaluate the sciatic nerves of patients with unilateral sciatica by using an ultrasound, and to determine whether ultrasonographic findings were related to clinical and electrophysiologic parameters. Cross-sectional study. Physical medicine and rehabilitation departments of a university hospital and a rehabilitation hospital. Consecutive patients (N=30; 10 men, 20 women) with complaints of low back pain and unilateral sciatica of more than 1 month of duration were enrolled. Not applicable. All patients underwent a substantial clinical assessment, and they were also evaluated by electromyogram and magnetic resonance imaging. Pain was evaluated by a visual analog scale and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Scale. A linear array probe (7.5-12MHz) was used to scan sciatic nerves bilaterally in the prone position. Sciatic nerve diameters-thickness (short axis) and width (long axis)-and cross-sectional areas were measured bilaterally at the same levels, proximal to the bifurcation and midthigh. The values pertaining to the unaffected limbs were taken as controls. When compared with the unaffected sides, mean values for sciatic nerve measurements-long axis at bifurcation level (P=.017) and cross-sectional area at midthigh level (P=.005)-were significantly larger on the affected sides. Swelling ratios negatively correlated with symptom duration (r=-.394, P=.038) and LANSS scores (r=-.451, P=.016) at only midthigh level. Sciatic nerves seem to be enlarged on the side of sciatica in patients with low back pain. Our preliminary results may provide insight into better understanding the lower limb radiating pain in this group of patients. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Cyclic sciatica caused by infiltrative endometriosis: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Yekeler, Ensar; Kumbasar, Basak; Tunaci, Atadan; Barman, Ahmet; Tunaci, Mehtap [Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, 34390, Capa, Istanbul (Turkey); Bengisu, Ergin [Department of Obstetrics and Gynecology, Istanbul Faculty of Medicine, Istanbul University, Istanbul (Turkey); Yavuz, Ekrem [Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, 34390, Capa, Istanbul (Turkey)

    2004-03-01

    Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch. (orig.)

  5. Trial of Pregabalin for Acute and Chronic Sciatica.

    Science.gov (United States)

    Mathieson, Stephanie; Maher, Christopher G; McLachlan, Andrew J; Latimer, Jane; Koes, Bart W; Hancock, Mark J; Harris, Ian; Day, Richard O; Billot, Laurent; Pik, Justin; Jan, Stephen; Lin, C-W Christine

    2017-03-23

    Sciatica can be disabling, and evidence regarding medical treatments is limited. Pregabalin is effective in the treatment of some types of neuropathic pain. This study examined whether pregabalin may reduce the intensity of sciatica. We conducted a randomized, double-blind, placebo-controlled trial of pregabalin in patients with sciatica. Patients were randomly assigned to receive either pregabalin at a dose of 150 mg per day that was adjusted to a maximum dose of 600 mg per day or matching placebo for up to 8 weeks. The primary outcome was the leg-pain intensity score on a 10-point scale (with 0 indicating no pain and 10 the worst possible pain) at week 8; the leg-pain intensity score was also evaluated at week 52, a secondary time point for the primary outcome. Secondary outcomes included the extent of disability, back-pain intensity, and quality-of-life measures at prespecified time points over the course of 1 year. A total of 209 patients underwent randomization, of whom 108 received pregabalin and 101 received placebo; after randomization, 2 patients in the pregabalin group were determined to be ineligible and were excluded from the analyses. At week 8, the mean unadjusted leg-pain intensity score was 3.7 in the pregabalin group and 3.1 in the placebo group (adjusted mean difference, 0.5; 95% confidence interval [CI], -0.2 to 1.2; P=0.19). At week 52, the mean unadjusted leg-pain intensity score was 3.4 in the pregabalin group and 3.0 in the placebo group (adjusted mean difference, 0.3; 95% CI, -0.5 to 1.0; P=0.46). No significant between-group differences were observed with respect to any secondary outcome at either week 8 or week 52. A total of 227 adverse events were reported in the pregabalin group and 124 in the placebo group. Dizziness was more common in the pregabalin group than in the placebo group. Treatment with pregabalin did not significantly reduce the intensity of leg pain associated with sciatica and did not significantly improve other outcomes

  6. Cyclic sciatica caused by infiltrative endometriosis: MRI findings

    International Nuclear Information System (INIS)

    Yekeler, Ensar; Kumbasar, Basak; Tunaci, Atadan; Barman, Ahmet; Tunaci, Mehtap; Bengisu, Ergin; Yavuz, Ekrem

    2004-01-01

    Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch. (orig.)

  7. MRI of intraspinal nerve sheath tumours presenting with sciatica

    International Nuclear Information System (INIS)

    Loke, T.K.L.; Chan, C.S.; Ma, H.T.G.; Ward, S.C.; Metreweli, C.

    1995-01-01

    The magnetic resonance imaging (MRI) characteristics of 14 intraspinal nerve sheath tumours (NST) presenting with sciatica were reviewed. The group comprised seven schwannomas, six neurofibromas and one perineuroma. The tumours were either iso- or hypointense with respect to spinal cord on T1-weighted (T1W) images; almost all tumours were hyperintense compared with spinal cord on T2-weighted (T2W) images. The tumours were all detectable on unenhanced T1 W images. Nine NST were scanned following Gadolinium-Diethylenetriamine penta acetic acid (DTPA) injection and all showed intense enhancement. This aids differentiation from sequestrated disc fragments. Tumours were more likely to show homogeneous enhancement unless they were recurrent tumours. Rim enhancement occurs more commonly in schwannomas and this can be used to differentiate these from neurofibromas. It is estimated that on unenhanced images, schwannomas cannot be distinguished from neurofibromas. Four tumours occurred at T1 1-T12. There was poor correlation of the site of the lesion with the clinical findings. It is recommended that the MRI studies in patients with sciatica should include the lower thoracic region especially if no protruded disc was found in the lumbar region. 15 refs., 4 figs

  8. MRI of intraspinal nerve sheath tumours presenting with sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L.; Chan, C.S. [United Christian Hospital (Hong Kong). Dept. of Diagnostic Radiology; Ma, H.T.G. [St Teresa`s Hospital, Kowloon (Hong Kong). MRI and CT scanning Dept.; Ward, S.C.; Metreweli, C. [Prince of wales Hospital, New Territories (Hong Kong). Dept. of Diagnostic Radiology

    1995-08-01

    The magnetic resonance imaging (MRI) characteristics of 14 intraspinal nerve sheath tumours (NST) presenting with sciatica were reviewed. The group comprised seven schwannomas, six neurofibromas and one perineuroma. The tumours were either iso- or hypointense with respect to spinal cord on T1-weighted (T1W) images; almost all tumours were hyperintense compared with spinal cord on T2-weighted (T2W) images. The tumours were all detectable on unenhanced T1 W images. Nine NST were scanned following Gadolinium-Diethylenetriamine penta acetic acid (DTPA) injection and all showed intense enhancement. This aids differentiation from sequestrated disc fragments. Tumours were more likely to show homogeneous enhancement unless they were recurrent tumours. Rim enhancement occurs more commonly in schwannomas and this can be used to differentiate these from neurofibromas. It is estimated that on unenhanced images, schwannomas cannot be distinguished from neurofibromas. Four tumours occurred at T1 1-T12. There was poor correlation of the site of the lesion with the clinical findings. It is recommended that the MRI studies in patients with sciatica should include the lower thoracic region especially if no protruded disc was found in the lumbar region. 15 refs., 4 figs.

  9. Isthmic lumbar spondylolisthesis with sciatica; MR imaging vs myelography

    Energy Technology Data Exchange (ETDEWEB)

    Annertz, M.; Holtaas, S.; Cronqvist, S.; Joensson, B.; Stroemqvist, B. (Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology Lund Univ. Hospital (Sweden). Dept. of Orthopedics)

    1990-09-01

    Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal. On sagittal MR examinations the neural foramen had an altered shape bilaterally with the long axis horizontal in all cases. In addition to altered shape the following was found in the 33 foramina evaluated. I: Normal nerve (n=8), II: Compressed nerve (n=16); III: Disappearance of fat, nerve not possible to identify (n=9). In patients with unilateral sciatica, the degree of foraminal stenosis correlated well with the side of symptoms. Coronal views showed the course of the nerve and pedicular kinking. Eight patients underwent decompressive surgery which revealed nerve compression by hypertrophic fibrous tissue and pedicular kinking, which correlated well with the findings on MR. Since the site of nerve compression often was peripheral to the root sleeves, myelography did not give complete information. (orig.).

  10. Acupuncture for treating sciatica: a systematic review protocol

    Science.gov (United States)

    Qin, Zongshi; Liu, Xiaoxu; Yao, Qin; Zhai, Yanbing; Liu, Zhishun

    2015-01-01

    Introduction This systematic review aims to assess the effectiveness and safety of acupuncture for treating sciatica. Methods The following nine databases will be searched from their inception to 30 October 2014: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Biomedical Literature Database (CBM), the Chinese Medical Current Content (CMCC), the Chinese Scientific Journal Database (VIP database), the Wan-Fang Database, the China National Knowledge Infrastructure (CNKI) and Citation Information by National Institute of Informatics (CiNii). Randomised controlled trials (RCTs) of acupuncture for sciatica in English, Chinese or Japanese without restriction of publication status will be included. Two researchers will independently undertake study selection, extraction of data and assessment of study quality. Meta-analysis will be conducted after screening of studies. Data will be analysed using risk ratio for dichotomous data, and standardised mean difference or weighted mean difference for continuous data. Dissemination This systematic review will be disseminated electronically through a peer-reviewed publication or conference presentations. Trial registration number PROSPERO CRD42014015001. PMID:25922105

  11. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  12. Bilateral Persistent Sciatic Artery Aneurysm Discovered by Atypical Sciatica: A Case Report

    International Nuclear Information System (INIS)

    Mazet, Nathalie; Soulier-Guerin, Karine; Ruivard, Marc; Garcier, Jean-Marc; Boyer, Louis

    2006-01-01

    We report a case of a bilateral persistent sciatic artery aneurysm, diagnosed by atypical sciatica on computed tomography and magnetic resonance imaging. The different variants, the revealing features, and possible treatment are discussed

  13. The role of arginine vasopressin in electroacupuncture treatment of primary sciatica in human.

    Science.gov (United States)

    Zhao, Xue-Yan; Zhang, Qi-Shun; Yang, Jun; Sun, Fang-Jie; Wang, Da-Xin; Wang, Chang-Hong; He, Wei-Ya

    2015-08-01

    It has been implicated that electroacupuncture can relieve the symptoms of sciatica with the increase of pain threshold in human, and arginine vasopressin (AVP) in the brain rather than the spinal cord and blood circulation participates in antinociception. Our previous study has proven that AVP in the brain played a role in the process of electroacupuncture analgesia in rat. The goal of the present study was to investigate the role of AVP in electroacupuncture in treating primary sciatica in human. The results showed that (1) AVP concentration of cerebrospinal fluid (CSF) (7.5 ± 2.5 pg/ml), not plasma (13.2 ± 4.2 pg/ml) in primary sciatica patients was lower than that in health volunteers (16.1 ± 3.8 pg/ml and 12.3 ± 3.4 pg/ml), although the osmotic pressure in CSF and plasma did not change; (2) electroacupuncture of the bilateral "Zusanli" points (St. 36) for 60 min relieved the pain sensation in primary sciatica patients; (3) electroacupuncture increased the AVP level of CSF, not plasma in primary sciatica patients; and (4) there was the positive correlation between the effect of electroacupuncture relieving the pain and the AVP level of CSF in the primary sciatica patients. The data suggested that central AVP, not peripheral AVP might improve the effect of electroacupuncture treatment of primary sciatica in human, i.e., central AVP might take part in the electroacupuncture relieving the pain sensation in primary sciatica patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Prognostic factors in non-surgically treated sciatica: a systematic review.

    Science.gov (United States)

    Ashworth, Julie; Konstantinou, Kika; Dunn, Kate M

    2011-09-25

    When present sciatica is considered an obstacle to recovery in low back pain patients, yet evidence is limited regarding prognostic factors for persistent disability in this patient group. The aim of this study is to describe and summarise the evidence regarding prognostic factors for sciatica in non-surgically treated cohorts. Understanding the prognostic factors in sciatica and their relative importance may allow the identification of patients with particular risk factors who might benefit from early or specific types of treatment in order to optimise outcome. A systematic literature search was conducted using Medline, EMBASE and CINAHL electronic databases. Prospective cohort studies describing subjects with sciatica and measuring pain, disability or recovery outcomes were included. Studies of cohorts comprised entirely of surgically treated patients were excluded and mixed surgically and conservatively treated cohorts were included only if the results were analysed separately by treatment group or if the analysis was adjusted for treatment. Seven adequate or high quality eligible studies were identified. There were conflicting but mainly negative results regarding the influence of baseline pain severity, neurological deficit, nerve root tension signs, duration of symptoms and radiological findings on outcome. A number of factors including age, gender, smoking, previous history of sciatica and heaviness of work do not appear to influence outcome. In contrast to studies of low back pain and purely surgically treated sciatica cohorts, psychological factors were rarely investigated. At present, the heterogeneity of the available studies makes it difficult to draw firm conclusions about sciatica prognosis, and highlights the need for further research for this group of patients. Large scale prospective studies of high methodological quality, using a well-defined, consistent definition of sciatica and investigating psychosocial factors alongside clinical and

  15. Do MRI findings identify patients with low back pain or sciatica who respond better to particular interventions?

    DEFF Research Database (Denmark)

    Steffens, Daniel; Hancock, Mark J; Pereira, Leani S M

    2016-01-01

    ) or sciatica who respond better to particular interventions. METHODS: MEDLINE, EMBASE and CENTRAL databases were searched. We included RCTs investigating MRI findings as treatment effect modifiers for patients with LBP or sciatica. We excluded studies with specific diseases as the cause of LBP. Risk of bias...... in more than a single trial. High quality, adequately powered trials investigating MRI findings as effect modifiers are essential to determine the clinical importance of MRI findings in LBP and sciatica (PROSPERO: CRD42013006571)....

  16. The mediating effect of 'bothersome' urinary incontinence on help-seeking intentions among community-dwelling women.

    Science.gov (United States)

    Xu, Dongjuan; Wang, Xiaojuan; Li, Jingjing; Wang, Kefang

    2015-02-01

    To explore the mediating effect of bother of urinary incontinence between urinary incontinence severity and help-seeking intentions and detect whether the International Consultation on Incontinence Questionnaire-UI Short Form could be a valid measure to delineate bothersome urinary incontinence. Urinary incontinence is a common condition among women, which has a profound adverse effect on quality of life. However, many of them experiencing significant clinical symptoms do not seek medical help. A cross-sectional survey design. Women with urinary incontinence (N = 620) from three randomized selected community health service centres from May-October 2011 participated in the study. Data were collected using a pencil-and-paper questionnaire. Multivariate regression models were used to test the role of bother as a mediator in the relation between urinary incontinence severity and help-seeking intentions. Receiver operating characteristic analysis was used to find the best cut-off International Consultation on Incontinence Questionnaire-UI Short Form score (range: 0-21) to delineate the bother of urinary incontinence. Bothersome urinary incontinence mediated the relationship between urinary incontinence severity and help-seeking intentions. Age and duration of urine leakage had a negative association on help-seeking intentions, while educational level and previous help-seeking behaviours had a positive association. Bother was a mediator in the relation between urinary incontinence severity and help-seeking intentions. The International Consultation on Incontinence Questionnaire-UI Short Form was a discriminative measure to delineate the bothersome urinary incontinence. © 2014 John Wiley & Sons Ltd.

  17. Cardiovascular and lifestyle risk factors in lumbar radicular pain or clinically defined sciatica: a systematic review

    Science.gov (United States)

    Karppinen, Jaro; Leino-Arjas, Päivi; Solovieva, Svetlana; Varonen, Helena; Kalso, Eija; Ukkola, Olavi; Viikari-Juntura, Eira

    2007-01-01

    Lumbar radicular pain is a fairly common health problem, yet its risk factors are far from clear. There are no published systematic reviews on associations between cardiovascular or lifestyle risk factors and lumbar radicular pain or sciatica. The aim of this systematic literature review was to assess associations between these risk factors and lumbar radicular pain or sciatica. We conducted a systematic search of the Medline database for all original articles on lumbar radicular pain or sciatica published until August 2006. Twenty-two papers from 19 studies were included in the review. Overweight or obesity was associated with sciatica in most of the case-control and cohort studies. Some studies showed an increased risk of lumbar radicular pain in smokers with a long smoking history or in those with high levels of physical activity. A few case-control studies showed an association between serum C-reactive protein and sciatica. No consistent associations were found for serum lipids levels or high blood pressure. In summary, the associations of overweight, long smoking history, high physical activity and a high serum C-reactive protein level with lumbar radicular pain or sciatica were substantiated by the present review. However, more prospective studies are needed in order to further clarify these associations and the mechanisms of action. PMID:17525856

  18. Recurrent postoperative sciatica: Evaluation with MR imaging and enhanced CT

    International Nuclear Information System (INIS)

    Duvauferrier, R.; Frocain, L.; Husson, J.L.

    1987-01-01

    The authors prospectively compared MR imaging performed with a surface coil and CT performed with iodinated contrast agent enhancement in 50 patients with recurrent postoperative sciatica. Surgical decision was an objective measure of accuracy. Surgical treatment was selected for 27 patients. All 27 underwent MR imaging. The 15 patients who underwent CT/surgical treatment were included in the 27 indications of SCMR. All predictions based on MR imaging findings were confirmed at surgery. There were 25 recurrent disk herniations, including five with scar tissue, and two disk herniations above or below the level of the diskectomy. In the 12 patients with scar tissue detected on CT there were seven recurrent disk hernitions, four recurrent disk herniations with scar tissue, and one disk herniation below the level of the diskectomy

  19. Radiological imaging in patients with low back pain and sciatica

    International Nuclear Information System (INIS)

    Dullerud, R.

    1999-01-01

    Low back pain and sciatica are among the most common medical problems in Western countries, affecting up to 80% of the population at some time during their lives. Plain radiography is still a sensitive method in degenerative spinal disease and for the identification of spondylolysis and destructions as well as transitional vertebra and other anomalies in the lumbosacral region. In lumbar disk herniation CT and MR have higher sensitivity than lumbar myelography and should be used as the primary imaging methods. Myelography is still the method of choice in lumbar spinal stenosis. Myelography should also be considered in patients with poor consistency between CT and MR findings and the clinical presentation. Postoperatively MR is superior to CT and myelography for distinguishing between scar tissue and recurrent disk herniation

  20. Recurrent postoperative sciatica: Evaluation with MR imaging and enhanced CT

    International Nuclear Information System (INIS)

    Duoauferrier, R.; Frocrain, L.; Husson, J.L.

    1987-01-01

    The authors prospectively compared surface coil MR (SCMR) imaging and CT with iodinate contrast enhancement in 50 patients with recurrent postoperative sciatica. Of the 50 patients enrolled in the study, surgical treatment was elected in 27 patients after independent examination of SCMR imaging and enhanced CT. All predictions made with the 27 SCMR images were surgically confirmed. The surgical findings were 20 recurrent disk herniations, five recurrent disk herniations with scar tissue, one disk herniation above the level of diskectomy, and one disk herniation below the level of diskectomy. The surgical findings of the 12 patients who had scar tissue on CT were seven recurrent disk herniations, four recurrent disk herniations with scar tissue, and one disk herniation below the operated level. SCMR imaging was more sensitive and more specific than CT to differentiate scar tissue from recurrent disk herniation

  1. Non-steroidal anti-inflammatory drugs for sciatica.

    Science.gov (United States)

    Rasmussen-Barr, Eva; Held, Ulrike; Grooten, Wilhelmus Ja; Roelofs, Pepijn Ddm; Koes, Bart W; van Tulder, Maurits W; Wertli, Maria M

    2016-10-15

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most frequently prescribed drugs for the treatment of sciatica. A previous Cochrane review on the efficacy of NSAIDs summarised findings for acute and chronic low back pain (LBP) and sciatica. This is an update of the original review (2008) focusing on people suffering from sciatica. To determine the efficacy of NSAIDs in pain reduction, overall improvement, and reported side effects in people with sciatica. We performed electronic searches up to 24 June 2015 in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PubMed, and two trials registers. We searched reference lists of included studies and relevant reviews on the topics for additional trials. We included randomised controlled trials (double-blind, single-blind, and open-label) that assessed the efficacy of NSAIDs in sciatica. We included all trials that compared NSAIDs to placebo, to other NSAIDs, or to other medication. Additional interventions were allowed if there was a clear contrast for the treatment with NSAIDs in the trial. Three review authors independently assessed the risk of bias and extracted the data. Where feasible we calculated pooled results using Review Manager 5.3. We reported pain relief outcomes using mean difference (MD) with 95% confidence intervals (95% CI). We used risk ratios (RR) with 95% CI to report global improvement of treatment, adverse effects, and additional medication. We performed a meta-analysis if possible. We assessed level of evidence using the GRADE approach. We used standard methodological procedures recommended by The Cochrane Collaboration. We included 10 trials reported in 9 publications (N = 1651). Only one trial out of 10 was assessed at low risk of bias. Five trials used the currently recommended daily dose for the drug, and two trials used lower daily doses available over the counter. Three trials investigated NSAIDs no longer approved for human use. The follow-up duration

  2. Alteration of cystatin C in cerebrospinal fluid of patients with sciatica revealed by a proteomical approach

    International Nuclear Information System (INIS)

    Liu, X; Zeng, B.; Xu, J.

    2005-01-01

    To better understand the pathophysiological mechanisms underlying sciatica induced by lumbar intervertebral disk herniation and to ascertain the protein that presents with the most observable changes in the cerebrospinal fluid (CSF) of patients with sciatica. We conducted the study in the Key Laboratory of Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, Peoples Republic of China, during the period June 2004 to March 2005. In 2 separate experiments, we carried out the study involving the CSF of sciatica patients (the case group) and the CSF of otherwise, healthy volunteers (the control group). We utilized a proteomical analysis to compare the samples of 10 patients with sciatica with 10 volunteers in the control group. We individually separated each of the groups' CSF by 2-dimensional gel electrophoresis. We analyzed the harvested gel images with PD Quest 2D-gel software (Bio-Rad) to ascertain the differential proteins between the 2 groups. We based the enzyme linked immuno- absorbent assay (ELISA) experiment, which followed, on the results of the first experiment. We found 15 of the protein spots in the CSF differed appreciably in varying degrees between the 2 groups, and identification made by LC-MS/MS revealed that the most significant disparity was with cystatin C. The result of ELISA experiment confirmed a considerable decrease in the level of cystatin C (p<0.01) in the patients with sciatica. In the CSF of patients with sciatica, the volume of cystatin C increased markedly indicating that it may play an important role in the pathophysiological processes of sciatica. (author)

  3. Intensive short-term vasodilation effect in the pain area of sciatica patients--case study.

    Science.gov (United States)

    Skorupska, Elżbieta; Rychlik, Michał; Pawelec, Wiktoria; Bednarek, Agata; Samborski, Włodzimierz

    2014-09-09

    Varied and complicated etiology of low back pain radiating distally to the extremities is still causing disagreement and controversy around the issue of its diagnosis and treatment. Most clinicians believe that the source of that pain is generally radicular. While some of them postulate the clinical significance of the sacroiliac joint syndrome, others demonstrate that almost one in five people with back pain experience symptoms indicative of the neuropathic pain component. To date, neuropathic involvement has not been completely understood, and different mechanisms are thought to play an important role. It has been established that muscle pain (myofascial pain) e.g. active trigger points from the gluteus minimus, can mimic pain similar to sciatica, especially in the chronic stage. This paper describes patients presenting with radicular sciatica (case one and two) and sciatica-like symptoms (case three). For the first time, intensive short-term vasodilation in the pain area following needle infiltration of the gluteus minimus trigger point was recorded. Three Caucasian, European women suffering from radicular sciatica (case one and two) and sciatica-like symptoms (case three) at the age of 57, 49 and 47 respectively underwent infrared camera observation during needle infiltration of the gluteus minimus trigger point. The patients were diagnosed by a neurologist; they underwent magnetic resonance imaging, electromyography, neurography and blood test analysis. Apart from that, the patients were diagnosed by a clinician specializing in myofascial pain diagnosis. In the examined cases, trigger points-related short-term vasodilation was recorded. Confirmation of these findings in a controlled, blinded study would indicate the existence of a link between the pain of sciatica patients (radicular or sciatica-like pain) and the activity of the autonomic nervous system. Further studies on a bigger group of patients are still needed.

  4. Designing an implementation strategy to improve interprofessional shared decision making in sciatica : study protocol of the DISC study

    NARCIS (Netherlands)

    Hofstede, Stefanie N.; Marang-van de Mheen, Perla J.; Assendelft, Willem J. J.; Vleggeert-Lankamp, Carmen L. A.; Stiggelbout, Anne M.; Vroomen, Patrick C. A. J.; van den Hout, Wilbert B.; Vlieland, Thea P. M. Vliet; van Bodegom-Vos, Leti

    2012-01-01

    Background: Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs

  5. Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study

    NARCIS (Netherlands)

    Hofstede, S.N.; Marang-van de Mheen, P.J.; Assendelft, W.J.J.; Vleggeert-Lankamp, C.L.; Stiggelbout, A.M.; Vroomen, P.C.; van den Hout, W.B.; Vliet Vlieland, T.P.M.; Bodegom-Vos, L. van; for the, D.s.g.

    2012-01-01

    ABSTRACT: BACKGROUND: Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and

  6. Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain

    NARCIS (Netherlands)

    A. el Barzouhi (Abdelilah); C.L.A.M. Vleggeert-Lankamp (Carmen); G.J.L.A. Nijeholt (Geert J. Lycklama A); B.F.W. van der Kallen (Bas); W.B. van den Hout (Wilbert); B.W. Koes (Bart); W.C. Peul (Wilco)

    2014-01-01

    textabstractBackground: Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. Methods: The study population

  7. A Randomized Clinical Trial Comparing the Effectiveness of Electroacupuncture versus Medium-Frequency Electrotherapy for Discogenic Sciatica

    Directory of Open Access Journals (Sweden)

    Xue Zhang

    2017-01-01

    Full Text Available Objective. To investigate the short- and long-term effects of electroacupuncture (EA compared with medium-frequency electrotherapy (MFE on chronic discogenic sciatica. Methods. One hundred participants were randomized into two groups to receive EA (n=50 or MFE (n=50 for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI, patient global impression (PGI, drug use frequency, and EA acceptance. Results. The mean changes in the average leg pain numerical rating scale (NRS scores were 2.30 (1.86–2.57 and 1.06 (0.62–1.51 in the EA and MFE groups at week 4, respectively. The difference was significant (P<0.001. The long-term follow-up resulted in significant differences. The average leg pain NRS scores decreased by 2.12 (1.70–2.53 and 0.36 (−0.05–0.78 from baseline in the EA and MFE groups, respectively, at week 28. However, low back pain intensity and PGI did not differ significantly at week 4. No serious adverse events occurred. Conclusions. EA showed greater short-term and long-term benefits for chronic discogenic sciatica than MFE, and the effect of EA was superior to that of MFE. The study findings warrant verification. This trial was registered under identifier ChiCTR-IPR-15006370.

  8. Prognostic Factors for Persistent Leg-Pain in Patients Hospitalized With Acute Sciatica.

    Science.gov (United States)

    Fjeld, Olaf; Grotle, Margreth; Siewers, Vibeke; Pedersen, Linda M; Nilsen, Kristian Bernhard; Zwart, John-Anker

    2017-03-01

    Prospective cohort study. To identify potential prognostic factors for persistent leg-pain at 12 months among patients hospitalized with acute severe sciatica. The long-term outcome for patients admitted to hospital with sciatica is generally unfavorable. Results concerning prognostic factors for persistent sciatica are limited and conflicting. A total of 210 patients acutely admitted to hospital for either surgical or nonsurgical treatment of sciatica were consecutively recruited and received a thorough clinical and radiographic examination in addition to responding to a comprehensive questionnaire. Follow-up assessments were done at 6 weeks, 6 months, and 12 months. Potential prognostic factors were measured at baseline and at 6 weeks. The impact of these factors on leg-pain was analyzed by multiple linear regression modeling. A total of 151 patients completed the entire study, 93 receiving nonrandomized surgical treatment. The final multivariate models showed that the following factors were significantly associated with leg-pain at 12 months: high psychosocial risk according to the Örebro Musculosceletal Pain Questionnaire (unstandardized beta coefficient 1.55, 95% confidence interval [CI] 0.72-2.38, P sciatica. 2.

  9. Preliminary Clinical Evaluation of Acupuncture Therapy in Patients With Postpartum Sciatica.

    Science.gov (United States)

    He, Bing-Shu; Li, Yang; Gui, Tong

    2018-03-01

    This study evaluated clinical outcomes following acupuncture treatment of postpartum sciatica. One hundred eleven women with postpartum sciatica were enrolled in an acupuncture group (n = 86) or a control group (n = 25), according to their preference. Participants in the acupuncture group attended acupuncture therapy sessions 3 times a week for 4 weeks, while participants in the control group were assigned to bed rest. Outcome measures included the Roland Disability Questionnaire for sciatica, a visual analog scale for leg pain, and patient-reported perceived recovery. In addition, participants were surveyed after treatment to assess the acceptability of acupuncture therapy. The outcome scores for disability and leg pain were significantly lower in the acupuncture group compared with the control group (P acupuncture improved their well-being after treatment. At one month after treatment, 98% of participants in the treatment group reported recovery compared with 24% of the control group participants (P acupuncture group believed that acupuncture had no significant interference with breast milk production. No adverse effects of acupuncture were reported. All participants in the acupuncture group stated they would choose acupuncture in case of relapse. However, the recurrence rate of sciatica in the acupuncture group (32%) was comparable to that of the control group (35%) at the one-year follow-up interview. Compared with bed rest, acupuncture might be an effective and acceptable strategy to relieve symptoms of postpartum sciatica. © 2018 by the American College of Nurse-Midwives.

  10. Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain.

    Science.gov (United States)

    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

    2014-01-01

    Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. The study population contained patients with sciatica who underwent a baseline MRI to assess eligibility for a randomized trial designed to compare the efficacy of early surgery with prolonged conservative care for sciatica. Two neuroradiologists and one neurosurgeon independently evaluated all MR images. The MRI readers were blinded to symptom status. The MRI findings were compared between sciatica patients with and without disabling back pain. The presence of disabling back pain at baseline was correlated with perceived recovery at one year. Of 379 included sciatica patients, 158 (42%) had disabling back pain. Of the patients with both sciatica and disabling back pain 68% did reveal a herniated disc with nerve root compression on MRI, compared to 88% of patients with predominantly sciatica (Psciatica at baseline was negatively associated with perceived recovery at one year (Odds ratio [OR] 0.32, 95% Confidence Interval 0.18-0.56, PSciatica patients with disabling back pain in absence of nerve root compression on MRI at baseline reported less perceived recovery at one year compared to those with predominantly sciatica and nerve root compression on MRI (50% vs 91%, PSciatica patients with disabling low back pain reported an unfavorable outcome at one-year follow-up compared to those with predominantly sciatica. If additionally a clear herniated disc with nerve root compression on MRI was absent, the results were even worse.

  11. Persistent sciatica induced by quadratus femoris muscle tear and treated by surgical decompression: a case report

    Directory of Open Access Journals (Sweden)

    Tzanakakis George

    2010-08-01

    Full Text Available Abstract Introduction Quadratus femoris tear is an uncommon injury, which is only rarely reported in the literature. In the majority of cases the correct diagnosis is delayed due to non-specific symptoms and signs. A magnetic resonance imaging scan is crucial in the differential diagnosis since injuries to contiguous soft tissues may present with similar symptoms. Presentation with sciatica is not reported in the few cases existing in the English literature and the reported treatment has always been conservative. Case presentation We report here on a case of quadratus femoris tear in a 22-year-old Greek woman who presented with persistent sciatica. She was unresponsive to conservative measures and so was treated with surgical decompression. Conclusion The correct diagnosis of quadratus muscle tear is a challenge for physicians. The treatment is usually conservative, but in cases of persistent sciatica surgical decompression is an alternative option.

  12. Neuropathic pain, depressive symptoms, and C-reactive protein in sciatica patients.

    Science.gov (United States)

    Uher, Tomas; Bob, Petr

    2013-03-01

    There is evidence that neuropathic pain component in low back pain (LBP) patients is associated with higher ratings of comorbidities such as depression and anxiety disorders. In line with current findings, the purpose of this clinical study is to examine a hypothesis regarding a relationship of neuropathic pain component, depression, and other psychopathological symptoms in a specific group of LBP patients with sciatica pain. With respect to findings that depression is related to inflammatory changes, and inflammatory mediators may play a role in neuropathic pain generation, we have assessed also serum C-reactive protein (CRP). Results of the present study show that increased neuropathic pain component in sciatica patients is associated with elevated levels of depression, anxiety, alexithymia, and serum CRP levels. In conclusion, results of this study indicate that CRP levels in sciatica patients are closely associated with neuropathic pain.

  13. Timing of surgery for sciatica: subgroup analysis alongside a randomized trial

    Science.gov (United States)

    Arts, Mark P.; Brand, Ronald; Koes, Bart W.

    2009-01-01

    Surgery speeds up recovery for sciatica. Prolonged conservative care with surgery for those patients with persistent sciatica however, yields similar results at 1 year. To investigate whether baseline variables modify the difference in recovery rates between these treatment strategies, baseline data of 283 patients enrolled in a randomized trial, comparing early surgery with prolonged conservative care, were used to analyse effect modification of the allotted treatment strategy. For predictors shown to modify the effect of the treatment strategy, repeated measurement analyses with the Roland Disability Questionnaire and visual analogue scale pain as continuous outcomes were performed for every level of that predictor. Presumed predictive variables did not have any interaction with treatment, while “sciatica provoked by sitting” showed to be a significant effect modifier (P = 0.07). In a Cox model we estimated a hazard ratio (HR, surgery versus conservative) of 2.2 (95% CI 1.7–3.0) in favour of surgery when sciatica was provoked by sitting, while the HR was 1.3 (95% CI 0.8–2.2) when this sign was absent. The interaction effect is marginally significant (interactions are usually tested at the 10% level) but the patterns generated by the repeated measurement analyses of all primary outcomes are completely consistent with the inferred pattern from the survival analysis. Classical signs did not show any contribution as decision support tools in deciding when to operate for sciatica, whereas treatment effects of early surgery are emphasized when sciatica is provoked by sitting and negligible when this symptom is absent. PMID:19132412

  14. Diagnosis value of NMR imaging in recurring postoperative sciatica

    International Nuclear Information System (INIS)

    Frocrain, L.; Duvauferrier, R.; Chales, G.; Ramee, A.; Pawlotsky, Y.

    1987-01-01

    Twelve patients who had a subsequent lumbar sciatica after surgery were evaluated with computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.). The M.R.I. was performed with a 0.35 T whole body superconducting unit using spin echo technique. Two pulse sequences were realized varying the repetition time (TR) from 500 to 2,000 ms and the echo time (TE) from 28 to 60 ms. For the longer pulse, the twice echo were interpreted. The slide obtained with a surface-coil were performed in sagittal plane for the twice pulse sequences and in transaxial plane for the shorter pulse sequence. In seven cases, the results obtained with C.T. and M.R.I. were correlated. In two cases, the C.T. showed a scar formation, the M.R.I. showed a recurrent disk herniation. In three times, C.T. was unable to differentiate clearly between recurrent disk herniation and scar formation, the M.R.I. showed unequivocally on one case a scar formation and on two cases a recurrent disk herniation [fr

  15. Traction for low-back pain with or without sciatica.

    Science.gov (United States)

    Wegner, Inge; Widyahening, Indah S; van Tulder, Maurits W; Blomberg, Stefan E I; de Vet, Henrica Cw; Brønfort, Gert; Bouter, Lex M; van der Heijden, Geert J

    2013-08-19

    Traction has been used to treat low-back pain (LBP), often in combination with other treatments. We included both manual and machine-delivered traction in this review. This is an update of a Cochrane review first published in 1995, and previously updated in 2006. To assess the effects of traction compared to placebo, sham traction, reference treatments and no treatment in people with LBP. We searched the Cochrane Back Review Group Specialized Register, the Cochrane Central Register of Controlled Trials (2012, Issue 8), MEDLINE (January 2006 to August 2012), EMBASE (January 2006 to August 2012), CINAHL (January 2006 to August 2012), and reference lists of articles and personal files. The review authors are not aware of any important new randomized controlled trial (RCTs) on this topic since the date of the last search. RCTs involving traction to treat acute (less than four weeks' duration), subacute (four to 12 weeks' duration) or chronic (more than 12 weeks' duration) non-specific LBP with or without sciatica. Two review authors independently performed study selection, risk of bias assessment and data extraction. As there were insufficient data for statistical pooling, we performed a descriptive analysis. We did not find any case series that identified adverse effects, therefore we evaluated adverse effects that were reported in the included studies. We included 32 RCTs involving 2762 participants in this review. We considered 16 trials, representing 57% of all participants, to have a low risk of bias based on the Cochrane Back Review Group's 'Risk of bias' tool.For people with mixed symptom patterns (acute, subacute and chronic LBP with and without sciatica), there was low- to moderate-quality evidence that traction may make little or no difference in pain intensity, functional status, global improvement or return to work when compared to placebo, sham traction or no treatment. Similarly, when comparing the combination of physiotherapy plus traction with

  16. Diagnosis value of NMR imaging in recurring postoperative sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Frocrain, L.; Duvauferrier, R.; Chales, G.; Ramee, A.; Pawlotsky, Y.

    1987-05-01

    Twelve patients who had a subsequent lumbar sciatica after surgery were evaluated with computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.). The M.R.I. was performed with a 0.35 T whole body superconducting unit using spin echo technique. Two pulse sequences were realized varying the repetition time (TR) from 500 to 2,000 ms and the echo time (TE) from 28 to 60 ms. For the longer pulse, the twice echo were interpreted. The slide obtained with a surface-coil were performed in sagittal plane for the twice pulse sequences and in transaxial plane for the shorter pulse sequence. In seven cases, the results obtained with C.T. and M.R.I. were correlated. In two cases, the C.T. showed a scar formation, the M.R.I. showed a recurrent disk herniation. In three times, C.T. was unable to differentiate clearly between recurrent disk herniation and scar formation, the M.R.I. showed unequivocally on one case a scar formation and on two cases a recurrent disk herniation.

  17. Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Zongshi Qin

    2015-01-01

    Full Text Available This is a systematic review and meta-analysis, which aimed to assess the current evidence on the effects and safety of acupuncture for treating sciatica. In this review, a total of 11 randomized controlled trials were included. As a result, we found that the use of acupuncture may be more effective than drugs and may enhance the effect of drugs for patients with sciatica, but because of the insufficient number of relevant and rigorous studies, the evidence is limited. Future trials using rigorous methodology, appropriate comparisons, and clinically relevant outcomes should be conducted.

  18. Refractory sciatica could be a sign of malignancy: A unique case presentation.

    Science.gov (United States)

    Arunachalam, Karuppiah

    2016-01-04

    t Renal cell carcinoma is one of the highly aggressive tumors and notorious for late presentations. It is associated with high morbidity and mortality. Renal cell carcinoma is known for rare metastatic sites. In clinical practice, it is often important not to anchor to a particular diagnosis but rather revisit and revaluate entire history and clinical examination. We describe a case of metastatic renal cell carcinoma that was initially treated as sciatica and later found to have advanced debilitating malignancy. Internal medicine physicians should be able to recognize one of the rare metastatic sites of renal cell carcinoma and understand the importance of imaging studies if patient has persisting sciatica symptoms without improvement.

  19. Primary Epidural Varicosis as a Rare Cause of Sciatica: A Case Report

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2015-11-01

    Full Text Available Non-discogenic sciatica can be caused by any lesion along the course of the lumbosacral nerve roots and sciatic nerve. We aim to present a rare case of refractory sciatica in an otherwise healthy 25-year-old man. He complained of left leg pain without significant back pain. Extensor hallucis longus muscle was weak on the left side with limited straight leg rising. On magnetic resonance imaging, a space-occupying lesion resembling a sequestrated disc was noted that after surgical decompression, epidural varicosis was demonstrated.

  20. Advice to stay active or structured exercise in the management of sciatica

    DEFF Research Database (Denmark)

    Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L

    2015-01-01

    STUDY DESIGN: A systematic review and meta-analysis. OBJECTIVE: To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. SUMMARY OF BACKGROUND DATA: Conservative management of sciatica usually includes...... comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short; intermediate...

  1. Comorbid subjective health complaints in patients with sciatica: a prospective study including comparison with the general population.

    Science.gov (United States)

    Grøvle, Lars; Haugen, Anne J; Ihlebaek, Camilla M; Keller, Anne; Natvig, Bård; Brox, Jens I; Grotle, Margreth

    2011-06-01

    Chronic nonspecific low back pain is accompanied by high rates of comorbid mental and physical conditions. The aims of this study were to investigate if patients with specific back pain, that is, sciatica caused by lumbar herniation, report higher rates of subjective health complaints (SHCs) than the general population and if there is an association between change in sciatica symptoms and change in SHCs over a 12-month period. A multicenter cohort study of 466 sciatica patients was conducted with follow-up at 3 months and 1 year. Comorbid SHCs were measured by 27 items of the SHC inventory. Odds ratios (ORs) for each SHC were calculated with comparison to a general population sample (n=928) by logistic regression. The SHC number was calculated by summing all complaints present. At baseline, the ORs for reporting SHCs for the sciatica patients were significantly elevated in 15 of the 27 items with a mean (S.D.) SHC number of 7.5 (4.4), compared to 5.2 (4.4) in the general population (Psciatica, the SHC number was reduced to normal levels. Among those with persisting or worsening sciatica, the number increased to a level almost double that of the general population. Compared to the general population, the prevalence of subjective health complaints in sciatica is increased. During follow-up, the number of health complaints increased in patients with persisting or worsening sciatica. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain

    Science.gov (United States)

    Konstantinou, Kika; Ogollah, Reuben; Hay, Elaine M.; Dunn, Kate M.

    2018-01-01

    Background Identification of sciatica may assist timely management but can be challenging in clinical practice. Diagnostic models to identify sciatica have mainly been developed in secondary care settings with conflicting reference standard selection. This study explores the challenges of reference standard selection and aims to ascertain which combination of clinical assessment items best identify sciatica in people seeking primary healthcare. Methods Data on 394 low back-related leg pain consulters were analysed. Potential sciatica indicators were seven clinical assessment items. Two reference standards were used: (i) high confidence sciatica clinical diagnosis; (ii) high confidence sciatica clinical diagnosis with confirmatory magnetic resonance imaging findings. Multivariable logistic regression models were produced for both reference standards. A tool predicting sciatica diagnosis in low back-related leg pain was derived. Latent class modelling explored the validity of the reference standard. Results Model (i) retained five items; model (ii) retained six items. Four items remained in both models: below knee pain, leg pain worse than back pain, positive neural tension tests and neurological deficit. Model (i) was well calibrated (p = 0.18), discrimination was area under the receiver operating characteristic curve (AUC) 0.95 (95% CI 0.93, 0.98). Model (ii) showed good discrimination (AUC 0.82; 0.78, 0.86) but poor calibration (p = 0.004). Bootstrapping revealed minimal overfitting in both models. Agreement between the two latent classes and clinical diagnosis groups defined by model (i) was substantial, and fair for model (ii). Conclusion Four clinical assessment items were common in both reference standard definitions of sciatica. A simple scoring tool for identifying sciatica was developed. These criteria could be used clinically and in research to improve accuracy of identification of this subgroup of back pain patients. PMID:29621243

  3. The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Mei Ji

    2015-01-01

    Full Text Available Background. Sciatica is one of the most frequently reported complaints; it affects quality of life and reduces social and economic efficacy. Clinical studies on the efficacy of acupuncture therapy in sciatica are increasing, while systematic reviews assessing the efficacy of acupuncture therapy are still lacking. Objective. This study aims to assess the effectiveness of acupuncture therapy for sciatica. Methods. Comprehensive searches of 8 databases were conducted up until April 2015. Outcomes included effectiveness (proportion of patients who improved totally or partly in clinical symptoms, pain intensity, and pain threshold. Effect sizes were presented as risk ratio (RR and mean difference (MD. Pooled effect sizes were calculated by fixed effects or random effects model. Results. A total of 12 studies (involving 1842 participants were included. Results showed that acupuncture was more effective than conventional Western medicine (CWM in outcomes effectiveness (RR 1.21, 95% CI: 1.16–1.25, pain intensity (MD −1.25, 95% CI: −1.63 to −0.86, and pain threshold (MD: 1.08, 95% CI: 0.98–1.17. Subgroup and sensitivity analysis found that the results did not change in different treatment method and drug categories substantially. The reported adverse effects were acceptable. Conclusions. Acupuncture may be effective in treating the pain associated with sciatica.

  4. Immediate relief of herniated lumbar disc-related sciatica by ankle acupuncture

    Science.gov (United States)

    Xiang, Anfeng; Xu, Mingshu; Liang, Yan; Wei, Jinzi; Liu, Sheng

    2017-01-01

    Abstract Background: Around 90% of sciatica cases are due to a herniated intervertebral disc in the lumbar region. Ankle acupuncture (AA) has been reported to be effective in the treatment of acute nonspecific low back pain. This study aims to evaluate the efficacy of a single session of ankle acupuncture for disc-related sciatica. Method: This will be a double-blinded, randomized controlled clinical trial. Patients diagnosed with disc-related sciatica will be randomly divided into 3 parallel groups. The treatment group (n = 30) will receive ankle acupuncture. The 2 control groups will either undergo traditional needle manipulation (n = 30) or sham acupuncture (n = 30) at the same point as the treatment group. The primary outcome will be pain intensity on a visual analog scale (VAS). The secondary outcomes will be paresthesia intensity on a VAS and the Abbreviated Acceptability Rating Profile (AAPR). The success of blinding will be evaluated, and the needle-induced sensation and adverse events will be recorded. All outcomes will be evaluated before, during, and after the treatment. Discussion: This study will determine the immediate effect and specificity of ankle acupuncture for the treatment of disc-related sciatica. We anticipate that ankle acupuncture might be more effective than traditional needle manipulation or sham acupuncture. Trial registration ChiCTR-IPR-15007127 (http://www.chictr.org.cn/showprojen.aspx?proj=11989) PMID:29390461

  5. Sciatica in the female patient: anatomical considerations, aetiology and review of the literature

    Science.gov (United States)

    Bovay, Philippe; Gobelet, Charles

    2006-01-01

    The principal author was confronted few years ago with the case of a 38-year-old woman with a 5-month history of ill-defined L5 sciatic pain that was referred to an orthopaedic department for investigation and eventual surgical treatment for what was suspected to be herniated disc-related sciatica. Removal of her enlarged uterus found unexpectedly close to the sacroiliac joint upon lumbar MRI abolished her symptoms. Review of the literature showed that the lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Physiological processes in the female patient and gynaecological diseases may be the source of sciatica, often not readily searched for, leading to fruitless investigations and surgical treatments. The aim of the paper is to highlight gynaecological and obstetrical causes of sciatica and sciatica-like symptoms. To prevent unproductive expenses and morbidity, a thorough gynaecological examination should be done even though neurological examination may be suggestive of a herniated intervertebral disc, and the cyclic pattern of pain related to menses should be routinely asked for. PMID:16622708

  6. Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis.

    Science.gov (United States)

    Visser, L H; Nijssen, P G N; Tijssen, C C; van Middendorp, J J; Schieving, J

    2013-07-01

    To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. Patients with pain radiating below the buttocks with a duration of 4 weeks to 1 year were included. After physical and radiological examinations, a diagnosis of SI joint-related pain, pain due to disk herniation, or a combination of these two causes was made. Patients with SIJ-related leg pain (n = 77/186) were significantly more often female, had shorter statue, a shorter duration of symptoms, and had more often pain radiating to the groin and a history of a fall on the buttocks. Muscle weakness, corkscrew phenomenon, finger-floor distance ≥25 cm, lumbar scoliosis, positive Bragard or Kemp sign, and positive leg raising test were more often present when radiologic nerve root compression was present. Although these investigations may help, MRI of the spine is necessary to discriminate between the groups. Sciatica-like symptoms derived from the SIJ can clinically mimic a radiculopathy. We suggest to perform a thorough physical examination of the spine, SI joints, and hips with additional radiological tests to exclude other causes.

  7. PRECISE - pregabalin in addition to usual care for sciatica: Study protocol for a randomised controlled trial

    NARCIS (Netherlands)

    S. Mathieson (Stephanie); C. Maher (Chris); A.J. McLachlan (Andrew); J. Latimer (Jane); B.W. Koes (Bart); M.J. Hancock (Mark J.); I. Harris (Ian); R.N. Day (Richard); J. Pik (Justin); S. Jan (Stephen); L. Billot (Laurent); C.-W.C. Lin (Chung-Wei Christine)

    2013-01-01

    textabstractBackground: Sciatica is a type of neuropathic pain that is characterised by pain radiating into the leg. It is often accompanied by low back pain and neurological deficits in the lower limb. While this condition may cause significant suffering for the individual, the lack of evidence

  8. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica

    International Nuclear Information System (INIS)

    Shi, Yin; Zong, Min; Xu, Xiaoquan; Zou, Yuefen; Feng, Yang; Liu, Wei; Wang, Chuanbing; Wang, Dehang

    2015-01-01

    Highlights: •In the present study, we first elected ROIs corresponding to the proximal, medial, and distal levels of the lumbar foraminal zone. •The ROC analysis for FA values of distal nerves indicated a high level of reliability in the diagnosis of sciatica. •The declining trend of FA values from proximal to distal along the nerve tract may correlate with the disparity of axonal regeneration at different levels. •DTI is able to quantitatively evaluate compressed nerve roots and has a higher sensitivity and specificity for diagnosing sciatica than conventional MR imaging. •DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and probable localization of nerve compression. -- Abstract: Objective: To quantitatively evaluate nerve roots by measuring fractional anisotropy (FA) values in healthy volunteers and sciatica patients, visualize nerve roots by tractography, and compare the diagnostic efficacy between conventional magnetic resonance imaging (MRI) and DTI. Materials and methods: Seventy-five sciatica patients and thirty-six healthy volunteers underwent MR imaging using DTI. FA values for L5–S1 lumbar nerve roots were calculated at three levels from DTI images. Tractography was performed on L3–S1 nerve roots. ROC analysis was performed for FA values. Results: The lumbar nerve roots were visualized and FA values were calculated in all subjects. FA values decreased in compressed nerve roots and declined from proximal to distal along the compressed nerve tracts. Mean FA values were more sensitive and specific than MR imaging for differentiating compressed nerve roots, especially in the far lateral zone at distal nerves. Conclusions: DTI can quantitatively evaluate compressed nerve roots, and DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and localization of probable nerve compression. DTI has great potential utility for evaluating lumbar nerve compression in sciatica

  9. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Yin; Zong, Min; Xu, Xiaoquan; Zou, Yuefen; Feng, Yang; Liu, Wei; Wang, Chuanbing; Wang, Dehang, E-mail: njmu_wangdehang@126.com

    2015-04-15

    Highlights: •In the present study, we first elected ROIs corresponding to the proximal, medial, and distal levels of the lumbar foraminal zone. •The ROC analysis for FA values of distal nerves indicated a high level of reliability in the diagnosis of sciatica. •The declining trend of FA values from proximal to distal along the nerve tract may correlate with the disparity of axonal regeneration at different levels. •DTI is able to quantitatively evaluate compressed nerve roots and has a higher sensitivity and specificity for diagnosing sciatica than conventional MR imaging. •DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and probable localization of nerve compression. -- Abstract: Objective: To quantitatively evaluate nerve roots by measuring fractional anisotropy (FA) values in healthy volunteers and sciatica patients, visualize nerve roots by tractography, and compare the diagnostic efficacy between conventional magnetic resonance imaging (MRI) and DTI. Materials and methods: Seventy-five sciatica patients and thirty-six healthy volunteers underwent MR imaging using DTI. FA values for L5–S1 lumbar nerve roots were calculated at three levels from DTI images. Tractography was performed on L3–S1 nerve roots. ROC analysis was performed for FA values. Results: The lumbar nerve roots were visualized and FA values were calculated in all subjects. FA values decreased in compressed nerve roots and declined from proximal to distal along the compressed nerve tracts. Mean FA values were more sensitive and specific than MR imaging for differentiating compressed nerve roots, especially in the far lateral zone at distal nerves. Conclusions: DTI can quantitatively evaluate compressed nerve roots, and DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and localization of probable nerve compression. DTI has great potential utility for evaluating lumbar nerve compression in sciatica.

  10. Efficacy and tolerance of systemic steroids in sciatica: a systematic review and meta-analysis.

    Science.gov (United States)

    Roncoroni, Cécile; Baillet, Athan; Durand, Marjorie; Gaudin, Philippe; Juvin, Robert

    2011-09-01

    The efficacy of pharmacological interventions in sciatica is limited and the use of systemic steroids is still controversial. We aimed at evaluating the efficacy and tolerance of systemic steroids in sciatica. A systematic literature search was performed in the Medline, Embase and Cochrane databases until February 2010. Randomized placebo-controlled trials evaluating the efficacy and the tolerance of systemic steroids in sciatica were included. Efficacy and tolerance were assessed using the relative risk (RR) and 95% CI with the inverse variance method (RR > 1 means that the event is more likely to occur in the steroid group). We explored the heterogeneity between the studies using subgroup analysis. Seven studies (383 patients) were included. The difference in the rate of responders between both groups was not statistically significant (RR = 1.22, 95% CI 0.96, 1.56). The rate of adverse events was 13.3% for the patients in the steroid group and 6.6% for the placebo group (RR = 2.01, 95% CI 1.06, 3.80). The number needed to harm was 20 (95% CI 10, ∞). Twenty (15.3%) patients in the steroid group and seven (5.7%) patients in the placebo group underwent surgery. A trend towards a higher requirement for spinal surgery was observed in the steroid group (RR = 1.14, 95% CI 0.74, 1.75). The methodological quality slightly influenced the results. We did not find any publication bias. Steroid efficacy is not superior to the placebo in sciatica, but it has more side effects. The tolerance : efficacy ratio indicates against the use of systemic steroids in sciatica.

  11. Intradermal capsaicin as a neuropathic pain model in patients with unilateral sciatica

    Science.gov (United States)

    Aykanat, Verna; Gentgall, Melanie; Briggs, Nancy; Williams, Desmond; Yap, Sharon; Rolan, Paul

    2012-01-01

    AIM This study compared the responses between patients with unilateral sciatica and pain-free volunteers following administration of intradermal capsaicin. METHODS Fourteen patients with unilateral sciatica and 12 pain-free volunteers received one injection per hour over 4 h of 1 µg and 10 µg capsaicin, into each calf. For each dose, spontaneous pain (10 cm VAS), area of flare (cm2) and the sum of allodynia and hyperalgesia radii across eight axes (cm) were recorded pre-injection and at 5, 15, 30, 45 and 60 min post injection. RESULTS Sciatica subjects experienced higher spontaneous pain and hyperalgesia responses in both legs compared with pain-free volunteers. The largest mean difference in spontaneous pain was 2.8 cm (95% CI 1.6, 3.9) at 5 min in the unaffected leg following 10 µg. The largest mean difference in hyperalgesia was 19.7 cm (95% CI 12.4, 27.0) at 60 min in the unaffected leg following 10 µg. Allodynia was greater in patients than in controls with the largest mean difference of 2.9 cm (95% CI 1, 4.8) at 5 min following 10 µg in the affected leg. Allodynia was also higher in the affected leg compared with the unaffected leg in sciatica patients with the highest mean difference of 3.0 cm (95% CI 1.2, 4.7) at 5 min following 10 µg. CONCLUSIONS The responses to intradermal capsaicin are quantitatively and qualitatively different in unilateral sciatica patients compared with pain-free controls. PMID:21740458

  12. Self-Reported Bothersome Symptoms Across Different Socioepidemiological Groups of People Living With HIV Attending French Hospitals: Results From the ANRS-VESPA2 Survey.

    Science.gov (United States)

    Boyer, Véronique; Vilotitch, Antoine; Marcellin, Fabienne; Demoulin, Baptiste; Dray-Spira, Rosemary; Spire, Bruno

    2017-07-01

    Twenty years after the advent of combined antiretroviral therapies (ARTs), there is a growing need for up-to-date information about the daily experience of people living with HIV (PLWH). This study aimed to investigate the relationship between socioepidemiological groups and the types of bothersome symptoms reported by PLWH participating in a national survey in France. We analyzed self-reported bothersome symptoms in a representative sample of PLWH (ANRS-VESPA2 survey), most of whom were receiving ART treatment. PLWH (N = 2505) were grouped into three clusters according to the number of bothersome symptoms reported: Cluster A (low number, n = 1848), Cluster B (moderate number, n = 271), and Cluster C (high number, n = 386). Individuals in Cluster A (low number of bothersome symptoms) were less likely to report all the symptom types investigated. Psychological, sexual, and general symptoms were more likely to be reported in Cluster B (moderate number), whereas gastric-, pain-, and appearance-related symptoms were more likely in Cluster C (high number). In multivariate analyses, women not natives of Sub-Saharan Africa and former/active female injecting drug users were more likely to report a medium or high number of symptoms, and lower adherence to ART. Combining new biomedical strategies with coping mechanisms and providing better support to socially vulnerable PLWH may improve this population's quality of health and daily life. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. Effect of extracorporeal magnetic energy stimulation on bothersome lower urinary tract symptoms and quality of life in female patients with stress urinary incontinence and overactive bladder.

    Science.gov (United States)

    Lo, Tsia-Shu; Tseng, Ling-Hong; Lin, Yi-Hao; Liang, Ching-Chung; Lu, Ching-Yi; Pue, Leng Boi

    2013-11-01

    The aim of this study was to investigate the efficacy of extracorporeal magnetic stimulation (EMS) for the treatment of bothersome and severe symptoms of stress urinary incontinence (SUI) and overactive bladder syndrome (OAB) in female patients. A retrospective review was conducted on patients with SUI and OAB who were referred to EMS therapy. Successful treatment for the bothersome symptoms of OAB and SUI was defined as score ≤1 for questions 2 and 3 on the Urodynamic Distress Inventory-6. The objective cure of SUI and OAB was defined as no urinary leakage during the cough stress test and any urgency, urge incontinence and voiding frequency of less than eight times per 24 h based on the 3-day bladder diary, after the 9 weeks of treatment, respectively. Ninety-three patients with SUI or OAB underwent a 9-week course of EMS at 20 min twice weekly. Seventy-two (77%) patients completed EMS treatment. Geographical factor and poor economic status were two main factors for dropout. A total of 94.1% (32 of 34) and 86.8% (33 of 38) of subjects had successful treatment for the bothersome symptoms of OAB and SUI, respectively. In contrast, the cure rate for OAB and SUI was only 61.7% and 42.1%, respectively. There was also a significant improvement in both Urogenital Distress Inventory Short Form (bothersome on lower urinary tract symptoms) and the Incontinence Impact Questionnaire Short Form (quality of life) total score in both groups after EMS. EMS is a safe and effective alternative method for treating SUI and OAB. Further studies are needed to evaluate the long-term efficacy. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  14. Botulinum toxin injections for low-back pain and sciatica.

    Science.gov (United States)

    Waseem, Zeeshan; Boulias, Chris; Gordon, Allan; Ismail, Farooq; Sheean, Geoffrey; Furlan, Andrea D

    2011-01-19

    Adequate relief from low-back pain (LBP) is not always possible. Emerging evidence suggests a role for botulinum neurotoxin (BoNT) injections in treating pain disorders. Proponents of BoNT suggest its properties can decrease muscle spasms, ischemia and inflammatory markers, thereby reducing pain. To determine the effects of botulinum toxin injections in adults with LBP. We searched CENTRAL (The Cochrane Library 2009, issue 3) and MEDLINE, EMBASE, and CINAHL to August 2009; screened references from included studies; consulted with content experts and Allergan. We included published and unpublished randomised controlled trials without language restrictions We included randomised trials that evaluated BoNT serotypes versus other treatments in patients with non-specific LBP of any duration. Two review authors selected the studies, assessed the risk of bias using the Cochrane Back Review Group criteria, and extracted the data using standardized forms. We performed a qualitative analysis due to lack of data. We excluded evidence from nineteen studies due to non-randomisation, incomplete or unpublished data. We included three randomised trials (N =123 patients). Only one study included patients with chronic non-specific LBP; the other two examined unique subpopulations. Only one of the three trials had a low risk of bias and demonstrated that BoNT injections reduced pain at three and eight weeks and improved function at eight weeks better than saline injections. The second trial showed that BoNT injections were better than injections of corticosteroid plus lidocaine or placebo in patients with sciatica attributed to piriformis syndrome. The third trial concluded that BoNT injections were better than traditional acupuncture in patients with third lumbar transverse process syndrome. Both studies with high risk of bias had several key limitations. Heterogeneity of the studies prevented meta-analysis. There is low quality evidence that BoNT injections improved pain, function

  15. Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial.

    Science.gov (United States)

    Ter Meulen, Bastiaan C; Maas, Esther T; Vyas, Amrita; van der Vegt, Marinus; de Priester, Koo; de Boer, Michiel R; van Tulder, Maurits W; Weinstein, Henry C; Ostelo, Raymond W J G

    2017-05-25

    Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica. We will recruit a total of 264 patients with sciatica (sciatica should be recommended TESI-plus within the first few weeks rather than being treated with pain medication alone in order to relieve pain and improve their functioning. In case of a negative result (no relevant differences in outcome between the three study arms), pain medication will remain the mainstay of treatment in the acute stages of sciatica. Dutch National trial register: NTR4457 (March, 6th, 2014).

  16. Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial.

    Science.gov (United States)

    Visco, Anthony G; Brubaker, Linda; Richter, Holly E; Nygaard, Ingrid; Paraiso, Marie Fidela; Menefee, Shawn A; Schaffer, Joseph; Wei, John; Chai, Toby; Janz, Nancy; Spino, Cathie; Meikle, Susan

    2012-01-01

    This trial compares the change in urgency urinary incontinence episodes over 6 months, tolerability and cost effectiveness between women receiving daily anticholinergic therapy plus a single intra-detrusor injection of saline versus a single intra-detrusor injection of 100 U of botulinum toxin A plus daily oral placebo tablets. We present the rationale and design of a randomized-controlled trial, Anticholinergic versus Botulinum Toxin, Comparison Trial for the Treatment of Bothersome Urge Urinary Incontinence: ABC trial, conducted by the NICHD-funded Pelvic Floor Disorders Network. We discuss the innovative nature of this trial and the challenges related to choice of patient population, maintaining masking, cost effectiveness, ethical considerations, measuring adherence, and placebo development and testing. Enrollment began in April, 2010. 242 participants will be randomized and primary outcome data analysis is anticipated to begin in mid 2012. Several challenges in the trial design are discussed. Randomization to placebo intra-detrusor injections may limit recruitment, potentially impacting generalizability. Other challenges included the heavy marketing of drugs for overactive bladder which could impact recruitment of drug-naïve women. In addition, anticholinergic medications often cause dry mouth, making masking difficult. Finally, adverse reporting of transient urinary retention is challenging as there is no standardized definition; yet this is the most common adverse event following intra-detrusor botulinum toxin injection. The ABC trial will help women with urgency urinary incontinence balance efficacy, side effects and cost of anticholinergic medication versus botulinum toxin intra-detrusor injection. The results have the potential to fundamentally change the therapeutic approach to this condition. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Genome-Wide Meta-Analysis of Sciatica in Finnish Population.

    Directory of Open Access Journals (Sweden)

    Susanna Lemmelä

    Full Text Available Sciatica or the sciatic syndrome is a common and often disabling low back disorder in the working-age population. It has a relatively high heritability but poorly understood molecular mechanisms. The Finnish population is a genetic isolate where small founder population and bottleneck events have led to enrichment of certain rare and low frequency variants. We performed here the first genome-wide association (GWAS and meta-analysis of sciatica. The meta-analysis was conducted across two GWAS covering 291 Finnish sciatica cases and 3671 controls genotyped and imputed at 7.7 million autosomal variants. The most promising loci (p<1x10-6 were replicated in 776 Finnish sciatica patients and 18,489 controls. We identified five intragenic variants, with relatively low frequencies, at two novel loci associated with sciatica at genome-wide significance. These included chr9:14344410:I (rs71321981 at 9p22.3 (NFIB gene; p = 1.30x10-8, MAF = 0.08 and four variants at 15q21.2: rs145901849, rs80035109, rs190200374 and rs117458827 (MYO5A; p = 1.34x10-8, MAF = 0.06; p = 2.32x10-8, MAF = 0.07; p = 3.85x10-8, MAF = 0.06; p = 4.78x10-8, MAF = 0.07, respectively. The most significant association in the meta-analysis, a single base insertion rs71321981 within the regulatory region of the transcription factor NFIB, replicated in an independent Finnish population sample (p = 0.04. Despite identifying 15q21.2 as a promising locus, we were not able to replicate it. It was differentiated; the lead variants within 15q21.2 were more frequent in Finland (6-7% than in other European populations (1-2%. Imputation accuracies of the three significantly associated variants (chr9:14344410:I, rs190200374, and rs80035109 were validated by genotyping. In summary, our results suggest a novel locus, 9p22.3 (NFIB, which may be involved in susceptibility to sciatica. In addition, another locus, 15q21.2, emerged as a promising one, but failed to replicate.

  18. Recovery of motor deficit accompanying sciatica--subgroup analysis of a randomized controlled trial.

    Science.gov (United States)

    Overdevest, Gijsbert M; Vleggeert-Lankamp, Carmen L A M; Jacobs, Wilco C H; Brand, Ronald; Koes, Bart W; Peul, Wilco C

    2014-09-01

    In patients with sciatica due to a lumbar disc herniation, it is generally recommended to reserve surgical treatment for those who suffer from intolerable pain or those who demonstrate persistent symptoms after conservative management. Controversy exists about the necessity of early surgical intervention for those patients that have an additional motor deficit. The aim of this study was to compare the recovery of motor deficit among patients receiving early surgery to those receiving prolonged conservative treatment. Subgroup analysis of a randomized controlled trial. This subgroup analysis focuses on 150 (53%) of 283 patients with sciatica due to a lumbar disc herniation and whose symptoms at baseline (before randomization) were accompanied by a motor deficit. Motor deficit was assessed through manual muscle testing and graded according to the Medical Research Council (MRC) scale. In total, 150 patients with 6 to 12 weeks of sciatica due to a lumbar disc herniation and whose symptoms were accompanied by a moderate (MRC Grade 4) or severe (MRC Grade 3) motor deficit were randomly allocated to early surgery or prolonged conservative treatment. Repeated standardized neurologic examinations were performed at baseline and at 8, 26, and 52 weeks after randomization. This study was supported by a grant from the Netherlands Organization for Health Research and Development (ZonMW) and the Hoelen Foundation The Hague. Sciatica recovered among seven (10%) of the 70 patients assigned to early surgery before surgery could be performed, and of the 80 patients assigned to conservative treatment, 32 patients (40%) were treated surgically because of intolerable pain. Baseline severity of motor deficit was graded moderate in 84% of patients and severe in 16% of patients. Motor deficit recovered significantly faster among patients allocated to early surgery (p=.01), but the difference was no longer significant at 26 (p=.21) or 52 weeks (p=.92). At 1 year, complete recovery of motor

  19. The Effect of Smoking on the Risk of Sciatica: A Meta-analysis.

    Science.gov (United States)

    Shiri, Rahman; Falah-Hassani, Kobra

    2016-01-01

    The role of smoking in sciatica is unknown. This study aimed to estimate the effect of smoking on lumbar radicular pain and clinically verified sciatica. Comprehensive literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar, and ResearchGate databases from 1964 through March 2015. We used a random-effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses with regard to study design, methodological quality of included studies, and publication bias. Twenty-eight (7 cross-sectional [n = 20,111 participants], 8 case control [n = 10,815], and 13 cohort [n = 443,199]) studies qualified for a meta-analysis. Current smokers had an increased risk of lumbar radicular pain or clinically verified sciatica (pooled adjusted odds ratio [OR] 1.46; 95% confidence interval [CI], 1.30-1.64, n = 459,023). Former smokers had only slightly elevated risk compared with never smokers (pooled adjusted OR 1.15; 95% CI, 1.02-1.30, n = 387,196). For current smoking the pooled adjusted OR was 1.64 (95% CI, 1.24-2.16, n = 10,853) for lumbar radicular pain, 1.35 (95% CI, 1.09-1.68, n = 110,374) for clinically verified sciatica, and 1.45 (95% CI, 1.16-1.80, n = 337,796) for hospitalization or surgery due to a herniated lumbar disc or sciatica. The corresponding estimates for past smoking were 1.57 (95% CI, 0.98-2.52), 1.09 (95% CI, 1.00-1.19), and 1.10 (95% CI, 0.96-1.26). The associations did not differ between men and women, and they were independent of study design. Moreover, there was no evidence of publication bias, and the observed associations were not due to selection or detection bias, or confounding factors. Smoking is a modest risk factor for lumbar radicular pain and clinically verified sciatica. Smoking cessation appears to reduce, but not entirely eliminate, the excess risk. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Gabapentin Superadded to a Pre-Existent Regime Containing Amytriptyline for Chronic Sciatica.

    Science.gov (United States)

    Robertson, Kelvin L; Marshman, Laurence A G

    2016-11-01

    There is currently a gross lack of evidence base guiding the medical management of chronic sciatica (CS). Only scant previous studies have assessed gabapentin (GBP) in CS. Extrapolating NICE-UK guidelines, prescribing authorities often insist on trialling anti-depressants (e.g., amytriptyline, AMP) as a first line for neuropathic pain states such as CS. When super-adding second-line agents, such as GBP, NICE-UK encourages overlap with first-line agents to avoid decreased pain-control. No study has reflected this practice. Evaluate efficacy and side effects (SE) of GBP superadded to a pre-existent regime containing AMP for CS. Prospective cohort of patients with unilateral CS attending a specialist spine clinic. Eligible patients had experienced partial benefit to a pre-existent regime containing AMP: none had significant SE. No drugs other than GBP were added or discontinued (the latter was considered inequitable) for 3 months. Visual analog pain score (VAS), Oswestry disability index (ODI), and SE were recorded. Efficacy: in 56% (43/77) there were reductions in VAS (5.3 ± 3.6→2.8 ± 2.7, P < 0.0001) and ODI (42.8 ± 31.1→30.7 ± 25.2, P = 0.008). SE: Eighty-two SE (23 types) were reported in 53% (41/77). Efficacy was less in those with SE: a trend existed for a lesser reduction in VAS (2.0 ± 2.4 v 3.0 ± 2.7, P = 0.08), which proved significant for ODI (8.1 ± 11.4 v 16.7 ± 18.2, P = 0.01). Thirty-four percent (26/77) discontinued GBP all within 1 week (i.e., during titration). This is the first prospective cohort study of GBP super-added to a pre-existent regime containing AMP for CS, as per routine clinical practice and NICE-UK principles. Super-added GBP demonstrated further efficacy over the previous regime in 56%; however, SE were frequent (53%) and diverse (23 types), and 34% abruptly discarded GBP. Although SE were associated with decreased efficacy, 37% nevertheless tolerated GBP despite SE. © 2016

  1. Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman.

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2011-01-01

    The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient\\'s age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with \\'red flag\\' symptoms.

  2. Identification of risk factors for new-onset sciatica in Japanese workers: findings from the Japan epidemiological research of Occupation-related Back pain study.

    Science.gov (United States)

    Matsudaira, Ko; Kawaguchi, Mika; Isomura, Tatsuya; Arisaka, Mayumi; Fujii, Tomoko; Takeshita, Katsushi; Kitagawa, Tomoaki; Miyoshi, Kota; Konishi, Hiroaki

    2013-12-15

    Two-year, prospective cohort data collected for the Japan epidemiological research of Occupation-related Back pain study were used for the analysis. To identify potential risk factors for the development of new-onset sciatica in initially symptom-free Japanese workers with no history of sciatica. Although the associations between individual and occupational factors and cases of new-onset sciatica are established, the effect of psychosocial factors on the development of sciatica has still not been adequately clarified. In total, 5310 participants responded to a self-administered baseline questionnaire (response rate: 86.5%). Furthermore, 3194 (60.2%) completed both 1- and 2-year follow-up questionnaires. The baseline questionnaire assessed individual characteristics, ergonomic work demands, and work-related psychosocial factors. The outcome of interest was new-onset sciatica with or without low back pain during the 2-year follow-up period. Incidence was calculated for participants who reported no low back pain in the preceding year and no history of lumbar radicular pain (sciatica) at baseline. Logistical regression assessed risk factors associated with new-onset sciatica. Of 765 eligible participants, 141 (18.4%) reported a new episode of sciatica during the 2-year follow-up. In crude analysis, significant associations were found between new-onset sciatica and age and obesity. In adjusted analysis, significant associations were found for obesity and mental workload in a qualitative aspect after controlling for age and sex. Consequently, in multivariate analysis with all the potential risk factors, age and obesity remained statistically significant (odds ratios: 1.59, 95% confidence interval: 1.01-2.52; odds ratios: 1.77, 95% confidence interval: 1.17-2.68, respectively). In previously asymptomatic Japanese workers, the risk of developing new-onset sciatica is mediated by individual factors. Our findings suggest that the management of obesity may prevent new

  3. Dry Needling Related Short-Term Vasodilation in Chronic Sciatica under Infrared Thermovision

    Directory of Open Access Journals (Sweden)

    Elżbieta Skorupska

    2015-01-01

    Full Text Available Vasomotor responses to dry needling (DN of trigger points (TrPs under infrared thermovision (IRT camera control and TrPs coexistence in chronic sciatica patients have never been studied. Materials and Methods. Fifty consecutive chronic sciatica patients were enrolled in the study. DN under IRT control was performed for all patients regardless of gluteus minimus (GM active TrPs examination. Then, the vasomotor response and its agreement with TrPs examination were evaluated. Results. The prevalence of GM active TrPs was 32%. DN provokes intensive vasodilatation for TrPs-positive patients only, with the localization dependent on referred pain during the procedure (r=0.896;  P=0.000 not the daily complaint. The increase of vasodilatation was, for example, for thigh, TrPs-positive +30.29% (P<0.05 versus TrPs-negative +4.08%. Additionally, a significant skin temperature increase was observed for TrPs-positive only, for example, thigh +1.5 ± 1.3°C (maximum and +1.2 ± 1.0°C (average (both P<0.05. Conclusion. GM active TrPs prevalence among chronic sciatica patients was around one in three. Every TrPs-positive subject presented with vasodilatation under IRT in the area of DN related referred pain. Although TrPs involvement in chronic sciatica patients is possible, further studies on a bigger group of patients are still required.

  4. Ozone-augmented percutaneous discectomy: A novel treatment option for refractory discogenic sciatica

    International Nuclear Information System (INIS)

    Crockett, M.T.; Moynagh, M.; Long, N.; Kilcoyne, A.; Dicker, P.; Synnott, K.; Eustace, S.J.

    2014-01-01

    Aim: To assess the short and medium-term efficacy and safety of a novel, minimally invasive therapeutic option combining automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural: ozone-augmented percutaneous discectomy (OPLD). Materials and methods: One hundred and forty-seven patients with a clinical and radiological diagnosis of discogenic sciatica who were refractory to initial therapy were included. Fifty patients underwent OPLD whilst 97 underwent a further caudal epidural. Outcomes were evaluated using McNab's score, improvement in visual analogue score (VAS) pain score, and requirement for further intervention. Follow-up occurred at 1 and 6 months, and comparison was made between groups. Results: OPLD achieved successful outcomes in almost three-quarters of patients in the short and medium term. OPLD achieved superior outcomes at 1 and 6 months compared to caudal epidural. There was a reduced requirement for further intervention in the OPLD group. No significant complications occurred in either group. Discussion: OPLD is a safe and effective treatment for patients with refractory discogenic sciatica in the short and medium term. OPLD has the potential to offer an alternative second-line minimally invasive treatment option that could reduce the requirement for surgery in this patient cohort. - Highlights: • Discogenic sciatica is a common condition which causes significant morbidity. • Ozone augmented percutaneous lumbar discectomy (OPLD) is a novel treatment. • Comparison was made to caudal epidural injection. • All outcomes were superior in the OPLD treatment group. • OPLD appears is an effective treatment for refractory discogenic sciatica

  5. Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis

    Science.gov (United States)

    Maher, Chris G; Ferreira, Manuela L; Ferreira, Paulo H; Hancock, Mark; Oliveira, Vinicius C; McLachlan, Andrew J; Koes, Bart

    2012-01-01

    Objective To investigate the efficacy and tolerability of analgesic and adjuvant pain drugs typically administered in primary care for the management of patients with sciatica. Design Systematic review. Data source International Pharmaceutical Abstracts, PsycINFO, Medline, Embase, Cochrane Central Register of Clinical Trials (CENTRAL), CINAHL, and LILACS. Study selection Randomised controlled trials assessing the efficacy and tolerability of drugs versus placebo or other treatment for sciatica. Data extraction Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability outcomes were converted to a common 0 to 100 scale. Data were pooled with a random effects model, and the GRADE approach was used in summary conclusions. Results Twenty three published reports met the inclusion criteria. The evidence to judge the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antidepressants, anticonvulsants, muscle relaxants, and opioid analgesics ranged from moderate to low quality. Most of the pooled estimates did not favour the active treatment over placebo. The pooled results of two trials of corticosteroids (mean difference in overall and leg pain −12.2, 95% confidence interval −20.9 to −3.4) and a single trial of the anticonvulsant gabapentin for chronic sciatica (mean difference in overall pain relief −26.6, −38.3 to −14.9) showed some benefits but only in the short term. The median rate of adverse events was 17% (interquartile range 10-30%) for the active drugs and 11% (3-23%) for placebo. Trial limitations included failure to use validated outcome measures, lack of long term follow-up, and small sample size. Conclusions As the existing evidence from clinical trials is of low quality, the efficacy and tolerability of drugs commonly prescribed for the management of sciatica in primary care is unclear. PMID:22331277

  6. Obesity as a risk factor for sciatica: a meta-analysis.

    Science.gov (United States)

    Shiri, Rahman; Lallukka, Tea; Karppinen, Jaro; Viikari-Juntura, Eira

    2014-04-15

    The aim of this study was to assess the associations of overweight and obesity with lumbar radicular pain and sciatica using a meta-analysis. We searched the PubMed, Embase, Scopus, and Web of Science databases from 1966 to July 2013. We performed a random-effects meta-analysis and assessed publication bias. We included 26 (8 cross-sectional, 7 case-control, and 11 cohort) studies. Both overweight (pooled odds ratio (OR) = 1.23, 95% confidence interval (CI): 1.14, 1.33; n = 19,165) and obesity (OR = 1.40, 95% CI: 1.27, 1.55; n = 19,165) were associated with lumbar radicular pain. The pooled odds ratio for physician-diagnosed sciatica was 1.12 (95% CI: 1.04, 1.20; n = 109,724) for overweight and 1.31 (95% CI: 1.07, 1.62; n = 115,661) for obesity. Overweight (OR = 1.16, 95% CI: 1.09, 1.24; n = 358,328) and obesity (OR = 1.38, 95% CI: 1.23, 1.54; n = 358,328) were associated with increased risk of hospitalization for sciatica, and overweight/obesity was associated with increased risk of surgery for lumbar disc herniation (OR = 1.89, 95% CI: 1.25, 2.86; n = 73,982). Associations were similar for men and women and were independent of the design and quality of included studies. There was no evidence of publication bias. Our findings consistently showed that both overweight and obesity are risk factors for lumbar radicular pain and sciatica in men and women, with a dose-response relationship.

  7. Sciatica as the first manifestation of synovial sarcoma. Contribution of magnetic resonance imaging to the diagnosis

    International Nuclear Information System (INIS)

    Veillard, E.; Le Dantec, P.; Chales, G.; Jean, S.; Pawlotsky, Y.

    1995-01-01

    A 38-year-old man presented with paralyzing sciatica as the first manifestation of synovial sarcoma of his right leg. Although neurologic symptoms sometimes occur as manifestations of synovial sarcoma, they are exceptionally inaugural. Magnetic resonance imaging is a valuable tool in patients with synovial tumors, both for establishing the diagnosis and for evaluating the extent of the lesion. (authors). 13 refs., 3 figs

  8. Magnetic resonance imaging of endometriosis of the piriform muscle causing sciatica: case report

    International Nuclear Information System (INIS)

    Hickey, N.A.J.; Murphy, J.P.; Bloom, C.; Hamilton, P.

    1999-01-01

    Endometriosis is the presence of functioning endometrial tissue in a location outside the uterus and is a rare cause of sciatica. The superior soft-tissue contrast and sensitivity of magnetic resonance imaging (MRI) in detecting blood products make it a valuable imaging modality in patients with pelvic endometriosis. In the case described below, it allowed a presumptive diagnosis to be made and the response to medical therapy to be monitored. (author)

  9. Magnetic resonance imaging of endometriosis of the piriform muscle causing sciatica: case report

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, N.A.J.; Murphy, J.P.; Bloom, C.; Hamilton, P. [Sunnybrook and Women' s College Health Sciences Centre, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Endometriosis is the presence of functioning endometrial tissue in a location outside the uterus and is a rare cause of sciatica. The superior soft-tissue contrast and sensitivity of magnetic resonance imaging (MRI) in detecting blood products make it a valuable imaging modality in patients with pelvic endometriosis. In the case described below, it allowed a presumptive diagnosis to be made and the response to medical therapy to be monitored. (author)

  10. Magnetic resonance neurography evaluation of chronic extraspinal sciatica after remote proximal hamstring injury: a preliminary retrospective analysis.

    Science.gov (United States)

    Bucknor, Matthew D; Steinbach, Lynne S; Saloner, David; Chin, Cynthia T

    2014-08-01

    Extraspinal sciatica can present unique challenges in clinical diagnosis and management. In this study, the authors evaluated qualitative and quantitative patterns of sciatica-related pathology at the ischial tuberosity on MR neurography (MRN) studies performed for chronic extraspinal sciatica. Lumbosacral MRN studies obtained in 14 patients at the University of California, San Francisco between 2007 and 2011 were retrospectively reviewed. The patients had been referred by neurosurgeons or neurologists for chronic unilateral sciatica (≥ 3 months), and the MRN reports described asymmetrical increased T2 signal within the sciatic nerve at the level of the ischial tuberosity. MRN studies were also performed prospectively in 6 healthy volunteers. Sciatic nerve T2 signal intensity (SI) and cross-sectional area at the ischial tuberosity were calculated and compared between the 2 sides in all 20 subjects. The same measurements were also performed at the sciatic notch as an internal reference. Adjacent musculoskeletal pathology was compared between the 2 sides in all subjects. Seven of the 9 patients for whom detailed histories were available had a specific history of injury or trauma near the proximal hamstring preceding the onset of sciatica. Eight of the 14 patients also demonstrated soft-tissue abnormalities adjacent to the proximal hamstring origin. The remaining 6 had normal muscles, tendons, and marrow in the region of the ischial tuberosity. There was a significant difference in sciatic nerve SI and size between the symptomatic and asymptomatic sides at the level of the ischial tuberosity, with a mean adjusted SI of 1.38 compared with 1.00 (p sciatica remains a diagnosis of exclusion, this distinct category of patients has not been described in the radiographic literature and merits special attention from clinicians and radiologists in the management of extraspinal sciatica. Magnetic resonance neurography is useful for evaluating chronic sciatic neuropathy both

  11. Psychological defensive profile of sciatica patients with neuropathic pain and its relationship to quality of life.

    Science.gov (United States)

    Tutoglu, A; Boyaci, A; Karababa, I F; Koca, I; Kaya, E; Kucuk, A; Yetisgin, A

    2015-09-01

    To identify differences between defense styles and mechanisms in sciatica patients with or without neuropathic pain and their relationship to quality of life. The study included 37 sciatica patients with neuropathic pain (SNP), 36 sciatica patients without neuropathic pain and 38 healthy subjects. Pain severity was measured using the Visual Analogue Scale (VAS). Psychological condition was assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Defense mechanisms were assessed using a 40-item Defense Style Questionnaire (DSQ-40) and quality of life was assessed using Short Form-36 (SF-36). BDI and BAI scores were significantly higher in the SNP group (p < 0.001). Idealization and immature defense styles, as well as isolation, displacement and somatization were significantly higher in the SNP group (p < 0.05). SF-36 parameters also differed significantly between the groups, with controls having the best scores and the SNP group the worst. In linear regression analysis, acting out and BDI were found to affect the pain domain of the SF-36 (p < 0.001). The acting out defensive style and BDI were independently associated with pain-related quality of life. In the SNP group, significant differences were found in the immature and neurotic styles of the defense mechanisms.

  12. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica.

    Science.gov (United States)

    Shi, Yin; Zong, Min; Xu, Xiaoquan; Zou, Yuefen; Feng, Yang; Liu, Wei; Wang, Chuanbing; Wang, Dehang

    2015-04-01

    To quantitatively evaluate nerve roots by measuring fractional anisotropy (FA) values in healthy volunteers and sciatica patients, visualize nerve roots by tractography, and compare the diagnostic efficacy between conventional magnetic resonance imaging (MRI) and DTI. Seventy-five sciatica patients and thirty-six healthy volunteers underwent MR imaging using DTI. FA values for L5-S1 lumbar nerve roots were calculated at three levels from DTI images. Tractography was performed on L3-S1 nerve roots. ROC analysis was performed for FA values. The lumbar nerve roots were visualized and FA values were calculated in all subjects. FA values decreased in compressed nerve roots and declined from proximal to distal along the compressed nerve tracts. Mean FA values were more sensitive and specific than MR imaging for differentiating compressed nerve roots, especially in the far lateral zone at distal nerves. DTI can quantitatively evaluate compressed nerve roots, and DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and localization of probable nerve compression. DTI has great potential utility for evaluating lumbar nerve compression in sciatica. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation : two year results of a randomised controlled trial

    NARCIS (Netherlands)

    Peul, W.C.; Hout, van den W.B.; Brand, R.; Thomeer, R.T.W.M.; Koes, B.W.

    2008-01-01

    Objectives: To evaluate the effects of early lumbar disc surgery compared with prolonged conservative care for patients with sciatica over two years of follow-up. Design: Randomised controlled trial. Setting: Nine Dutch hospitals. Participants: 283 patients with 6-12 weeks of sciatica.

  14. PRECISE - pregabalin in addition to usual care for sciatica: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Mathieson, Stephanie; Maher, Christopher G; McLachlan, Andrew J; Latimer, Jane; Koes, Bart W; Hancock, Mark J; Harris, Ian; Day, Richard O; Pik, Justin; Jan, Stephen; Billot, Laurent; Lin, Chung-Wei Christine

    2013-07-11

    Sciatica is a type of neuropathic pain that is characterised by pain radiating into the leg. It is often accompanied by low back pain and neurological deficits in the lower limb. While this condition may cause significant suffering for the individual, the lack of evidence supporting effective treatments for sciatica makes clinical management difficult. Our objectives are to determine the efficacy of pregabalin on reducing leg pain intensity and its cost-effectiveness in patients with sciatica. PRECISE is a prospectively registered, double-blind, randomised placebo-controlled trial of pregabalin compared to placebo, in addition to usual care. Inclusion criteria include moderate to severe leg pain below the knee with evidence of nerve root/spinal nerve involvement. Participants will be randomised to receive either pregabalin with usual care (n = 102) or placebo with usual care (n = 102) for 8 weeks. The medicine dosage will be titrated up to the participant's optimal dose, to a maximum 600 mg per day. Follow up consultations will monitor individual progress, tolerability and adverse events. Usual care, if deemed appropriate by the study doctor, may include a referral for physical or manual therapy and/or prescription of analgesic medication. Participants, doctors and researchers collecting participant data will be blinded to treatment allocation. Participants will be assessed at baseline and at weeks 2, 4, 8, 12, 26 and 52. The primary outcome will determine the efficacy of pregabalin in reducing leg pain intensity. Secondary outcomes will include back pain intensity, disability and quality of life. Data analysis will be blinded and by intention-to-treat. A parallel economic evaluation will be conducted from health sector and societal perspectives. This study will establish the efficacy of pregabalin in reducing leg pain intensity in patients with sciatica and provide important information regarding the effect of pregabalin treatment on disability and quality of life

  15. Genome-Wide Meta-Analysis of Sciatica in Finnish Population.

    Science.gov (United States)

    Lemmelä, Susanna; Solovieva, Svetlana; Shiri, Rahman; Benner, Christian; Heliövaara, Markku; Kettunen, Johannes; Anttila, Verneri; Ripatti, Samuli; Perola, Markus; Seppälä, Ilkka; Juonala, Markus; Kähönen, Mika; Salomaa, Veikko; Viikari, Jorma; Raitakari, Olli T; Lehtimäki, Terho; Palotie, Aarno; Viikari-Juntura, Eira; Husgafvel-Pursiainen, Kirsti

    2016-01-01

    Sciatica or the sciatic syndrome is a common and often disabling low back disorder in the working-age population. It has a relatively high heritability but poorly understood molecular mechanisms. The Finnish population is a genetic isolate where small founder population and bottleneck events have led to enrichment of certain rare and low frequency variants. We performed here the first genome-wide association (GWAS) and meta-analysis of sciatica. The meta-analysis was conducted across two GWAS covering 291 Finnish sciatica cases and 3671 controls genotyped and imputed at 7.7 million autosomal variants. The most promising loci (psciatica patients and 18,489 controls. We identified five intragenic variants, with relatively low frequencies, at two novel loci associated with sciatica at genome-wide significance. These included chr9:14344410:I (rs71321981) at 9p22.3 (NFIB gene; p = 1.30x10-8, MAF = 0.08) and four variants at 15q21.2: rs145901849, rs80035109, rs190200374 and rs117458827 (MYO5A; p = 1.34x10-8, MAF = 0.06; p = 2.32x10-8, MAF = 0.07; p = 3.85x10-8, MAF = 0.06; p = 4.78x10-8, MAF = 0.07, respectively). The most significant association in the meta-analysis, a single base insertion rs71321981 within the regulatory region of the transcription factor NFIB, replicated in an independent Finnish population sample (p = 0.04). Despite identifying 15q21.2 as a promising locus, we were not able to replicate it. It was differentiated; the lead variants within 15q21.2 were more frequent in Finland (6-7%) than in other European populations (1-2%). Imputation accuracies of the three significantly associated variants (chr9:14344410:I, rs190200374, and rs80035109) were validated by genotyping. In summary, our results suggest a novel locus, 9p22.3 (NFIB), which may be involved in susceptibility to sciatica. In addition, another locus, 15q21.2, emerged as a promising one, but failed to replicate.

  16. Magnetic resonance imaging findings as predictors of clinical outcome in patients with sciatica receiving active conservative treatment

    DEFF Research Database (Denmark)

    Jensen, Tue Secher; Albert, Hanne B; Sorensen, Joan S

    2007-01-01

    OBJECTIVE: The aims of this study were to investigate the possible prognostic value of disk-related magnetic resonance imaging (MRI) findings in relation to recovery at 14 months in patients with severe sciatica, and whether improvement of disk herniation and/or nerve root compromise is concurrent...... with recovery. METHODS: All patients included in this prospective observational study of patients with sciatica receiving active conservative treatment were scanned at baseline and at 14 months' follow-up. Definite recovery at follow-up was defined as an absence of sciatic leg pain and a Roland Morris...... in that the prevalence of disk-related MRI findings was different for men and women, and they had different recovery rates. Improvement of disk herniations and nerve root compromise over time did not coincide with definite recovery. CONCLUSIONS: In patients with sciatica receiving active conservative treatment, broad...

  17. 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)

  18. A Comparison of the Efficacy and Tolerability of the Treatments for Sciatica: A Network Meta-Analysis.

    Science.gov (United States)

    Guo, Jian-Rong; Jin, Xiao-Ju; Shen, Hua-Chun; Wang, Huan; Zhou, Xun; Liu, Xiao-Qian; Zhu, Na-Na

    2017-12-01

    There remains a lack of a systematic summary of the efficacy and safety of various medicines for sciatica, and discrepancies among these exist. The aim of this study is to comprehensively assess the efficacy of and tolerance to several medical options for the treatment of sciatica. We performed a network meta-analysis and illustrated the results by the mean difference or odds ratio. The surface under the cumulative ranking curve (SUCRA) was used for indicating the preferable treatments. All data analyses and graphs were achieved via R 3.3.2 and Stata 13.0. The subcutaneous anti-tumor necrosis factor-α (anti-TNF-α) was superior to the epidural steroid + anesthetic in reducing lumbar pain in both acute + chronic sciatica patients and acute sciatica patients. The epidural steroid demonstrated a better ability regarding the Oswestry disability score (ODI) compared to the subcutaneous anti-TNF-α. In addition, for total pain relief, the use of nonsteroidal antiinflammatory drugs was inferior to the epidural steroid + anesthetic. The epidural anesthetic and epidural steroid + anesthetic both demonstrated superiority over the epidural steroid and intramuscular steroid. The intravenous anti-TNF-α ranked first in leg pain relief, while the subcutaneous anti-TNF-α ranked first in lumbar pain relief, and the epidural steroid ranked first in the ODI on the basis of SUCRA. In addition, their safety outcome (withdrawal) rankings were all medium to high. Intravenous and subcutaneous anti-TNF-α were identified as the optimal treatments for both acute + chronic sciatica patients and acute sciatica patients. In addition, the epidural steroid was also recommended as a good intervention due to its superiority in reducing ODI.

  19. Drug treatment of bothersome lower urinary tract symptoms after ureteric JJ-stent insertion: A contemporary, comparative, prospective, randomised placebo-controlled study, single-centre experience.

    Science.gov (United States)

    Hekal, Ihab A

    2016-12-01

    To provide a guide for medication to alleviate bothersome lower urinary tract symptoms (LUTS) in patients after JJ ureteric stenting. Between June 2011 and June 2015, a prospective randomised placebo-controlled study was conducted on 200 consecutive cases of ureteric stones that required JJ stents. All patients had signed informed consent and JJ-stent placement confirmed by X-ray. The patients were randomised into five groups: A, solifenacin 5 mg; B, trospium chloride 20 mg; C, antispasmodic; and E, α-blocker; and a placebo group (D). A standard model was created to lessen patient selection bias. Eligible patients were enrolled and assessed for side-effects and bothersome LUTS using the validated Ureteric Stent Symptoms Questionnaire. Appropriate statistical analysis was carried out. In all, 150 male patients in the five groups were compared. LUTS were less in groups A and B ( P  JJ-stent insertion, anti-muscarinic medication, namely solifenacin 5 mg or trospium chloride 20 mg, was the best. The advantage of trospium over solifenacin is in the control of frequency rather than the other symptoms. Addition of an α-blocker (alfuzosin 10 mg) is valuable when nocturia is the predominant symptom.

  20. Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study

    Directory of Open Access Journals (Sweden)

    Hofstede Stefanie N

    2012-06-01

    Full Text Available Abstract Background Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs after prolonged conservative treatment or surgery at one year follow-up. Guidelines recommend that the team of professionals involved in sciatica care and patients jointly decide about treatment options, so-called interprofessional shared decision making (SDM. However, there are strong indications that SDM for sciatica patients is not integrated in daily practice. We designed a study aiming to explore the barriers and facilitators associated with the everyday embedding of SDM for sciatica patients. All related relevant professionals and patients are involved to develop a tailored strategy to implement SDM for sciatica patients. Methods The study consists of two phases: identification of barriers and facilitators and development of an implementation strategy. First, barriers and facilitators are explored using semi-structured interviews among eight professionals of each (paramedical discipline involved in sciatica care (general practitioners, physical therapists, neurologists, neurosurgeons, and orthopedic surgeons. In addition, three focus groups will be conducted among patients. Second, the identified barriers and facilitators will be ranked using a questionnaire among a representative Dutch sample of 200 GPs, 200 physical therapists, 200 neurologists, all 124 neurosurgeons, 200 orthopedic surgeons, and 100 patients. A tailored team-based implementation strategy will be developed based on the results of the first phase using the principles of intervention mapping and an expert panel. Discussion Little is known about effective strategies to increase the uptake of SDM. Most implementation strategies only target a single discipline, whereas

  1. Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study.

    Science.gov (United States)

    Hofstede, Stefanie N; Marang-van de Mheen, Perla J; Assendelft, Willem J J; Vleggeert-Lankamp, Carmen L A; Stiggelbout, Anne M; Vroomen, Patrick C A J; van den Hout, Wilbert B; Vliet Vlieland, Thea P M; van Bodegom-Vos, Leti

    2012-06-15

    Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs after prolonged conservative treatment or surgery at one year follow-up. Guidelines recommend that the team of professionals involved in sciatica care and patients jointly decide about treatment options, so-called interprofessional shared decision making (SDM). However, there are strong indications that SDM for sciatica patients is not integrated in daily practice. We designed a study aiming to explore the barriers and facilitators associated with the everyday embedding of SDM for sciatica patients. All related relevant professionals and patients are involved to develop a tailored strategy to implement SDM for sciatica patients. The study consists of two phases: identification of barriers and facilitators and development of an implementation strategy. First, barriers and facilitators are explored using semi-structured interviews among eight professionals of each (para)medical discipline involved in sciatica care (general practitioners, physical therapists, neurologists, neurosurgeons, and orthopedic surgeons). In addition, three focus groups will be conducted among patients. Second, the identified barriers and facilitators will be ranked using a questionnaire among a representative Dutch sample of 200 GPs, 200 physical therapists, 200 neurologists, all 124 neurosurgeons, 200 orthopedic surgeons, and 100 patients. A tailored team-based implementation strategy will be developed based on the results of the first phase using the principles of intervention mapping and an expert panel. Little is known about effective strategies to increase the uptake of SDM. Most implementation strategies only target a single discipline, whereas multiple disciplines are involved in SDM among sciatica

  2. Cost-effectiveness of different strategies to manage patients with sciatica.

    Science.gov (United States)

    Fitzsimmons, Deborah; Phillips, Ceri J; Bennett, Hayley; Jones, Mari; Williams, Nefyn; Lewis, Ruth; Sutton, Alex; Matar, Hosam E; Din, Nafees; Burton, Kim; Nafees, Sadia; Hendry, Maggie; Rickard, Ian; Wilkinson, Claire

    2014-07-01

    The aim of this paper is to estimate the relative cost-effectiveness of treatment regimens for managing patients with sciatica. A deterministic model structure was constructed based on information from the findings from a systematic review of clinical effectiveness and cost-effectiveness, published sources of unit costs, and expert opinion. The assumption was that patients presenting with sciatica would be managed through one of 3 pathways (primary care, stepped approach, immediate referral to surgery). Results were expressed as incremental cost per patient with symptoms successfully resolved. Analysis also included incremental cost per utility gained over a 12-month period. One-way sensitivity analyses were used to address uncertainty. The model demonstrated that none of the strategies resulted in 100% success. For initial treatments, the most successful regime in the first pathway was nonopioids, with a probability of success of 0.613. In the second pathway, the most successful strategy was nonopioids, followed by biological agents, followed by epidural/nerve block and disk surgery, with a probability of success of 0.996. Pathway 3 (immediate surgery) was not cost-effective. Sensitivity analyses identified that the use of the highest cost estimates results in a similar overall picture. While the estimates of cost per quality-adjusted life year are higher, the economic model demonstrated that stepped approaches based on initial treatment with nonopioids are likely to represent the most cost-effective regimens for the treatment of sciatica. However, development of alternative economic modelling approaches is required. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  3. Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients.

    Science.gov (United States)

    Ustun, N; Erol, O; Ozcakar, L; Ceceli, E; Ciner, O Akar; Yorgancioglu, Z R

    2013-01-01

    Sensitive muscle strength tests are needed to measure muscle strength in the diagnosis and management of sciatica patients. The aim of this study was to assess the isokinetic muscle strength in sciatica patients' and control subjects' ankles that exhibited normal ankle muscle strength when measured clinically. Forty-six patients with L5 and/or S1 nerve compression, and whose age, sex, weight, and height matched 36 healthy volunteers, were recruited to the study. Heel-walking, toe-walking, and manual muscle testing were used to perform ankle dorsiflexion and plantar flexion strengths in clinical examination. Patients with normal ankle dorsiflexion and plantar flexion strengths assessed by manual muscle testing and heel-and toe-walking tests were included in the study. Bilateral isokinetic (concentric/concentric) ankle plantar-flexion-dorsiflexion measurements of the patients and controls were performed within the protocol of 30°/sec (5 repetitions). Peak torque and peak torque/body weight were obtained for each ankle motion of the involved limb at 30°/s speed. L5 and/or S1 nerve compression was evident in 46 patients (76 injured limbs). Mean disease duration was two years. The plantar flexion muscle strength of the patients was found to be lower than that of the controls (p=0.036). The dorsiflexion muscle strength of the patients was found to be the same as that of the controls (p=0.211). Isokinetic testing is superior to clinical muscle testing when evaluating ankle plantar flexion torque in sciatica patients. Therefore, isokinetic muscle testing may be helpful when deciding whether to place a patient into a focused rehabilitation program.

  4. Magnetic resonance imaging in low back pain and sciatica with special emphasis on the postdiskectomy period

    International Nuclear Information System (INIS)

    Annertz, M.

    1994-01-01

    The diagnostic capability of magnetic resonance (MR) imaging at 0.3 T was evaluated and compared with other modalities in patients with previous disk surgery and remaining or recurrent sciatica, and in patients with spondylolisthesis and sciatica. In the early postoperative period after successful lumbar diskectomy, MR showed a large amount of abnormal soft tissue in the anterior epidural space, without correlation with clinical symptoms. In the late postoperative period, contrast-enhanced MR provided the best correlation with surgical findings, compared with CT and myelography, in discriminating recurrent/remaining disk herniation from epidural fibrosis in patients with the lumbar postdiskectomy syndrome. Contrast-enhanced MR could not demonstrate any differences regarding presence and extent of epidural fibrosis between symptomatic and asymptomatic patients. In spondylolisthesis, MR gave excellent information about the root canals and the degree of nerve root stretching and compression, which was not possible to evaluate with myelography. MR at 0.3 T provided information comparable to that reported from examinations performed with superconducting MR scanners, and is well suited as the imaging modality in the evaluation of lumbar spine disorders. After introducing MR at 0.2 and 0.3 T with vertical magnetic fields as the first neuroradiological modality, instead of myelography or CT, in the evaluation of the soft tissues of the lumbar spine in patients with low back pain and sciatica, a significant increase in the number of patients examined, a moderate increase in the total cost of investigations, and a significant decrease in the cost per investigated and per operated patient was noted

  5. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses.

    Science.gov (United States)

    Lewis, Ruth A; Williams, Nefyn H; Sutton, Alex J; Burton, Kim; Din, Nafees Ud; Matar, Hosam E; Hendry, Maggie; Phillips, Ceri J; Nafees, Sadia; Fitzsimmons, Deborah; Rickard, Ian; Wilkinson, Clare

    2015-06-01

    There are numerous treatment approaches for sciatica. Previous systematic reviews have not compared all these strategies together. To compare the clinical effectiveness of different treatment strategies for sciatica simultaneously. Systematic review and network meta-analysis. We searched 28 electronic databases and online trial registries, along with bibliographies of previous reviews for comparative studies evaluating any intervention to treat sciatica in adults, with outcome data on global effect or pain intensity. Network meta-analysis methods were used to simultaneously compare all treatment strategies and allow indirect comparisons of treatments between studies. The study was funded by the UK National Institute for Health Research Health Technology Assessment program; there are no potential conflict of interests. We identified 122 relevant studies; 90 were randomized controlled trials (RCTs) or quasi-RCTs. Interventions were grouped into 21 treatment strategies. Internal and external validity of included studies was very low. For overall recovery as the outcome, compared with inactive control or conventional care, there was a statistically significant improvement following disc surgery, epidural injections, nonopioid analgesia, manipulation, and acupuncture. Traction, percutaneous discectomy, and exercise therapy were significantly inferior to epidural injections or surgery. For pain as the outcome, epidural injections and biological agents were significantly better than inactive control, but similar findings for disc surgery were not statistically significant. Biological agents were significantly better for pain reduction than bed rest, nonopioids, and opioids. Opioids, education/advice alone, bed rest, and percutaneous discectomy were inferior to most other treatment strategies; although these findings represented large effects, they were statistically equivocal. For the first time, many different treatment strategies for sciatica have been compared in the

  6. Suspected herniated lumbar disc - computed tomography in differential diagnosis of non-disc-related sciatica

    International Nuclear Information System (INIS)

    Weiss, T.; Koehler, D.; Treisch, J.; Claussen, C.; Felix, R.

    1984-01-01

    The most common reason a patient is referred for spinal CT examination is to exclude a ruptured intervertebral disc. Besides nerve root entrapment due to herniated disc, a number of unusual for unexpected conditions have been encountered in the course of CT lumbar spine studies. These include spondylolisthesis, spinal dysraphism, Paget's disease, and inflammatory, neoplastic, or metastatic lesions. The application of spinal (small-circle) target imaging includes the risk to overlook soft tissue lesions that extend beyond the reconstruction circle. Therefore, complete (large-circle) circumferential abdominal scanning is recommended in case of a suspected extraspinal cause of sciatica. (orig.) [de

  7. Suspected herniated lumbar disc - computed tomography in differential diagnosis of non-disc-related sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, T.; Koehler, D.; Treisch, J.; Claussen, C.; Felix, R.

    1984-07-01

    The most common reason a patient is referred for spinal CT examination is to exclude a ruptured intervertebral disc. Besides nerve root entrapment due to herniated disc, a number of unusual or unexpected conditions have been encountered in the course of CT lumbar spine studies. These include spondylolisthesis, spinal dysraphism, Paget's disease, and inflammatory, neoplastic, or metastatic lesions. The application of spinal (small-circle) target imaging includes the risk of overlooking soft tissue lesions that extend beyond the reconstruction circle. Therefore, complete (large-circle) circumferential abdominal scanning is recommended in case of a suspected extraspinal cause of sciatica.

  8. Pain-related fear and functional recovery in sciatica: results from a 2-year observational study

    Directory of Open Access Journals (Sweden)

    Haugen AJ

    2016-10-01

    Full Text Available AJ Haugen,1 L Grøvle,1 JI Brox,2 B Natvig,3 M Grotle4 1Department of Rheumatology, Østfold Hospital Trust, Grålum, 2Department of Physical Medicine and Rehabilitation, Division for Neuroscience, Oslo University Hospital, 3Department of General Practice, Institute of Health and Society, University of Oslo, 4FORMI (Communication Unit for Musculoskeletal Disorders, Division of Neuroscience, Oslo University Hospital, Oslo, Norway Objectives: The purpose of this study was to explore the associations between pain-related fear, pain disability, and self-perceived recovery among patients with sciatica and disk herniation followed up for 2 years.Patients and methods: Pain-related fear was measured by the Tampa Scale for Kinesiophobia (TSK and the Fear-Avoidance Beliefs Questionnaire-Physical Activity (FABQ-PA subscale. Disability was measured by the Maine–Seattle Back Questionnaire. At 2 years, patients reported their sciatica/back problem on a global change scale ranging from completely gone to much worse. No specific interventions regarding pain-related fear were provided.Results: Complete data were obtained for 372 patients. During follow-up, most patients improved. In those who at 2 years were fully recovered (n=66, pain-related fear decreased substantially. In those who did not improve (n=50, pain-related fear remained high. Baseline levels of pain-related fear did not differ significantly between those who were fully recovered and the rest of the cohort. In the total cohort, the correlation coefficients between the 0–2-year change in disability and the changes in the TSK and the FABQ-PA were 0.33 and 0.38, respectively. In the adjusted regression models, the 0–2-year change in pain-related disability explained 15% of the variance in the change in both questionnaires.Conclusion: Pain-related fear decreased substantially in patients who recovered from sciatica and remained high in those who did not improve. Generally, the TSK and the FABQ

  9. Isolated Facet Joint Fracture as a Cause of Chronic Low Back Pain and Sciatica

    Directory of Open Access Journals (Sweden)

    Robert W Teasell

    1996-01-01

    Full Text Available A case of facet joint fracture following a rear-end motor vehicle accident who presented with chronic low back pain and sciatica is outlined. Diagnosis was made with 99Tc nuclear bone scan and was confirmed on computed tomographic scan after diagnosis with regular radiographs had failed. Facetectomy relieved pain but led to symptoms related to asymmetric load on the opposite facet joint. Symptoms were substantially relieved with a facet joint deinnervation procedure. Facet joint fracture was felt to occur as a consequence of compression forces on the facet joint at the time of impact.

  10. Back pain's association with vertebral end-plate signal changes in sciatica.

    Science.gov (United States)

    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; van der Kallen, Bas F; Lycklama à Nijeholt, Geert J; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

    2014-02-01

    Patients with sciatica frequently experience disabling back pain. One of the proposed causes for back pain is vertebral end-plate signal changes (VESC) as visualized by magnetic resonance imaging (MRI). To report on VESC findings, changes of VESC findings over time, and the correlation between VESC and disabling back pain in patients with sciatica. A randomized clinical trial with 1 year of follow-up. Patients with 6 to 12 weeks of sciatica who participated in a multicenter, randomized clinical trial comparing an early surgery strategy with prolonged conservative care with surgery if needed. Patients were assessed by means of the 100-mm visual analog scale (VAS) for back pain (with 0 representing no pain and 100 the worst pain ever experienced) at baseline and 1 year. Disabling back pain was defined as a VAS score of at least 40 mm. Patients underwent MRI both at baseline and after 1 year follow-up. Presence and change of VESC was correlated with disabling back pain using chi-square tests and logistic regression analysis. At baseline, 39% of patients had disabling back pain. Of the patients with VESC at baseline, 40% had disabling back pain compared with 38% of the patients with no VESC (p=.67). The prevalence of type 1 VESC increased from 1% at baseline to 35% 1 year later in the surgical group compared with an increase from 3% to 11% in the conservative group. The prevalence of type 2 VESC decreased from 40% to 29% in the surgical group while remaining almost stable in the conservative group at 41%. The prevalence of disabling back pain at 1 year was 12% in patients with no VESC at 1 year, 16% in patients with type 1 VESC, 11% in patients with type 2 VESC, and 3% in patients with both types 1 and 2 VESC (p=.36). Undergoing surgery was associated with increase in the extent of VESC (odds ratio [OR], 8.6; 95% confidence interval [CI], 4.7-15.7; psciatica was highly associated with the development of VESC after 1 year. However, in contrast with the intuitive feeling

  11. Leisure-time physical activity and sciatica: A systematic review and meta-analysis.

    Science.gov (United States)

    Shiri, R; Falah-Hassani, K; Viikari-Juntura, E; Coggon, D

    2016-11-01

    The role of leisure-time physical activity in sciatica is uncertain. This study aimed to assess the association of leisure-time physical activity with lumbar radicular pain and sciatica. Literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar and ResearchGate databases from 1964 through August 2015. A random-effects meta-analysis was performed, and heterogeneity and small-study bias were assessed. Ten cohort (N = 82,024 participants), four case-control (N = 9350) and four cross-sectional (N = 10,046) studies qualified for meta-analysis. In comparison with no regular physical activity, high level of physical activity (≥4 times/week) was inversely associated with new onset of lumbar radicular pain or sciatica in a meta-analysis of prospective cohort studies [risk ratio (RR) = 0.88, 95% CI 0.78-0.99, I 2  = 0%, 7 studies, N = 78,065]. The association for moderate level of physical activity (1-3 times/week) was weaker (RR = 0.93, CI 0.82-1.05, I 2  = 0%, 6 studies, N = 69,049), and there was no association with physical activity for at least once/week (RR = 0.99, CI 0.86-1.13, 9 studies, N = 73,008). In contrast, a meta-analysis of cross-sectional studies showed a higher prevalence of lumbar radicular pain or sciatica in participants who exercised at least once/week [prevalence ratio (PR) = 1.29, CI 1.09-1.53, I 2  = 0%, 4 studies, N = 10,046], or 1-3 times/week (PR = 1.34, CI 1.02-1.77, I 2  = 0%, N = 7631) than among inactive participants. There was no evidence of small-study bias. This meta-analysis suggests that moderate to high level of leisure physical activity may have a moderate protective effect against development of lumbar radicular pain. However, a large reduction in risk (>30%) seems unlikely. Leisure-time physical activity may reduce the risk of developing lumbar radicular pain. © 2016 European Pain Federation - EFIC®.

  12. The Clinical Report on the 3 Cases of Sciatica treated on Direct Moxibustion

    Directory of Open Access Journals (Sweden)

    Jun-Hyuk Kang

    2007-06-01

    Full Text Available Objectives : The purpose of this report is to examine the effects of direct moxibustion on the Low back pain and Lowerlimb radiating pain. Methods : The patients were hospitalized in Daejeon Univ. Oriental Hospital and treated with acupuncture treatment, physical treatment and direct moxibustion. After treatments, we measured the Results & Conclusions : VAS(Visual Analogue Scale and PRS(Pain Rating Scale. VAS(Visual Analogue Scale and PRS(Pain Rating Scale scores were improved in 3 cases of Low back pain and Lowerlimb radiating pain treated with direct moxibustion. So it is suggested that direct moxibution have the possibility to treat on sciatica

  13. Whole-body vibration and the risk of low back pain and sciatica: a systematic review and meta-analysis.

    Science.gov (United States)

    Burström, Lage; Nilsson, Tohr; Wahlström, Jens

    2015-05-01

    The aim of this systematic literature review was to evaluate the association between whole-body vibration (WBV) and low back pain (LBP) and sciatica with special attention given to exposure estimates. Moreover, the aim was to estimate the magnitude of such an association using meta-analysis and to compare our findings with previous reviews. The authors systematically searched the PubMed (National Library of Medicine, Bethesda), Nioshtic2 (National Institute for Occupational Safety and Health (NIOSH, Morgantown), and ScienceDirect (Elsevier, Amsterdam) databases for records up to December 31, 2013. Two of the authors independently assessed studies to determine their eligibility, validity, and possible risk of bias. The literature search gave a total of 306 references out of which 28 studies were reviewed and 20 were included in the meta-analysis. Exposure to WBV was associated with increased prevalence of LBP and sciatica [pooled odds ratio (OR) = 2.17, 95% confidence interval (CI) 1.61-2.91 and OR 1.92, 95% CI 1.38-2.67, respectively]. Workers exposed to high vibration levels had a pooled risk estimate of 1.5 for both outcomes when compared with workers exposed to low levels of vibration. The results also indicate that some publication bias could have occurred especially for sciatica. This review shows that there is scientific evidence that exposure to WBV increases the risk of LBP and sciatica.

  14. Ozone-augmented percutaneous discectomy: a novel treatment option for refractory discogenic sciatica.

    Science.gov (United States)

    Crockett, M T; Moynagh, M; Long, N; Kilcoyne, A; Dicker, P; Synnott, K; Eustace, S J

    2014-12-01

    To assess the short and medium-term efficacy and safety of a novel, minimally invasive therapeutic option combining automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural: ozone-augmented percutaneous discectomy (OPLD). One hundred and forty-seven patients with a clinical and radiological diagnosis of discogenic sciatica who were refractory to initial therapy were included. Fifty patients underwent OPLD whilst 97 underwent a further caudal epidural. Outcomes were evaluated using McNab's score, improvement in visual analogue score (VAS) pain score, and requirement for further intervention. Follow-up occurred at 1 and 6 months, and comparison was made between groups. OPLD achieved successful outcomes in almost three-quarters of patients in the short and medium term. OPLD achieved superior outcomes at 1 and 6 months compared to caudal epidural. There was a reduced requirement for further intervention in the OPLD group. No significant complications occurred in either group. OPLD is a safe and effective treatment for patients with refractory discogenic sciatica in the short and medium term. OPLD has the potential to offer an alternative second-line minimally invasive treatment option that could reduce the requirement for surgery in this patient cohort. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. Influence of Combined Ultrasound With Pre modulated interferential Current in Discogenic Sciatica

    International Nuclear Information System (INIS)

    Selem, A.I.; El Hafez, H.M.; Alshatoury, H.A.; Ismail, G.

    2016-01-01

    Background and purpose : Lumbar- spine disorders rank fifth among disease categories in the cost of hospital care and account for higher costs resulting in absence from work and disability than any other category. Sciatica is a common clinical condition that can be extremely painful, disabling and life changing. This study was conducted to find out the effectiveness of adding interferential current therapy to conventional treatment and to compare with conventional treatment only in patients with chronic discogenic sciatica. Methods : This randomized controlled trial was conducted at Ismailia General Hospital. Sixty patients (22 males and 38 females) aged between 20 and 40 years old and duration of illness of more than 3 months. They were classified randomly into two groups of equal number. The Experimental Group received interferential therapy (IFT) combined with conventional therapy while control Group received conventional therapy only, 3 times/ week for 4 weeks. Outcome measures : back and leg pain intensity was measured by numeric pain rating scale (0 - 10), functional disability was measured by Roland Morris disability questionnaire, range of motion (Rom) was measured by inclinometer and latency of H- reflex was measured by electromyography. The assessment was done twice for every subject (pre and post the treatment program). Results : Statistical interpretation showed significant improvement of both groups. But in case of experimental group, the amount of improvement was higher with decrease in pain, increasing functional ability, increasing range of motion and improvement in H- reflex latency when compared to control group

  16. Development and validation of a condition-specific diary to measure severity, bothersomeness and impact on daily activities for patients with acute urinary tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anne; Cordoba, Gloria; Siersma, Volkert

    2017-01-01

    Background: Urinary tract infection (UTI) is a common condition in primary care. Patient-reported outcome measures (PROMs) are crucial in the evaluation of interventions to improve diagnosis, treatment and prognosis of UTI. The aim of this study was to identify an existing condition-specific PROM...... for polytomous items in a cohort of 451 women participating in two studies regarding UTI. Results: No existing PROM fulfilled the inclusion criteria. Content validation resulted in one domain concerning symptom severity (18 items), one concerning bothersomeness (18 items), and one concerning impact on daily...... activities (7 items). Psychometrical validation resulted in four dimensions in each of the first two domains and one dimension in the third domain. Conclusions: Domains were not unidimensional, which meant that we identified dimensions of patient-experienced UTI that differed substantially from those...

  17. Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences.

    Science.gov (United States)

    Boote, Jonathan; Newsome, Ruth; Reddington, Michael; Cole, Ashley; Dimairo, Munyaradzi

    2017-07-01

    Sciatica is a common clinical condition that can be extremely painful, disabling and life-changing. Whether conservative or surgical treatment for sciatica secondary to an intervertebral disc prolapse is most effective is still much debated. An important component of conservative treatment is physiotherapy, which aims to promote physical and psychological health for the patient, whilst resorption of the disc takes place. This paper reports a qualitative study of patients' views and experiences of a bespoke physiotherapy intervention for the treatment of sciatica. A qualitative study nested within a pilot randomized controlled trial of bespoke physiotherapy for the treatment of patients with sciatica awaiting lumbar microdiscectomy surgery. Patients randomized to receive bespoke physiotherapy in the intervention arm of the trial were invited to take part in semi-structured interviews. Twenty-one in-depth, semi-structured interviews took place. All interviews were recorded, fully transcribed and thematically analysed. Most patients in the sample found the physiotherapy valuable, appreciating the individual nature of the approach, the exercises to reduce pain and discomfort, techniques for improving functional spinal movement, walking and dynamic posture, and manual therapy and cardiovascular exercise. A small number did not find the physiotherapy of benefit. Sixteen patients in the sample went on to proceed with surgery, but most of these found value in having had the physiotherapy first. Many patients with sciatica appreciate the value of physiotherapy prior to surgery. Future research should examine patients' experiences of bespoke physiotherapy delivered within primary care. Copyright © 2016 The Authors Physiotherapy Research International published by John Wiley & Sons Ltd. Copyright © 2016 The Authors Physiotherapy Research International published by John Wiley & Sons Ltd.

  18. Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro‐discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences

    Science.gov (United States)

    Newsome, Ruth; Reddington, Michael; Cole, Ashley; Dimairo, Munyaradzi

    2016-01-01

    Abstract Background and Purpose Sciatica is a common clinical condition that can be extremely painful, disabling and life‐changing. Whether conservative or surgical treatment for sciatica secondary to an intervertebral disc prolapse is most effective is still much debated. An important component of conservative treatment is physiotherapy, which aims to promote physical and psychological health for the patient, whilst resorption of the disc takes place. This paper reports a qualitative study of patients' views and experiences of a bespoke physiotherapy intervention for the treatment of sciatica. Methods A qualitative study nested within a pilot randomized controlled trial of bespoke physiotherapy for the treatment of patients with sciatica awaiting lumbar microdiscectomy surgery. Patients randomized to receive bespoke physiotherapy in the intervention arm of the trial were invited to take part in semi‐structured interviews. Twenty‐one in‐depth, semi‐structured interviews took place. All interviews were recorded, fully transcribed and thematically analysed. Results Most patients in the sample found the physiotherapy valuable, appreciating the individual nature of the approach, the exercises to reduce pain and discomfort, techniques for improving functional spinal movement, walking and dynamic posture, and manual therapy and cardiovascular exercise. A small number did not find the physiotherapy of benefit. Sixteen patients in the sample went on to proceed with surgery, but most of these found value in having had the physiotherapy first. Discussion Many patients with sciatica appreciate the value of physiotherapy prior to surgery. Future research should examine patients' experiences of bespoke physiotherapy delivered within primary care. Copyright © 2016 The Authors Physiotherapy Research International published by John Wiley & Sons Ltd. PMID:26914525

  19. [Treatment of lumbar intervertebral disc herniation and sciatica with percutaneous transforaminal endoscopic technique].

    Science.gov (United States)

    Jiang, Yi; Song, Hua-Wei; Wang, Dong; Yang, Ming-Lian

    2013-10-01

    To analyze the clinical effects of percutaneous transforaminal endoscopic technique in treating lumbar intervertebral disc herniation and sciatica. From June 2011 to January 2012,the clinical data of 46 patients with lumbar intervertebral disc herniation and sciatica underwent percutaneous transforaminal endoscopic technique were retrospectively analyzed. There were 28 males and 18 females,ranging in age from 11 to 77 years old with an average of (39.7_ 15.3) years old,20 cases were L5S1 and 26 cases were L4,5. All patients had the symptoms such as lumbago and sciatica and their straight-leg raising test were positive. Straight-leg raising test of patients were instantly repeated after operation;operative time,volume of blood loss,complication, length of stay and duration of back to work or daily life were recorded. The clinical effects were assessed according to the VAS,JOA and JOABPEQ score. All operations were successful,postoperative straight-leg raising test were all negative. Operative time,volume of blood loss,length of stay,duration of back to work or daily life,follow-up time were (93.0+/-28.0) min, (20.0+/-9.0)ml, (3.1+/-1.5) d, (11.6+/-4.2) d, (13.9+/-1.6) months,respectively. VAS score of lumbar before operation and at the 1st and 3rd,6th,12th month after operation were 5.3+/-1.2,1.9+/-1.1,1.0+/-0.8,0.9+/-0.8,0.8+/-0.6,respectively;VAS score of leg before operation and at the 1st and 3rd,6th,12th month after operation were 7.2+ 1.2,0.8+/-1.2,0.5+/-0.8,0.5+/-0.8,0.3+/-0.8,respectively. Five factors of JOABPEQ score,including lumbar pain,lumbar function, locomotor activity,social life viability and mental status,were respectively 27.0+/-30.6,37.3+/-27.4,38.5+/-26.6,33.0+/-13.7,55.4+/-19.0 before operation and 83.6+/-24.8,89.4+/-15.7,87.0+/-17.9,58.4+/-14.6,79.5+/-13.4 at final follow-up. Preoperative and postoperative JOA score were 9.1+/-2.6 and 27.3+/- 1.7, respectively. The postoperative VAS,JOA and JOABPEQ score had significantly improved (Psciatica

  20. Myelopathy and sciatica induced by an extradural S1 root haemangioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Hermier, M.; Cotton, F.; Froment, J.C. [Department of Radiology, Hopital Neurologique et Neurochirurgical, Lyon (France); Saint-Pierre, G.; Jouvet, A. [Department of Neuropathology, Hopital Neurologique et Neurochirurgical, Lyon (France); Ongolo-Zogo, P. [Department of Radiology, Hopital Neurologique et Neurochirurgical, Lyon (France); Department of Radiology, Hopital Central, Yaounde (Cameroon); Fischer, G. [Department of Neurosurgery, Hopital Neurologique et Neurochirurgical, Lyon (France)

    2002-06-01

    Haemangioblastomas are vascular tumours which mainly involve the central nervous system and retina, often in the setting of von Hippel-Lindau disease. Haemangioblastomas occurring outside the central nervous system are uncommon. Wherever it is, recognising this tumour prior to surgery is desirable, as preoperative embolisation may be considered. We report the clinical, imaging and pathological features of a sporadic sacral root haemangioblastoma in a 58-year-old man with chronic sciatica and myelopathy. The diagnosis was questioned preoperatively because an enlarged sacral foramen, seen to be filled by a highly vascular, enhancing mass and dilated vessels. Myelopathy was attributed to the presumed high venous pressure resulting from increased flow in veins draining the vascular tumour. Microneurosurgical excision was performed after endovascular embolisation and led to persistent clinical improvement. (orig.)

  1. Myelopathy and sciatica induced by an extradural S1 root haemangioblastoma

    International Nuclear Information System (INIS)

    Hermier, M.; Cotton, F.; Froment, J.C.; Saint-Pierre, G.; Jouvet, A.; Ongolo-Zogo, P.; Fischer, G.

    2002-01-01

    Haemangioblastomas are vascular tumours which mainly involve the central nervous system and retina, often in the setting of von Hippel-Lindau disease. Haemangioblastomas occurring outside the central nervous system are uncommon. Wherever it is, recognising this tumour prior to surgery is desirable, as preoperative embolisation may be considered. We report the clinical, imaging and pathological features of a sporadic sacral root haemangioblastoma in a 58-year-old man with chronic sciatica and myelopathy. The diagnosis was questioned preoperatively because an enlarged sacral foramen, seen to be filled by a highly vascular, enhancing mass and dilated vessels. Myelopathy was attributed to the presumed high venous pressure resulting from increased flow in veins draining the vascular tumour. Microneurosurgical excision was performed after endovascular embolisation and led to persistent clinical improvement. (orig.)

  2. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 250 of 1463 ... Vol 15, No 1 (2015), Bone turnover biomarkers in obese ... Vol 11 (2011): Special Issue, Bothersome lower urinary ... erosion: are Soroti children and adolescents at risk from increased soft-drink availability in Uganda?

  3. The prognostic value of electrodiagnostic testing in patients with sciatica receiving physical therapy.

    Science.gov (United States)

    Savage, Nathan J; Fritz, Julie M; Kircher, John C; Thackeray, Anne

    2015-03-01

    To investigate the prognostic value of electrodiagnostic testing in patients with sciatica receiving physical therapy. Electrodiagnostic testing was performed on 38 patients with sciatica participating in a randomized trial comparing different physical therapy interventions. Patients were grouped and analyzed according to the presence or absence of radiculopathy based on electrodiagnostic testing. Longitudinal data analysis was conducted using multilevel growth modeling with ten waves of data collected from baseline through the treatment and post-treatment periods up to 6 months. The primary outcome measure was changes in low back pain-related disability assessed using the Roland and Morris disability questionnaire (RMDQ). Patients with radiculopathy (n = 19) had statistically significant and clinically meaningful improvements in RMDQ scores at every post-treatment follow-up occasion regardless of treatment received. The final multilevel growth model revealed improvements in RMDQ scores in patients with radiculopathy at the 6-week (-8.1, 95 % CI -12.6 to -2.6; P = 0.006) and 6-month (-4.1, 95 % CI -7.4 to -0.7; P = 0.020) follow-up occasions compared to patients without radiculopathy. Treatment group was not a significant predictive factor at any follow-up occasion. An interaction between electrodiagnostic status and time revealed faster weekly improvements in RMDQ scores in patients with radiculopathy at the 6-week (-0.72, 95 % CI -1.4 to -0.04; P = 0.040) through the 16-week (-0.30, 95 % CI, -0.57 to -0.04; P = 0.028) follow-up occasions compared to patients without radiculopathy. The presence of lumbosacral radiculopathy identified with electrodiagnostic testing is a favorable prognostic factor for recovery in low back pain-related disability regardless of physical therapy treatment received.

  4. Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review.

    Science.gov (United States)

    Rasmussen-Barr, Eva; Held, Ulrike; Grooten, Wilhelmus J A; Roelofs, Pepijn D D M; Koes, Bart W; van Tulder, Maurits W; Wertli, Maria M

    2017-04-15

    Systematic review and meta-analysis. To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. NSAIDs are one of the most frequently prescribed drugs for sciatica. We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included. Outcomes included pain using mean difference (MD, 95% confidence intervals [95% CI]). For global improvement and adverse effects risk ratios (RR, 95% CI) were used. We assessed level of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Ten trials were included (N = 1651). Nine out of 10 trials were assessed at high risk of bias. For pain reduction (visual analog scale, 0 to 100) NSAIDs were no more effective than placebo (MD -4.56, 95% CI -11.11 to 1.99, quality of evidence: very low). For global improvement NSAIDs were more effective than placebo (RR 1.14 [95% CI 1.03 to 1.27], low quality of evidence). One trial reported the effect of NSAIDs on disability with very low-quality evidence that NSAIDs are no more effective than placebo. There was low-quality evidence that the risk for adverse effects is higher for NSAID than placebo (RR 1.40, 95% CI 1.02 to 1.93). Our findings show very low-quality evidence that the efficacy of NSAIDs for pain reduction is comparable with that of placebo, low-quality evidence that NSAIDs is better than placebo for global improvement and low-quality evidence for higher risk of adverse effects using NSAIDs compared with placebo. The findings must be interpreted with caution, due to small study samples, inconsistent results, and a high risk of bias in the included trials. 1.

  5. Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms.

    Science.gov (United States)

    Lemos, Nucelio; Marques, Renato Moretti; Kamergorodsky, Gil; Ploger, Christine; Schor, Eduardo; Girão, Manoel J B C

    2016-02-01

    Pelvic congestion syndrome is a well-known cause of cyclic pelvic pain (Ganeshan et al., Cardiovasc Intervent Radiol 30(6):1105-11, 2007). What is much less well known is that dilated or malformed branches of the internal or external iliac vessels can entrap the nerves of the sacral plexus against the pelvic sidewalls, producing symptoms that are not commonly seen in gynecological practice, such as sciatica, or refractory urinary and anorectal dysfunction (Possover et al., Fertil Steril 95(2):756-8. 2011). The objective of this video is to explain and describe the symptoms suggestive of vascular entrapment of the sacral plexus, as well as the technique for the laparoscopic decompression of these nerves. Two anecdotal cases of intrapelvic vascular entrapment are used to review the anatomy of the lumbosacral plexus and demonstrate the laparoscopic surgical technique for decompression at two different sites, one on the sciatic nerve and one on the sacral nerve roots. After surgery, the patient with the sciatic entrapment showed full recovery of the sciatica and partial recovery of the myofascial pain. The patient with sacral nerve root entrapment showed full recovery with resolution of symptoms. The symptoms suggestive of intrapelvic nerve entrapment are: perineal pain or pain irradiating to the lower limbs in the absence of a spinal disorder, and lower urinary tract symptoms in the absence of prolapse of a bladder lesion. In the presence of such symptoms, the radiologist should provide specific MRI sequences of the intrapelvic portion of the sacral plexus and a team and equipment to expose and decompress the sacral nerves should be prepared.

  6. Comparison of Intravenous Morphine Versus Paracetamol in Sciatica: A Randomized Placebo Controlled Trial.

    Science.gov (United States)

    Serinken, Mustafa; Eken, Cenker; Gungor, Faruk; Emet, Mucahit; Al, Behcet

    2016-06-01

    The objective was to compare intravenous morphine and intravenous acetaminophen (paracetamol) for pain treatment in patients presenting to the emergency department with sciatica. Patients, between the ages of 21 and 65 years, suffering from pain in the sciatic nerve distribution and a positive straight leg-raise test composed the study population. Study patients were assigned to one of three intravenous interventions: morphine (0.1 mg/kg), acetaminophen (1 g), or placebo. Physicians, nurses, and patients were blinded to the study drug. Changes in pain intensity were measured at 15 and 30 minutes using a visual analog scale. Rescue drug (fentanyl) use and adverse effects were also recorded. Three-hundred patients were randomized. The median change in pain intensity between treatment arms at 30 minutes were as follows: morphine versus acetaminophen 25 mm (95% confidence interval [CI] = 20 to 29 mm), morphine versus placebo 41 mm (95% CI = 37 to 45 mm), and acetaminophen versus placebo 16 mm (95% CI = 12 to 20 mm). Eighty percent of the patients in the placebo group (95% CI = 63.0% to 99%), 18% of the patients in the acetaminophen group (95% CI = 10.7% to 28.5%), and 6% of those in the morphine group (95% CI = 2.0% to 13.2%) required a rescue drug. Adverse effects were similar between the morphine and acetaminophen groups. Morphine and acetaminophen are both effective for treating sciatica at 30 minutes. However, morphine is superior to acetaminophen. © 2016 by the Society for Academic Emergency Medicine.

  7. Percutaneous laser disc decompression versus conventional microdiscectomy in sciatica: a randomized controlled trial.

    Science.gov (United States)

    Brouwer, Patrick A; Brand, Ronald; van den Akker-van Marle, M Elske; Jacobs, Wilco C H; Schenk, Barry; van den Berg-Huijsmans, Annette A; Koes, Bart W; van Buchem, M A; Arts, Mark P; Peul, Wilco C

    2015-05-01

    Percutaneous laser disc decompression (PLDD) is a minimally invasive treatment for lumbar disc herniation, with Food and Drug Administration approval since 1991. However, no randomized trial comparing PLDD to conventional treatment has been performed. In this trial, we assessed the effectiveness of a strategy of PLDD as compared with conventional surgery. This randomized prospective trial with a noninferiority design was carried out in two academic and six teaching hospitals in the Netherlands according to an intent-to-treat protocol with full institutional review board approval. One hundred fifteen eligible surgical candidates, with sciatica from a disc herniation smaller than one-third of the spinal canal, were included. The main outcome measures for this trial were the Roland-Morris Disability Questionnaire for sciatica, visual analog scores for back and leg pain, and the patient's report of perceived recovery. Patients were randomly allocated to PLDD (n=57) or conventional surgery (n=58). Blinding was impossible because of the nature of the interventions. This study was funded by the Healthcare Insurance Board of the Netherlands. The primary outcome, Roland-Morris Disability Questionnaire, showed noninferiority of PLDD at 8 (-0.1; [95% confidence interval (CI), -2.3 to 2.1]) and 52 weeks (-1.1; 95% CI, -3.4 to 1.1) compared with conventional surgery. There was, however, a higher speed of recovery in favor of conventional surgery (hazard ratio, 0.64 [95% CI, 0.42-0.97]). The number of reoperations was significantly less in the conventional surgery group (38% vs. 16%). Overall, a strategy of PLDD, with delayed surgery if needed, resulted in noninferior outcomes at 1 year. At 1 year, a strategy of PLDD, followed by surgery if needed, resulted in noninferior outcomes compared with surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Evaluation of the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica

    International Nuclear Information System (INIS)

    Tong Guohai; Wang Wei; Chen Wei; Chen Kemin

    2005-01-01

    Objective: To evaluate the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica. Methods: CT-guided epidural steroid injection was performed in 180 patients with sciatica from May 1998 to March 2004, and all patients had failure to previous conservative treatment. Visual analogue scale was used to evaluate the pain of the patient before and after the treatment. Results: Follow-up was taken for 112 cases during 1-6 years after the treatment, 89 patients (79.5%) had successful long-term outcome and 80 patients (71.4%) were satisfied. Conclusions: CT-guided epidural steroid injection can reduce low back pain and radical pain. It should be preferentially considered as the first choice when conservative treatments are failed. (authors)

  9. Obturator internus pyomyositis manifested as sciatica in a patient with subacute bacterial endocarditis: A rare case report.

    Science.gov (United States)

    Hsu, Wei-Ching; Hsu, Jin-Yi; Chen, Michael Yu-Chih; Liang, Chung-Chao

    2016-07-01

    Pyomyositis is a pyogenic infection of the skeletal muscles causing myalgia and fever in patients. Hematogenous seeding engendered by persistent bacteremia and septic embolism is usually the underlying cause of the disease. Trauma, intravenous drug use, and immunodeficiency are the main predisposing factors.Obturator internus pyomyositis with sciatica has not previously been reported. We report a rare case of a patient with subacute bacterial endocarditis presenting with left buttock pain and sciatica.Computed tomography confirmed the diagnosis of obturator internus pyomyositis. The patient was discharged uneventfully after successful antibiotic treatment.The mortality rate of patients who have pyomyositis comorbid with another condition or disease is extremely high. Early diagnosis and aggressive management are imperative.

  10. Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomised controlled trial.

    Science.gov (United States)

    Brouwer, Patrick A; Brand, Ronald; van den Akker-van Marle, M Elske; Jacobs, Wilco Ch; Schenk, Barry; van den Berg-Huijsmans, Annette A; Koes, Bart W; Arts, Mark A; van Buchem, M A; Peul, Wilco C

    2017-06-01

    Background Percutaneous laser disc decompression is a minimally invasive treatment, for lumbar disc herniation and might serve as an alternative to surgical management of sciatica. In a randomised trial with two-year follow-up we assessed the clinical effectiveness of percutaneous laser disc decompression compared to conventional surgery. Materials and methods This multicentre randomised prospective trial with a non-inferiority design, was carried out according to an intent-to-treat protocol with full institutional review board approval. One hundred and fifteen eligible surgical candidates, with sciatica from a disc herniation smaller than one-third of the spinal canal, were randomly allocated to percutaneous laser disc decompression ( n = 55) or conventional surgery ( n = 57). The main outcome measures for this trial were the Roland-Morris Disability Questionnaire for sciatica, visual analogue scores for back and leg pain and the patient's report of perceived recovery. Results The primary outcome measures showed no significant difference or clinically relevant difference between the two groups at two-year follow-up. The re-operation rate was 21% in the surgery group, which is relatively high, and with an even higher 52% in the percutaneous laser disc decompression group. Conclusion At two-year follow-up, a strategy of percutaneous laser disc decompression, followed by surgery if needed, resulted in non-inferior outcomes compared to a strategy of microdiscectomy. Although the rate of reoperation in the percutaneous laser disc decompression group was higher than expected, surgery could be avoided in 48% of those patients that were originally candidates for surgery. Percutaneous laser disc decompression, as a non-surgical method, could have a place in the treatment arsenal of sciatica caused by contained herniated discs.

  11. Dimensions of the spinal canal in individuals symptomatic and non-symptomatic for sciatica: A CT study

    International Nuclear Information System (INIS)

    Wilmink, J.T.; Korte, J.H.; Penning, L.

    1988-01-01

    Measurements obtained in 50 spinal CT studies of patients referred for suspected lumbosacral nerve root compression, were compared to those of a group of 30 individuals asymptomatic in this respect, who had been referred for abdominal pathology. Transverse ligamentous interfacet and transverse dural dimensions were significantly reduced in the sciatica group, with usually normal interpedicular and sagittal dimensions ruling out idiopathic developmental stenosis. The borderline value for ligamentous interfacet distance (ILD) at L4-5 appeared to be 11 mm. (orig.)

  12. Advice to Stay Active or Structured Exercise in the Management of Sciatica: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L; Refshauge, Kathryn M; Machado, Aryane F; Lemes, Ítalo R; Maher, Chris G; Ferreira, Paulo H

    2015-09-15

    A systematic review and meta-analysis. To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. Conservative management of sciatica usually includes interventions to promote physical activity in the form of advice to stay active or exercise, but there has been no systematic review directly comparing the effectiveness of these 2 approaches. Data Sources included MEDLINE, CINAHL, EMBASE, and PEDro databases. Studies were randomized controlled trials comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short, intermediate, and long-term follow-ups. The GRADE approach was used to summarize the strength of evidence. Five trials were included in the meta-analysis, which showed a significant, although small effect favoring exercise over advice for reducing leg pain intensity in the short term (weighted mean difference: 11.43 [95% confidence interval, 0.71-22.16]) but no difference for disability (weighted mean difference: 1.45 [95% confidence interval, -2.86 to 5.76]). Furthermore, there was no difference at intermediate and long-term follow-ups between advice and exercise for patient-relevant outcomes. There is low-quality evidence (GRADE) that exercise provides small, superior effects compared with advice to stay active on leg pain in the short term for patients experiencing sciatica. However, there is moderate-quality evidence showing no difference between advice to stay active and exercise on leg pain and disability status in people with sciatica in the long term. 1.

  13. Dimensions of the spinal canal in individuals symptomatic and non-symptomatic for sciatica: A CT study

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, J.T.; Korte, J.H.; Penning, L.

    1988-12-01

    Measurements obtained in 50 spinal CT studies of patients referred for suspected lumbosacral nerve root compression, were compared to those of a group of 30 individuals asymptomatic in this respect, who had been referred for abdominal pathology. Transverse ligamentous interfacet and transverse dural dimensions were significantly reduced in the sciatica group, with usually normal interpedicular and sagittal dimensions ruling out idiopathic developmental stenosis. The borderline value for ligamentous interfacet distance (ILD) at L4-5 appeared to be 11 mm.

  14. The role of perceived family social support and parental solicitous responses in adjustment to bothersome pain in young people with physical disabilities.

    Science.gov (United States)

    Miró, Jordi; de la Vega, Rocío; Gertz, Kevin J; Jensen, Mark P; Engel, Joyce M

    2017-11-12

    Family social support and parental solicitous responses have been hypothesised to play an important role in paediatric pain. However, research testing the hypothesised associations between these social domains and measures of adjustment to pain in youths with disabilities and chronic pain is non-existent. About 111 youths with physical disabilities and bothersome pain were interviewed and asked to complete measures of average pain intensity, pain interference, family social support, parent solicitous responding, and catastrophising. Children's perceptions of pain-related solicitous responses from their parent/guardian were associated both with more pain interference and greater pain-related catastrophising; perceived social support was negatively associated with pain interference. The findings provide new information regarding the role that psychosocial factors have in predicting function and adjustment, and have important implications as to how youth with physical disabilities with pain might be most effectively treated. Implications for rehabilitation Little is known about the role of perceived family social support or parental solicitous responses in the adjustment to chronic pain in young people with physical disabilities. This study provides new and important findings that have significant theoretical and practical implications that could help to understand and manage function in these patients. Results show that it matters how parents respond to their children with disabilities who have pain, and raise the possibility that interventions which target these responses may result in significant benefits for the children.

  15. Do MRI findings identify patients with low back pain or sciatica who respond better to particular interventions? A systematic review.

    Science.gov (United States)

    Steffens, Daniel; Hancock, Mark J; Pereira, Leani S M; Kent, Peter M; Latimer, Jane; Maher, Chris G

    2016-04-01

    Magnetic resonance imaging (MRI) can reveal a range of degenerative findings and anatomical abnormalities; however, the clinical importance of these remains uncertain and controversial. We aimed to investigate if the presence of MRI findings identifies patients with low back pain (LBP) or sciatica who respond better to particular interventions. MEDLINE, EMBASE and CENTRAL databases were searched. We included RCTs investigating MRI findings as treatment effect modifiers for patients with LBP or sciatica. We excluded studies with specific diseases as the cause of LBP. Risk of bias was assessed using the criteria of the Cochrane Back Review Group. Each MRI finding was examined for its individual capacity for effect modification. Eight published trials met the inclusion criteria. The methodological quality of trials was inconsistent. Substantial variability in MRI findings, treatments and outcomes across the eight trials prevented pooling of data. Patients with Modic type 1 when compared with patients with Modic type 2 had greater improvements in function when treated by Diprospan (steroid) injection, compared with saline. Patients with central disc herniation when compared with patients without central disc herniation had greater improvements in pain when treated by surgery, compared with rehabilitation. Although individual trials suggested that some MRI findings might be effect modifiers for specific interventions, none of these interactions were investigated in more than a single trial. High quality, adequately powered trials investigating MRI findings as effect modifiers are essential to determine the clinical importance of MRI findings in LBP and sciatica ( CRD42013006571).

  16. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.

    Science.gov (United States)

    Fernandez, Matthew; Ferreira, Manuela L; Refshauge, Kathryn M; Hartvigsen, Jan; Silva, Isabela R C; Maher, Chris G; Koes, Bart W; Ferreira, Paulo H

    2016-11-01

    Previous reviews have compared surgical to non-surgical management of sciatica, but have overlooked the specific comparison between surgery and physical activity-based interventions. Systematic review using MEDLINE, CINAHL, Embase and PEDro databases was conducted. Randomised controlled trials comparing surgery to physical activity, where patients were experiencing the three most common causes of sciatica-disc herniation, spondylolisthesis and spinal stenosis. Two independent reviewers extracted pain and disability data (converted to a common 0-100 scale) and assessed methodological quality using the PEDro scale. The size of the effects was estimated for each outcome at three different time points, with a random effects model adopted and the GRADE approach used in summary conclusions. Twelve trials were included. In the short term, surgery provided better outcomes than physical activity for disc herniation: disability [WMD -9.00 (95 % CI -13.73, -4.27)], leg pain [WMD -16.01 (95 % CI -23.00, -9.02)] and back pain [WMD -12.44 (95 % CI -17.76, -7.09)]; for spondylolisthesis: disability [WMD -14.60 (95 % CI -17.12, -12.08)], leg pain [WMD -35.00 (95 % CI -39.66, -30.34)] and back pain [WMD -20.00 (95 % CI -24.66, -15.34)] and spinal stenosis: disability [WMD -11.39 (95 % CI -17.31, -5.46)], leg pain [WMD, -27.17 (95 % CI -35.87, -18.46)] and back pain [WMD -20.80 (95 % CI -25.15, -16.44)]. Long-term and greater than 2-year post-randomisation results favoured surgery for spondylolisthesis and stenosis, although the size of the effects reduced with time. For disc herniation, no significant effect was shown for leg and back pain comparing surgery to physical activity. There are indications that surgery is superior to physical activity-based interventions in reducing pain and disability for disc herniation at short-term follow-up only; but high-quality evidence in this field is lacking (GRADE). For spondylolisthesis and spinal stenosis, surgery is superior to physical

  17. Prognostic value of magnetic resonance imaging findings in patients with sciatica.

    Science.gov (United States)

    El Barzouhi, Abdelilah; Verwoerd, Annemieke J H; Peul, Wilco C; Verhagen, Arianne P; Lycklama À Nijeholt, Geert J; Van der Kallen, Bas F; Koes, Bart W; Vleggeert-Lankamp, Carmen L A M

    2016-06-01

    OBJECTIVE This study aimed to determine the prognostic value of MRI variables to predict outcome in patients with herniated disc-related sciatica, and whether MRI could facilitate the decision making between early surgery and prolonged conservative care in these patients. METHODS A prospective observational evaluation of patients enrolled in a randomized trial with 1-year follow-up was completed. A total of 283 patients with sciatica who had a radiologically confirmed disc herniation were randomized either to surgery or to prolonged conservative care with surgery if needed. Outcome measures were recovery and leg pain severity. Recovery was registered on a 7-point Likert scale. Complete/near complete recovery was considered a satisfactory outcome. Leg pain severity was measured on a 0- to 100-mm visual analog scale. Multiple MRI characteristics of the degenerated disc herniation were independently scored by 3 spine experts. Cox models were used to study the influence of MRI variables on rate of recovery, and linear mixed models were used to determine the predictive value of MRI variables for leg pain severity during follow-up. The interaction of each MRI predictor with treatment allocation was tested. There were no study-specific conflicts of interest. RESULTS Baseline MRI variables associated with less leg pain severity were the reader's assessment of presence of nerve root compression (p < 0.001), and assessment of extrusion compared with protrusion of the disc herniation (p = 0.006). Both variables tended to be associated, but not significantly, with satisfactory outcome during follow-up (HR 1.45, 95% CI 0.93-2.24, and HR 1.24, 95% CI 0.96-1.61, respectively). The size of disc herniation at baseline was not associated with outcome. There was no significant change in the effects between treatment groups. CONCLUSIONS MRI assessment of the presence of nerve root compression and extrusion of a herniated disc at baseline was associated with less leg pain during 1-year

  18. A systematic review of low back pain and sciatica patients' expectations and experiences of health care.

    Science.gov (United States)

    Hopayian, Kevork; Notley, Caitlin

    2014-08-01

    Previous systematic reviews of patients' experience of health services have used mixed qualitative and quantitative studies. This review focused on qualitative studies, which are more suitable for capturing experience, using modern methods of synthesis of qualitative studies. To describe the experience of health care of low back pain and sciatica patients and the sources of satisfaction or dissatisfaction with special reference to patients who do not receive a diagnosis. A systematic review of qualitative studies. Primary qualitative studies identified from Medline, Embase, CINAHL, and Psychinfo databases. Conceptual themes of patients' experiences. Data collection and analysis were through thematic content analysis. Two reviewers independently screened titles and collected and analyzed data. The authors were in receipt of a Primary Care Research Bursary from National Health Service Suffolk and Norfolk Research Departments, a not-for-profit organization. Twenty-eight articles met the inclusion criteria. Most studies were of high quality. Nine themes emerged: the process and content of care, relationships and interpersonal skills, personalized care, information, the outcome of care, the importance of a diagnosis, delegitimation, recognizing the expert, and service matters. How care was given mattered greatly to patients, with importance given to receiving a perceived full assessment, consideration for the individual's context, good relationships, empathy, and the sharing of information. These aspects of care facilitated the acceptance by some of the limitations of health care and were spread across disciplines. Not having a diagnosis made coping more difficult for some but for others led to delegitimation, a feeling of not being believed. Service matters such as cost and waiting time received little mention. Although much research into the development of chronic low back pain (LBP) has focused on the patient, this review suggests that research into aspects of care

  19. Imaging of sciatica; A short historical review and the present situation. Bildediagnostikk ved isjas; En kort historisk oversikt og status presens

    Energy Technology Data Exchange (ETDEWEB)

    Anda, S. (Trondheim Regional Hospital (Norway))

    1993-02-01

    Cotugno described the clinical entity of sciatica in 1764. However, the association between sciatica and compression of lumbar nerve roots was not realized until the 1920s. Back surgery for herniated nucleus pulposus then became fashionable, and plain radiography and myelography enabled preoperative mapping. Recently other imaging techniques have emerged, such as computerized tomography and magnetic resonance imaging. This has increased the knowledge of the etiology of lumbar root compressions, and invasive therapies for sciatica have become more diversified. It is easy to lose perspective among the available imaging procedures and therapeutic techniques. The aim of this paper is to present the current status from a historical point of view, with special emphasis on the most common imaging methods for the investigation of lumbosacral radiculopathies. 48 refs., 4 figs.

  20. Value of Perineural Edema/Inflammation Detected by Fat Saturation Sequences in Lumbar Magnetic Resonance Imaging of Patients with Unilateral Sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Sirvanci, M.; Duran, C. (Dept. of Radiology, Faculty of Medicine, Istanbul Bilim Univ., Istanbul (Turkey)); Kara, B.; Onat, L.; Ulusoy, O.L.; Mutlu, A. (Dept. of Radiology of Florence Nightingale Hospital, Istanbul (Turkey)); Ozturk, E. (Dept. of Radiology, GATA Haydarpasa Teaching Hospital, Istanbul (Turkey)); Karatoprak, O. (Dept. of Orthopeadic Surgery, Kadikoy Florence Nightingale Hospital, Istanbul (Turkey))

    2009-02-15

    Background: Routine lumbar spine magnetic resonance imaging (MRI) may not show any evidence of the cause of sciatica in some cases. The relationship between nerve root compression detected on lumbar MRI and sciatica is also sometimes uncertain. Purpose: To ascertain whether axial (and, when necessary, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted MRI findings can be used to study the level of sciatica in patients with a non-yielding routine MRI examination. Material and Methods: A total of 215 patients with unilateral sciatica underwent MRI. All patients were asked to complete pain drawing forms describing their pain dermatomal distributions. Perineural edema/inflammation corresponding to the pain location indicated by the pain drawings was sought on short-tau inversion recovery or fat-saturated T2-weighted images. Results: Routine MRI findings revealed that 110 of the 215 patients had nerve root compromise related to the patients' symptoms. Routine MRI could not ascertain the cause of these symptoms in the remaining 105 patients. In 31 (29.5%) of these 105 patients, short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images revealed perineural edema/inflammation surrounding the nerve roots related to the pain locations indicated in the pain drawings. Conclusion: Axial (and, when required, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images may be helpful for revealing additional findings in cases of unexplained sciatica in standard magnetic resonance imaging. However, the value of this imaging may be not great enough to justify routine use of these additional sequences to study the level of sciatica

  1. Value of Perineural Edema/Inflammation Detected by Fat Saturation Sequences in Lumbar Magnetic Resonance Imaging of Patients with Unilateral Sciatica

    International Nuclear Information System (INIS)

    Sirvanci, M.; Duran, C.; Kara, B.; Onat, L.; Ulusoy, O.L.; Mutlu, A.; Ozturk, E.; Karatoprak, O.

    2009-01-01

    Background: Routine lumbar spine magnetic resonance imaging (MRI) may not show any evidence of the cause of sciatica in some cases. The relationship between nerve root compression detected on lumbar MRI and sciatica is also sometimes uncertain. Purpose: To ascertain whether axial (and, when necessary, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted MRI findings can be used to study the level of sciatica in patients with a non-yielding routine MRI examination. Material and Methods: A total of 215 patients with unilateral sciatica underwent MRI. All patients were asked to complete pain drawing forms describing their pain dermatomal distributions. Perineural edema/inflammation corresponding to the pain location indicated by the pain drawings was sought on short-tau inversion recovery or fat-saturated T2-weighted images. Results: Routine MRI findings revealed that 110 of the 215 patients had nerve root compromise related to the patients' symptoms. Routine MRI could not ascertain the cause of these symptoms in the remaining 105 patients. In 31 (29.5%) of these 105 patients, short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images revealed perineural edema/inflammation surrounding the nerve roots related to the pain locations indicated in the pain drawings. Conclusion: Axial (and, when required, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images may be helpful for revealing additional findings in cases of unexplained sciatica in standard magnetic resonance imaging. However, the value of this imaging may be not great enough to justify routine use of these additional sequences to study the level of sciatica

  2. Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment

    International Nuclear Information System (INIS)

    Touraine, Sebastien; Tran, Olivia; Laredo, Jean-Denis; Damiano, Joel

    2015-01-01

    To investigate the efficacy of percutaneous chemonucleolysis using ethanol gel (PCEG) in alleviating radicular pain due to disc herniation after failure of conservative treatment. After failure of conservative treatment, PCEG was performed under fluoroscopic guidance in 42 patients with sciatica >4/10 on a Visual Analog Scale (VAS) for at least 6 weeks and consistent disc herniation on MRI or CT <3 months. The VAS pain score was determined at baseline, then after 1 and 3 months. We assessed the influence of patient-related factors (age, gender, pain duration) and disc herniation-related factors (level, migration pattern, disc herniation-related spinal stenosis) on outcome of PCEG. Mean pain duration was 6.7 months. Pain intensity decreased by 44 % and 62.6 % after 1 and 3 months, respectively, versus baseline (P = 0.007). A mild improvement was noted by the rheumatologist in 30/42 (71.4 %) and 36/42 (85.7 %) patients after 1 and 3 months, respectively, and in 31/42 (73.8 %) and 33/42 (78.6 %) patients by self-evaluation. Patients who failed PCEG were significantly older (49.8 vs. 37.3 years, P = 0.03). None of the other variables studied were significantly associated with pain relief. PCEG may significantly improve disc-related radicular pain refractory to conservative treatment. (orig.)

  3. Sudden post-traumatic sciatica caused by a thoracic spinal meningioma.

    Science.gov (United States)

    Mariniello, Giuseppe; Malacario, Francesca; Dones, Flavia; Severino, Rocco; Ugga, Lorenzo; Russo, Camilla; Elefante, Andrea; Maiuri, Francesco

    2016-10-01

    Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position. At surgery, a meningioma with dural attachment of the left postero-lateral dural surface was removed. The intervention resulted in rapid remission of both pain and neurological deficits. Spinal meningiomas may exceptionally present with sudden pain and neurological deficits as result of tumour bleeding or post-traumatic injury of the already compressed nervous structures, both in normal patients and in those with conus displacement or tethered cord. In this case, the traumatic impact of the left foot was transmitted to the spine, resulting in stretching of the already compressed cord and of the contralateral lombosacral roots. This case suggests that low thoracic cord compression should be suspected in patients with post-traumatic radicular leg pain with normal lumbar spine MRI. © The Author(s) 2016.

  4. Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Touraine, Sebastien; Tran, Olivia; Laredo, Jean-Denis [Hopital Lariboisiere, AP-HP, Radiologie Osteo-Articulaire, Paris Cedex 10 (France); Damiano, Joel [Hopital Lariboisiere, AP-HP, Rhumatologie, Centre Viggo-Petersen, Paris Cedex 10 (France)

    2015-11-15

    To investigate the efficacy of percutaneous chemonucleolysis using ethanol gel (PCEG) in alleviating radicular pain due to disc herniation after failure of conservative treatment. After failure of conservative treatment, PCEG was performed under fluoroscopic guidance in 42 patients with sciatica >4/10 on a Visual Analog Scale (VAS) for at least 6 weeks and consistent disc herniation on MRI or CT <3 months. The VAS pain score was determined at baseline, then after 1 and 3 months. We assessed the influence of patient-related factors (age, gender, pain duration) and disc herniation-related factors (level, migration pattern, disc herniation-related spinal stenosis) on outcome of PCEG. Mean pain duration was 6.7 months. Pain intensity decreased by 44 % and 62.6 % after 1 and 3 months, respectively, versus baseline (P = 0.007). A mild improvement was noted by the rheumatologist in 30/42 (71.4 %) and 36/42 (85.7 %) patients after 1 and 3 months, respectively, and in 31/42 (73.8 %) and 33/42 (78.6 %) patients by self-evaluation. Patients who failed PCEG were significantly older (49.8 vs. 37.3 years, P = 0.03). None of the other variables studied were significantly associated with pain relief. PCEG may significantly improve disc-related radicular pain refractory to conservative treatment. (orig.)

  5. Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation

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    Rogerio Carlos Sanfelice Nunes

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: Sciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation. METHODS: A clinical study was conducted based on a retrospective and prospective survey. The blockade consisted of interlaminar puncture and bolus drug delivery. The number of procedures varied according to the clinical response, as determined through weekly evaluations and then 30, 90, and 180 days after the final session. A total of 124 patients who received one to five blockades were evaluated. RESULTS: The success rate (defining success as a reduction in sciatic pain of at least 80% was 75.8%. CONCLUSION: The results demonstrated the therapeutic action of epidural blockade over the short term, i.e. in cases of acute pain, thus showing that intense and excruciating sciatic pain can be relieved through this technique. Because of the multifactorial genesis of sciatica and the difficulties encountered by healthcare professionals in treating this condition, epidural blockade can become part of therapeutic arsenal available. This procedure is situated between conservative treatment with an eminently clinical focus and surgical approaches.

  6. Bothersome tinnitus : Cognitive behavioral perspectives

    NARCIS (Netherlands)

    Cima, R F F

    Tinnitus is not traceable to a single disease or pathology, but merely a symptom, which is distressing to some but not all individuals able to perceive it. The experience of tinnitus does not equate to tinnitus distress. Tinnitus suffering might be understood as a function of tinnitus-related

  7. Efeitos do ultrassom terapêutico em modelo experimental de ciatalgia Therapeutic ultrasound effects in a sciatica experimental model

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    Adriano Policam Ciena

    2009-12-01

    Full Text Available A ciática possui grande prevalência geral e seu tratamento tende a resolver as causas de compressão nervosa. A fisioterapia objetiva reduzir os sintomas causados pela compressão. O presente estudo teve como objetivo avaliar a eficácia do ultrassom terapêutico sobre a dor, em animais submetidos a modelo experimental de ciatalgia. Foram usados 18 ratos neste estudo, divididos em três grupos: GS (n = 4, submetido a modelo de ciatalgia e tratados com ultrassom desligado; GUP (n = 7, submetido à ciatalgia e tratados com ultrassom pulsado 2W/cm² (SATP; 0,4 - SATA; e grupo GUC (n = 7, submetido à ciática e ultrassom contínuo (0,4W/cm². O nervo ciático do membro posterior direito foi exposto à compressão com fio categute em quatro pontos. No 3º dia pós-operatório (PO, iniciou-se tratamento indireto por quatro dias. No 9º dia PO, o tratamento direto começou sobre a área do procedimento cirúrgico, por cinco dias consecutivos. O tempo de elevação da pata, durante a marcha, foi avaliado antes e após a ciatalgia, no 3º, 6º, 9º e 13º PO. Os resultados demonstraram que a aplicação do ultrassom reduziu a dor com ambos os tratamentos efetivos e tendeu a ser mais eficaz na forma pulsada.The sciatica possesses great general population prevalence, and its treatment tends to solve the nervous compression causes. Physiotherapy aims to reduce the symptoms caused by compression. This study aimed to evaluate the effectiveness of therapeutic ultrasound on pain in animals subjected to sciatica experimental model. Eighteen rats were used and they were divided in 3 groups: group SG (n=4 submitted to the sciatica and treated with the ultrasound off, group PUG (n=7 submitted to the sciatica and treated with pulsed ultrasound 2 W/cm² (SATP; 0,4 - SATA and group CUG (n=7 submitted to the sciatica and treated with continuous ultrasound (0,4 W/cm². The sciatic nerve of the posterior right limb was exposed to the compression with Catgut wire in 4

  8. Use of Temporary Implantable Biomaterials to Reduce Leg Pain and Back Pain in Patients with Sciatica and Lumbar Disc Herniation

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    Gere S. diZerega

    2010-05-01

    Full Text Available The principle etiology of leg pain (sciatica from lumbar disc herniation is mechanical compression of the nerve root. Sciatica is reduced by decompression of the herniated disc, i.e., removing mechanical compression of the nerve root. Decompression surgery typically reduces sciatica more than lumbar back pain (LBP. Decompression surgery reduces mechanical compression of the nerve root. However, decompression surgery does not directly reduce sensitization of the sensory nerves in the epidural space and disc. In addition, sensory nerves in the annulus fibrosus and epidural space are not protected from topical interaction with pain mediators induced by decompression surgery. The secondary etiology of sciatica from lumbar disc herniation is sensitization of the nerve root. Sensitization of the nerve root results from a mechanical compression, b exposure to cellular pain mediators, and/or c exposure to biochemical pain mediators. Although decompression surgery reduces nerve root compression, sensory nerve sensitization often persists. These observations are consistent with continued exposure of tissue in the epidural space, including the nerve root, to increased cellular and biochemical pain mediators following surgery. A potential contributor to lumbar back pain (LBP is stimulation of sensory nerves in the annulus fibrosus by a cellular pain mediators and/or b biochemical pain mediators that accompany annular tears or disruption. Sensory fibers located in the outer one-third of the annulus fibrosus increase in number and depth as a result of disc herniation. The nucleus pulposus is comprised of material that can produce an autoimmune stimulation of the sensory nerves located in the annulus and epidural space leading to LBP. The sensory nerves of the annulus fibrosus and epidural space may be sensitized by topical exposure to cellular and biochemical pain mediators induced by lumbar surgery. Annulotomy or annular rupture allows the nucleus pulposus

  9. Reliability of gadolinium-enhanced magnetic resonance imaging findings and their correlation with clinical outcome in patients with sciatica.

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    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

    2014-11-01

    Gadolinium-enhanced magnetic resonance imaging (Gd-MRI) is often performed in the evaluation of patients with persistent sciatica after lumbar disc surgery. However, correlation between enhancement and clinical findings is debated, and limited data are available regarding the reliability of enhancement findings. To evaluate the reliability of Gd-MRI findings and their correlation with clinical findings in patients with sciatica. Prospective observational evaluation of patients who were enrolled in a randomized trial with 1-year follow-up. Patients with 6- to 12-week sciatica, who participated in a multicentre randomized clinical trial comparing an early surgery strategy with prolonged conservative care with surgery if needed. In total 204 patients underwent Gd-MRI at baseline and after 1 year. Patients were assessed by means of the Roland Disability Questionnaire (RDQ) for sciatica, visual analog scale (VAS) for leg pain, and patient-reported perceived recovery at 1 year. Kappa coefficients were used to assess interobserver reliability. In total, 204 patients underwent Gd-MRI at baseline and after 1 year. Magnetic resonance imaging findings were correlated to the outcome measures using the Mann-Whitney U test for continuous data and Fisher exact tests for categorical data. Poor-to-moderate agreement was observed regarding Gd enhancement of the herniated disc and compressed nerve root (kappa0.95). Of the 59 patients with an enhancing herniated disc at 1 year, 86% reported recovery compared with 100% of the 12 patients with nonenhancing herniated discs (p=.34). Of the 12 patients with enhancement of the most affected nerve root at 1 year, 83% reported recovery compared with 85% of the 192 patients with no enhancement (p=.69). Patients with and without enhancing herniated discs or nerve roots at 1 year reported comparable outcomes on RDQ and VAS-leg pain. Reliability of Gd-MRI findings was poor-to-moderate and no correlation was observed between enhancement and

  10. Cyclic Sciatica and Back Pain Responds to Treatment of Underlying Endometriosis: Case Illustration.

    Science.gov (United States)

    Uppal, Jaya; Sobotka, Stanislaw; Jenkins, Arthur L

    2017-01-01

    Multiple causes outside the spine can mimic spinal back pain. Endometriosis is an important gynecologic disorder, which commonly affects the lower region of the female pelvis and less frequently the spine and soft tissues. The lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Therefore symptoms of endometriosis include severe reoccurring pain in the pelvic area as well as lower back and abdominal pain. We report on a 39-year-old gymnast with cyclic sciatica and back pain, whose initial presentation initially led to a spinal fusion at L4/5 and L5/S1, but that procedure did not change her symptoms. Her diagnosis of endometriosis was not made until 2 years after her spinal fusion. Ultimately, once diagnosed with endometriosis of the retroperitoneal spinal and neural elements, her back and leg pain responded completely to hormonal therapy and then to a hysterectomy and a bilateral salpingo-oophorectomy. Because her true diagnosis of endometriosis was unknown and she had some degenerative changes in her spine, she underwent a spinal fusion that would probably not have been done if the diagnosis of endometriosis had been suggested. It is critical for any clinician who deals with back pain to at least consider the diagnosis of endometriosis in female patients who have a history of pelvic pain. The diagnosis of endometriosis should be considered in candidate patients by asking whether there is a significant hormonal cyclic nature to the symptoms, to prevent such unnecessary surgical adventures. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment.

    Science.gov (United States)

    Touraine, Sébastien; Damiano, Joël; Tran, Olivia; Laredo, Jean-Denis

    2015-11-01

    To investigate the efficacy of percutaneous chemonucleolysis using ethanol gel (PCEG) in alleviating radicular pain due to disc herniation after failure of conservative treatment. After failure of conservative treatment, PCEG was performed under fluoroscopic guidance in 42 patients with sciatica >4/10 on a Visual Analog Scale (VAS) for at least 6 weeks and consistent disc herniation on MRI or CT <3 months. The VAS pain score was determined at baseline, then after 1 and 3 months. We assessed the influence of patient-related factors (age, gender, pain duration) and disc herniation-related factors (level, migration pattern, disc herniation-related spinal stenosis) on outcome of PCEG. Mean pain duration was 6.7 months. Pain intensity decreased by 44% and 62.6% after 1 and 3 months, respectively, versus baseline (P = 0.007). A mild improvement was noted by the rheumatologist in 30/42 (71.4%) and 36/42 (85.7%) patients after 1 and 3 months, respectively, and in 31/42 (73.8%) and 33/42 (78.6%) patients by self-evaluation. Patients who failed PCEG were significantly older (49.8 vs. 37.3 years, P = 0.03). None of the other variables studied were significantly associated with pain relief. PCEG may significantly improve disc-related radicular pain refractory to conservative treatment. • Percutaneous chemonucleolysis using ethanol gel (PCEG) is feasible on an outpatient basis. • PCEG improves disc-related radicular pain refractory to conservative treatment. • PCEG is feasible on an outpatient basis. • Failure of PCEG does not interfere with subsequent spinal surgery.

  12. Vascular Entrapment of Both the Sciatic and Pudendal Nerves Causing Persistent Sciatica and Pudendal Neuralgia.

    Science.gov (United States)

    Kale, Ahmet; Basol, Gulfem; Usta, Taner; Cam, Isa

    2018-04-24

    To demonstrate the laparoscopic approach to malformed branches of the vessels entrapping the nerves of the sacral plexus. A step-by-step explanation of the surgery using video (educative video) (Canadian Task force classification II). The university's Ethics Committee ruled that approval was not required for this video. Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey. A 26-year-old patient who had failed medical therapy and presented with complaints of numbness and burning pain on the right side of her vagina and pain radiating to her lower limbs for a period of approximately 36 months. The peritoneum was incised along the external iliac vessels, and these vessels were separated from the iliopsoas muscle on the right side of the pelvis. The laparoscopic decompression of intrapelvic vascular entrapment was performed at 3 sites: the lumbosacral trunk, sciatic nerve, and pudendal nerve. The aberrant dilated veins were gently dissected from nerves, and then coagulated and cut with the LigaSure sealing device (Medtronic, Minneapolis, Minn). The operation was completed successfully with no complications, and the patient was discharged from the hospital 24 hours after the operation. At a 6-month follow-up, she reported complete resolution of dyspareunia and sciatica (visual analog scale score 1 of 10). A less well-known cause of chronic pelvic pain is compression of the sacral plexus by dilated or malformed branches of the internal iliac vessels. Laparoscopic management of vascular entrapment of the sacral plexus has been described by Possover et al [1,2] and Lemos et al [3]. This procedure appears to be feasible and effective, but requires significant experience and familiarity with laparoscopy techniques and pelvic nerve anatomy. Copyright © 2018 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

  13. The treatment of disc herniation-induced sciatica with infliximab - One-year follow-up results of FIRST II, a randomized controlled trial

    NARCIS (Netherlands)

    Korhonen, Timo; Karppinen, Jaro; Paimela, Leena; Malmivaara, Antti; Lindgren, Karl-August; Bowman, Chris; Hammond, Anthony; Kirkham, Bruce; Jarvinen, Simo; Niinimaki, Jaakko; Veeger, Nic; Haapea, Marianne; Torkki, Markus; Tervonen, Osmo; Seitsalo, Seppo; Hurri, Heikki

    2006-01-01

    Study Design. A randomized controlled trial. Objectives. To evaluate the long-term efficacy of infliximab, a monoclonal antibody against tumor necrosis factor alpha (TNF-alpha), in patients with acute/subacute sciatica secondary to herniated disc. Summary of Background Data. The results of

  14. Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment.

    Science.gov (United States)

    Monro, Robin; Bhardwaj, Abhishek Kumar; Gupta, Ram Kumar; Telles, Shirley; Allen, Beth; Little, Paul

    2015-01-01

    Previous trials of yoga therapy for nonspecific low back pain (nsLBP) (without sciatica) showed beneficial effects. To test effects of yoga therapy on pain and disability associated with lumbar disc extrusions and bulges. Parallel-group, randomised, controlled trial. Sixty-one adults from rural population, aged 20-45, with nsLBP or sciatica, and disc extrusions or bulges. Randomised to yoga (n=30) and control (n=31). Yoga: 3-month yoga course of group classes and home practice, designed to ensure safety for disc extrusions. normal medical care. OUTCOME MEASURES (3-4 months) Primary: Roland Morris Disability Questionnaire (RMDQ); worst pain in past two weeks. Secondary: Aberdeen Low Back Pain Scale; straight leg raise test; structural changes. Disc projections per case ranged from one bulge or one extrusion to three bulges plus two extrusions. Sixty-two percent had sciatica. Intention-to-treat analysis of the RMDQ data, adjusted for age, sex and baseline RMDQ scores, gave a Yoga Group score 3.29 points lower than Control Group (0.98, 5.61; p=0.006) at 3 months. No other significant differences in the endpoints occurred. No adverse effects of yoga were reported. Yoga therapy can be safe and beneficial for patients with nsLBP or sciatica, accompanied by disc extrusions and bulges.

  15. Immediate relief of herniated lumbar disc-related sciatica by ankle acupuncture: A study protocol for a randomized controlled clinical trial.

    Science.gov (United States)

    Xiang, Anfeng; Xu, Mingshu; Liang, Yan; Wei, Jinzi; Liu, Sheng

    2017-12-01

    Around 90% of sciatica cases are due to a herniated intervertebral disc in the lumbar region. Ankle acupuncture (AA) has been reported to be effective in the treatment of acute nonspecific low back pain. This study aims to evaluate the efficacy of a single session of ankle acupuncture for disc-related sciatica. This will be a double-blinded, randomized controlled clinical trial. Patients diagnosed with disc-related sciatica will be randomly divided into 3 parallel groups. The treatment group (n = 30) will receive ankle acupuncture. The 2 control groups will either undergo traditional needle manipulation (n = 30) or sham acupuncture (n = 30) at the same point as the treatment group. The primary outcome will be pain intensity on a visual analog scale (VAS). The secondary outcomes will be paresthesia intensity on a VAS and the Abbreviated Acceptability Rating Profile (AAPR). The success of blinding will be evaluated, and the needle-induced sensation and adverse events will be recorded. All outcomes will be evaluated before, during, and after the treatment. This study will determine the immediate effect and specificity of ankle acupuncture for the treatment of disc-related sciatica. We anticipate that ankle acupuncture might be more effective than traditional needle manipulation or sham acupuncture. ChiCTR-IPR-15007127 (http://www.chictr.org.cn/showprojen.aspx?proj=11989). Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  16. INDEXING AND INDEX FUNDS

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    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  17. The clinical and cost-effectiveness of stratified care for patients with sciatica: the SCOPiC randomised controlled trial protocol (ISRCTN75449581).

    Science.gov (United States)

    Foster, Nadine E; Konstantinou, Kika; Lewis, Martyn; Ogollah, Reuben; Dunn, Kate M; van der Windt, Danielle; Beardmore, Ruth; Artus, Majid; Bartlam, Bernadette; Hill, Jonathan C; Jowett, Sue; Kigozi, Jesse; Mallen, Christian; Saunders, Benjamin; Hay, Elaine M

    2017-04-26

    Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work. The aim of the SCOPiC trial (SCiatica Outcomes in Primary Care) is to establish whether stratified care based on subgrouping using a combination of prognostic and clinical information, with matched care pathways, is more effective than non-stratified care, for improving time to symptom resolution in patients consulting with sciatica in primary care. We will also assess the impact of stratified care on service delivery and evaluate its cost-effectiveness compared to non-stratified care. Multicentre, pragmatic, parallel arm randomised trial, with internal pilot, cost-effectiveness analysis and embedded qualitative study. We will recruit 470 adult patients with sciatica from general practices in England and Wales, over 24 months. Patients will be randomised to stratified care or non-stratified care, and treated in physiotherapy and spinal specialist services, in participating NHS services. The primary outcome is time to first resolution of sciatica symptoms, measured on a 6-point ordered categorical scale, collected using text messaging. Secondary outcomes include physical function, pain intensity, quality of life, work loss, healthcare use and satisfaction with treatment, and will be collected using postal questionnaires at 4 and 12-month follow-up. Semi-structured qualitative interviews with a subsample of participants and clinicians will explore the

  18. The Effects of Pregabalin and the Glial Attenuator Minocycline on the Response to Intradermal Capsaicin in Patients with Unilateral Sciatica

    Science.gov (United States)

    Sumracki, Nicole M.; Hutchinson, Mark R.; Gentgall, Melanie; Briggs, Nancy; Williams, Desmond B.; Rolan, Paul

    2012-01-01

    Background Patients with unilateral sciatica have heightened responses to intradermal capsaicin compared to pain-free volunteers. No studies have investigated whether this pain model can screen for novel anti-neuropathic agents in patients with pre-existing neuropathic pain syndromes. Aim This study compared the effects of pregabalin (300 mg) and the tetracycline antibiotic and glial attenuator minocycline (400 mg) on capsaicin-induced spontaneous pain, flare, allodynia and hyperalgesia in patients with unilateral sciatica on both their affected and unaffected leg. Methods/Results Eighteen patients with unilateral sciatica completed this randomised, double-blind, placebo-controlled, three-way cross-over study. Participants received a 10 µg dose of capsaicin into the middle section of their calf on both their affected and unaffected leg, separated by an interval of 75 min. Capsaicin-induced spontaneous pain, flare, allodynia and hyperalgesia were recorded pre-injection and at 5, 20, 40, 60 and 90 min post-injection. Minocycline tended to reduce pre-capsaicin injection values of hyperalgesia in the affected leg by 28% (95% CI 0% to 56%). The area under the effect time curves for capsaicin-induced spontaneous pain, flare, allodynia and hyperalgesia were not affected by either treatment compared to placebo. Significant limb differences were observed for flare (AUC) (−38% in affected leg, 95% CI for difference −19% to −52%). Both hand dominance and sex were significant covariates of response to capsaicin. Conclusions It cannot be concluded that minocycline is unsuitable for further evaluation as an anti-neuropathic pain drug as pregabalin, our positive control, failed to reduce capsaicin-induced neuropathic pain. However, the anti-hyperalgesic effect of minocycline observed pre-capsaicin injection is promising pilot information to support ongoing research into glial-mediated treatments for neuropathic pain. The differences in flare response between limbs may

  19. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

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    Homayoun Tabesh

    2015-01-01

    Full Text Available Background: Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH straight leg raising (SLR test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. Materials and Methods: All patients with leg pain referring to neurosurgery clinic were enrolled. Those with a history of pain other than sciatica excluded and SLR test and magnetic resonance imaging (MRI of the lumbosacral spine performed. The patients with negative MRI findings excluded and finally 269 patients with true sciatica and positive MRI were included. SLR tests were performed for different age groups. Results: Of 269 patients, 167 were male. The age range was 16-80 years. The most involved levels were L5-S1 (47% and L4-L5 (42%, respectively. The rate of positive SLR result, which was 100%, 87% and 82% for 10-19, 20-29 and 30-39 years age group respectively. With an increment of age, the rate of positive test regularly declined . The chance of positive SLR in men is 1.3 times the women (odds ratio [OR] 2.4; 95% confidence interval [CI] = 1.265-4.557; P = 0.007. Increasing the age has suppression effect in positivity of SLR so that for each 1-year the chance of SLR become 0.27 times less to become positive and this is also statically meaningful (OR = 0.271;95% CI = 0.188-0.391; P,0.001. The chance of positive SLR for patients under 60 is 5.4 folds more than patients above 60 years old (OR = 5.4; 95% CI = 4-8.3; P, 0.001. Conclusion: Age, sex (male, and disk level had statistically the effect on SLR positive test.

  20. Frequency of depression and anxiety among patients with chronic sciatica; unscreened and undiagnosed cases may represent an iceberg phenomenon

    International Nuclear Information System (INIS)

    Atif, K.; Khan, H.U.

    2017-01-01

    To calculate frequency and grades of undocumented anxiety and depression in patients having unilateral sciatica due to single prolapsed lumbar inter-vertebral disc (PLIVD). Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital Lahore, from Mar 2013 to Jun 2014. Material and Methods: Cross-sectional study conducted at Combined Military Hospital Lahore, from March 2013 to Jun 2014, with non-probability consecutive sampling. Cases were taken from neurosurgery department, having sciatica due to single PLIVD. Controls were selected from healthy personnel with neither any current major/minor ailment nor any diagnosed mental or physical health issue. First hundred individuals meeting the inclusion and exclusion criteria were enrolled as controls and cases (100 each). Independent variables were multiple demographic factors; dependent variables were grades of anxiety and depression. Standardized Beck Anxiety Inventory-Udru (BAI-U) and Beck Depression Inventory-Urdu (BDI-U) were selected. Authors assisted the subjects to fill inventories. Statistical analysis was done via descriptive statistics (SPSS-15), data expressed in frequencies, percentages and mean +- SD (standard deviation), cross-tabulation done via chi-square; p-value <0.05 was considered as significant. Results: Out of 200 subjects, frequencies of males and females were 72.0% and 28.0% respectively; mean age 39.15 +- 15.001 years, education grades 9.27 +- 5.87 and income/month 43510.00 +- 53305.32 PKR. Among cases, higher frequencies of anxiety (84%) and depression (55%) were found as compared to controls (anxiety 24%, depression 8%). Anxiety (p-0.03) was more significant than depression (p-0.131); while severe anxiety, severe depression and suicidal ideation were present in 27.0%, 19.0% and 4% respectively. Females were more prone to have anxiety (p-0.003); patients aged 25-60 years had significant depression (p-0.02). Conclusion: Considerable number of patients with

  1. Patients with sciatica still experience pain and disability 5 years after surgery: A systematic review with meta-analysis of cohort studies.

    Science.gov (United States)

    Machado, G C; Witzleb, A J; Fritsch, C; Maher, C G; Ferreira, P H; Ferreira, M L

    2016-11-01

    The clinical course of patients with sciatica is believed to be favourable, but there is conflicting evidence on the postoperative course of this condition. We aimed to investigate the clinical course of sciatica following surgery. An electronic search was conducted on MEDLINE, EMBASE and CINAHL from inception to April 2015. We screened for prospective cohort studies investigating pain or disability outcomes for patients with sciatica treated surgically. Fractional polynomial regression analysis was used to generate pooled means and 95% confidence intervals (CI) of pain and disability up to 5 years after surgery. Estimates of pain and disability (converted to a 0-100 scale) were plotted over time, from inception to last available follow-up time. Forty records (39 cohort studies) were included with a total of 13,883 patients with sciatica. Before surgery, the pooled mean leg pain score was 75.2 (95% CI 68.1-82.4) which reduced to 15.3 (95% CI 8.5-22.1) at 3 months. Patients were never fully recovered in the long-term and pain increased to 21.0 (95% CI 12.5-29.5) at 5 years. The pooled mean disability score before surgery was 55.1 (95% CI 52.3-58.0) and this decreased to 15.5 (95% CI 13.3-17.6) at 3 months, and further reduced to 13.1 (95% CI 10.6-15.5) at 5 years. Although surgery is followed by a rapid decrease in pain and disability by 3 months, patients still experience mild to moderate pain and disability 5 years after surgery. WHAT DOES THIS REVIEW ADD?: This review provides a quantitative summary of the postoperative course of patients with sciatica. Patients with sciatica experienced a rapid reduction in pain and disability in the first 3 months, but still had mild to moderate symptoms 5 years after surgery. Although no significant differences were found, microdiscectomy showed larger improvements compared to other surgical techniques. © 2016 European Pain Federation - EFIC®.

  2. Radiological imaging in patients with low back pain and sciatica[6 figs., 14 refs]; Billeddiagnostikk ved lumbago og isjas

    Energy Technology Data Exchange (ETDEWEB)

    Dullerud, R. [Aker Sykehus, Oslo (Norway)

    1999-05-01

    Low back pain and sciatica are among the most common medical problems in Western countries, affecting up to 80% of the population at some time during their lives. Plain radiography is still a sensitive method in degenerative spinal disease and for the identification of spondylolysis and destructions as well as transitional vertebra and other anomalies in the lumbosacral region. In lumbar disk herniation CT and MR have higher sensitivity than lumbar myelography and should be used as the primary imaging methods. Myelography is still the method of choice in lumbar spinal stenosis. Myelography should also be considered in patients with poor consistency between CT and MR findings and the clinical presentation. Postoperatively MR is superior to CT and myelography for distinguishing between scar tissue and recurrent disk herniation.

  3. Does the diagnosis influence the outcome in multimodal outpatient pain management program for low back pain and sciatica? a comparative study

    Directory of Open Access Journals (Sweden)

    Artner J

    2012-07-01

    Full Text Available Juraj Artner, Stephan Kurz, Balkan Cakir, Heiko Reichel, Friederike LattigDepartment of Orthopaedic Surgery, University of Ulm, GermanyAbstract: The literature describes multimodal pain-management programs as successful therapy options in the conservative treatment of chronic low back pain. Yet, the intensity and inclusion criteria of such programs remain debatable. In many studies, the pain originating from spinal structures is described as nonspecific low back pain – a diffuse diagnosis without serious implications. The purpose of this study is to compare the short-term outcomes between patients suffering from sciatica due to a discus intervertebralis herniation and those suffering from low back pain caused by facet joint disease after 3 weeks of treatment in an intense multimodal outpatient program in the Department of Orthopaedic Surgery at the university hospital.Keywords: chronic low back pain, sciatica, interdisciplinary management, discus herniation, spondylarthritis

  4. Does Kinesiophobia Modify the Effects of Physical Therapy on Outcomes in Patients With Sciatica in Primary Care? Subgroup Analysis From a Randomized Controlled Trial.

    Science.gov (United States)

    Verwoerd, Annemieke J H; Luijsterburg, Pim A J; Koes, Bart W; el Barzouhi, Abdelilah; Verhagen, Arianne P

    2015-09-01

    A higher level of kinesiophobia appears to be associated with poor recovery in patients with sciatica. The aim of this study was to investigate whether kinesiophobia modifies the effect of physical therapy on outcomes in patients with sciatica. This was a subgroup analysis from a randomized controlled trial. The study was conducted in a primary care setting. A total of 135 patients with acute sciatica participated. Patients were randomly assigned to groups that received (1) physical therapy plus general practitioners' care (intervention group) or (2) general practitioners' care alone (control group). Kinesiophobia at baseline was measured with the Tampa Scale for Kinesiophobia (TSK) and a single substitute question for kinesiophobia (SQK). Pain and recovery were assessed at 3- and 12-month follow-ups. Regression analysis was used to test for interaction between the level of kinesiophobia at baseline and treatment allocation. Subgroup results were calculated for patients classified with high fear of movement and for those classified with low fear of movement. Kinesiophobia at baseline interacted with physical therapy in the analysis with leg pain intensity at 12-month follow-up. Kinesiophobia at baseline did not interact with physical therapy regarding any outcome at 3-month follow-up or recovery at 12-month follow-up. When comparing both treatment groups in the subgroup of patients with high fear of movement (n=73), the only significant result was found for leg pain intensity difference from baseline at 12-month follow-up (intervention group: X̅=-5.0, SD=2.6; control group: X̅=-3.6, SD=2.7). The post hoc study design and relatively small sample size were limitations of the study. In 135 patients with sciatica, evidence shows that patients with a higher level of kinesiophobia at baseline may particularly benefit from physical therapy with regard to decreasing leg pain intensity at 12-month follow-up. © 2015 American Physical Therapy Association.

  5. Do MRI Findings Change Over a Period of Up to 1 Year in Patients With Low Back Pain and/or Sciatica?: A Systematic Review.

    Science.gov (United States)

    Panagopoulos, John; Hush, Julia; Steffens, Daniel; Hancock, Mark J

    2017-04-01

    Systematic review OBJECTIVE.: The aim of the study was to investigate whether magnetic resonance imaging (MRI) findings change over a relatively short period of time (sciatica. We also investigated whether there was an association between any change in MRI findings and change in clinical outcomes. MRI offers the potential to identify possible pathoanatomic sources of LBP and/or sciatica; however, the clinical importance of MRI findings remains unclear. Little is known about whether lumbar MRI findings change over the short term and if so whether these changes are associated with changes in clinical outcomes. Medline, EMBASE, and CINAHL databases were searched. Included were cohort studies that performed repeat MRI scans within 12 months in patients with LBP and/or sciatica. Data on study characteristics and change in MRI findings were extracted from included studies. Any data describing associations between change in MRI findings and change in clinical outcomes were also extracted. A total of 12 studies met the inclusion criteria and were included in the review. Pooling was not possible due to heterogeneity of studies and findings. Seven studies reported on changes in disc herniation and reported 15% to 93% of herniations reduced or disappeared in size. Two studies reported on changes in nerve root compression and reported 17% to 91% reduced or disappeared. Only one study reported on the association between change in MRI findings and change in clinical outcomes within 1 year, and found no association. This review found moderate evidence that the natural course of herniations and nerve root compression is favorable over a 1-year period in people with sciatica or LBP. There is a lack of evidence on whether other MRI findings change, and whether changes in MRI findings are associated with changes in clinical outcomes. 1.

  6. Healthcare utilisation of pregnant women who experience sciatica, leg cramps and/or varicose veins: A cross-sectional survey of 1835 pregnant women.

    Science.gov (United States)

    Hall, Helen; Lauche, Romy; Adams, Jon; Steel, Amie; Broom, Alex; Sibbritt, David

    2016-02-01

    Common discomforts of pregnancy experienced in the lower extremity include sciatica, leg cramps and varicose veins. Whilst research attention has focused on aetiology and outcomes, the health service utilisation of pregnant women suffering from these complaints has been largely overlooked. To examine the health status and health service utilisation profile of pregnant women experiencing sciatica, leg cramps or varicose veins. Linear and logistic regression was applied to a cross-sectional survey of a pregnant women drawn from the 1973 to 1978 cohort (aged 31-36 years in 2009), of the Australian Longitudinal Study on Women's Health (n=1835). Participant's demographics, health status and health service utilisation were compared for all three complaints based upon three subgroups (yes, sought help; yes, did not seek help; no). A number of women experienced sciatica (22.1%), leg cramps (18.2%) or varicose veins (9.4%). Of these, a greater proportion of women with sciatica (79.3%) or varicose veins (71.5%) sought help for their condition compared with women with leg cramps (46.7%). Comparisons between women with the conditions of interest who did seek help and those who did not only found that women with a university degree were 0.29 (95% CI: 0.10, 0.85) times less likely to seek help for their condition compared to women with a school only education. Further research examining all health seeking behaviour and treatment use of pregnant women who experience lower extremity problems is required in order to facilitate safe, effective and coordinated maternity care to further support these women during pregnancy. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. Sciatica as the first manifestation of synovial sarcoma. Contribution of magnetic resonance imaging to the diagnosis; Sciatique revelatrice d`un synovialosarcome. Interet de l`IRM

    Energy Technology Data Exchange (ETDEWEB)

    Veillard, E.; Le Dantec, P.; Chales, G.; Jean, S.; Pawlotsky, Y. [Centre Hospitalier Universitaire, 35 - Rennes (France)

    1995-07-01

    A 38-year-old man presented with paralyzing sciatica as the first manifestation of synovial sarcoma of his right leg. Although neurologic symptoms sometimes occur as manifestations of synovial sarcoma, they are exceptionally inaugural. Magnetic resonance imaging is a valuable tool in patients with synovial tumors, both for establishing the diagnosis and for evaluating the extent of the lesion. (authors). 13 refs., 3 figs.

  8. 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.

  9. The relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy.

    Science.gov (United States)

    Savage, Nathan J; Fritz, Julie M; Thackeray, Anne

    2014-07-01

    Cross-sectional diagnostic accuracy study. To investigate the relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy. Electrodiagnostic testing is routinely used to evaluate patients with sciatica. Recent evidence suggests that the presence of radiculopathy identified with electrodiagnostic testing may predict better functional outcomes in these patients. While some patient history and physical examination findings have been shown to predict the presence of disc herniation or neurological insult, little is known about their relationship to the results of electrodiagnostic testing. Electrodiagnostic testing was performed on 38 patients with sciatica who participated in a randomized trial that compared different physical therapy interventions. The diagnostic gold standard was the presence or absence of radiculopathy, based on the results of the needle electromyographic examination. Diagnostic sensitivity and specificity values were calculated, along with corresponding likelihood ratios, for select patient history and physical examination variables. No significant relationship was found between select patient history and physical examination findings, analyzed individually or in combination, and the outcome of electrodiagnostic testing. Diagnostic sensitivity values ranged from 0.03 (95% confidence interval [CI]: 0.00, 0.24) to a high of 0.95 (95% CI: 0.72, 0.99), and specificity values ranged from 0.10 (95% CI: 0.02, 0.34) to a high of 0.95 (95% CI: 0.72, 0.99). Positive likelihood ratios ranged from 0.15 (95% CI: 0.01, 2.87) to a high of 2.33 (95% CI: 0.71, 7.70), and negative likelihood ratios ranged from 2.00 (95% CI: 0.35, 11.48) to a low of 0.50 (95% CI: 0.03, 8.10). In this investigation, the relationship between patient history and physical examination findings and the outcome of electrodiagnostic testing among patients with sciatica was not found to be

  10. Fluoroscopically-guided transforaminal epidural steroid injection for the treatment of sciatica due to herniated nucleus pulposus

    International Nuclear Information System (INIS)

    Liu Xiao; Wang Jianhui; Duan Zhaohui; Xu Zhitao; Shu Xiaomin; Qiu Ronghua

    2009-01-01

    Objective: To discuss the therapeutic benefit of fluoroscopically-guided lumbar transforaminal epidural steroid injections (TFESI) in treating patients with sciatica due to a herniated nucleus pulposus. Methods: From October 2004 to November 2007, fluoroscopically-guided lumbar TFESI as performed in 79 patients (41 males and 38 females with a mean age of 45.75 years,ranged from 20 to 70 years) with sciatica due to a herniated nucleus pulposus. Patients had a symptomatic course of disease from 8 weeks to 22 years and showed no response to conservative treatment. The diagnosis was confirmed by computed tomography or magnetic resonance imaging. TFESI was performed at patient's request. Additional injections, up to 3 times, were given with an interval of 7 or 10 days. The injection medicine consisted of 25 mg of prednisolone acetate and (9-14) ml of 0.5% lidocaine. Patients were evaluated by an independent observer and received questionnaires before the initial injection and at 6,12 months after TFESI. Questionnaires included an eleven points visual analog scale (VAS) and a five points patient satisfaction scale. A successful outcome required a patient satisfaction scale score of 3 (very good) or 4(excellent) and a reduction on the VAS score of 2 or more points after TFESI. Pain relief was classified as 'excellent' when the pain was completely resolved or diminished by 5 points or more, as 'good' when a diminution of pain was 2 points or more, as 'fair' and 'poor' when a diminution of pain was 1 point or less, or even an increase in pain. Results: Twenty-nine patients received single injection, 22 patients received two, 15 patients received three and 13 patients received four times of injection, with a mean of 1.96 times per patient. The mean VAS scores were 6.5(ranged 3.5-9.5) before and 3.8(ranged 0-9.5) 6 months after the procedure. Pain relief was graded as excellent in 35 patients (44.3%), good in 26 patients(32.9%), fair in 10 patients(12.7%), and poor in 8

  11. Progressive paralyzing sciatica revealing a pelvic pseudoaneurysm a year after hip surgery in a 12yo boy.

    Science.gov (United States)

    Boulouis, Grégoire; Shotar, Eimad; Dangouloff-Ros, Volodia; Janklevicz, Pierre-Henri; Boddaert, Nathalie; Naggara, Olivier; Brunelle, Francis

    2016-01-01

    Identifying extra spinal causes of a lumbar radiculopathy or polyneuropathy can be a tricky diagnosis challenge, especially in children. Among them, traumatic or iatrogenic pseudoaneurysms of iliac arteries have been seldom reported, in adults' series. The authors report an unusual case of progressive paralyzing left sciatica and lumbar plexopathy in a 12 years old boy, 12 months after a pelvic osteotomy for bilateral hip luxation secondary to osteochondritis dissecans. Spine MRI and pelvic CT angiography revealed a giant internal iliac artery pseudoaneurysm, enclosed in a chronic hematoma. The patient was successfully treated with endovascular coil embolization, and subsequent surgical hematoma evacuation. However, three months after treatment, neurological recovery was incomplete. This case highlights the importance of a rapid and extensive diagnosis work up of all causes of lower limb radiculopathies in children, including pelvic arteries lesions especially after pelvic surgery to avoid therapeutic delays that may jeopardize the chances of neurological recovery. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  12. Pharmacokinetics and pharmacodynamics of multiple doses of BG00010, a neurotrophic factor with anti-hyperalgesic effects, in patients with sciatica.

    Science.gov (United States)

    Okkerse, Pieter; Hay, Justin L; Versage, Eve; Tang, Yongqiang; Galluppi, Gerald; Ravina, Bernard; Verma, Ajay; Williams, Leslie; Aycardi, Ernesto; Groeneveld, Geert Jan

    2016-07-01

    BG00010 is a protein in the glial cell line-derived neurotrophic factor (GDNF) family. It is a selective ligand for the GDNF family receptor alpha-3 (GFRα3) co-receptor that normalizes cellular changes resulting from damage or disease, and potentially alleviates neuropathic pain. The main objectives of this study were to evaluate the pharmacokinetic and safety profiles and to determine the effects on pain of ascending doses of intravenous injections of BG00010 in patients with sciatica. This was a randomized, blinded, placebo-controlled multiple-dose study in subjects with sciatica. In Part I (16 patients), four IV dose levels were examined (50, 150, 400, 800 μg kg(-1) ) and in Part II (12 patients), three dose levels were examined (400, 600 and 1200 μg kg(-1) ). Safety and efficacy assessments were used as endpoints. The BG00010 concentration-time data indicated relatively low inter-patient variability and there was a dose-dependent (not dose-proportional) increase in serum exposure from 150 to 1200 μg kg(-1) . The effective half-life was between 40 and 60 h. The most frequently occurring adverse events (AEs) reported by patients receiving BG00010 were headache (67-83%), feeling hot (50-100%), and pruritus (42-67%). Most AEs were mild; no serious AEs or AEs leading to discontinuation occurred. Higher dose regimens of BG00010 resulted in greater pain reduction than placebo or lower dose regimens, although a clear dose-response relationship was not seen. The pharmacokinetic profile of BG00010 was characterized by low intra-patient variability. These data from a small sample suggest that BG00010 may have a benefit for patients with sciatica. © 2016 The British Pharmacological Society.

  13. Prolonged conservative treatment or 'early' surgery in sciatica caused by a lumbar disc herniation: rationale and design of a randomized trial [ISRCT 26872154

    Science.gov (United States)

    Peul, Wilco C; van Houwelingen, Hans C; van der Hout, Wilbert B; Brand, Ronald; Eekhof, Just AH; Tans, Joseph ThJ; Thomeer, Ralph TWM; Koes, Bart W

    2005-01-01

    Background The design of a randomized multicenter trial is presented on the effectiveness of a prolonged conservative treatment strategy compared with surgery in patients with persisting intense sciatica (lumbosacral radicular syndrome). Methods/design Patients presenting themselves to their general practitioner with disabling sciatica lasting less than twelve weeks are referred to the neurology outpatient department of one of the participating hospitals. After confirmation of the diagnosis and surgical indication MRI scanning is performed. If a distinct disc herniation is discerned which in addition covers the clinically expected site the patient is eligible for randomization. Depending on the outcome of the randomization scheme the patient will either be submitted to prolonged conservative care or surgery. Surgery will be carried out according to the guidelines and between six and twelve weeks after onset of complaints. The experimental therapy consists of a prolonged conservative treatment under supervision of the general practitioner, which may be followed by surgical intervention in case of persisting or progressive disability. The main primary outcome measure is the disease specific disability of daily functioning. Other primary outcome measures are perceived recovery and intensity of legpain. Secondary outcome measures encompass severity of complaints, quality of life, medical consumption, absenteeism, costs and preference. The main research question will be answered at 12 months after randomization. The total follow-up period covers two years. Discussion Evidence is lacking concerning the optimal treatment of lumbar disc induced sciatica. This pragmatic randomized trial, focusses on the 'timing' of intervention, and will contribute to the decision of the general practictioner and neurologist, regarding referral of patients for surgery. PMID:15707491

  14. Assessment of Patient-Specific Surgery Effect Based on Weighted Estimation and Propensity Scoring in the Re-Analysis of the Sciatica Trial

    Science.gov (United States)

    Mertens, Bart J. A.; Jacobs, Wilco C. H.; Brand, Ronald; Peul, Wilco C.

    2014-01-01

    We consider a re-analysis of the wait-and-see (control) arm of a recent clinical trial on sciatica. While the original randomised trial was designed to evaluate the public policy effect of a conservative wait-and-see approach versus early surgery, we investigate the impact of surgery at the individual patient level in a re-analysis of the wait-and-see group data. Both marginal structural model re-weighted estimates as well as propensity score adjusted analyses are presented. Results indicate that patients with high propensity to receive surgery may have beneficial effects at 2 years from delayed disc surgery. PMID:25353633

  15. Assessment of patient-specific surgery effect based on weighted estimation and propensity scoring in the re-analysis of the sciatica trial.

    Directory of Open Access Journals (Sweden)

    Bart J A Mertens

    Full Text Available We consider a re-analysis of the wait-and-see (control arm of a recent clinical trial on sciatica. While the original randomised trial was designed to evaluate the public policy effect of a conservative wait-and-see approach versus early surgery, we investigate the impact of surgery at the individual patient level in a re-analysis of the wait-and-see group data. Both marginal structural model re-weighted estimates as well as propensity score adjusted analyses are presented. Results indicate that patients with high propensity to receive surgery may have beneficial effects at 2 years from delayed disc surgery.

  16. Risk factors for low back pain and sciatica in elderly men-the MrOS Sweden study.

    Science.gov (United States)

    Kherad, Mehrsa; Rosengren, Björn E; Hasserius, Ralph; Nilsson, Jan-Åke; Redlund-Johnell, Inga; Ohlsson, Claes; Mellström, Dan; Lorentzon, Mattiaz; Ljunggren, Östen; Karlsson, Magnus K

    2017-01-08

    The aim of this study was to identify whether factors beyond anatomical abnormalities are associated with low back pain (LBP) and LBP with sciatica (SCI) in older men. Mister Osteoporosis Sweden includes 3,014 men aged 69–81 years. They answered questionnaires on lifestyle and whether they had experienced LBP and SCI during the preceding 12 months. About 3,007 men answered the back pain (BP) questions, 258 reported BP without specified region. We identified 1,388 with no BP, 1,361 with any LBP (regardless of SCI), 1,074 of those with LBP also indicated if they had experienced LBP (n = 615), LBP+SCI (n = 459). About 49% of those with LBP and 54% of those with LBP+SCI rated their health as poor/very poor (P < 0.001). Men with any LBP to a greater extent than those without BP had poor self-estimated health, depressive symptoms, dizziness, fall tendency, serious comorbidity (diabetes, stroke, coronary heart disease, pulmonary disease and/or cancer) (all P < 0.001), foreign background, were smokers (all P < 0.01), had low physical activity and used walking aids (all P < 0.05). Men with LBP+SCI to a greater extent than those with LBP had lower education, lower self-estimated health, comorbidity, dizziness and used walking aids (all P < 0.001). In older men with LBP and SCI, anatomical abnormalities such as vertebral fractures, metastases, central or lateral spinal stenosis or degenerative conditions may only in part explain prevalent symptoms and disability. Social and lifestyle factors must also be evaluated since they are associated not only with unspecific LBP but also with LBP with SCI.

  17. Growth Factor and Laminin Effect with Muscular Fiber Sheath on Repairing of the Sciatica Nerve

    Directory of Open Access Journals (Sweden)

    S Torabi

    2014-01-01

    Background & aim: Peripheral nerve injuries which can lead to a physical disability. If the defect is very low, direct suture without tension on both ends of the cut nerve regeneration is considered as a standard procedure. Otherwise, to reconstruct the axons, the gap must be filled by graft material in order to the guidance. Due to the similarity of the matrix tubular skeletal muscle and nerve muscles graft was used to repair in this study. Methods: In the present experimental study, 42 female Wistar rats were divided into three groups and underwent surgery. In the first group a narrow strip of muscle was prepared by freezing – thawing, and later sutured between the distal and proximal sciatic nerve. In the second group, the gap caused by muscle graft was regenerated and the nerve growth factor and laminin was injected into the graft. In the control group, the two ends of the cut nerve were hidden beneath the adjacent muscles. Next, a group of rats with sciatic functional index was investigated for the behavioral. On the other group were examined for histological studies after two months. Results: Sciatic functional index and Mean counts of myelinated fibers in two graft groups compared with the control group was significant p<0.05. Statistical analysis was performed using ANOVA test. Conclusion: co-axially aligned muscle grafts were an appropriate alternative substitute for repairing. It seems that the nerve growth factor and laminin have a positive role in axonal regeneration and functional recovery acceleration. Key words: Sciatic Functional Index, muscle graft, NGF, Laminin

  18. A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI.

    Science.gov (United States)

    Verwoerd, Annemieke J H; Mens, Jan; El Barzouhi, Abdelilah; Peul, Wilco C; Koes, Bart W; Verhagen, Arianne P

    2016-05-01

    To test whether the localization of worsening of pain during coughing, sneezing and straining matters in the assessment of lumbosacral nerve root compression or disc herniation on MRI. Recently the diagnostic accuracy of history items to assess disc herniation or nerve root compression on magnetic resonance imaging (MRI) was investigated. A total of 395 adult patients with severe sciatica of 6-12 weeks duration were included in this study. The question regarding the influence of coughing, sneezing and straining on the intensity of pain could be answered on a 4 point scale: no worsening of pain, worsening of back pain, worsening of leg pain, worsening of back and leg pain. Diagnostic odds ratio's (DORs) were calculated for the various dichotomization options. The DOR changed into significant values when the answer option was more narrowed to worsening of leg pain. The highest DOR was observed for the answer option 'worsening of leg pain' with a DOR of 2.28 (95 % CI 1.28-4.04) for the presence of nerve root compression and a DOR of 2.50 (95 % CI 1.27-4.90) for the presence of a herniated disc on MRI. Worsening of leg pain during coughing, sneezing or straining has a significant diagnostic value for the presence of nerve root compression and disc herniation on MRI in patients with sciatica. This study also highlights the importance of the formulation of answer options in history taking.

  19. Ultra-som terapêutico contínuo térmico em modelo experimental de ciatalgia Continuous thermic therapeutic ultrasound in sciatica experimental model

    Directory of Open Access Journals (Sweden)

    Adriano Polican Ciena

    2009-06-01

    Full Text Available O ultra-som é um recurso fisioterapêutico que pode atuar na redução dos sintomas da ciatalgia. O objetivo deste estudo foi verificar a eficácia do ultra-som terapêutico, no modo contínuo, em duas diferentes densidades de potência (0,5 W/cm² e 1 W/cm², na redução do quadro álgico em ratos submetidos a modelo experimental de ciatalgia. Foram utilizados 20 ratos, divididos em 3 grupos: G1 (n=6 submetido à ciatalgia e a tratamento placebo; G2 (n=7 submetido à ciatalgia e tratado com ultra-som com 0,5 W/cm²; e G3 (n=7 submetido à ciatalgia e tratado com ultra-som com 1 W/cm². A ciatalgia foi provocada por lesão cirúrgica de compressão do nervo no membro posterior direito de todos os animais. O tratamento na região do procedimento cirúrgico, iniciado no 3º dia pós-operatório, consistiu em 10 sessões diárias de 5 minutos. Verificou-se a dor pelo do tempo de elevação da pata (TEP durante a marcha, medido pré-cirurgia e em mais cinco momentos. Os resultados mostram aumentos no TEP em todos os grupos após a lesão; e, naqueles tratados com ultra-som terapêutico, houve diminuição significativa da TEP, restaurando-se os valores iniciais, sendo mais precoce e intensa em G2. Conclui-se que a entrega na forma continua do ultra-som terapêutico foi eficaz na redução da dor ciática.Therapeutic ultrasound is a physical therapy resource for relieving sciatic pain. The aim of this study was to assess the effectiveness of continuous therapeutic ultrasound in two different power densities (0,5 W/cm² and 1 W/cm², on reducing pain in rats submitted to a sciatica experimental model. Twenty rats were used, divided into 3 groups: G1 (n=6 submitted to sciatica and placebo treatment; G2 (n=7 submitted to sciatica and treated with 0.5 W/cm² ultrasound; and G3 (n=7, submitted to sciatica and treated with 1 W/cm² ultrasound. Sciatica was provoked by surgical nerve compression on the right posterior limb of all animals. Treatment on the

  20. Tumor necrosis factor-α blockade in recurrent and disabling chronic sciatica associated with post-operative peridural lumbar fibrosis: results of a double-blind, placebo randomized controlled study.

    Science.gov (United States)

    Nguyen, Christelle; Palazzo, Clémence; Grabar, Sophie; Feydy, Antoine; Sanchez, Katherine; Zee, Nathalie; Quinquis, Laurent; Ben Boutieb, Myriam; Revel, Michel; Lefèvre-Colau, Marie-Martine; Poiraudeau, Serge; Rannou, François

    2015-11-19

    The aim of this study was to assess the efficacy and safety of tumor necrosis factor (TNF)-α inhibition with infliximab (IFX) in treating recurrent and disabling chronic sciatica pain associated with post-operative peridural lumbar fibrosis. A double-blind, placebo-controlled study randomized 35 patients presenting with sciatica pain associated with post-operative peridural lumbar fibrosis to two groups: IFX (n = 18), a single intravenous injection of 3 mg/kg IFX; and placebo (n = 17), a single saline serum injection. The primary outcome was a 50 % reduction in sciatica pain on a visual analog scale (VAS) at day 10. Secondary outcomes were radicular and lumbar VAS pain at day 0 and radicular and lumbar VAS pain, Québec disability score, drug-sparing effect and tolerance at days 10, 30, 90, and 180. At day 10, the placebo and IFX groups did not differ in the primary outcome (50 % reduction in sciatica pain observed in three (17.6 %) versus five (27.8 %) patients; p = 0.69). The number of patients reaching the patient acceptable symptom state for radicular pain was significantly higher in the placebo than IFX group after injection (12 (70.6 %) versus five (27.8 %) patients; p = 0.01). The two groups were comparable for all other secondary outcomes. Treatment with a single 3 mg/kg IFX injection for post-operative peridural lumbar fibrosis-associated sciatica pain does not significantly reduce radicular symptoms at day 10 after injection. ClinicalTrials.gov NCT00385086 ; registered 4 October 2006 (last updated 15 October 2015).

  1. Walkability Index

    Science.gov (United States)

    The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

  2. AP Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  3. Seeking Allergy Relief: When Breathing Becomes Bothersome

    Science.gov (United States)

    ... symptoms. But triggers aren’t always easy to identify. Notice when and where your symptoms occur. This can help you figure out the cause. “Most people with allergies are sensitive to more than one allergen,” Salo explains. “Grass, weed, and tree pollens are the most common causes of outdoor ...

  4. Bothersome lower urinary symptoms during pregnancy

    African Journals Online (AJOL)

    Administrator

    Results: Storage phase symptoms (nocturia, urgency, daytime frequency and painful bladder) were common ... (hesitancy, straining to pass urine and interrupted stream) were also found. ..... mixed sample and found that more white women.

  5. Most Important Factors for the Implementation of Shared Decision Making in Sciatica Care: Ranking among Professionals and Patients

    Science.gov (United States)

    Hofstede, Stefanie N.; van Bodegom-Vos, Leti; Wentink, Manon M.; Vleggeert-Lankamp, Carmen L. A.; Vliet Vlieland, Thea P. M.; de Mheen, Perla J. Marang-van

    2014-01-01

    Introduction Due to the increasing specialization of medical professionals, patients are treated by multiple disciplines. To ensure that delivered care is patient-centered, it is crucial that professionals and the patient together decide on treatment (shared decision making (SDM)). However, it is not known how SDM should be integrated in multidisciplinary practice. This study determines the most important factors for SDM implementation in sciatica care, as it is known that a prior inventory of factors is crucial to develop a successful implementation strategy. Methods 246 professionals (general practitioners, physical therapists, neurologists, neurosurgeons, orthopedic surgeons) (30% response) and 155 patients (96% response) responded to an internet-based survey. Respondents ranked barriers and facilitators identified in previous interviews, on their importance using Maximum Difference Scaling. Feeding back the personal top 5 most important factors, each respondent indicated whether these factors were barriers or facilitators. Hierarchical Bayes estimation was used to estimate the relative importance (RI) of each factor. Results Professionals assigned the highest importance to: quality of professional-patient relationship (RI 4.87; CI 4.75–4.99); importance of quick recovery of patient (RI 4.83; CI 4.69–4.97); and knowledge about treatment options (RI 6.64; CI 4.53–4.74), which were reported as barrier and facilitator. Professionals working in primary care had a different ranking than those working in hospital care. Patients assigned the highest importance to: correct diagnosis by professionals (barrier, RI 8.19; CI 7.99–8.38); information provision about treatment options and potential harm and benefits (RI 7.87; CI 7.65–8.08); and explanation of the professional about the care trajectory (RI 7.16; CI 6.94–7.38), which were reported as barrier and facilitator. Conclusions Knowledge, information provision and a good relationship are the most important

  6. Clinical significance of tumor necrosis factor-α inhibitors in the treatment of sciatica: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Yun Fu; Chen, Ping You; Chang, Wei; Zhu, Fi Qi; Xu, Li Li; Wang, Song Lin; Chang, Li Ying; Luo, Jie; Liu, Guang Jian

    2014-01-01

    Currently, no satisfactory treatment is available for sciatica caused by herniated discs and/or spinal stenosis. The objective of this study is to assess the value of tumor necrosis factor (TNF)-α inhibitors in the treatment of sciatica. Without language restrictions, we searched PubMed, OVID, EMBASE, the Web of Science, the Clinical Trials Registers, the Cochrane Central Register of Controlled Trials and the China Academic Library and Information System. We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria. Nine prospective randomized controlled trials (RCTs) and two before-after controlled trials involving 531 patients met our inclusion criteria and were included in this study. Our systematic assessment and meta-analysis demonstrated that in terms of the natural course of the disease, compared with the control condition, TNF-α inhibitors neither significantly relieved lower back and leg pain (both p > 0.05) nor enhanced the proportion of patients who felt overall satisfaction (global perceived effect (satisfaction)) or were able to return to work (return to work) (combined endpoint; p > 0.05) at the short-term, medium-term and long-term follow-ups. In addition, compared with the control condition, TNF-α inhibitors could reduce the risk ratio (RR) of discectomy or radicular block (combined endpoint; RR = 0.51, 95% CI 0.26 to 1.00, p = 0.049) at medium-term follow-up, but did not decrease RR at the short-term (RR = 0.64, 95% CI 0.17 to 2.40, p = 0.508) and long-term follow-ups (RR = 0.64, 95% CI 0.40 to 1.03, p = 0.065). The currently available evidence demonstrated that other than reducing the RR of discectomy or radicular block (combined endpoint) at medium-term follow-up, TNF-α inhibitors showed limited clinical value in the treatment of sciatica caused by herniated discs and/or spinal stenosis.

  7. Clinical significance of tumor necrosis factor-α inhibitors in the treatment of sciatica: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yun Fu Wang

    Full Text Available Currently, no satisfactory treatment is available for sciatica caused by herniated discs and/or spinal stenosis. The objective of this study is to assess the value of tumor necrosis factor (TNF-α inhibitors in the treatment of sciatica.Without language restrictions, we searched PubMed, OVID, EMBASE, the Web of Science, the Clinical Trials Registers, the Cochrane Central Register of Controlled Trials and the China Academic Library and Information System. We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria.Nine prospective randomized controlled trials (RCTs and two before-after controlled trials involving 531 patients met our inclusion criteria and were included in this study. Our systematic assessment and meta-analysis demonstrated that in terms of the natural course of the disease, compared with the control condition, TNF-α inhibitors neither significantly relieved lower back and leg pain (both p > 0.05 nor enhanced the proportion of patients who felt overall satisfaction (global perceived effect (satisfaction or were able to return to work (return to work (combined endpoint; p > 0.05 at the short-term, medium-term and long-term follow-ups. In addition, compared with the control condition, TNF-α inhibitors could reduce the risk ratio (RR of discectomy or radicular block (combined endpoint; RR = 0.51, 95% CI 0.26 to 1.00, p = 0.049 at medium-term follow-up, but did not decrease RR at the short-term (RR = 0.64, 95% CI 0.17 to 2.40, p = 0.508 and long-term follow-ups (RR = 0.64, 95% CI 0.40 to 1.03, p = 0.065.The currently available evidence demonstrated that other than reducing the RR of discectomy or radicular block (combined endpoint at medium-term follow-up, TNF-α inhibitors showed limited clinical value in the treatment of sciatica caused by herniated discs and/or spinal stenosis.

  8. AA Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa index provides a long climatology of global geomagnetic activity using 2 antipodal observatories at Greenwich and Melbourne- IAGA Bulletin 37,...

  9. Walkability Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  10. Diversity Index

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This map service summarizes racial and ethnic diversity in the United States in 2012.The Diversity Index shows the likelihood that two persons chosen at random from...

  11. AUTHOR INDEX

    Indian Academy of Sciences (India)

    a granitic terrain of southern India using factor analysis and GIS. 1059. Radhakrishna M see Dev Sheena V .... Landslide susceptibility analysis using Probabilistic. Certainty Factor ... index via entropy-difference analysis. 687. Yidana Sandow ...

  12. Intelligent indexing

    International Nuclear Information System (INIS)

    Farkas, J.

    1992-01-01

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space ι 2 to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs

  13. Intelligent indexing

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J

    1993-12-31

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space {iota}{sup 2} to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs.

  14. Pathomechanisms of sciatica in lumbar disc herniation: effect of periradicular adhesive tissue on electrophysiological values by an intraoperative straight leg raising test.

    Science.gov (United States)

    Kobayashi, Shigeru; Takeno, Kenichi; Yayama, Takafumi; Awara, Kousuke; Miyazaki, Tsuyoshi; Guerrero, Alexander; Baba, Hisatoshi

    2010-10-15

    This study is aimed to investigate the changes of nerve root functions during the straight leg raising (SLR) test in vivo. To investigate the relationship between nerve root movement and the electrophysiological values during an intraoperative SLR test. The SLR test is one of the most significant signs for making a clinical diagnosis of lumbar disc herniation. A recent study showed that intraradicular blood flow apparently decreased during the SLR test in patients with disc herniation. The study included 32 patients who underwent microdiscectomy. During the surgery, the nerve root motion affected by the hernia was observed during the SLR test. The patients' legs were allowed to hang down to the angle at which sciatica had occurred and the change of nerve root action potentials was measured. After removal of the hernia, a similar procedure was repeated. The periradicular specimens collected during surgery were examined by light and electron microscope. In all patients intraoperative microscopy revealed that the hernia was adherent to the dura mater of the nerve roots. During the SLR test, the limitation of nerve root movement occurred by periradicular adhesive tissue and amplitude of action potential showed a sharp decrease at the angle that produced sciatica. After removal of the hernia, all the patients showed smooth gliding of the nerve roots during the test, and there was no marked decrease of amplitude. Our data suggest that temporary ischemic changes in the nerve root cause transient conduction disturbances. Pathologic examination showed that the periradicular tissue consisted of the granulation with vascularization and many inflammatory cell infiltrations. The presence of periradicular fibrosis will compound the nerve root pain by fixing the nerve in one position, thereby increasing the susceptibility of the nerve root to tension or compression.

  15. Virginia ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  16. Indexing mechanisms

    International Nuclear Information System (INIS)

    Wood, A.G.; Parker, G.E.; Berry, R.

    1976-01-01

    It is stated that the indexing mechanism described can be used in a nuclear reactor fuel element inspection rig. It comprises a tubular body adapted to house a canister containing a number of fuel elements located longtitudinally, and has two chucks spaced apart for displacing the fuel elements longitudinally in a stepwise manner, together with a plunger mechanism for displacing them successively into the chucks. A measuring unit is located between the chucks for measuring the diameter of the fuel elements at intervals about their circumferences, and a secondary indexing mechanism is provided for rotating the measuring unit in a stepwise manner. (U.K.)

  17. Author Index

    Indian Academy of Sciences (India)

    user1

    Astr. (2012) 33, 419–420. Author Index. 419. AGGARWAL SUNNY. Photoionization Cross-Section of Chlorine-like Iron, 291. AMBASTHA ASHOK see Das, A. C., 1. ARAKIDA HIDEYOSHI. Effect of Inhomogeneity of the Universe on a Gravitationally. Bound Local System: A No-Go Result for Explaining the Secular Increase in.

  18. AUTHOR INDEX

    Indian Academy of Sciences (India)

    automorphic solutions to fractional order abstract integro-differential equations. 323. Afrouzi G A see Ala Samira ... 521. Agarwal Praveen. Certain fractional integral operators and the generalized multi-index Mittag- ... of positive solutions for sys- tems of second order multi-point bound- ary value problems on time scales 353.

  19. Afghanistan Index

    DEFF Research Database (Denmark)

    Linnet, Poul Martin

    2007-01-01

    basis. The data are divided into different indicators such as security, polls, drug, social, economic, refugees etc. This represents a practical division and does not indicate that a picture as to for instance security can be obtained by solely looking at the data under security. In order to obtain...... a more valid picture on security this must incorporate an integrated look on all data meaning that for instance the economic data provides an element as to the whole picture of security.......The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...

  20. Uso do laser, 670 nm, no quadro álgico de ratos submetidos à modelo experimental de ciatalgia Use of laser, 670 nm, in painful episodes of rats submitted to experimental model of sciatica

    Directory of Open Access Journals (Sweden)

    Núbia Broetto Cunha

    2008-04-01

    Full Text Available A ciatalgia deve-se a compressão do nervo isquiático em algum ponto de seu trajeto, e seu tratamento consiste em solucionar a causa da compressão nervosa, seja por tratamento cirúrgico ou conservador. Alguns recursos fisioterapêuticos atuam basicamente na redução dos sintomas ocasionados por este distúrbio. O objetivo deste estudo foi verificar a eficácia do laser 670 nm, em duas diferentes densidades de energia, na redução do quadro álgico, em ratos submetidos a modelo experimental de ciatalgia. Foram utilizados 18 ratos, divididos em 3 grupos: G1 (n=6 submetidos à ciatalgia e simulado o tratamento (grupo placebo, G2 (n=6 submetido à ciatalgia e tratados com laser 2 J/cm², G3 (n=6 submetidos à ciatalgia e irradiados com laser 4 J/cm². O nervo isquiático do membro posterior direito dos animais foi exposto e compressão com fio catgut em 4 pontos ao redor do nervo foi realizada. No 3° dia pós-operatório, iniciou-se o tratamento com laser na região do procedimento cirúrgico do membro posterior direito durante 10 dias consecutivos. Verificou-se por meio da marcha, o tempo em que o membro permanecia no ar nos períodos: anterior à ciatalgia, pré e pós-tratamento. Os resultados demonstraram que o laser não foi eficaz na redução do quadro álgico, porém com 4 J/cm² houve efeito positivo, sem restabelecimento completo da funcionalidade.Sciatica is caused by the sciatic nerve compression in some point of its course, and its treatment consists of solving the nervous compression cause, either by surgical or conservative treatment. Some physiotherapeutic resources act basically in the reduction of the symptoms caused by this disturbance. The aim of this study was to verify the effectiveness of the laser 670 nm, in two different energy densities, in the pain reduction, in rats submitted to a sciatica experimental model. Eighteen rats, divided in 3 groups were used: G1 (n=6 submitted to sciatica and simulated treatment (placebo

  1. Magnetic resonance imaging in low back pain and sciatica with special emphasis on the postdiskectomy period. A study using 0.2 and 0.3 T vertical magnetic fields

    Energy Technology Data Exchange (ETDEWEB)

    Annertz, M.

    1994-09-01

    The diagnostic capability of magnetic resonance (MR) imaging at 0.3 T was evaluated and compared with other modalities in patients with previous disk surgery and remaining or recurrent sciatica, and in patients with spondylolisthesis and sciatica. In the early postoperative period after successful lumbar diskectomy, MR showed a large amount of abnormal soft tissue in the anterior epidural space, without correlation with clinical symptoms. In the late postoperative period, contrast-enhanced MR provided the best correlation with surgical findings, compared with CT and myelography, in discriminating recurrent/remaining disk herniation from epidural fibrosis in patients with the lumbar postdiskectomy syndrome. Contrast-enhanced MR could not demonstrate any differences regarding presence and extent of epidural fibrosis between symptomatic and asymptomatic patients. In spondylolisthesis, MR gave excellent information about the root canals and the degree of nerve root stretching and compression, which was not possible to evaluate with myelography. MR at 0.3 T provided information comparable to that reported from examinations performed with superconducting MR scanners, and is well suited as the imaging modality in the evaluation of lumbar spine disorders. After introducing MR at 0.2 and 0.3 T with vertical magnetic fields as the first neuroradiological modality, instead of myelography or CT, in the evaluation of the soft tissues of the lumbar spine in patients with low back pain and sciatica, a significant increase in the number of patients examined, a moderate increase in the total cost of investigations, and a significant decrease in the cost per investigated and per operated patient was noted.

  2. The Effect of 8 weeks of combined training on the angle of lumbar lordosis and pain of women suffering from sciatica pain

    Directory of Open Access Journals (Sweden)

    Behnaz Karimi

    2016-11-01

    Full Text Available Chronic low back pain is among the most commonly pains caused by malfunctions, poor physical condition, and mental stresses. Various non-surgical methods are recommended to reduce pain, to maintain mobility, and to minimize disability in patients. The main objective of this study was to determine the impact of 8 weeks of combined exercises on lumbar lordosis angle, pain, and quality of life of females suffering from sciatic pain. In this study, 15 female patients participated aged between 30 and 50 years with low back pain, sciatic pain, and lumbar lordosis. Lumbar lordosis angle (flexible ruler and pain (McGill questionnaire of patients before and after 8 weeks of exercise were evaluated. Data were analyzed using t-test (P<0.05. In this study, no significant difference was found in lumbar lordosis angle of sciatica patients before (± 0.1 43.2 and after the exercises (0.8 ± 34.2 (p<0.05.Significant difference was observed in pain perceptions between the before (0.8 ± 2.6 and after exercises (0.5 ± 1.8, emotional perceptions of pain between before (0.26 ± 1.4 and after exercises (0.3 ± 1.9 and various pain perceptions between before (0.6 ± 2.2 and after exercises (0.2 ± 1.5 (P<0.05. It can be concluded that hydrotherapy exercises along with on land exercises can improve lumbar lordosis and pain in patients with sciatic pain. Therefore, it can be recommended as a modality for these patients.

  3. EJSCREEN Indexes 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The EJ Index names are:...

  4. EJSCREEN Indexes 2016 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eleven EJ Indexes in EJSCREEN reflecting the 11 environmental indicators. The EJ Index names are:...

  5. Does the duration of symptoms influence outcome in patients with sciatica undergoing micro-discectomy and decompressions?

    Science.gov (United States)

    Pitsika, Marina; Thomas, Eleanor; Shaheen, Sabeena; Sharma, Himanshu

    2016-04-01

    Early surgical treatment for back and leg pain secondary to disc herniation has been associated with very good outcomes. However, there are conflicting data on the role of surgical treatment in case of prolonged radicular symptomatology. We aimed to evaluate whether the duration of symptoms at presentation affects the subjective outcome. This is a retrospective review of prospectively collected data from a single surgeon including micro-discectomies and lateral recess decompressions in patients younger than 60 years old using patient medical notes, radiology imaging, operation notes, and Patient Reported Outcome Measures (PROMS) including Oswestry Disability Index (ODI), visual analogue scale for back pain and leg pain (VAS-BP and VAS-LP). The final follow-up was carried out through postal questionnaire or telephone consultation. Demographic information, duration of symptoms, type and incidence of complications, length of hospital stay, and follow-up were analyzed. Data were categorized into four subgroups: symptoms 0≥6 months, 6 months≥1 year, 1 year≥2 years, and >2 years. A clinically significant result was an average improvement of 2 or more points in the VAS and of 20% and over in the ODI. The level of statistical significance was 2 years (VAS-LP 4.77±3.61, VAS-BP 3.54±3.43, ODI 28.36±20.93). The length of hospital stay and complication rate was comparable between groups. Average follow-up was 15.69 months. Our study showed significant improvement in patients with symptoms beyond 1 as well as 2 years since onset, and surgery is a viable option in selected patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: a prospective randomised controlled trial [NTR1300].

    Science.gov (United States)

    Arts, Mark P; Verstegen, Marco J T; Brand, Ronald; Koes, Bart W; van den Akker, M Elske; Peul, Wilco C

    2008-09-28

    Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. All patients (age between 18 and 70 years) with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best surgical treatment of symptomatic patients with low

  7. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    Directory of Open Access Journals (Sweden)

    Brand Ronald

    2008-09-01

    Full Text Available Abstract Background Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. Methods/design All patients (age between 18 and 70 years with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Discussion Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best

  8. How indexes have changed

    International Nuclear Information System (INIS)

    Farrar, G.L.

    1993-01-01

    The accompanying table compares refinery construction and operating wages monthly for the years 1990 and 1991. The Nelson-Farrar refinery construction cost indexes are inflation indexes, while the operating indexes incorporate a productivity which shows improvement with experience and the increasing size of operations. The refinery construction wage indexes in the table show a steady advance over the 2-year period. Common labor indexes moved up faster than skilled indexes. Refinery operating wages showed a steady increase, while productivities averaged higher near the end of the period. Net result is that labor costs remained steady for the period

  9. Western Alaska ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  10. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  11. Human Use Index (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  12. Human Use Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  13. IndexCat

    Data.gov (United States)

    U.S. Department of Health & Human Services — IndexCat provides access to the digitized version of the printed Index-Catalogue of the Library of the Surgeon General's Office; eTK for medieval Latin texts; and...

  14. Body Mass Index Table

    Science.gov (United States)

    ... Families ( We Can! ) Health Professional Resources Body Mass Index Table 1 for BMI greater than 35, go ... Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute of Health Department of ...

  15. Content validity of the Benign Prostatic Hyperplasia Impact Index (BII); a measure of how urinary trouble and problems associated with BPH may impact the patient.

    Science.gov (United States)

    Kingery, L; Martin, M L; Naegeli, A N; Khan, S; Viktrup, L

    2012-09-01

    The objective of this qualitative interview study was to assess the content validity of the Benign Prostatic Hyperplasia Impact Index (BII) in a sample of men with signs and symptoms of Benign Prostatic Obstruction believed to be caused by benign prostatic hyperplasia (BPH lower urinary tract symptoms/BPH-LUTS) using concept elicitation (CE) and cognitive interviewing (CI) methods. Fifty men with BPH-LUTS participated in the study; 27 completed CE interviews and 23 completed cognitive interviews. Patient's average age was 69 years with a mean duration of BPH-LUTS of 6.5 years. IPSS scores ranged from 8 to 33 (higher scores indicating greater symptom severity). Overall, the most frequent symptoms (prevalence of ≥ 75%) reported spontaneously or after further explanation were awakening from sleep, increased daytime voiding (frequency), urgent desire to void (urgency), slow stream, and feeling of incomplete bladder emptying. Symptoms primarily recognized in response to follow up probe questions with a prevalence of ≥ 40% included terminal dribble, splitting of urinary stream, intermittent stream, straining and post-micturition dribble. Especially bothersome [> 5 on the numerical rating scale (NRS) of 0-10] and frequent symptoms included urgency and awakening at night to void. Discomfort or pain while urinating and post-micturition dribble were equally bothersome though less frequent. Five BPH symptom-related impact themes were identified: coping, daily responsibilities, emotion, lifestyle and relationships, and sleep. The BII was found to be easily understood, does capture clinically relevant BPH impacts related to urinary trouble and problems, and does capture most of the important symptom-related impacts as described by participants in this study. © 2012 Blackwell Publishing Ltd.

  16. Timing of surgery for sciatica

    NARCIS (Netherlands)

    Peul, Wilco C.

    2008-01-01

    The frequently diagnosed lumbar disc herniation can disappear by natural course, but still leads to high low back surgery rates. The optimal period of conservative care, before surgery is executed, was unknown. It is surprising that scientific evidence was lacking which justified “early” surgery.

  17. Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models.

    Science.gov (United States)

    Wasson, John H; Ho, Lynn; Soloway, Laura; Moore, L Gordon

    2018-01-01

    Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models. Five measures with well-documented impacts on the use of health services are summed to create a "What Matters Index." These measures are: 1) insufficient confidence to self-manage health problems, 2) pain, 3) bothersome emotions, 4) polypharmacy, and 5) adverse medication effects. We compare the sensitivity and predictive values of this index with two representative risk models in a population of 8619 Medicaid recipients. The patient-reported "What Matters Index" and the conventional risk models are found to exhibit similar sensitivities and predictive values for subsequent hospital or emergency room use. The "What Matters Index" is also reliable: akin to its performance during development, for patients with index scores of 1, 2, and ≥3, the odds ratios (with 95% confidence intervals) for subsequent hospitalization within 1 year, relative to patients with a score of 0, are 1.3 (1.1-1.6), 2.0 (1.6-2.4), and 3.4 (2.9-4.0), respectively; for emergency room use, the corresponding odds ratios are 1.3 (1.1-1.4), 1.9 (1.6-2.1), and 2.9 (2.6-3.3). Similar findings were replicated among smaller populations of 1061 mostly older patients from nine private practices and 4428 Medicaid patients without chronic conditions. In contrast to complex computer-generated risk models, the brief patient-reported "What Matters Index" immediately and unambiguously identifies fundamental, remediable needs for each patient and more sensibly directs the delivery of services to patient categories based on

  18. Supplement: Commodity Index Report

    Data.gov (United States)

    Commodity Futures Trading Commission — Shows index traders in selected agricultural markets. These traders are drawn from the noncommercial and commercial categories. The noncommercial category includes...

  19. Indexing mergers and acquisitions

    OpenAIRE

    Gang, Jianhua; Guo, Jie (Michael); Hu, Nan; Li, Xi

    2017-01-01

    We measure the efficiency of mergers and acquisitions by putting forward an index (the ‘M&A Index’) based on stochastic frontier analysis. The M&A Index is calculated for each takeover deal and is standardized between 0 and 1. An acquisition with a higher index encompasses higher efficiency. We find that takeover bids with higher M&A Indices are more likely to succeed. Moreover, the M&A Index shows a strong and positive relation with the acquirers’ post-acquisition stock perfo...

  20. Analysis in indexing

    DEFF Research Database (Denmark)

    Mai, Jens Erik

    2005-01-01

    is presented as an alternative and the paper discusses how this approach includes a broader range of analyses and how it requires a new set of actions from using this approach; analysis of the domain, users and indexers. The paper concludes that the two-step procedure to indexing is insufficient to explain...

  1. Rethinking image indexing?

    DEFF Research Database (Denmark)

    Christensen, Hans Dam

    2017-01-01

    Hans Dam Christensen, ”Rethinking image indexing?”, in: Journal of the Association for Information Science and Technology, vol. 68, no. 7, 2017, 1782-1785......Hans Dam Christensen, ”Rethinking image indexing?”, in: Journal of the Association for Information Science and Technology, vol. 68, no. 7, 2017, 1782-1785...

  2. GRI Index 2017

    OpenAIRE

    World Bank

    2017-01-01

    This World Bank GRI Index 2017 provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting, the GRI Standards: Core option (https://www.globalreporting.org). T...

  3. 2016 GRI Index

    OpenAIRE

    World Bank

    2016-01-01

    This 2016 World Bank Global Reporting Initiative (GRI) Index provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting GRI guidelines (https://www.globalrepo...

  4. Global Ecosystem Restoration Index

    DEFF Research Database (Denmark)

    Fernandez, Miguel; Garcia, Monica; Fernandez, Nestor

    2015-01-01

    The Global ecosystem restoration index (GERI) is a composite index that integrates structural and functional aspects of the ecosystem restoration process. These elements are evaluated through a window that looks into a baseline for degraded ecosystems with the objective to assess restoration...

  5. EJSCREEN Supplementary Indexes 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There are 40 supplementary EJSCREEN indexes that are divided into 5 categories: EJ Index with supplementary demographic index, Supplementary EJ Index 1 with...

  6. First-In-Human, Double-Blind, Placebo-Controlled, Randomized, Dose-Escalation Study of BG00010, a Glial Cell Line-Derived Neurotrophic Factor Family Member, in Subjects with Unilateral Sciatica.

    Science.gov (United States)

    Rolan, Paul E; O'Neill, Gilmore; Versage, Eve; Rana, Jitesh; Tang, Yongqiang; Galluppi, Gerald; Aycardi, Ernesto

    2015-01-01

    To evaluate the safety, tolerability, and pharmacokinetics of single doses of BG00010 (neublastin, artemin, enovin) in subjects with unilateral sciatica. This was a single-center, blinded, placebo-controlled, randomized Phase 1 sequential-cohort, dose-escalation study (ClinicalTrials.gov identifier NCT00961766; funded by Biogen Idec). Adults with unilateral sciatica were enrolled at The Royal Adelaide Hospital, Australia. Four subjects were assigned to each of eleven cohorts (intravenous BG00010 0.3, 1, 3, 10, 25, 50, 100, 200, 400, or 800 μg/kg, or subcutaneous BG00010 50 μg/kg) and were randomized 3:1 to receive a single dose of BG00010 or placebo. The primary safety and tolerability assessments were: adverse events; clinical laboratory parameters and vital signs; pain as measured by a Likert rating scale; intra-epidermal nerve fiber density; and longitudinal assessment of quantitative sensory test parameters. Blood, serum, and plasma samples were collected for pharmacokinetic and pharmacodynamic assessments. Subjects were blinded to treatment assignment throughout the study. The investigator was blinded to treatment assignment until the Data Safety Review Committee review of unblinded data, which occurred after day 28. Beyond the planned enrollment of 44 subjects, four additional subjects were enrolled into to the intravenous BG00010 200 μg/kg cohort after one original subject experienced mild generalized pruritus. Therefore, a total of 48 subjects were enrolled between August 2009 and December 2011; all were included in the safety analyses. BG00010 was generally well tolerated: in primary analyses, the most common treatment-emergent adverse events were changes in temperature perception, pruritus, rash, or headache; no trends were observed in clinical laboratory parameters, vital signs, intra-epidermal nerve fiber density, or quantitative sensory testing. BG00010 was not associated with any clear, dose-dependent trends in Likert pain scores. BG00010 was

  7. A new supersymmetric index

    International Nuclear Information System (INIS)

    Cecotti, S.; Fendley, P.; Intriligator, K.; Vafa, C.

    1992-01-01

    We show that Tr(-1) F F e -βH is an index for N = 2 supersymmetric theories in two dimensions, in the sense that it is independent of almost all deformations of the theory. This index is related to the geometry of the vacua (Berry's curvature) and satisfies an exact differential equation as a function of β. For integrable theories we can also compute the index thermodynamically, using the exact S-matrix. The equivalence of these two results implies a highly non-trivial equivalence of a set of coupled integral equations with these differential equations, among them Painleve III and the affine Toda equations. (orig.)

  8. Indexes to Volume 75

    Indian Academy of Sciences (India)

    SUBJECT INDEX. Mathematical .... A 10-Hz terawatt class Ti:sapphire laser system: Development and ... Indigenous development of a 2 kW RF-excited fast axial flow CO2 .... Polarized spectral features of human breast tissues through wavelet.

  9. Glycemic index and diabetes

    Science.gov (United States)

    ... Most snack foods Potatoes White rice Watermelon Meal Planning with the Glycemic Index When planning your meals: ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  10. TOMS Absorbing Aerosol Index

    Data.gov (United States)

    Washington University St Louis — TOMS_AI_G is an aerosol related dataset derived from the Total Ozone Monitoring Satellite (TOMS) Sensor. The TOMS aerosol index arises from absorbing aerosols such...

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 1034 ... Vol 49, No 2 (2007), African Index Medicus: Improving access to African ... insulin therapy initiation among patients with type 2 diabetes attending a ... Risk Factors Implicated in Diabetic Ketoacidosis (DKA), Abstract PDF.

  12. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 194 ... Journal Home > Advanced Search > Browse Title Index ... Vol 14, No 1 (2000), A functional categoriality of adjectives in ... Vol 1, No 1 (1987), Alienation and affirmation: The humanistic vision of Bessie Head, Abstract PDF.

  13. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 879 ... South African Journal of Higher Education. ... Browse Title Index ... in a USA school setting: Merging transition theory with a narrative approach, Abstract ... Citation analysis of theses and dissertations submitted at the ...

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 601 - 650 of 879 ... South African Journal of Higher Education. ... Browse Title Index .... The challenge of thesis supervision in an art university, Abstract ... No 2 (2004), Robert Sternberg's mental self-government theory and its contribution to ...

  15. Palmer Drought Severity Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — PDSI from the Dai dataset. The Palmer Drought Severity Index (PDSI) is devised by Palmer (1965) to represent the severity of dry and wet spells over the U.S. based...

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 346 ... Journal Home > Advanced Search > Browse Title Index ... and hygiene promotion services in Rungwe district, Tanzania, Abstract .... as seen in NIgerian teaching hospital: pattern and a simple classification, Abstract.

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 437 ... Journal Home > Advanced Search > Browse Title Index ... prospects and realistic strategies to its implementation in Nigeria\\'s Institute of ... and Communication Technology (ICT) in information dissemination, Abstract.

  18. Browse Title Index

    African Journals Online (AJOL)

    Items 901 - 950 of 1355 ... Journal of Applied Sciences and Environmental Management. ... Journal Home > Advanced Search > Browse Title Index .... Vol 22, No 2 (2018), Performance evaluation of a locally fabricated sawdust fired oven for ...

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 301 - 350 of 788 ... Journal Home > Advanced Search > Browse Title Index ... Vol 26, No 1 (2018), Gender differentials in the perception of .... Vol 25, No 1 (2017), Impact of total quality management on students' academic performance in ...

  20. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 465 ... Journal Home > Advanced Search > Browse Title Index ... and twinning data of an igbo kindred during the Nigerian Civil War, Abstract ... on laboratory estimations with special reference to clinical chemistry, Abstract.

  1. National Death Index

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Death Index (NDI) is a centralized database of death record information on file in state vital statistics offices. Working with these state offices, the...

  2. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 300 of 1260 ... Journal Home > Advanced Search > Browse Title Index ... Consumption of ammonia-nitrogen by aob in immobilized batch culture, Abstract PDF .... Vol 9, No 3S (2017): Special Issue, Design an automatic temperature ...

  3. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 294 ... Journal Home > Advanced Search > Browse Title Index. Log in or .... S Edwards, M Hlongwane, J Thwala, N Robinson ... Vol 16, No 1 (2017), Infancy of internet cafe: The substitute of ubuntu-padare pedagogy, Abstract.

  4. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 130 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... using the technological pedagogical content knowledge(TPACK) framework, Abstract PDF ... Tamara N. Hrin, Dušica D. Milenković, Mirjana D. Segedinac.

  5. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 278 ... Journal Home > Advanced Search > Browse Title Index ... drie paradigmas beskou: 'n eenheid, of 'n veelheid van perspektiewe? ... Vol 45, No 1 (2011), Genre pedagogy in the mediation of socially-situated literacies ...

  6. Browse Title Index

    African Journals Online (AJOL)

    Items 551 - 600 of 879 ... Journal Home > Advanced Search > Browse Title Index ... A James, E Ralfe, L van Laren, N Ngcobo ... 1 (2011), Recognition of prior learning in promoting lifelong learning: A pedagogy of hope or a shattering of dreams?

  7. Browse Title Index

    African Journals Online (AJOL)

    Items 451 - 500 of 533 ... Journal Home > Advanced Search > Browse Title Index .... for past tense forms in Northern Sotho: verb stems with final 'm' and 'n', Abstract ... in an academic writing class: Implications for a dialogic pedagogy, Abstract.

  8. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 183 ... Journal Home > Advanced Search > Browse Title Index ... Vol 61 (2017), New interventions and sustainable solutions: .... Vol 35 (2011), Resurgence of tribal levies: Double taxation for the rural poor, Abstract PDF.

  9. Regional Snowfall Index (RSI)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA's National Climatic Data Center is now producing the Regional Snowfall Index (RSI) for significant snowstorms that impact the eastern two thirds of the U.S. The...

  10. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 736 ... Journal Home > Advanced Search > Browse Title Index ... Vol 5 (2008), A Contagious Malady: The Human Quest for Truth through Religion, Abstract ... A Study of Politeness Strategies Used by the National University of ...

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 414 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... of an algebraic function for the permutation of truth table columns, Abstract ... appraisal and productivity levels in selected Nigerian universities, Abstract.

  12. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 879 ... Journal Home > Advanced Search > Browse Title Index ... Vol 20, No 4 (2006), Assessing academic potential for university admission: ... Vol 16, No 2 (2002), Book Review: Rethinking truth by Higgs, P & Smith, J, Details.

  13. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 165 ... Journal Home > Advanced Search > Browse Title Index ... Vol 43 (2011), Assessment of the Learning Commons takeoff at the University of ... the archive of South Africa's Truth and Reconciliation Commission, Abstract.

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 644 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... Ethics review n international health research: quality assurance or bureaucratic nightmare? Details ... Audit of Management of Open Fractures, Details PDF.

  15. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 449 ... Vol 1, No 3 (2012), Adult Functional Literacy Curriculum: Effective Strategy for Human ... and Exchange Rate Influence on the Nigerian Stock Market Index ... for the Stimulation and Attraction of Foreign Direct Investments ...

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 98 ... Journal Home > Advanced Search > Browse Title Index ... model for the continued professionalisation of student affairs in Africa, Abstract PDF ... Vol 2, No 2 (2014), Book Review: How College Affects Students, A Third decade ...

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 76 ... Journal Home > Advanced Search > Browse Title Index ... Vol 4, No 1 (2011), Automation of AutoCAD for Detailing of Reinforced .... Vol 10, No 1 (2017), Housing data base for sustainable housing provision, Abstract PDF.

  18. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 147 ... Journal Home > Advanced Search > Browse Title Index .... Library (TEEAL) Database among faculty members in Federal University, ... Vol 5, No 2 (2014), Effects of corporate culture on the implementation of automation in ...

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 851 - 900 of 1255 ... Vol 16, No 4 (2010), Origin and generation mechanisms of ... Vol 13, No 4 (2007), Osmotic fragility index of HBAA red blood cells in the presence of ... (2004), Photovoltaic cells, efficiency and optimization, Abstract PDF.

  20. Browse Title Index

    African Journals Online (AJOL)

    Items 401 - 450 of 985 ... Vol 17 (2010), Flood Frequency Analysis of Ikpoba River ... and the corresponding Refractive Index in Uniaxial Crystals, Abstract ... Vol 8 (2004), Further on stokes expansions for the finite amplitude water waves, Abstract.

  1. Transportation Services Index

    Data.gov (United States)

    Department of Transportation — The TSI is a monthly measure of the volume of services performed by the for-hire transportation sector. The index covers the activities of for-hire freight carriers,...

  2. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 250 of 531 ... Journal Home > Advanced Search > Browse Title Index ... thermal conductivity and viscosity in a flat plate solar collector, Abstract PDF .... similarity method in unsteady two-dimensional MHD boundary layer on the body ...

  3. Validation and Test-Retest Reliability of New Thermographic Technique Called Thermovision Technique of Dry Needling for Gluteus Minimus Trigger Points in Sciatica Subjects and TrPs-Negative Healthy Volunteers

    Science.gov (United States)

    Rychlik, Michał; Samborski, Włodzimierz

    2015-01-01

    The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN) for the gluteus minimus muscle. TTDN is a new thermography approach used to support trigger points (TrPs) diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain. Method. Thirty chronic sciatica patients (n=15 TrP-positive and n=15 TrPs-negative) and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the gluteus minimus muscle confirmed additionally by referred pain presence. TTDN employs average temperature (T avr), maximum temperature (T max), low/high isothermal-area, and autonomic referred pain phenomenon (AURP) that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently. Results. Two components of TTDN validity and reliability, T avr and AURP, had almost perfect agreement according to κ (e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.). The sensitivity for T avr, T max, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was for T avr and AURP only. Conclusion. TTDN is a valid and reliable method for T avr and AURP measurement to support TrPs diagnostic criteria for the gluteus minimus muscle when digitally evoked referred pain pattern is present. PMID:26137486

  4. Lattice Index Coding

    OpenAIRE

    Natarajan, Lakshmi; Hong, Yi; Viterbo, Emanuele

    2014-01-01

    The index coding problem involves a sender with K messages to be transmitted across a broadcast channel, and a set of receivers each of which demands a subset of the K messages while having prior knowledge of a different subset as side information. We consider the specific case of noisy index coding where the broadcast channel is Gaussian and every receiver demands all the messages from the source. Instances of this communication problem arise in wireless relay networks, sensor networks, and ...

  5. Sustainability index for Taipei

    International Nuclear Information System (INIS)

    Lee, Y.-J.; Huang Chingming

    2007-01-01

    Sustainability indicators are an effective means of determining whether a city is moving towards sustainable development (SD). After considering the characteristics of Taipei, Taiwan, discussions with experts, scholars and government departments and an exhaustive literature review, this study selected 51 sustainability indicators corresponding to the socio-economic characteristic of Taipei City. Such indicators should be regarded as a basis for assessing SD in Taipei City. The 51 indicators are classified into economic, social, environmental and institutional dimensions. Furthermore, statistical data is adopted to identify the trend of SD from 1994 to 2004. Moreover, the sustainability index is calculated for the four dimensions and for Taipei as a whole. Analysis results demonstrate that social and environmental indicators are moving towards SD, while economic and institutional dimensions are performing relatively poorly. However, since 2002, the economic sustainability index has gradually moved towards SD. Overall, the Taipei sustainability index indicates a gradual trend towards sustainable development during the past 11 years

  6. Calculate Your Body Mass Index

    Science.gov (United States)

    ... Can! ) Health Professional Resources Calculate Your Body Mass Index Body mass index (BMI) is a measure of body fat based ... Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute of Health Department of ...

  7. The Cognitive Mobilization Index

    Directory of Open Access Journals (Sweden)

    Antonio Alaminos

    2012-01-01

    Full Text Available This article shows how the cognitive mobilization index, designed for use in observing potential political participation, can be used as an indicator of the political climate that a particular society is going through. Following a discussion of the theoretical elaborations (and their working definitions of the concept of cognitive mobilization, a longitudinal study of various European countries is used to consider the question of how political crises influence cognitive mobilization indexes and what effects they have on the political socialization process among the youngest cohorts.

  8. ParkIndex

    DEFF Research Database (Denmark)

    Kaczynski, Andrew T; Schipperijn, Jasper; Hipp, J Aaron

    2016-01-01

    using ArcGIS 9.3 and the Community Park Audit Tool. Four park summary variables - distance to nearest park, and the number of parks, amount of park space, and average park quality index within 1 mile were analyzed in relation to park use using logistic regression. Coefficients for significant park......, planners, and citizens to evaluate the potential for park use for a given area. Data used for developing ParkIndex were collected in 2010 in Kansas City, Missouri (KCMO). Adult study participants (n=891) reported whether they used a park within the past month, and all parks in KCMO were mapped and audited...

  9. The normative score and the cut-off value of the Oswestry Disability Index (ODI).

    Science.gov (United States)

    Tonosu, Juichi; Takeshita, Katsushi; Hara, Nobuhiro; Matsudaira, Ko; Kato, So; Masuda, Kazuhiro; Chikuda, Hirotaka

    2012-08-01

    The Oswestry Disability Index (ODI) is one of the most common scoring systems used for patients with low back pain (LBP). Although the normative score of the ODI was reported to be 10.19 in a review article, no study has calculated the normative score after adjusting the value based on the age distribution. In addition, none of the previous studies has estimated the cut-off value which separates LBP with disability from LBP without disability. The purpose of this study was to estimate the normative score by adjusting the data for age distribution in Japan, and to determine the cut-off value which separates LBP with disability from LBP without disability. We conducted an internet survey on LBP using the Japanese version of the ODQ. A total of 1,200 respondents, composed of 100 males and 100 females in each age group (from the 20s to 70s), participated in this study. We also asked them to provide information about their backgrounds. We estimated the normative score after correcting for the age distribution of Japan. We also estimated the ODI of those with or without disability, the factors associated with the ODI, and the cut-off value which separates LBP with disability from LBP without disability. The participants' backgrounds were similar to the national survey. The normative score of the ODI was estimated at 8.73. The ODI of the LBP with disability group was 22.07. Those with sciatica and obese subjects showed higher ODI than those without. The optimal cut-off value was estimated to be 12. We defined the normative score and the cut-off value of the ODI.

  10. 2005 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2005 Environmental Sustainability Index (ESI) is a measure of overall progress towards environmental sustainability, developed for 146 countries. The index...

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 391 ... Journal Home > Advanced Search > Browse Title Index ... Efficacy of four Rodenticides on the Ghanaian Market, Abstract ... Vol 2, No 1 (2000):, Determination of some wear elements in used car engine oil and oil filter ...

  12. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 46 of 46 ... Vol 4, No 1 (2015), Fiscal Federalism and Development In Nigeria, Abstract. Dorcas Akhere Odigwe, Stanley Aibieyi. Vol 1, No 1 (2011), Good Governance Analysing Performance of Economic Community of West African States and Southern African Development Community Members on Mo Ibrahim Index ...

  13. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 73 of 73 ... Journal Home > Advanced Search > Browse Title Index ... Vol 13 (2006), The ageing eye” functional changes from cradle to gray: A ... Vol 12 (2005), The evaluation of vision in children using monocular vision acuity and ...

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 224 of 224 ... Vol 13, No 2 (2010), Spatial Analysis of Particle Size Distribution of Soils Formed on ... swelling index and moisture content of white and yellow garri in ... and Composition of Milk of West African Dwarf (Wad) Sheep Fed ...

  15. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 229 ... Browse Title Index ... Issue, Title. Vol 14, No 2 ... Vol 15, No 1 (2017), Qualitative and quantitative methods of suicide research in old age, Abstract PDF ... Vol 11, No 2 (2013), Simple Algorithm in the Management of Fetal ...

  16. Nitrate leaching index

    Science.gov (United States)

    The Nitrate Leaching Index is a rapid assessment tool that evaluates nitrate (NO3) leaching potential based on basic soil and climate information. It is the basis for many nutrient management planning efforts, but it has considerable limitations because of : 1) an oversimplification of the processes...

  17. Data Citation Index

    Directory of Open Access Journals (Sweden)

    Laura L. Pavlech

    2016-01-01

    Full Text Available Introduced by Thomson Reuters in 2012 as a, ‘‘Single point of access to quality research data from repositories across disciplines and around the world’’ [1], the Data Citation Index (DCI is a searchable collection of data sets and data studies from a select list of repositories.

  18. Indexing Moving Points

    DEFF Research Database (Denmark)

    Agarwal, Pankaj K.; Arge, Lars Allan; Erickson, Jeff

    2003-01-01

    We propose three indexing schemes for storing a set S of N points in the plane, each moving along a linear trajectory, so that any query of the following form can be answered quickly: Given a rectangle R and a real value t, report all K points of S that lie inside R at time t. We first present an...

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 1215 ... Journal Home > Advanced Search > Browse Title Index. Log in or ... Vol 12, No 1 (2018), Analysis of the effects of frequent strikes on academic performance of students in universities in Nigeria: Edo State as a focal point, Abstract PDF ... Vol 6, No 1 (2012), Appraisal as a Determinant for Adequate ...

  20. Browse Title Index

    African Journals Online (AJOL)

    weighted Index of Biotic Integrity (SIBI) for use in the assessment of biotic integrity in the Klip River, Gauteng, South Africa, Abstract. P J Kotze, G J Steyn, H H du Preez, C J Kleynhans. Vol 40, No 4 (2015), Diatoms as water ...

  1. Indexes to Volume 77

    Indian Academy of Sciences (India)

    2015-11-27

    Proceedings of the International Workshop/Conference on Computational Condensed Matter Physics and Materials Science (IWCCMP-2015). Posted on November 27, 2015. Guest Editors: Anurag Srivastava, C. S. Praveen, H. S. Tewari. © 2015 Indian Academy of Sciences, Bengaluru. Contact | Site index.

  2. A Tourism Conditions Index

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); H-K. Hsu (Hui-Kuang); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ This paper uses monthly data from April 2005 to August 2013 for Taiwan to propose a novel tourism indicator, namely the Tourism Conditions Index (TCI). TCI accounts for the spillover weights based on the Granger causality test and estimates of the multivariate BEKK

  3. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 300 of 652 ... Journal Home > Advanced Search > Browse Title Index ... Vol 18, No 7 (2015), Introduction to virtual property: Lex virtualis ipsa ... Vol 17, No 1 (2014), Legal challenges relating to the commercial use of outer space, with ...

  4. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 100 ... Vol 5, No 1 (2010), A simple note on some empirical stochastic process ... poverty index with when the parameter is strictly between 0 and 1, Abstract PDF ... Vol 10, No 2 (2015), Bilinear regression model with Kronecker and ...

  5. Browse Title Index

    African Journals Online (AJOL)

    Items 501 - 550 of 913 ... Vol 10, No 1 (2018), Modeling and comparison of IP and fuzzy-pi ... Modeling the potential impacts of global climate change in Bangladesh: An optimal ... Vol 9, No 4S (2017): Special Issue, New flood risk index in tropical ...

  6. Browse Title Index

    African Journals Online (AJOL)

    Items 751 - 800 of 846 ... Journal Home > Advanced Search > Browse Title Index ... Vol 9, No 3S (2017): Special Issue, The effect of torrefaction on oil palm ... core competency skills of IRBM tax auditors towards their performance, Abstract PDF ... of exchange rates behavior in Malaysia by using NATREX model, Abstract PDF.

  7. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 286 of 286 ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced ... the Hire Purchase and credit sale Act - An unnecessary duplication ? ... Vol 21 (2015), The Influence of Peer Pressure on Adolescents' Social Behaviour, Abstract PDF ... quality indexing for predicting variation of water quality over time ...

  8. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 1463 ... Vol 14, No 4 (2014), Association between mean platelet volume levels and inflammation in SLE patients presented with arthritis, Abstract PDF ... Vol 10, No 3 (2010), Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria, Abstract ...

  9. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 1117 ... Journal Home > Advanced Search > Browse Title Index ... Vol 13, No 3 (2007):, an edu-ethical perspecitve on the nature of truth: case studies in elite ... 2009: September: Supplement, An empirical study of university ...

  10. Browse Title Index

    African Journals Online (AJOL)

    Items 601 - 650 of 788 ... Browse Title Index ... Issue, Title ... Vol 14, No 1 (2006), Social science research: a critique of quantitative and qualitative methods ... Vol 18, No 1 (2010), Stress among part-time business students: a study in a Ghanaian ...

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 1732 ... Journal Home > Advanced Search > Browse Title Index ... Vol 10, No 3 (2007), An Audit Of Perioperative Cardiac Arrest At ... Vol 11, No 4 (2008), An Audit Of Rejected Repeated X-ray Films As A Quality Assurance ...

  12. The Index House

    International Nuclear Information System (INIS)

    Reilly, M.A.

    1990-01-01

    This paper reports on the Pennsylvania Radon Research and Demonstration Project. The project involved the monitoring of the Index House for indoor radon, and was one of the earliest programs involving indoor radon contamination. The history of the house, the investigation, and testing and remediation procedures are discussed

  13. Browse Title Index

    African Journals Online (AJOL)

    Items 351 - 400 of 823 ... Vol 9, No 2 (2016), Evaluation of antiulcer activity of aqueous ... and Practices About Tsetse Fly in Muri District, Taraba State, Nigeria ... Vol 10, No 1 (2017): Special Conference Edition, Evaluation of heavy metals' health risk index in ... of phytoplankton as bioindicators of water quality in Jakara dam, ...

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 300 of 2005 ... Issue, Title. Vol 92, No 4 (2015), Blood Pressure and Obesity Index Assessment in a Typical Urban Slum in Enugu, Nigeria, Abstract. GI Ahaneku, CU Osuji, OC Oguejiofor, BC Anisiuba, VO Ikeh, JE Ahaneku. Vol 80, No 10 (2003):, Blood pressure control in a population where antihypertensives are ...

  15. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 250 of 661 ... Journal Home > Advanced Search > Browse Title Index. Log in or Register to get access to full text downloads. .... A El-Mahdy, B Bolduc, J Upadhyay, R Shoukr, A Khoury. Vol 19, No 1 (2013), Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy, Abstract PDF.

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 985 ... Journal Home > Advanced Search > Browse Title Index ... Vol 17 (2010), Alternating Direction Implicit Finite Difference Time Domain Acoustic Wave Algorithm, Abstract. E Ikata .... Vol 17 (2010), Analytic derivation of the wave profile and phase speed of sixth order Stokes waves in deep water, Abstract.

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 217 ... Browse Title Index. Journal Home > Advanced ... Vol 13, No 1 (2016), Access to specialized surgical care, Abstract PDF. H Saidi ... Vol 9, No 2 (2012), Clinical Assessment of the Palmaris Longus – Accuracy of common tests, Abstract PDF ... Vol 11, No 2 (2014), Clinical trials in Surgery, Abstract PDF.

  18. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 97 of 97 ... Journal Home > Advanced Search > Browse Title Index ... Vol 20, No 2 (2008), Research Note: Anthropometric data of the foot of ... Vol 26, No 1 (2014), Validation of the Automation Attitude Questionnaire for Airline Pilots ...

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 351 - 400 of 400 ... Vol 2, No 1 (2007), The effects of Aloe vera [gel] on clotting time, prothrombin time and plasma fibrinogen concentration in albino Wistar rats, Abstract. D V Dapper, P N Achinike, M D Gwotmut. Vol 8, No 3 (2014), The effects of body mass index on some electrocardiographic parameters in young adults: ...

  20. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 719 ... African Journal of Aquatic Science. ... Vol 32, No 2 (2007), Algal communities associated with aquatic macrophytes ... index to Clarias gariepinus (Teleostei: Clariidae) in the Vaal River system, South Africa, Abstract ... Vol 40, No 2 (2015), Benthic macroinvertebrate assemblages in mangroves and open ...

  1. Refractive index based measurements

    DEFF Research Database (Denmark)

    2014-01-01

    In a method for performing a refractive index based measurement of a property of a fluid such as chemical composition or temperature, a chirp in the local spatial frequency of interference fringes of an interference pattern is reduced by mathematical manipulation of the recorded light intensity...

  2. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 148 ... Vol 12, No 1S (2018), Addition of anti-Toxoplasma gondii membrane immunoglobulin Y to reduce necrotic index in mice's liver, Abstract PDF. Heni Puspitasari, Lucia T. Suwanti, Mufasirin Mufasirin. Vol 6, No 2 (2012), Advances in the Diagnosis, Treatment and Control of HIV Associated Tuberculosis ...

  3. Drug Impact Index.

    Science.gov (United States)

    Western Center for Drug-Free Schools and Communities.

    The Drug Impact Index provides a set of indicators designed to determine the extent of the local drug problem in a community. Each indicator includes a technical note on the data sources, a graph showing comparative statistics on that indicator for the Portland area and for the State of Oregon, and brief remarks on the implications of the data.…

  4. Scientific Journal Indexing

    Directory of Open Access Journals (Sweden)

    Getulio Teixeira Batista

    2007-08-01

    Full Text Available It is quite impressive the visibility of online publishing compared to offline. Lawrence (2001 computed the percentage increase across 1,494 venues containing at least five offline and five online articles. Results shown an average of 336% more citations to online articles compared to offline articles published in the same venue. If articles published in the same venue are of similar quality, then they concluded that online articles are more highly cited because of their easier access. Thomson Scientific, traditionally concerned with printed journals, announced on November 28, 2005, the launch of Web Citation Index™, the multidisciplinary citation index of scholarly content from institutional and subject-based repositories (http://scientific.thomson. com/press/2005/8298416/. The Web Citation Index from the abstracting and indexing (A&I connects together pre-print articles, institutional repositories and open access (OA journals (Chillingworth, 2005. Basically all research funds are government granted funds, tax payer’s supported and therefore, results should be made freely available to the community. Free online availability facilitates access to research findings, maximizes interaction among research groups, and optimizes efforts and research funds efficiency. Therefore, Ambi-Água is committed to provide free access to its articles. An important aspect of Ambi-Água is the publication and management system of this journal. It uses the Electronic System for Journal Publishing (SEER - http://www.ibict.br/secao.php?cat=SEER. This system was translated and customized by the Brazilian Institute for Science and Technology Information (IBICT based on the software developed by the Public Knowledge Project (Open Journal Systems of the British Columbia University (http://pkp.sfu.ca/ojs/. The big advantage of using this system is that it is compatible with the OAI-PMH protocol for metadata harvesting what greatly promotes published articles

  5. Indexing for summary queries

    DEFF Research Database (Denmark)

    Yi, Ke; Wang, Lu; Wei, Zhewei

    2014-01-01

    ), of a particular attribute of these records. Aggregation queries are especially useful in business intelligence and data analysis applications where users are interested not in the actual records, but some statistics of them. They can also be executed much more efficiently than reporting queries, by embedding...... returned by reporting queries. In this article, we design indexing techniques that allow for extracting a statistical summary of all the records in the query. The summaries we support include frequent items, quantiles, and various sketches, all of which are of central importance in massive data analysis....... Our indexes require linear space and extract a summary with the optimal or near-optimal query cost. We illustrate the efficiency and usefulness of our designs through extensive experiments and a system demonstration....

  6. Conformity index: A review

    International Nuclear Information System (INIS)

    Feuvret, Loic; Noel, Georges; Mazeron, Jean-Jacques; Bey, Pierre

    2006-01-01

    We present a critical analysis of the conformity indices described in the literature and an evaluation of their field of application. Three-dimensional conformal radiotherapy, with or without intensity modulation, is based on medical imaging techniques, three-dimensional dosimetry software, compression accessories, and verification procedures. It consists of delineating target volumes and critical healthy tissues to select the best combination of beams. This approach allows better adaptation of the isodose to the tumor volume, while limiting irradiation of healthy tissues. Tools must be developed to evaluate the quality of proposed treatment plans. Dosimetry software provides the dose distribution in each CT section and dose-volume histograms without really indicating the degree of conformity. The conformity index is a complementary tool that attributes a score to a treatment plan or that can compare several treatment plans for the same patient. The future of conformal index in everyday practice therefore remains unclear

  7. Browse Title Index

    African Journals Online (AJOL)

    Vol 9, No 2S (2017): Special Issue, Water quality assessment of the rivers in bauxite mining area at Kuantan Pahang, Abstract PDF. N Yaakub, M.N.A. Raoff, M.N. Haris, A.A.A. Halim, M.K.A. Kamarudin. Vol 9, No 2S (2017): Special Issue, Water quality index assesment around industrial area in Kuantan, Pahang, Abstract ...

  8. Gradient-Index Optics

    Science.gov (United States)

    2010-03-31

    nonimaging design capabilities to incorporate 1. REPORT DATE (DD-MM-YYYY) 4. TITLE AND SUBTITLE 12-04-2011 13. SUPPLEMENTARY NOTES The views, opinions...Box 12211 Research Triangle Park, NC 27709-2211 15. SUBJECT TERMS Imaging Optics, Nonimaging Optics, Gradient Index Optics, Camera, Concentrator...imaging and nonimaging design capabilities to incorporate manufacturable GRIN lenses can provide imaging lens systems that are compact and

  9. Index of cyber integrity

    Science.gov (United States)

    Anderson, Gustave

    2014-05-01

    Unfortunately, there is no metric, nor set of metrics, that are both general enough to encompass all possible types of applications yet specific enough to capture the application and attack specific details. As a result we are left with ad-hoc methods for generating evaluations of the security of our systems. Current state of the art methods for evaluating the security of systems include penetration testing and cyber evaluation tests. For these evaluations, security professionals simulate an attack from malicious outsiders and malicious insiders. These evaluations are very productive and are able to discover potential vulnerabilities resulting from improper system configuration, hardware and software flaws, or operational weaknesses. We therefore propose the index of cyber integrity (ICI), which is modeled after the index of biological integrity (IBI) to provide a holistic measure of the health of a system under test in a cyber-environment. The ICI provides a broad base measure through a collection of application and system specific metrics. In this paper, following the example of the IBI, we demonstrate how a multi-metric index may be used as a holistic measure of the health of a system under test in a cyber-environment.

  10. Indexical Hybrid Tense Logic

    DEFF Research Database (Denmark)

    Blackburn, Patrick Rowan; Jørgensen, Klaus Frovin

    2012-01-01

    In this paper we explore the logic of now, yesterday, today and tomorrow by combining the semantic approach to indexicality pioneered by Hans Kamp [9] and refined by David Kaplan [10] with hybrid tense logic. We first introduce a special now nominal (our @now corresponds to Kamp’s original now...... operator N) and prove completeness results for both logical and contextual validity. We then add propositional constants to handle yesterday, today and tomorrow; our system correctly treats sentences like “Niels will die yesterday” as contextually unsatisfiable. Building on our completeness results for now......, we prove completeness for the richer language, again for both logical and contextual validity....

  11. Heart rate index

    DEFF Research Database (Denmark)

    Haedersdal, C; Pedersen, F H; Svendsen, J H

    1992-01-01

    after the myocardial infarction. A significant correlation (Spearman's correlation coefficient rs, p less than 0.05) was found between LVEF at rest and the following variables assessed at exercise test: 1) the heart rate at rest, 2) rise in heart rate, 3) ratio between maximal heart rate and heart rate...... at rest, 4) rise in systolic blood pressure, 5) rate pressure product at rest, 6) rise in rate pressure product, 7) ratio (rHR) between maximal rate pressure product and rate pressure product at rest, 8) total exercise time. The heart rate was corrected for effects caused by age (heart index (HR...

  12. Refractive index based measurements

    DEFF Research Database (Denmark)

    2014-01-01

    In a method for performing a refractive index based measurement of a property of a fluid such as chemical composition or temperature by observing an apparent angular shift in an interference fringe pattern produced by back or forward scattering interferometry, ambiguities in the measurement caused...... by the apparent shift being consistent with one of a number of numerical possibilities for the real shift which differ by 2n are resolved by combining measurements performed on the same sample using light paths therethrough of differing lengths....

  13. 2016 Traffic Safety Culture Index

    Science.gov (United States)

    ... Newsroom SEARCH Driver Behavior & Performance 2016 Traffic Safety Culture Index This report presents the results of our annual Traffic Safety Culture Index survey, providing data on the attitudes and ...

  14. 2001 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2001 Environmental Sustainability Index (ESI) utilizes a refined methodology based on the 2000 Pilot ESI effort, to construct an index covering 122 countries...

  15. Life quality index revisited

    DEFF Research Database (Denmark)

    Ditlevsen, Ove Dalager

    2004-01-01

    The derivation of the life quality index (LQI) is revisited for a revision. This revision takes into account the unpaid but necessary work time needed to stay alive in clean and healthy conditions to be fit for effective wealth producing work and to enjoyable free time. Dimension analysis...... at birth should not vary between countries. Finally the distributional assumptions are relaxed as compared to the assumptions made in an earlier work by the author. These assumptions concern the calculation of the life expectancy change due to the removal of an accident source. Moreover a simple public...... consistency problems with the standard power function expression of the LQI are pointed out. It is emphasized that the combination coefficient in the convex differential combination between the relative differential of the gross domestic product per capita and the relative differential of the expected life...

  16. Automated Water Extraction Index

    DEFF Research Database (Denmark)

    Feyisa, Gudina Legese; Meilby, Henrik; Fensholt, Rasmus

    2014-01-01

    Classifying surface cover types and analyzing changes are among the most common applications of remote sensing. One of the most basic classification tasks is to distinguish water bodies from dry land surfaces. Landsat imagery is among the most widely used sources of data in remote sensing of water...... resources; and although several techniques of surface water extraction using Landsat data are described in the literature, their application is constrained by low accuracy in various situations. Besides, with the use of techniques such as single band thresholding and two-band indices, identifying...... an appropriate threshold yielding the highest possible accuracy is a challenging and time consuming task, as threshold values vary with location and time of image acquisition. The purpose of this study was therefore to devise an index that consistently improves water extraction accuracy in the presence...

  17. Refractive index based measurements

    DEFF Research Database (Denmark)

    2014-01-01

    A refractive index based measurement of a property of a fluid is measured in an apparatus comprising a variable wavelength coherent light source (16), a sample chamber (12), a wavelength controller (24), a light sensor (20), a data recorder (26) and a computation apparatus (28), by - directing...... coherent light having a wavelength along an input light path, - producing scattering of said light from each of a plurality of interfaces within said apparatus including interfaces between said fluid and a surface bounding said fluid, said scattering producing an interference pattern formed by said...... scattered light, - cyclically varying the wavelength of said light in said input light path over a 1 nm to 20nm wide range of wavelengths a rate of from 10Hz to 50 KHz, - recording variation of intensity of the interfering light with change in wavelength of the light at an angle of observation...

  18. Indexing contamination surveys

    International Nuclear Information System (INIS)

    Brown, R.L.

    1998-01-01

    The responsibility for safely managing the Tank Farms at Hanford belongs to Lockheed Martin Hanford Corporation which is part of the six company Project Hanford Management Team led by Fluor Daniel Hanford, Inc.. These Tank Farm Facilities contain numerous outdoor contamination areas which are surveyed at a periodicity consistent with the potential radiological conditions, occupancy, and risk of changes in radiological conditions. This document describes the survey documentation and data tracking method devised to track the results of contamination surveys this process is referred to as indexing. The indexing process takes a representative data set as an indicator for the contamination status of the facility. The data are further manipulated into a single value that can be tracked and trended using standard statistical methodology. To report meaningful data, the routine contamination surveys must be performed in a manner that allows the survey method and the data collection process to be recreated. Three key criteria are necessary to accomplish this goal: Accurate maps, consistent documentation, and consistent consolidation of data meeting these criteria provides data of sufficient quality to be tracked. Tracking of survey data is accomplished by converting the individual survey results into a weighted value, corrected for the actual number of survey points. This information can be compared over time using standard statistical analysis to identify trends. At the Tank Farms, the need to track and trend the facility's radiological status presents unique challenges. Many of these Tank Farm facilities date back to the second world war. The Tank Farm Facilities are exposed to weather extremes, plant and animal intrusion, as well as all of the normal challenges associated with handling radiological waste streams. Routine radiological surveys did not provide a radiological status adequate for continuing comparisons

  19. Viva the h-index

    OpenAIRE

    Waaijers, Leo

    2011-01-01

    In their article 'The inconsistency of the h-index' Ludo Waltman and Nees Jan van Neck give three examples to demonstrate the inconsistency of the h-index. As will be explained, a little extension of their examples just illustrate the opposite, a stable feature of the h-index. For starting authors it, the h-index that is, focusses on the number of articles; for experienced authors its focus shifts towards the citation scores. This feature may be liked or not but does not make the h-index an i...

  20. SUBJECT AND AUTHOR INDEXS

    Directory of Open Access Journals (Sweden)

    IJBE Volume 1

    2015-09-01

    Full Text Available SUBJECT INDEX IJBE VOLUME 1EPA, 1Agrotourism, 148AHP, 148balance scorecard, 63batik tulis Rolla Junior, 23Broiler, 90business model canvas, 137business performance,32capital structure, 81cashew industry,158CHAID,106CLI,42coal transportation service,63company’s characteristics, 81competitive advantage, 12competitive strategy, 127consumer satisfaction, 51CSI, 42customer loyalty, 42customer satisfaction,42decision of visitors, 72development strategy, 23development,158entrepreneurship, 32Feasibility studies, 90FEM, 81gap analysis, 1Indonesia Stock Exchange, 177Indosat, 137investor,177Kawah Putih, 72kedai sop durian lodaya (KSDL,51klassen typology, 96leading sector, 96less cash society, 137liquidity ratio, 165location quotient, 96logistic regression, 115market, 177marketing development strategy, 148Marketing mix, 72mobile payment, 137modern and Traditional cage, 90multiple regression analyse,165multiple regression, 177net working capital, 165organic tofu product, 115Padang, 106paired comparison, 63partnership, 1, 32Pecking Order Theory, 81PLS, 81Portfolio, 96power, 32product quality, 51profitability ratio, 165Prol Tape Primadona, 127purchase decision, 115purchase intention, 51purchasing interest,115QSPM, 23, 127refilled drinking water, 106seed,1segmentation, 106SEM, 42, 51service quality, 51SMEs, 96specialty coffee, 12stock,177strategic diagnosis,137strategy, 158Sukorambi Botanic Garden, 148SWOT, 23, 127, 148, 158SWOT-AHP, 12tourists,72UD. Primadona, 127value chain, 12VRIO,12 AUTHOR INDEX IJBE VOLUME 1Adiningsih, Kartika Puspitasari,42Aknesia, Vharessa,12Amalia, Firda Rachma,90Andati, Trias, 177Anggraeni, Lukytawati,23Asriani,158Daryanto, Arief,12, 90Djamaludin, MD., 42Djohar, Setiadi,96Fachrodji, Achmad,72Fahmi, Idqan,1, 63, 127Fasyni, Awisal,106Hubeis, Musa,148Iskandar, Dodi,51Juanda, Bambang, 165Kirbrandoko, 12, 106, 115Lumbantoruan, Dewi Margareth,96Maulana, TB Nur Ahmad,81Muksin, 148Mukti Soleh, Cecep,63Najib, Mukhamad,106Noor, Tajudin,81

  1. 2012 Environmental Performance Index and Pilot Trend Environmental Performance Index

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2012 Environmental Performance Index (EPI) ranks 132 countries on 22 performance indicators in the following 10 policy categories: environmental burden of...

  2. SUBJECT AND AUTHOR INDEXS

    Directory of Open Access Journals (Sweden)

    IJBE Volume 2

    2016-09-01

    Full Text Available SUBJECT INDEX IJBE VOLUME 2access credit, 93acquisition, 177AHP, 61, 82, 165arena simulation,43BMC, 69Bojonegoro, 69brand choice, 208brand image, 208brand positioning, 208bullwhip effect, 43burger buns, 1business synergy and financial reports, 177capital structure, 130cluster, 151coal reserves, 130coffee plantation, 93competitiveness, 82consumer behaviour, 33consumer complaint behavior, 101cooking spices, 1crackers, 1cross sectional analytical, 139crosstab, 101CSI, 12direct selling, 122discriminant analysis, 33economic value added, 130, 187employee motivation, 112employee performance, 112employees, 139EOQ, 23farmer decisions, 93farmer group, 52financial performance evaluation, 187financial performance, 52, 177financial ratio, 187financial report, 187fiva food, 23food crops, 151horticulture, 151imports, 151improved capital structure, 177IPA, 12leading sector, 151life insurance, 165LotteMart, 43main product, 61marketing mix, 33, 165matrix SWOT, 69MPE, 61multiple linear regression, 122muslim clothing, 197Ogun, 139Pangasius fillet, 82Pati, 93pearson correlation, 101perceived value, 208performance suppy chain, 23PLS, 208POQ, 23portfolio analyzing, 1product, 101PT SKP, 122pulp and papers, 187purchase decision, 165purchase intention, 33remuneration, 112re-purchasing decisions, 197sales performance, 122sawmill, 52SCOR, 23sekolah peternakan rakyat, 69SEM, 112SERVQUAL, 12Sido Makmur farmer groups, 93SI-PUHH Online, 12small and medium industries (IKM, 61socio-demographic, 139sport drink, 208stress, 139supply chain, 43SWOT, 82the mix marketing, 197Tobin’s Q, 130trade partnership, 52uleg chili sauce, 1 AUTHOR INDEX IJBE VOLUME 2Achsani, Noer Azam, 177Andati, Trias, 52, 177Andihka, Galih, 208Arkeman, Yandra, 43Baga, Lukman M, 69Cahyanugroho, Aldi, 112Daryanto, Arief, 12David, Ajibade, 139Djoni, 122Fahmi, Idqan, 1Fattah, Muhammad Unggul Abdul, 61Hakim, Dedi Budiman, 187Harianto, 93Hartoyo, 101Homisah, 1Hubeis, Musa, 112Hutagaol, M. Parulian, 93Jaya, Stevana

  3. Filter indexing for spectrophotometer system

    International Nuclear Information System (INIS)

    Chamran, M.M.; Scott, L.B.; Williams, P.B.

    1982-01-01

    A spectrophotometer system has an optical system for transmitting a beam from a source at select wavelengths onto a detector. A plurality of filters are positioned in a tray. A stepper mechanism indexes the tray along a path. A microcomputer controls the stepper mechanism and the optical system. The wavelength is successively changed over a range, the tray is indexed to move a select filter into the beam at a predetermined wavelength and the changing is discontinued during indexing

  4. Asset pricing with index investing

    OpenAIRE

    Georgy Chabakauri; Oleg Rytchkov

    2014-01-01

    We provide a novel theoretical analysis of how index investing affects capital market equilibrium. We consider a dynamic exchange economy with heterogeneous investors and two Lucas trees and find that indexing can either increase or decrease the correlation between stock returns and in general increases (decreases) volatilities and betas of stocks with larger (smaller) market capitalizations. Indexing also decreases market volatility and interest rates, although those effects are weak. The im...

  5. Complete cumulative index (1963-1983)

    International Nuclear Information System (INIS)

    1983-01-01

    This complete cumulative index covers all regular and special issues and supplements published by Atomic Energy Review (AER) during its lifetime (1963-1983). The complete cumulative index consists of six Indexes: the Index of Abstracts, the Subject Index, the Title Index, the Author Index, the Country Index and the Table of Elements Index. The complete cumulative index supersedes the Cumulative Indexes for Volumes 1-7: 1963-1969 (1970), and for Volumes 1-10: 1963-1972 (1972); this Index also finalizes Atomic Energy Review, the publication of which has recently been terminated by the IAEA

  6. Mangrove vulnerability index using GIS

    Science.gov (United States)

    Yunus, Mohd Zulkifli Mohd; Ahmad, Fatimah Shafinaz; Ibrahim, Nuremira

    2018-02-01

    Climate change, particularly its associated sea level rise, is major threat to mangrove coastal areas, and it is essential to develop ways to reduce vulnerability through strategic management planning. Environmental vulnerability can be understood as a function of exposure to impacts and the sensitivity and adaptive capacity of ecological systems towards environmental tensors. Mangrove vulnerability ranking using up to 14 parameters found in study area, which is in Pulau Kukup and Sg Pulai, where 1 is low vulnerability and 5 is very high vulnerability. Mangrove Vulnerability Index (MVI) is divided into 3 main categories Physical Mangrove Index (PMI), Biological Mangrove Index (BMI) and Hazard Mangrove Index (HMI).

  7. Index Bioclimatic "Wind-Chill"

    Directory of Open Access Journals (Sweden)

    Teodoreanu Elena

    2015-05-01

    Full Text Available This paper presents an important bioclimatic index which shows the influence of wind on the human body thermoregulation. When the air temperature is high, the wind increases thermal comfort. But more important for the body is the wind when the air temperature is low. When the air temperature is lower and wind speed higher, the human body is threatening to freeze faster. Cold wind index is used in Canada, USA, Russia (temperature "equivalent" to the facial skin etc., in the weather forecast every day in the cold season. The index can be used and for bioclimatic regionalization, in the form of skin temperature index.

  8. 2008 Environmental Performance Index (EPI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2008 Environmental Performance Index (EPI) centers on two broad environmental protection objectives: (1) reducing environmental stresses on human health, and (2)...

  9. 2002 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2002 Environmental Sustainability Index (ESI) measures overall progress toward environmental sustainability for 142 countries based on environmental systems,...

  10. Nelson-Farrar cost indexes

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper discusses the Nelson-Farrar Cost Indexs. Topics covered include: economic analysis, petroleum refineries, petroleum industry, pumps, compressors, beat exchangers, cost estimation, productivity and wages

  11. Malaysian Education Index (MEI): An Online Indexing and Repository System

    Science.gov (United States)

    Kabilan, Muhammad Kamarul; Ismail, Hairul Nizam; Yaakub, Rohizani; Yusof, Najeemah Mohd; Idros, Sharifah Noraidah Syed; Umar, Irfan Naufal; Arshad, Muhammad Rafie Mohd.; Idrus, Rosnah; Rahman, Habsah Abdul

    2010-01-01

    This "Project Sheet" describes an on-going project that is being carried out by a group of educational researchers, computer science researchers and librarians from Universiti Sains Malaysia, Penang. The Malaysian Education Index (MEI) has two main functions--(1) Online Indexing System, and (2) Online Repository System. In this brief…

  12. Sprache und Sozio-Oekonomischer Index (Speech and Socioeconomic Index)

    Science.gov (United States)

    Bluhme, Hermann

    1976-01-01

    A comparison of the socioeconomic index of 77 speakers of Dutch, recorded in 40 places, revealed certain correlations between index and individual linguistic behavior, particularly in regard to the speed of articulation, quantity quotient (low vowels/short vowels), pitch modulation, number of relative clauses and passive construction. (Text is in…

  13. The Pemberton Happiness Index

    Science.gov (United States)

    Paiva, Bianca Sakamoto Ribeiro; de Camargos, Mayara Goulart; Demarzo, Marcelo Marcos Piva; Hervás, Gonzalo; Vázquez, Carmelo; Paiva, Carlos Eduardo

    2016-01-01

    Abstract The Pemberton Happiness Index (PHI) is a recently developed integrative measure of well-being that includes components of hedonic, eudaimonic, social, and experienced well-being. The PHI has been validated in several languages, but not in Portuguese. Our aim was to cross-culturally adapt the Universal Portuguese version of the PHI and to assess its psychometric properties in a sample of the Brazilian population using online surveys. An expert committee evaluated 2 versions of the PHI previously translated into Portuguese by the original authors using a standardized form for assessment of semantic/idiomatic, cultural, and conceptual equivalence. A pretesting was conducted employing cognitive debriefing methods. In sequence, the expert committee evaluated all the documents and reached a final Universal Portuguese PHI version. For the evaluation of the psychometric properties, the data were collected using online surveys in a cross-sectional study. The study population included healthcare professionals and users of the social network site Facebook from several Brazilian geographic areas. In addition to the PHI, participants completed the Satisfaction with Life Scale (SWLS), Diener and Emmons’ Positive and Negative Experience Scale (PNES), Psychological Well-being Scale (PWS), and the Subjective Happiness Scale (SHS). Internal consistency, convergent validity, known-group validity, and test–retest reliability were evaluated. Satisfaction with the previous day was correlated with the 10 items assessing experienced well-being using the Cramer V test. Additionally, a cut-off value of PHI to identify a “happy individual” was defined using receiver-operating characteristic (ROC) curve methodology. Data from 1035 Brazilian participants were analyzed (health professionals = 180; Facebook users = 855). Regarding reliability results, the internal consistency (Cronbach alpha = 0.890 and 0.914) and test–retest (intraclass correlation coefficient = 0.814) were

  14. A temporary index

    International Nuclear Information System (INIS)

    Thomson, Jon; Craighead, Alison

    2015-01-01

    The ongoing management of low, intermediate and high-level nuclear waste is an unresolved issue for humanity, not least because the time-frames in question when dealing with the hazards of radioactive wastes, range from as little as a few tens of years to more than 100 000 years. It is from this starting point that we are beginning the development of an ambitious multifaceted artwork aiming to help us consider our relationship with deep-time and our nuclear legacy. The expressed aim of Temporary Index is to raise general awareness about these long-term management issues, and in doing so, to embed this knowledge into our collective cultural memory so as to transmit useful information about our nuclear waste into the future. We wish to create a series of decorative, real-time numeric counters based on the probabilistic decay (including decay of daughter products) of existing nuclear waste that we identify from the earliest weapons' development programmes in the United States right through to contemporary wastes being produced by nuclear energy production today across the world. Each display will countdown in seconds, showing the time remaining before the given item of waste (or a particular site) is considered safe to humans. A hypothetical example of one counter could be a bottle of sludge containing plutonium discovered in 2004 during an attempted clean-up of the Hanford nuclear site in Washington State, United States. Another example might be the geological storage facility for vitrified nuclear waste at Horonobe in Japan, should it be established in the future. Accident sites, such as Chernobyl or Fukushima Daiichi could also be tagged with counters, as could low-level waste (LLW) repositories such as the one at Drigg near Sellafield in the United Kingdom. Whatever the items identified and this will be a complex process requiring collaboration with experts in the field, it is important that a wide range of short- and long-term counters are established to

  15. The Carbon City Index (CCI)

    DEFF Research Database (Denmark)

    Boyd, Britta; Straatman, Bas; Mangalagiu, Diana

    This paper presents a consumption-based Carbon City Index for CO2 emissions in a city. The index is derived from regional consumption and not from regional production. It includes imports and exports of emissions, factual emission developments, green investments as well as low carbon city...

  16. Index Selection in Relational Databases

    NARCIS (Netherlands)

    Choenni, R.S.; Blanken, Henk; Chang, S.C.

    Intending to develop a tool which aims to support the physical design of relational databases can not be done without considering the problem of index selection. Generally the problem is split into a primary and secondary index selection problem and the selection is done per table. Whereas much

  17. A Tourism Financial Conditions Index

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); H-K. Hsu (Hui-Kuang); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ The paper uses monthly data on financial stock index returns, tourism stock sub-index returns, effective exchange rate returns and interest rate differences from April 2005 – August 2013 for Taiwan that applies Chang’s (2014) novel approach for constructing a tourism

  18. Maslov index for Hamiltonian systems

    Directory of Open Access Journals (Sweden)

    Alessandro Portaluri

    2008-01-01

    Full Text Available The aim of this article is to give an explicit formula for computing the Maslov index of the fundamental solutions of linear autonomous Hamiltonian systems in terms of the Conley-Zehnder index and the map time one flow.

  19. A New Index of Democracy

    Directory of Open Access Journals (Sweden)

    Jesús M. de Miguel

    2014-01-01

    Full Text Available The present paper analyses and revises the latest Democracy Index published by the Economist Intelligence Unit in the United Kingdom. We analyze the changes produced in the index from 2006 to 2011, as well as in the five basic factors that constitute the index: electoral process and pluralism; civil liberties; the functioning of government; political participation; and political culture. The analysis of these factors ?measured by sixty variables? has made it possible to develop a new index, based on the data from 167 countries, and calculate a revised ranking. Countries have been classified into four types: democracies, flawed democracies, mixed systems, and authoritarian/totalitarian regimes. The new index permits a better understanding of the impact of the crisis through variables such as economic growth, human development, quality of life, corruption, and violence.

  20. A new relative hazard index

    International Nuclear Information System (INIS)

    Smith, C.F.; Burnett, T.W.T; Kastenberg, W.E.

    1976-01-01

    Several indexes for the evaluation of relative radionuclide hazards have been previously developed. In this paper, a new relative hazard index is derived for use in the assessment of the future burden to mankind from the presence of radionuclides in the environment. Important features of this hazard index are that it takes into account multiple decay schemes, non-equilibrium conditions, and finite time periods. As an application of this hazard index, a comparison is made between thermal reactor radioactive waste and the uranium required as fuel with the following conclusions: (1) For short time intervals (d 234 U breaking the uranium decay chain. (3) For long time intervals of concern (d >= 500 000 years), the reactor waste and consumed uranium indexes are equal after a much shorter decay time (approximately 10 years.) (author)

  1. Cook Inlet and Kenai Peninsula, Alaska ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries used in the creation of the Environmental Sensitivity Index (ESI) for Cook Inlet and Kenai...

  2. Negative index effects from a homogeneous positive index prism

    Science.gov (United States)

    Marcus, Sherman W.; Epstein, Ariel

    2017-12-01

    Cellular structured negative index metamaterials in the form of a right triangular prism have often been tested by observing the refraction of a beam across the prism hypotenuse which is serrated in order to conform to the cell walls. We show that not only can this negative index effect be obtained from a homogeneous dielectric prism having a positive index of refraction, but in addition, for sampling at the walls of the cellular structure, the phase in the material has the illusory appearance of moving in a negative direction. Although many previous reports relied on refraction direction and phase velocity of prism structures to verify negative index design, our investigation indicates that to unambiguously demonstrate material negativity additional empirical evidence is required.

  3. Louisiana ESI: LG_INDEX (Large Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  4. Bristol Bay, Alaska Subarea ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  5. Deterministic indexing for packed strings

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Skjoldjensen, Frederik Rye

    2017-01-01

    Given a string S of length n, the classic string indexing problem is to preprocess S into a compact data structure that supports efficient subsequent pattern queries. In the deterministic variant the goal is to solve the string indexing problem without any randomization (at preprocessing time...... or query time). In the packed variant the strings are stored with several character in a single word, giving us the opportunity to read multiple characters simultaneously. Our main result is a new string index in the deterministic and packed setting. Given a packed string S of length n over an alphabet σ...

  6. 2014 Environmental Performance Index (EPI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2014 Environmental Performance Index (EPI) ranks 178 countries on 20 performance indicators in the following 9 policy categories: health impacts, air quality,...

  7. 2016 Environmental Performance Index (EPI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2016 Environmental Performance Index (EPI) ranks 180 countries on 20 performance indicators in the following 9 policy categories: health impacts, air quality,...

  8. VT - Vermont Social Vulnerability Index

    Data.gov (United States)

    Vermont Center for Geographic Information — Social vulnerability refers to the resilience of communities when responding to or recovering from threats to public health. The Vermont Social Vulnerability Index...

  9. Antimicrobial Pesticide Use Site Index

    Science.gov (United States)

    This Use Site Index provides guidance to assist applicants for antimicrobial pesticide registration by helping them identify the data requirements necessary to register a pesticide or support their product registrations.

  10. Allegheny County Map Index Grid

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Map Index Sheets from Block and Lot Grid of Property Assessment and based on aerial photography, showing 1983 datum with solid line and NAD 27 with 5 second grid...

  11. Ozone - Current Air Quality Index

    Science.gov (United States)

    GO! Local Air Quality Conditions Zip Code: State : My Current Location Current AQI Forecast AQI Loop More Maps AQI: Good (0 - 50) ... resources for Hawaii residents and visitors more announcements Air Quality Basics Air Quality Index | Ozone | Particle Pollution | Smoke ...

  12. Author's capabilities in author indexing

    International Nuclear Information System (INIS)

    Ooi, Shoichi

    1988-01-01

    The purpose of this paper is to provide a author capability of current author indexing practices in journal literature indexing practices in 'Journal of Nuclear Science and Technology of Japan'. This Journal employed keywords freely assigned by author and not taken from INIS Thesaurus or other vocabulary list. Author examined 413 literatures, comparing keywords assigned by the literatures' authors with descriptor's (ATOMINDEX) assigned by an experienced professional indexer. The results of the comparisons showed that the average set of terms assigned by author included about 70% of all the terms assigned to the same literature by the professional indexer. Authors eventually would contribute, for the most effective point to create reference to information is at the time of its generation. Consequently, it may be possible to transfer them easily to descriptors in every secondary information system. (author)

  13. VT US National Grid Index

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) USNGVT is a U.S. National Grid Index (1000m x 1000m) covering Vermont. It is a polygon feature class originally constructed by the Center for...

  14. 2010 Environmental Performance Index (EPI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2010 Environmental Performance Index (EPI) ranks 163 countries on environmental performance based on twenty-five indicators grouped within ten core policy...

  15. KWIC Index to Government Publications

    Directory of Open Access Journals (Sweden)

    Margaret Norden

    2013-05-01

    Full Text Available United States and United Nations publications were not efficiently proc- essed nor readily available to the reader at Brandeis University Library. Data processing equipment was used to make a list of this material which could be referred to by a computer produced KWIC index. Currency and availability to the user, and time and cost efficiencies for the library were given precedence over detailed subject access. United States and United Nations classification schemes> and existing bibliographies and indexes were used extensively.

  16. 1999 who's who category index

    International Nuclear Information System (INIS)

    1999-01-01

    A classified index and alphabetical directory of Canadian corporate entities involved in the production, manufacturing, conversion, service, retail sales, research and development, transportation, insurance, legal and communications aspects of propane in Canada is provided. The alphabetical directory section provides the usual business information (name, postal address, phone, fax, e-mail and Internet addresses), names of principal officers, affiliations, products or services produced or marketed, and the category under which the company is listed in the classified index

  17. The "Antidirector Rights Index" Revisited

    OpenAIRE

    Holger Spamann

    2010-01-01

    The "antidirector rights index" has been used as a measure of shareholder protection in over a hundred articles since it was introduced by La Porta et al. ("Law and Finance." 1998, Journal of Political Economy 106:1113--55). A thorough reexamination of the legal data, however, leads to corrections for thirty-three of the forty-six countries analyzed. The correlation between corrected and original values is only 0.53. Consequently, many empirical results established using the original index ma...

  18. Congestive index of portal vein

    International Nuclear Information System (INIS)

    Kim, Won Ho; Kim, H. K.; Lee, S. C.; Han, S. H.; Han, K. H.; Chung, J. B.; Choi, H. J.

    1989-01-01

    In patients with portal hypertension, the blood flow volume is maintained despite decreased blood flow velocity due to enlargement of the vascular cross sectional area. Thus, the 'congestion index' of the portal vein, which is the ratio between the cross sectional area (cm2) and the blood flow velocity (cm/sec) determined by a Doppler ultrasonography, may be a sensitive index by which to assess portal hypertension. We performed Doppler ultrasonography on 24 normal subjects, 14 patients with biopsy proved chronic active hepatitis and 55 patients with liver cirrhosis in order to assess the diagnostic value of the congestion index. The cross sectional area of the portal vein was significantly enlarged and the mean blood flow velocity was significantly reduced in patients with liver cirrhosis compared with controls. However, the blood flow volume was no difference. The congestion index of the portal vein was significantly increased in patients with liver cirrhosis (0.113+0.035) compared with patients with chronic active hepatitis(0.078+0.029) (p<0.001) and controls (0.053+0.016) (p<0.001). The sensitivity, specificity and predictability of the congestion index for detection of patients with the cirrhosis of the liver were 76.4%, 100% and 100% respectively, when the normal range was set at mean+2SD. The results suggest that the congestion index of the portal vein may pla a significant role in diagnosis of portal hypertensive patients

  19. [Sciatica. From stretch rack to microdiscectomy].

    Science.gov (United States)

    Gruber, P; Böni, T

    2015-12-01

    In ancient times as well as in the Middle Ages treatment options for discogenic nerve compression syndrome were limited and usually not very specific because of low anatomical and pathophysiological knowledge. The stretch rack (scamnum Hippocratis) was particularly prominent but was widely used as a therapeutic device for very different spinal disorders. Since the beginning of the nineteenth century anatomical knowledge increased and the advances in the fields of asepsis, anesthesia and surgery resulted in an increase in surgical interventions on the spine. In 1908 the first successful lumbar discectomy was initiated and performed by the German neurologist Heinrich O. Oppenheim (1858-1919) and the surgeon Fedor Krause (1857-1937); however, neither recognized the true pathological condition of discogenic nerve compression syndrome. With the landmark report in the New England Journal of Medicine in 1934, the two American surgeons William Jason Mixter (1880-1958) and Joseph Seaton Barr (1901-1963) finally clarified the pathomechanism of lumbar disc herniation and furthermore, propagated discectomy as the standard therapy. Since then interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. The surgical procedures changed over time and were continuously being refined. In the late 1960s the surgical microscope was introduced for spinal surgery by the work of the famous neurosurgeon Mahmut Gazi Yasargil and his colleague Wolfhard Caspar and so-called microdiscectomy was introduced. Besides open discectomy other interventional techniques were developed to overcome the side effects of surgical procedures. In 1964 the American orthopedic surgeon Lyman Smith (1912-1991) introduced chemonucleolysis, a minimally invasive technique consisting only of a cannula and the proteolytic enzyme chymopapain, which is injected into the disc compartment to dissolve the displaced disc material. In 1975 the Japanese orthopedic surgeon Sadahisa Hijikata described percutaneous discectomy for the first time, which was a further minimally invasive surgical technique. Further variants of minimally invasive surgical procedures, such as percutaneous laser discectomy in 1986 and percutaneous endoscopic microdiscectomy in 1997, were also introduced; however, open discectomy, especially microdiscectomy remains the therapeutic gold standard for lumbar disc herniation.

  20. Predicting fiber refractive index from a measured preform index profile

    Science.gov (United States)

    Kiiveri, P.; Koponen, J.; Harra, J.; Novotny, S.; Husu, H.; Ihalainen, H.; Kokki, T.; Aallos, V.; Kimmelma, O.; Paul, J.

    2018-02-01

    When producing fiber lasers and amplifiers, silica glass compositions consisting of three to six different materials are needed. Due to the varying needs of different applications, substantial number of different glass compositions are used in the active fiber structures. Often it is not possible to find material parameters for theoretical models to estimate thermal and mechanical properties of those glass compositions. This makes it challenging to predict accurately fiber core refractive index values, even if the preform index profile is measured. Usually the desired fiber refractive index value is achieved experimentally, which is expensive. To overcome this problem, we analyzed statistically the changes between the measured preform and fiber index values. We searched for correlations that would help to predict the Δn-value change from preform to fiber in a situation where we don't know the values of the glass material parameters that define the change. Our index change models were built using the data collected from preforms and fibers made by the Direct Nanoparticle Deposition (DND) technology.

  1. Corporate Sustainability Indexes: FTSE 4 Good Index Report on Nestle

    Directory of Open Access Journals (Sweden)

    Gülay Keskin

    2018-04-01

    Full Text Available Corporate sustainability and economic business activities are focused on the social and environmental impacts. In this sense, the economic activity created by the businesses is to pursue social and environmental impacts, and producing information related to these effects is essential for the formation of structure for a sustainable business. Sustainability indices are structures edited on first generation sustainability indicators, which are structures constructed in order to share information with consumers and businesses. The most important benefits are improvements in transparency without the need for regulation of the sustainability index, better understanding of the social and environmental impact of companies and the guidance for arrangements to minimize the negative side effects of company activities. FTSE4Good is a responsible investment index designed to help investors identify companies that meet globally recognised corporate responsibility standards. It is the only index of its kind since it includes specific criteria on the responsible marketing of breast milk substitutes.

  2. Prediction of massive bleeding. Shock index and modified shock index.

    Science.gov (United States)

    Terceros-Almanza, L J; García-Fuentes, C; Bermejo-Aznárez, S; Prieto-Del Portillo, I J; Mudarra-Reche, C; Sáez-de la Fuente, I; Chico-Fernández, M

    2017-12-01

    To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. Retrospective cohort. Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  3. DIDA: Distributed Indexing Dispatched Alignment.

    Directory of Open Access Journals (Sweden)

    Hamid Mohamadi

    Full Text Available One essential application in bioinformatics that is affected by the high-throughput sequencing data deluge is the sequence alignment problem, where nucleotide or amino acid sequences are queried against targets to find regions of close similarity. When queries are too many and/or targets are too large, the alignment process becomes computationally challenging. This is usually addressed by preprocessing techniques, where the queries and/or targets are indexed for easy access while searching for matches. When the target is static, such as in an established reference genome, the cost of indexing is amortized by reusing the generated index. However, when the targets are non-static, such as contigs in the intermediate steps of a de novo assembly process, a new index must be computed for each run. To address such scalability problems, we present DIDA, a novel framework that distributes the indexing and alignment tasks into smaller subtasks over a cluster of compute nodes. It provides a workflow beyond the common practice of embarrassingly parallel implementations. DIDA is a cost-effective, scalable and modular framework for the sequence alignment problem in terms of memory usage and runtime. It can be employed in large-scale alignments to draft genomes and intermediate stages of de novo assembly runs. The DIDA source code, sample files and user manual are available through http://www.bcgsc.ca/platform/bioinfo/software/dida. The software is released under the British Columbia Cancer Agency License (BCCA, and is free for academic use.

  4. Computerized index for teaching files

    International Nuclear Information System (INIS)

    Bramble, J.M.

    1989-01-01

    A computerized index can be used to retrieve cases from a teaching file that have radiographic findings similar to an unknown case. The probability that a user will review cases with a correct diagnosis was estimated with use of radiographic findings of arthritis in hand radiographs of 110 cases from a teaching file. The nearest-neighbor classification algorithm was used as a computer index to 110 cases of arthritis. Each case was treated as an unknown and inputted to the computer index. The accuracy of the computer index in retrieving cases with the same diagnosis (including rheumatoid arthritis, gout, psoriatic arthritis, inflammatory osteoarthritis, and pyrophosphate arthropathy) was measured. A Bayes classifier algorithm was also tested on the same database. Results are presented. The nearest-neighbor algorithm was 83%. By comparison, the estimated accuracy of the Bayes classifier algorithm was 78%. Conclusions: A computerized index to a teaching file based on the nearest-neighbor algorithm should allow the user to review cases with the correct diagnosis of an unknown case, by entering the findings of the unknown case

  5. Macdonald index and chiral algebra

    Science.gov (United States)

    Song, Jaewon

    2017-08-01

    For any 4d N = 2 SCFT, there is a subsector described by a 2d chiral algebra. The vacuum character of the chiral algebra reproduces the Schur index of the corresponding 4d theory. The Macdonald index counts the same set of operators as the Schur index, but the former has one more fugacity than the latter. We conjecture a prescription to obtain the Macdonald index from the chiral algebra. The vacuum module admits a filtration, from which we construct an associated graded vector space. From this grading, we conjecture a notion of refined character for the vacuum module of a chiral algebra, which reproduces the Macdonald index. We test this prescription for the Argyres-Douglas theories of type ( A 1 , A 2 n ) and ( A 1 , D 2 n+1) where the chiral algebras are given by Virasoro and \\widehat{su}(2) affine Kac-Moody algebra. When the chiral algebra has more than one family of generators, our prescription requires a knowledge of the generators from the 4d.

  6. Index

    Directory of Open Access Journals (Sweden)

    Antonio Juan SÁNCHEZ

    2013-05-01

    Full Text Available The Advances in Distributed Computing and Artificial Intelligence Journal (ADCAIJ is an open access journal that publishes articles which contribute new results associated with distributed computing and artificial intelligence,and their application in different areas. The artificial intelligence is changing our society. Its application in distributed environments, such as the Internet, electronic commerce, mobile communications, wireless devices, distributed computing and so on, is increasing and becoming and element of high added value and economic potential in industry and research. These technologies are changing constantly as a result of the large research and technical effort being undertaken in both universities and businesses. The exchange of ideas between scientists and technicians from both academic and business areas is essential to facilitate the development of systems that meet the demands of today's society. We would like to thank all the contributing authors for their hard and highly valuable work. Their work has helped to contribute to the success of this special issue. Finally, the Editors wish to thank Scientific Committee of Advances in Distributed Computing and Artificial Intelligence Journal for the collaboration of this special issue, that notably contributes to improve the quality of the journal. We hope the reader will share our joy and find this special issue very useful.

  7. Index

    Directory of Open Access Journals (Sweden)

    Antonio Juan Sánchez

    2013-08-01

    Full Text Available The Advances in Distributed Computing and Artificial Intelligence Journal (ADCAIJ is an open access journal that publishes articles which contribute new results associated with distributed computing and artificial intelligence,and their application in different areas.The artificial intelligence is changing our society. Its application in distributed environments, such as the Internet, electronic commerce, mobile communications, wireless devices, distributed computing and so on, is increasing and becoming and element of high added value and economic potential in industry and research. These technologies are changing constantly as a result of the large research and technical effort being undertaken in both universities and businesses. The exchange of ideas between scientists and technicians from both academic and business areas is essential to facilitate the development of systems that meet the demands of today's society.We would like to thank all the contributing authors for their hard and highly valuable work. Their work has helped to contribute to the success of this special issue. Finally, the Editors wish to thank Scientific Committee of Advances in Distributed Computing and Artificial Intelligence Journal for the collaboration of this special issue, that notably contributes to improve the quality of the journal. We hope the reader will share our joy and find this special issue very useful.

  8. Index

    Directory of Open Access Journals (Sweden)

    Antonio Juan Sánchez

    2012-09-01

    Full Text Available The Advances in Distributed Computing and Artificial Intelligence Journal (ISSN: 2255-2863 is an open access journal that publishes articles which contribute new results associated with distributed computing and artificial intelligence, and their application in different areas. The artificial intelligence is changing our society. Its application in distributed environments, such as the Internet, electronic commerce, mobile communications, wireless devices, distributed computing and so on, is increasing and becoming and element of high added value and economic potential in industry and research. These technologies are changing constantly as a result of the large research and technical effort being undertaken in both universities and businesses. The exchange of ideas between scientists and technicians from both academic and business areas is essential to facilitate the development of systems that meet the demands of today's society.

  9. INDEX

    OpenAIRE

    Pette, Dirk; Gondin, Julien; Bizzarini, Emiliana; Kern, Helmut; Hofer, Christian; L?fler, Stefan; Mayr, Winfried; M?dlin, Michaela; Urban, Samantha; Kern, Helmut; Biowski, Peter; Marcante, Andrea; Baba, Alfonc; Ghezzo, Luca; Weis, Luca

    2017-01-01

    It is well known that repeated bouts of exercise (i.e. exercise training) lead to an elevated content of mitochondria within muscle. This adaptation confers metabolic advantages during exercise, such as an increase in the aerobic metabolism of lipids, reduced glycogen usage, and diminished lactate production. The molecular basis for this increase in organelle content involves the activation of PGC-1? along with numerous transcription factors which increase the expression of nuclear genes enco...

  10. Energetic consumption levels and human development indexes

    International Nuclear Information System (INIS)

    Boa Nova, Antonio Carlos

    1999-01-01

    The article overviews the energetic consumption levels and human development indexes. The human development indexes are described based on the United Nations Development Programme. A comparison between the energetic consumption levels and human development indexes is also presented

  11. FRELIB, Failure Reliability Index Calculation

    International Nuclear Information System (INIS)

    Parkinson, D.B.; Oestergaard, C.

    1984-01-01

    1 - Description of problem or function: Calculation of the reliability index given the failure boundary. A linearization point (design point) is found on the failure boundary for a stationary reliability index (min) and a stationary failure probability density function along the failure boundary, provided that the basic variables are normally distributed. 2 - Method of solution: Iteration along the failure boundary which must be specified - together with its partial derivatives with respect to the basic variables - by the user in a subroutine FSUR. 3 - Restrictions on the complexity of the problem: No distribution information included (first-order-second-moment-method). 20 basic variables (could be extended)

  12. Indexing from thesauri to the semantic web

    CERN Document Server

    de Keyser, Piet

    2012-01-01

    Indexing consists of both novel and more traditional techniques. Cutting-edge indexing techniques, such as automatic indexing, ontologies, and topic maps, were developed independently of older techniques such as thesauri, but it is now recognized that these older methods also hold expertise. Indexing describes various traditional and novel indexing techniques, giving information professionals and students of library and information sciences a broad and comprehensible introduction to indexing. This title consists of twelve chapters: an Introduction to subject readings and theasauri; Automatic i

  13. Indexes to Nuclear Regulatory Commission Issuances

    International Nuclear Information System (INIS)

    1996-01-01

    Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and licensing Board Panel (LBP), the Administrative Law Judges (ALJ) the Directors' Decisions (DD), and the Decisions on Petitions for Rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. Information elements are displayed in one or more of five separate formats arranged as follows: Case Name Index; Headers and Digests; Legal Citations Index; Subject Index; and Facility Index

  14. Indexes to Nuclear Regulatory Commission Issuances

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and licensing Board Panel (LBP), the Administrative Law Judges (ALJ) the Directors` Decisions (DD), and the Decisions on Petitions for Rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. Information elements are displayed in one or more of five separate formats arranged as follows: Case Name Index; Headers and Digests; Legal Citations Index; Subject Index; and Facility Index.

  15. Transportation environment data bank index

    International Nuclear Information System (INIS)

    Davidson, C.A.; Foley, J.T.

    1975-06-01

    In an effort to determine the environmental intensities to which shipping containers will be exposed, a ''Data Bank'' of environmental information has been established by Sandia Laboratories, Division 1542, for the ERDA Division of Waste Management and Transportation. This document is an index which can be used to request data of interest. (U.S.)

  16. Witten index for noncompact dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung-Joo [Department of Physics, Robeson Hall, Virginia Tech,Robeson Hall, 0435, 850 West Campus Drive, Blacksburg, VA 24061 (United States); Yi, Piljin [School of Physics and Quantum Universe Center, Korea Institute for Advanced Study,85 Hoegi-ro, Dongdaemun-gu, Seoul 02455 (Korea, Republic of)

    2016-06-16

    Among gauged dynamics motivated by string theory, we find many with gapless asymptotic directions. Although the natural boundary condition for ground states is L{sup 2}, one often turns on chemical potentials or supersymmetric mass terms to regulate the infrared issues, instead, and computes the twisted partition function. We point out how this procedure generically fails to capture physical L{sup 2} Witten index with often misleading results. We also explore how, nevertheless, the Witten index is sometimes intricately embedded in such twisted partition functions. For d=1 theories with gapless continuum sector from gauge multiplets, such as non-primitive quivers and pure Yang-Mills, a further subtlety exists, leading to fractional expressions. Quite unexpectedly, however, the integral L{sup 2} Witten index can be extracted directly and easily from the twisted partition function of such theories. This phenomenon is tied to the notion of the rational invariant that appears naturally in the wall-crossing formulae, and offers a general mechanism of reading off Witten index directly from the twisted partition function. Along the way, we correct early numerical results for some of N=4,8,16 pure Yang-Mills quantum mechanics, and count threshold bound states for general gauge groups beyond SU(N).

  17. 1988 Bulletin compilation and index

    International Nuclear Information System (INIS)

    1989-02-01

    This document is published to provide current information about the national program for managing spent fuel and high-level radioactive waste. This document is a compilation of issues from the 1988 calendar year. A table of contents and one index have been provided to assist in finding information

  18. Follicular lymphoma international prognostic index

    NARCIS (Netherlands)

    Solal-Céligny, Philippe; Roy, Pascal; Colombat, Philippe; White, Josephine; Armitage, Jim O.; Arranz-Saez, Reyes; Au, Wing Y.; Bellei, Monica; Brice, Pauline; Caballero, Dolores; Coiffier, Bertrand; Conde-Garcia, Eulogio; Doyen, Chantal; Federico, Massimo; Fisher, Richard I.; Garcia-Conde, Javier F.; Guglielmi, Cesare; Hagenbeek, Anton; Haïoun, Corinne; LeBlanc, Michael; Lister, Andrew T.; Lopez-Guillermo, Armando; McLaughlin, Peter; Milpied, Noël; Morel, Pierre; Mounier, Nicolas; Proctor, Stephen J.; Rohatiner, Ama; Smith, Paul; Soubeyran, Pierre; Tilly, Hervé; Vitolo, Umberto; Zinzani, Pier-Luigi; Zucca, Emanuele; Montserrat, Emili

    2004-01-01

    The prognosis of follicular lymphomas (FL) is heterogeneous and numerous treatments may be proposed. A validated prognostic index (PI) would help in evaluating and choosing these treatments. Characteristics at diagnosis were collected from 4167 patients with FL diagnosed between 1985 and 1992.

  19. Proceedings (Mathematical Sciences) SUBJECT INDEX

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    SUBJECT INDEX. Abel's summation formula. Analogues of Euler and Poisson summa- tion formulae. 213 ... theorems of Wiener and Lévy on absolutely convergent Fourier series. 179. Brownian motion. Probabilistic representations of solutions to the heat equation. 321. Cesáro matrix. Necessary and sufficient conditions for.

  20. Witten index for noncompact dynamics

    Science.gov (United States)

    Lee, Seung-Joo; Yi, Piljin

    2016-06-01

    Among gauged dynamics motivated by string theory, we find many with gapless asymptotic directions. Although the natural boundary condition for ground states is L 2, one often turns on chemical potentials or supersymmetric mass terms to regulate the infrared issues, instead, and computes the twisted partition function. We point out how this procedure generically fails to capture physical L 2 Witten index with often misleading results. We also explore how, nevertheless, the Witten index is sometimes intricately embedded in such twisted partition functions. For d = 1 theories with gapless continuum sector from gauge multiplets, such as non-primitive quivers and pure Yang-Mills, a further subtlety exists, leading to fractional expressions. Quite unexpectedly, however, the integral L 2 Witten index can be extracted directly and easily from the twisted partition function of such theories. This phenomenon is tied to the notion of the rational invariant that appears naturally in the wall-crossing formulae, and offers a general mechanism of reading off Witten index directly from the twisted partition function. Along the way, we correct early numerical results for some of mathcal{N} = 4 , 8 , 16 pure Yang-Mills quantum mechanics, and count threshold bound states for general gauge groups beyond SU( N ).

  1. Witten index for noncompact dynamics

    International Nuclear Information System (INIS)

    Lee, Seung-Joo; Yi, Piljin

    2016-01-01

    Among gauged dynamics motivated by string theory, we find many with gapless asymptotic directions. Although the natural boundary condition for ground states is L"2, one often turns on chemical potentials or supersymmetric mass terms to regulate the infrared issues, instead, and computes the twisted partition function. We point out how this procedure generically fails to capture physical L"2 Witten index with often misleading results. We also explore how, nevertheless, the Witten index is sometimes intricately embedded in such twisted partition functions. For d=1 theories with gapless continuum sector from gauge multiplets, such as non-primitive quivers and pure Yang-Mills, a further subtlety exists, leading to fractional expressions. Quite unexpectedly, however, the integral L"2 Witten index can be extracted directly and easily from the twisted partition function of such theories. This phenomenon is tied to the notion of the rational invariant that appears naturally in the wall-crossing formulae, and offers a general mechanism of reading off Witten index directly from the twisted partition function. Along the way, we correct early numerical results for some of N=4,8,16 pure Yang-Mills quantum mechanics, and count threshold bound states for general gauge groups beyond SU(N).

  2. Automatic indexing, compiling and classification

    International Nuclear Information System (INIS)

    Andreewsky, Alexandre; Fluhr, Christian.

    1975-06-01

    A review of the principles of automatic indexing, is followed by a comparison and summing-up of work by the authors and by a Soviet staff from the Moscou INFORM-ELECTRO Institute. The mathematical and linguistic problems of the automatic building of thesaurus and automatic classification are examined [fr

  3. Asymptotics for the Hirsch Index

    NARCIS (Netherlands)

    Beirlant, J.; Einmahl, J.H.J.

    2007-01-01

    The last decade methods for quantifying the research output of individual researchers have become quite popular in academic policy making. The h- index (Hirsch, 2005) constitutes an interesting quality measure that has attracted a lot of attention recently. It is now a standard measure available for

  4. Fermion fractionization and index theorem

    International Nuclear Information System (INIS)

    Hirayama, Minoru; Torii, Tatsuo

    1982-01-01

    The relation between the fermion fractionization and the Callias-Bott-Seeley index theorem for the Dirac operator in the open space of odd dimension is clarified. Only the case of one spatial dimension is discussed in detail. Sum rules for the expectation values of various quantities in fermion-fractionized configurations are derived. (author)

  5. The Danish Neck Disability Index

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; O'Neill, Lotte; Kongsted, Alice

    2017-01-01

    Objective: To (1) translate and culturally adapt and (2) determine the clinimetric properties of the Danish 8-item Neck Disability Index (NDI-8) in primary sector patients (PSPs) and secondary sector patients (SSPs). Methods: Analyses included 326 patients with neck pain. Validity and reliability...

  6. Transportation Environment Data Bank index

    International Nuclear Information System (INIS)

    Davidson, C.A.; Foley, J.T.

    1977-04-01

    In an effort to determine the environment intensities to which energy materials in transit will be exposed, a ''Data Bank'' of environmental information has been established by Sandia Laboratories, Division 1285 for the ERDA Division of Environmental Control Technology. This document is an index which can be used to request data of interest

  7. Transportation environment data bank index

    International Nuclear Information System (INIS)

    Davidson, C.A.; Foley, J.T.

    1976-02-01

    In an effort to determine the environment intensities to which shipping containers will be exposed, a ''Data Bank'' of environmental information has been established by Sandia Laboratories, Division 1285 for the ERDA Division of Environmental Control Technology. This document is an index which can be used to request data of interest

  8. 1988 Bulletin compilation and index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-02-01

    This document is published to provide current information about the national program for managing spent fuel and high-level radioactive waste. This document is a compilation of issues from the 1988 calendar year. A table of contents and one index have been provided to assist in finding information.

  9. An Index of Loss Aversion

    NARCIS (Netherlands)

    Köbberling, V.; Wakker, P.P.

    2005-01-01

    To a considerable extent, risk aversion as it is commonly observed is caused by loss aversion. Several indexes of loss aversion have been proposed in the literature. The one proposed in this paper leads to a clear decomposition of risk attitude into three distinct components: basic utility,

  10. An Index of Loss Aversion

    NARCIS (Netherlands)

    V. Köbberling (Veronika); P.P. Wakker (Peter)

    2005-01-01

    textabstractTo a considerable extent, risk aversion as it is commonly observed is caused by loss aversion. Several indexes of loss aversion have been proposed in the literature. The one proposed in this paper leads to a clear decomposition of risk attitude into three distinct components: basic

  11. Index to AEC Information Booklets

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-01-01

    The U. S. Atomic Energy Commission publishes a series of information booklets for the general public. These booklets explain many aspects of nuclear science. Because these booklets cover such a variety of scientific fields, this index was prepared to help the reader find quickly those booklets that contain the information he needs.

  12. Central index of dose information

    International Nuclear Information System (INIS)

    1991-01-01

    The Central Index of Dose Information (CIDI) is a national database of occupational exposure to radiation operated by the NRPB as agent for the Health and Safety Executive. It receives summarised information on the radiation doses to classified persons in Great Britain annually from Approved Dosimetry Services. This document is the first annual CIDI summary of the data, giving statistics for 1986. (UK)

  13. Alaska Index of Watershed Integrity

    Science.gov (United States)

    The US Environmental Protection Agency’s (EPA) Index of Watershed Integrity (IWI) is used to calculate and visualize the status of natural watershed infrastructure that supports ecological processes (e.g., nutrient cycling) and services provided to society (e.g., subsistenc...

  14. 75 FR 64642 - Indexed Annuities

    Science.gov (United States)

    2010-10-20

    ... 3235-AK16 Indexed Annuities AGENCY: Securities and Exchange Commission. ACTION: Final rule; withdrawal... under the Securities Act of 1933, which defines the terms ``annuity contract'' and ``optional annuity... under the Securities Act of 1933.\\1\\ Rule 151A defines the terms ``annuity contract'' and ``optional...

  15. Lifestyle index and work ability.

    Science.gov (United States)

    Kaleta, Dorota; Makowiec-Dabrowska, Teresa; Jegier, Anna

    2006-01-01

    In many countries around the world, negative changes in lifestyles are observed. The aim of this study was to analyze the influence of selected lifestyle indicators on work ability among professionally active individuals. The study was performed in the randomly selected group of full-time employees (94 men and 93 women) living in the city of Lódź. Work ability was measured with the work ability index and lifestyle characteristic was assessed with the healthy lifestyle index. We analyzed four lifestyle indicators: non-smoking, healthy weight, fiber intake per day, and regular physical activity. Logistic regression was used to estimate odds ratios and 95% confidence intervals to control the effects of lifestyle and work ability. The analysis of lifestyle index indicated that 27.7, 30.9, 27.7 and 11.7% of men and 15.1, 21.5, 35.5 and 26.9% of women scored 0, 1, 2, 3 points, respectively. Only 2.1% of men and 1.1% of women met the criteria for the healthy lifestyle (score 4). Work ability was excellent, good and moderate in 38.3, 46.8 and 14.9% of men, and in 39.8, 14.9 and 19.3% of women, respectively. Poor work ability was found in 9.7% women. Work ability was strongly associated with lifestyle in both men and women. Among men with index score = 0, the risk of moderate work ability was nearly seven times higher than in men whose lifestyle index score exceeded 1 or more points (OR = 6.67; 95% CI: 1.94-22.90). Among women with lifestyle index score = 0, the risk of moderate or lower work ability was also highly elevated as compared to those with lifestyle index = 1 or higher (OR = 14.44; 95% CI: 3.53-59.04). Prophylactic schedules associated with the improvement of lifestyles should be addressed to all adults. Future programs aimed at increasing work ability should consider work- and lifestyle-related factors.

  16. 21 CFR 516.157 - Publication of the index and content of an index listing.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Publication of the index and content of an index... MINOR SPECIES Index of Legally Marketed Unapproved New Animal Drugs for Minor Species § 516.157 Publication of the index and content of an index listing. (a) FDA will make the list of indexed drugs...

  17. The Biodiversity Informatics Potential Index

    Science.gov (United States)

    2011-01-01

    Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a) identifying countries most likely to

  18. Event Index - a LHCb Event Search System

    CERN Document Server

    INSPIRE-00392208; Kazeev, Nikita; Redkin, Artem

    2015-12-23

    LHC experiments generate up to $10^{12}$ events per year. This paper describes Event Index - an event search system. Event Index's primary function is quickly selecting subsets of events from a combination of conditions, such as the estimated decay channel or stripping lines output. Event Index is essentially Apache Lucene optimized for read-only indexes distributed over independent shards on independent nodes.

  19. An atmospheric dispersion index for prescribed burning

    Science.gov (United States)

    Leonidas G. Lavdas

    1986-01-01

    A numerical index that estimates the atmosphere's capacity to disperse smoke from prescribed burning is described. The physical assumptions and mathematical development of the index are given in detail. A preliminary interpretation of dispersion index values is offered. A FORTRAN subroutine package for computing the index is included.

  20. 40 CFR 58.50 - Index reporting.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Index reporting. 58.50 Section 58.50... QUALITY SURVEILLANCE Air Quality Index Reporting § 58.50 Index reporting. (a) The State or where... quality index that complies with the requirements of appendix G to this part. (b) Reporting is required...

  1. 32 CFR 701.39 - Vaughn index.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Vaughn index. 701.39 Section 701.39 National... DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.39 Vaughn index. Itemized index, correlating... agency's nondisclosure justification. The index may contain such information as: date of document...

  2. Regulatory and technical reports (abstract index journal)

    International Nuclear Information System (INIS)

    1994-03-01

    This compilation consists of bibliographic data and abstracts for the formal regulatory and technical reports issued by the US Nuclear Regulatory Commission staff and its contractors. There are four types of reports included: staff reports, conference reports, contractor reports, and international agreement reports. In addition to the main citations with abstracts, the following are also included: Secondary report number index; Personal author index; Subject index; NRC originating organization indices for staff reports and international agreement reports; NRC contract sponsor index; Contractor index; International organization index; and Licensed facility index

  3. Pricing of temperature index insurance

    Directory of Open Access Journals (Sweden)

    Che Mohd Imran Che Taib

    2012-01-01

    Full Text Available The aim of this paper is to study pricing of weather insurance contracts based on temperature indices. Three different pricing methods are analysed: the classical burn approach, index modelling and temperature modelling. We take the data from Malaysia as our empirical case. Our results show that there is a significant difference between the burn and index pricing approaches on one hand, and the temperature modelling method on the other. The latter approach is pricing the insurance contract using a seasonal autoregressive time series model for daily temperature variations, and thus provides a precise probabilistic model for the fine structure of temperature evolution. We complement our pricing analysis by an investigation of the profit/loss distribution from the contract, in the perspective of both the insured and the insurer.

  4. Need for an Ecological Index

    Directory of Open Access Journals (Sweden)

    Rohan Wickramasinghe

    2007-12-01

    Full Text Available The article was published in the Sri Lankan newspaper 'The Island' on the 30th November 2005 after the World Environmental Education Congress (WEEC held in Milan. Author hopes it could provide a base for a project for senior school children or more senior students to devise an Ecological Index and ‘If nothing else, it could help them in thinking out the issues involved!’ Author supposes that could be a form of environmental education.

  5. KWIC Index to Government Publications

    OpenAIRE

    Norden, Margaret

    2013-01-01

    United States and United Nations publications were not efficiently proc- essed nor readily available to the reader at Brandeis University Library. Data processing equipment was used to make a list of this material which could be referred to by a computer produced KWIC index. Currency and availability to the user, and time and cost efficiencies for the library were given precedence over detailed subject access. United States and United Nations classification schemes> and existing bibliograp...

  6. Body Mass Index and Stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2013-01-01

    Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....

  7. Generic communications index: User's manual

    International Nuclear Information System (INIS)

    Dean, R.S.; Steinbrecher, D.H.; Hennick, A.

    1987-12-01

    This report is a manual for providing information required to use a special computer program developed by the NRC for indexing generic communications. The program is written in a user-friendly menu driven form using dBASE III programming language. It facilitates use of the required dBASE III search and sort capabilities to access records in a database called Generic Communications Index. This index is made up of one record each for all bulletins, circulars, and information notices, including revisions and supplements, from 1971, when such documentation started, through 1986 (or to the latest update). The program is designed for use by anyone modestly acquainted with the general use of IBM-compatible personal computers. The manual contains both a brief overview and a detailed description of the program, as well as detailed instructions for getting started using the program on a personal computer with either a two-floppy disk or a hard disk system. Included at the end are a brief description of how to handle problems which might occur, and notes on the makeup of the program and database files for help in adding records of communications for future years

  8. Bureau of Radiological Health publications index

    International Nuclear Information System (INIS)

    1979-08-01

    The Key Word in Context (KWIC) index to the publications of the Bureau of Radiological Health was prepared to aid in the retrieval and identification of publications originated or authored by Bureau staff or published by the Bureau. These publications include journal articles, government publications and technical reports, selected staff papers, and Bureau news releases issued by HEW. For convenience, the document is divided into four sections, KWIC Index, Author Index, Bibliography Index, and BRH Publications Subject Index

  9. Experimental comparison between speech transmission index, rapid speech transmission index, and speech intelligibility index.

    Science.gov (United States)

    Larm, Petra; Hongisto, Valtteri

    2006-02-01

    During the acoustical design of, e.g., auditoria or open-plan offices, it is important to know how speech can be perceived in various parts of the room. Different objective methods have been developed to measure and predict speech intelligibility, and these have been extensively used in various spaces. In this study, two such methods were compared, the speech transmission index (STI) and the speech intelligibility index (SII). Also the simplification of the STI, the room acoustics speech transmission index (RASTI), was considered. These quantities are all based on determining an apparent speech-to-noise ratio on selected frequency bands and summing them using a specific weighting. For comparison, some data were needed on the possible differences of these methods resulting from the calculation scheme and also measuring equipment. Their prediction accuracy was also of interest. Measurements were made in a laboratory having adjustable noise level and absorption, and in a real auditorium. It was found that the measurement equipment, especially the selection of the loudspeaker, can greatly affect the accuracy of the results. The prediction accuracy of the RASTI was found acceptable, if the input values for the prediction are accurately known, even though the studied space was not ideally diffuse.

  10. 7 CFR 5.1 - Parity index and index of prices received by farmers.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Parity index and index of prices received by farmers... § 5.1 Parity index and index of prices received by farmers. (a) The parity index and related indices... farmers, interest, taxes, and farm wage rates, as revised May 1976 and published in the May 28, 1976, and...

  11. Rejection index for pressure tubes

    International Nuclear Information System (INIS)

    Mitchell, A.B.; Meneley, D.

    1989-10-01

    The objective of the present study was to establish a set of criteria (or Rejection Index) which could be used to decide whether a zirconium-2 1/2 w/o niobium pressure tube in a CANDU reactor should be removed from service due to in-service degradation. A critique of key issues associated with establishing a realistic rejection index was prepared. Areas of uncertainty in available information were identified and recommendations for further analysis and laboratory testing made. A Rejection Index based on the following limits has been recommended: 1) Limits related to design intent and normal operation: any garter spring must remain within the tolerance band specified for its design location; the annulus gas system must normally be operated in a circulating mode with a procedure in place for purging to prevent accumulation of deuterium. It must remain sensitive to leaks into any part of the systems; and pressure tube dimensions and distortions must be limited to maintain the fuel channels within the original design intent; 2) Limits related to defect tolerance: adequate time margins between occurrence of a leaking crack and unstable failure must be demonstrated for all fuel channels; long lap-type flaws are unacceptable; crack-like defects of any size are unacceptable; and score marks, frat marks and other defects with contoured profiles must fall below certain depth, length and stress intensity limits; and 3) Limits related to property degradation: at operating temperature each pressure tube must be demonstrated to have a critical length in excess of a stipulated value; the maximum equivalent hydrogen level in any pressure tube should not exceed a limit which should be defined taking into account the known history of that tube; the maximum equivalent hydrogen level in any rolled joint should not exceed a limit which is presently recommended as 200 ppm equivalent hydrogen; and the maximum diametral creep strain should be limited to less than 5%

  12. Regional indexes for France. Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of regional weather indexes for France. Each regional index covers an homogenous area in terms of temperature represented by the biggest city. Five reference cities are used to represent the 22 economical regions of France (Paris Orly, Lyon, Marignane, Bordeaux and Strasbourg). (J.S.)

  13. Climate risk index for Italy

    Science.gov (United States)

    Mysiak, Jaroslav; Torresan, Silvia; Bosello, Francesco; Mistry, Malcolm; Amadio, Mattia; Marzi, Sepehr; Furlan, Elisa; Sperotto, Anna

    2018-06-01

    We describe a climate risk index that has been developed to inform national climate adaptation planning in Italy and that is further elaborated in this paper. The index supports national authorities in designing adaptation policies and plans, guides the initial problem formulation phase, and identifies administrative areas with higher propensity to being adversely affected by climate change. The index combines (i) climate change-amplified hazards; (ii) high-resolution indicators of exposure of chosen economic, social, natural and built- or manufactured capital (MC) assets and (iii) vulnerability, which comprises both present sensitivity to climate-induced hazards and adaptive capacity. We use standardized anomalies of selected extreme climate indices derived from high-resolution regional climate model simulations of the EURO-CORDEX initiative as proxies of climate change-altered weather and climate-related hazards. The exposure and sensitivity assessment is based on indicators of manufactured, natural, social and economic capital assets exposed to and adversely affected by climate-related hazards. The MC refers to material goods or fixed assets which support the production process (e.g. industrial machines and buildings); Natural Capital comprises natural resources and processes (renewable and non-renewable) producing goods and services for well-being; Social Capital (SC) addressed factors at the individual (people's health, knowledge, skills) and collective (institutional) level (e.g. families, communities, organizations and schools); and Economic Capital (EC) includes owned and traded goods and services. The results of the climate risk analysis are used to rank the subnational administrative and statistical units according to the climate risk challenges, and possibly for financial resource allocation for climate adaptation. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  14. Diffusion Indexes with Sparse Loadings

    DEFF Research Database (Denmark)

    Kristensen, Johannes Tang

    The use of large-dimensional factor models in forecasting has received much attention in the literature with the consensus being that improvements on forecasts can be achieved when comparing with standard models. However, recent contributions in the literature have demonstrated that care needs...... to the problem by using the LASSO as a variable selection method to choose between the possible variables and thus obtain sparse loadings from which factors or diffusion indexes can be formed. This allows us to build a more parsimonious factor model which is better suited for forecasting compared...... it to be an important alternative to PC....

  15. Quality index on computed tomography

    International Nuclear Information System (INIS)

    Travassos, P.C.B.; Magalhães, L.A.G.; Peixoto, J.G.P.

    2017-01-01

    Quality analysis was carried out from Indicators divided into 3 sectors: Regulation and Management; Equipment; Image Quality and Dosimetry. Values were assigned for each indicator according to the degree of compliance with the specifications, and were used to calculate the Index. The model was applied in 110 institutions of the State of Rio de Janeiro, and the results were distributed into 5 ranges of values. About 40% of the institutions received grades belonging to the two highest ranges of values. There was no significant difference between the results of old scanners compared to the younger ones. (author)

  16. New developments related to the Hirsch index

    OpenAIRE

    Rousseau, Ronald

    2006-01-01

    It is shown that the h-index on the one hand, and the A- and g-indices on the other, measure different things. The A-index, however, seems overly sensitive to one extremely highly cited article. For this reason it would seem that the g-index is the more useful of the two. As to the h- and the g-index: they do measure different aspects of a scientist’s publication list. Certainly the h-index does not tell the full story, and, although a more sensitive indicator than the h-index, neither does t...

  17. Dow's chemical exposure index guide

    International Nuclear Information System (INIS)

    Marshall, J.T.; Mundt, A.

    1995-01-01

    A number of events in the 1970's and 1980's impacted the course of process safety. Incidents such as Flixborough, Seveso, Three-Mile Island, and Bhopal are well known throughout industry and are recognized as examples of major disasters. Even though events leading up to these disasters were completely different they had one common element between them: a substance was released from a manufacturing unit, became airborne and presented a hazard of such magnitude as to place the safety of both employees and the surrounding public in jeopardy. As a result, industry became increasingly concerned regarding potential loss, in human and economic terms, as plants and equipment grew in size. The Flixborough incident raised the level of concern for process safety, particularly in terms of the hazards presented by fire and explosion. Seveso and Three-Mile Island emphasized the need to consider far-field exposure. The Bhopal incident created an urgent need to recognize and understand the expected downwind impact of potential releases of acutely toxic substances to the air. In order to meet this need, the Dow Chemical Company, a recognized leader in the area of safety and loss prevention, presented a Chemical Exposure Index in 1986. AIChE has recently published an updated version entitled Dow's Chemical Exposure Index Guide. 7 refs., 5 figs

  18. Climate index for Switzerland - Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of Switzerland. (J.S.)

  19. INDEXING OF MAPING SCIENCE JOURNALS

    Directory of Open Access Journals (Sweden)

    Jadranka Stojanovski

    2015-01-01

    Full Text Available Bibliometric analyses based on citations are most often at the forefront where scientific publications are concerned. A fact often neglected is that the visibility and availability of scientific publications are basic prerequisites for future reading, citation and influence. Journal visibility can be significantly improved by providing open access and availability through popular online databases. In this study, we investigated 112 mapping science journals to determine the visibility of scientific publications in a smaller interdisciplinary field. In addition to other data, we collected data on open access, indexing, subject areas within the Web of Science and Scopus bibliographic databases and the number of journals in these databases. The coverage of mapping science journals in 14 bibliographic databases was analyzed. Only 11% of the titles from the journals analyzed were indexed in 10 or more databases. Google Scholar, Scopus, Bibliotheca Cartographica and GEOBASE include most mapping science journals, while only 19 are included in Web of Science. A comparison indicates more thorough coverage of an individual journal in Web of Science than in Scopus. Only a few mapping science journals appear in the Directory of Open Access Journals, despite the large number of open access mapping science journals available. Adding subject categories within databases does not facilitate finding mapping science journals, which are dispersed among numerous, mostly inadequate categories in the Web of Science and Scopus databases.

  20. Climate index for Belgium - Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of Belgium. (J.S.)

  1. Environmental/Biomedical Terminology Index

    Energy Technology Data Exchange (ETDEWEB)

    Huffstetler, J.K.; Dailey, N.S.; Rickert, L.W.; Chilton, B.D.

    1976-12-01

    The Information Center Complex (ICC), a centrally administered group of information centers, provides information support to environmental and biomedical research groups and others within and outside Oak Ridge National Laboratory. In-house data base building and development of specialized document collections are important elements of the ongoing activities of these centers. ICC groups must be concerned with language which will adequately classify and insure retrievability of document records. Language control problems are compounded when the complexity of modern scientific problem solving demands an interdisciplinary approach. Although there are several word lists, indexes, and thesauri specific to various scientific disciplines usually grouped as Environmental Sciences, no single generally recognized authority can be used as a guide to the terminology of all environmental science. If biomedical terminology for the description of research on environmental effects is also needed, the problem becomes even more complex. The building of a word list which can be used as a general guide to the environmental/biomedical sciences has been a continuing activity of the Information Center Complex. This activity resulted in the publication of the Environmental Biomedical Terminology Index (EBTI).

  2. Climate index for Portugal - Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of Portugal. (J.S.)

  3. Climate index for France - Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of France. (J.S.)

  4. Environmental/Biomedical Terminology Index

    International Nuclear Information System (INIS)

    Huffstetler, J.K.; Dailey, N.S.; Rickert, L.W.; Chilton, B.D.

    1976-12-01

    The Information Center Complex (ICC), a centrally administered group of information centers, provides information support to environmental and biomedical research groups and others within and outside Oak Ridge National Laboratory. In-house data base building and development of specialized document collections are important elements of the ongoing activities of these centers. ICC groups must be concerned with language which will adequately classify and insure retrievability of document records. Language control problems are compounded when the complexity of modern scientific problem solving demands an interdisciplinary approach. Although there are several word lists, indexes, and thesauri specific to various scientific disciplines usually grouped as Environmental Sciences, no single generally recognized authority can be used as a guide to the terminology of all environmental science. If biomedical terminology for the description of research on environmental effects is also needed, the problem becomes even more complex. The building of a word list which can be used as a general guide to the environmental/biomedical sciences has been a continuing activity of the Information Center Complex. This activity resulted in the publication of the Environmental Biomedical Terminology Index

  5. Climate index for Spain - Methodology

    International Nuclear Information System (INIS)

    2006-01-01

    According to the U.S. Department of Energy, an estimated 25% of the GNP is affected by weather-related events. The variations in temperature - even small ones - can also have long-lasting effects on the operational results of a company. Among other, the Energy supply sector is sensitive to weather risks: a milder or harsher than usual winter leads to a decrease or increase of energy consumption. The price of electricity on power trading facilities like Powernext is especially sensitive to odd changes in temperatures. Powernext and Meteo-France (the French meteorological agency) have joined expertise in order to promote the use of weather indices in term of decision making or underlying of hedging tools to energy actors, end users from any other sector of activity and specialists of the weather risk hedging. The Powernext Weather indices are made from information collected by Meteo-France's main observation network according to the norms of international meteorology, in areas carefully selected. The gross data are submitted to a thorough review allowing the correction of abnormalities and the reconstitution of missing data. Each index is fashioned to take into account the economic activity in the various regions of the country as represented by each region's population. This demographic information represents a fair approximation of the weight of the regional economic activity. This document presents the calculation methodology of average, minimum and maximum weather indexes with the winter and summer regression equations for the different economical regions of Spain. (J.S.)

  6. Indexes to Nuclear Regulatory Commission issuances, January-March 1984. Volume 19, Index 1

    International Nuclear Information System (INIS)

    1984-01-01

    Digests and indexes for issuances of the Commission, the Atomic Safety and Licensing Appeal Panel, the Atomic Safety and Licensing Board Panel, the Administrative Law Judge, the Directors' Decisions, and the Denials of Petitions of Rulemaking are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. Information elements are displayed in one or more of five separate formats: Case Name Index, Digests and Headers, Legal Citations Index, Subject Index, and Facility Index

  7. Indexes to Nuclear Regulatory Commission issuances, January--June 1995. Volume 41, Index 2

    International Nuclear Information System (INIS)

    1995-09-01

    Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judges (ALJ), the directors' Decisions (DD), and the Denials of Petitions for rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. The information elements are displayed in one or more of five separate formats arranged as follows: Case name index; digests and headers; legal citations index; subject index; and facility index

  8. Indexes to Nuclear Regulatory Commission Issuances, July--December 1993. Volume 38, Index 2

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judges (ALJ), the Directors` Decisions (DD), and the Denials of Petitions for Rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. These information elements are displayed in one or more of five separate formats arranged as follows: Case Name Index; Digests and Headers; Legal Citations Index; Subject Index, and Facility Index.

  9. Indexes to Nuclear Regulatory Commission issuances, January--June 1995. Volume 41, Index 2

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judges (ALJ), the directors` Decisions (DD), and the Denials of Petitions for rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. The information elements are displayed in one or more of five separate formats arranged as follows: Case name index; digests and headers; legal citations index; subject index; and facility index.

  10. ASSESSMENT OF WATER QUALITY INDEX FOR GROUNDWATER ...

    African Journals Online (AJOL)

    2013-12-31

    Dec 31, 2013 ... The advantages of an index include its ability to represent measurements of a ... Fair. Water quality is usually protected but occasionally threatened or ... Electrical Conductivity (EC) value is an index to represent the total.

  11. Enhanced index tracking modelling in portfolio optimization

    Science.gov (United States)

    Lam, W. S.; Hj. Jaaman, Saiful Hafizah; Ismail, Hamizun bin

    2013-09-01

    Enhanced index tracking is a popular form of passive fund management in stock market. It is a dual-objective optimization problem, a trade-off between maximizing the mean return and minimizing the risk. Enhanced index tracking aims to generate excess return over the return achieved by the index without purchasing all of the stocks that make up the index by establishing an optimal portfolio. The objective of this study is to determine the optimal portfolio composition and performance by using weighted model in enhanced index tracking. Weighted model focuses on the trade-off between the excess return and the risk. The results of this study show that the optimal portfolio for the weighted model is able to outperform the Malaysia market index which is Kuala Lumpur Composite Index because of higher mean return and lower risk without purchasing all the stocks in the market index.

  12. Automatic inference of indexing rules for MEDLINE

    Directory of Open Access Journals (Sweden)

    Shooshan Sonya E

    2008-11-01

    Full Text Available Abstract Background: Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. Methods: In this paper, we describe the use and the customization of Inductive Logic Programming (ILP to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Results: Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI, a system producing automatic indexing recommendations for MEDLINE. Conclusion: We expect the sets of ILP rules obtained in this experiment to be integrated into MTI.

  13. Puerto Rico ESI/RSI: INDEX

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set comprises the Environmental Sensitivity Index (ESI) and Reach Sensitivity Index (RSI) data for Puerto Rico. ESI data characterize estuarine...

  14. The local index formula in noncommutative geometry

    International Nuclear Information System (INIS)

    Higson, N.

    2003-01-01

    These notes present a partial account of the local index theorem in non-commutative geometry discovered by Alain Connes and Henri Moscovici. It includes Elliptic partial differential operators, cyclic homology theory, Chern characters, homotopy invariants and the index formulas

  15. Natural Resource Management Index (NRMI), 2010 Release

    Data.gov (United States)

    National Aeronautics and Space Administration — The Natural Resource Management Index (NRMI), 2011 Release is a composite index for 174 countries derived from the average of four proximity-to-target indicators for...

  16. EJSCREEN Version 1, EJ Index Alternatives

    Data.gov (United States)

    U.S. Environmental Protection Agency — This map service displays alternative environmental justice (EJ) indexes used in EJSCREEN. The alternative EJ indexes combine each of the 12 environmental indicators...

  17. KWIC Index of nuclear codes (1975 edition)

    International Nuclear Information System (INIS)

    Akanuma, Makoto; Hirakawa, Takashi

    1976-01-01

    It is a KWIC Index for 254 nuclear codes in the Nuclear Code Abstracts (1975 edition). The classification of nuclear codes and the form of index are the same as those in the Computer Programme Library at Ispra, Italy. (auth.)

  18. Natural Resource Management Index (NRMI), 2009 Release

    Data.gov (United States)

    National Aeronautics and Space Administration — The Natural Resource Management Index (NRMI), 2009 Release is a composite index for 171 countries derived from the average of four proximity-to-target indicators for...

  19. Natural Resource Management Index (NRMI), 2011 Release

    Data.gov (United States)

    National Aeronautics and Space Administration — The Natural Resource Management Index (NRMI), 2011 Release is a composite index for 174 countries derived from the average of four proximity-to-target indicators for...

  20. Natural Resource Management Index (NRMI), 2010 Release

    Data.gov (United States)

    National Aeronautics and Space Administration — The Natural Resource Management Index (NRMI), 2010 Release is a composite index for 157 countries derived from the average of four proximity-to-target indicators for...

  1. 2008 Natural Resource Management Index (NRMI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2008 Natural Resources Management Index (NRMI) is a composite index for 226 countries derived from the average of four proximity-to-target scores from eco-region...

  2. Index to Drug-Specific Information

    Science.gov (United States)

    ... Postmarket Drug Safety Information for Patients and Providers Index to Drug-Specific Information Share Tweet Linkedin Pin ... options Linkedin Pin it Email Print Note: This Index does not include all FDA approved drugs. It ...

  3. Know Your Body Mass Index (BMI)

    Science.gov (United States)

    ... Past Issues Special Section Know Your Body Mass Index (BMI) Past Issues / Winter 2007 Table of Contents ... aging, it pays to understand your body mass index (BMI), a measure of body fat based on ...

  4. 2000 Pilot Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2000 Pilot Environmental Sustainability Index (ESI) is an exploratory effort to construct an index that measures the ability of a nation's economy to achieve...

  5. Photonic crystal fibres and effective index approaches

    DEFF Research Database (Denmark)

    Riishede, Jesper; Libori, Stig E. Barkou; Bjarklev, Anders Overgaard

    2001-01-01

    Photonic crystal fibres are investigated with an effective index approach. The effective index of both core and cladding is found to be wavelength dependent. Accurate modelling must respect the rich topology of these fibres.......Photonic crystal fibres are investigated with an effective index approach. The effective index of both core and cladding is found to be wavelength dependent. Accurate modelling must respect the rich topology of these fibres....

  6. Photonuclear data index 1986-1990

    Energy Technology Data Exchange (ETDEWEB)

    Varlamov, V A; Stepanov, M E; Sapunenko, V V [Moscow State University, Institute of Nuclear Physics, Centre for Photonuclear Experimental Data, Moscow (Russian Federation)

    1992-07-01

    This issue presents a bibliographic index to experimental photonuclear data published in periodical scientific literature during the years 1986-1990. The main tabulation is sorted by nucleus and reaction. It is supplemented by a reference index, an author index, explanatory tables of terms and abbreviations used, and a table of isotopic abundances and nucleon separation energies. The index is in English with an introduction in Russian and English. (author)

  7. A general index of inherent risk

    OpenAIRE

    Schnytzer, Adi; Westreich, Sara

    2009-01-01

    We extend the pioneering work of Aumann and Serrano by presenting an index of inherent riskiness of a gamble having the desirable properties of their index, while being applicable to gambles with either positive or negative expectations. As such, our index provides a measure of riskiness which is of use for both risk lovers and risk aversive gamblers, and is defined for all discrete and a large class of continuous gambles. We analyze abstract properties of our index, and present in addition t...

  8. Author Index, From > 1988-1992

    International Nuclear Information System (INIS)

    1992-01-01

    In 1988-1992, 824 papers were published in >. The papers were contributed by 1497 authors. The author index of the papers is annexed. The author index is divided into contained two parts: the first part is chinese author index, and the second part is foreign author index. The former is arranged according to the chinese phonetic alphabet. The latter is arranged according to the English alphabet

  9. 12 CFR 34.22 - Index.

    Science.gov (United States)

    2010-01-01

    ... an index or combination of indices to which changes in the interest rate will be linked. This index... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Index. 34.22 Section 34.22 Banks and Banking... Mortgages § 34.22 Index. (a) In general. If a national bank makes an ARM loan to which 12 CFR 226.19(b...

  10. Indexation doesn't make sense

    OpenAIRE

    Harry. M Kat

    2002-01-01

    In this brief note we argue that for investors that are serious about matching (the risks of) assets and liabilities, indexation is a doubtful proposition as significant autonomous changes may occur in the industry allocation and accompanying risk-return profile of the portfolio underlying the index. The name of the index may not change, but the underlying portfolio does!

  11. The Cultural Trade Index : An Introduction

    OpenAIRE

    Kabanda, Patrick

    2016-01-01

    The Cultural Trade Index aims to shed light on cultural trade and stimulate interest in how this little-known area can contribute to economic diversification, boost shared prosperity, and reduce extreme poverty. As the first index of its kind, the Cultural Trade Index would gather cultural trade data scattered across different sources, place them in one place, and show how countries are pe...

  12. 45 CFR 1100.4 - Current index.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Current index. 1100.4 Section 1100.4 Public... INFORMATION § 1100.4 Current index. Each agency shall maintain and make available for public inspection and copying a current index providing identifying information for the public as to any matter which is issued...

  13. 47 CFR Alphabetical Index - Part 78

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Part 78 Index Alphabetical Index... SERVICE Technical Regulations Modulation limits. Pt. 78, Index Alphabetical Index—Part 78 A Antenna... Changes in equipment 78.109 Conditions for license 78.27 Coordination, frequencies 78.36 Cross reference...

  14. 30 CFR 250.1401 - Index table.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Index table. 250.1401 Section 250.1401 Mineral... OPERATIONS IN THE OUTER CONTINENTAL SHELF Outer Continental Shelf (OCS) Civil Penalties § 250.1401 Index table. The following table is an index of the sections in this subpart: § 250.1401Table Definitions...

  15. 7 CFR 370.3 - Index.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Index. 370.3 Section 370.3 Agriculture Regulations of... AGRICULTURE FREEDOM OF INFORMATION § 370.3 Index. Pursuant to the regulations in § 1.4(b) of this title, APHIS will maintain and make available for public inspection and copying a current index providing...

  16. 12 CFR 1402.11 - Current index.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Current index. 1402.11 Section 1402.11 Banks... the Farm Credit System Insurance Corporation § 1402.11 Current index. The Farm Credit System Insurance Corporation will make available for public inspection and copying a current index to provide identifying...

  17. 45 CFR 502.6 - Current index.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Current index. 502.6 Section 502.6 Public Welfare..., DEPARTMENT OF JUSTICE RULES OF PRACTICE PUBLIC INFORMATION-FREEDOM OF INFORMATION ACT § 502.6 Current index. The Commission will maintain and make available for public inspection and copying, current indexes...

  18. 22 CFR 212.23 - Current index.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Current index. 212.23 Section 212.23 Foreign... Inspection and Copying § 212.23 Current index. USAID maintains and makes available for public inspection and copying a current index providing identifying information for the public as to any matter which has been...

  19. 7 CFR 798.3 - Index.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Index. 798.3 Section 798.3 Agriculture Regulations of... RECORDS AVAILABILITY OF INFORMATION TO THE PUBLIC § 798.3 Index. 5 U.S.C. 552(a)(2) requires that each agency publish or otherwise make available a current index of all materials required to be made available...

  20. Evaluation of the Thompson articular index

    NARCIS (Netherlands)

    van den Brink, H. R.; van der Heide, A.; Jacobs, J. W.; van der Veen, M. J.; Bijlsma, J. W.

    1993-01-01

    Three articular indices for measuring disease activity are compared. In a cross sectional study the Thompson articular index (a modified Lansbury index) correlated better with laboratory variables than the Ritchie articular index or a swollen joint score (Thompson 0.74-0.77; Ritchie 0.57-0.58;