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Sample records for single-level symptomatic cervical

  1. Cervical sagittal balance parameters after single-level anterior cervical discectomy and fusion: Correlations with clinical and functional outcomes

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    Ioannis Siasios

    2018-01-01

    Conclusions: Single-level ACDF significantly increases upper cervical lordosis (C1–C2 without significantly changing lower cervical lordosis (C2–C7. The C7 slope is a significant marker of overall cervical sagittal alignment (P < 0.05.

  2. EFFICACY OF CAGE PLACEMENT WITHOUT PLATE IN PATIENTS WITH CERVICAL MYELOPATHY WITH SINGLE-LEVEL AFFECTION

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    CARLOS ALBERTO ZUÑIGA-MAZÓN

    Full Text Available ABSTRACT Objective: To determine the efficacy of PEEK (Poly-ether-ether-ketone cage without plate for the treatment of single-level cervical spondylosis. Methods: Ten patients with cervical myelopathy data, with a single-level root condition, seen at the outpatient clinic of the Neurosurgery Service, operated in 2016, mean age 53 years, 6 (60% female, 4 (40% obese, 3 (30% smokers. The Cloward technique was used by anterior approach, discectomy, and PEEK cage placement. Results: At six months of surgery, 100% of the patients had increased intervertebral space, with a 100% reduction in osteophytes; only one patient had dysphagia, no patient had lesion of the adjacent segment and 10% had persistent root pathology. Cervical lordosis was observed in 90% of the patients and arthrodesis in 100% of the cases. Conclusions: Anterior approach arthrodesis using PEEK cage without cervical plate is effective as a treatment of cervical myelopathy in a single level.

  3. Failed back surgery syndrome: the role of symptomatic segmental single-level instability after lumbar microdiscectomy.

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    Schaller, B

    2004-05-01

    Segmental instability represents one of several different factors that may cause or contribute to the failed back surgery syndrome after lumbar microdiscectomy. As segmental lumbar instability poses diagnostic problems by lack of clear radiological and clinical criteria, only little is known about the occurrence of this phenomenon following primary microdiscectomy. Retrospectively, the records of 2,353 patients were reviewed according to postoperative symptomatic segmental single-level instability after lumbar microdiscectomy between 1989 and 1997. Progressive neurological deficits increased (mean of 24 months; SD: 12, range 1-70) after the initial surgical procedure in 12 patients. The mean age of the four men and eight women was 43 years (SD: 6, range 40-77). The main symptoms and signs of secondary neurological deterioration were radicular pain in 9 of 12 patients, increased motor weakness in 6 of 12 patients and sensory deficits in 4 of 12 patients. All 12 symptomatic patients had radiological evidence of segmental changes correlating with the clinical symptoms and signs. All but one patient showed a decrease in the disc height greater than 30% at the time of posterior spondylodesis compared with the preoperative images before lumbar microdiscectomy. All patients underwent secondary laminectomy and posterior lumbar sponylodesis. Postoperatively, pain improved in 8 of 9 patients, motor weakness in 3 of 6 patients, and sensory deficits in 2 of 4 patients. During the follow-up period of 72+/-7 months, one patient required a third operation to alleviate spinal stenosis at the upper end of the laminectomy. Patients with secondary segmental instability following microdiscectomy were mainly in their 40s. Postoperative narrowing of the intervertebral space following lumbar microdiscectomy is correlated to the degree of intervertebral disc resection. It can therefore be concluded that (1) patients in their 40s are prone to postoperative narrowing of the intervertebral

  4. Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion.

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    Kwon, O Ik; Son, Dong Wuk; Lee, Sang Weon; Song, Geun Sung

    2016-09-01

    Anterior cervical discectomy and fusion (ACDF) is a choice of surgical procedure for cervical degenerative diseases associated with radiculopathy or myelopathy. However, the patients undergoing ACDF still have problems. The purpose of the present study is to evaluate the radiologic results of 3 different methods in single-level ACDF. We conducted a retrospective collection of radiological data from January 2011 to December 2014. A total of 67 patients were included in this study. The patients were divided into 3 groups by operation procedure: using stand-alone cage (group cage, n=20); polyether-ether-ketone (PEEK)-titanium combined anchored cage (group AC, n=21); and anterior cervical cage-plate (group CP, n=26). Global cervical lordosis (C2-C7 Cobb angle), fused segment height, fusion rate, and cervical range of motion (ROM) were measured and analyzed at serial preoperative, postoperative, 6-month, and final 1-year follow-up. Successful bone fusion was achieved in all patients at the final follow-up examination; however, the loss of disc height over 3 mm at the surgical level was observed in 6 patients in group cage. Groups AC and CP yielded significantly better outcomes than group cage in fused segment height and cervical ROM(p=0.01 and p=0.02, respectively). Furthermore, group AC had similar radiologic outcomes to those of group CP. The PEEK-titanium combined anchored cage may be a good alternative procedure in terms of reducing complications induced by plate after ACDF.

  5. Anterior cervical discectomy with arthroplasty versus arthrodesis for single-level cervical spondylosis: a systematic review and meta-analysis.

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    Aria Fallah

    Full Text Available To estimate the effectiveness of anterior cervical discectomy with arthroplasty (ACDA compared to anterior cervical discectomy with fusion (ACDF for patient-important outcomes for single-level cervical spondylosis.Electronic databases (MEDLINE, EMBASE, Cochrane Register for Randomized Controlled Trials, BIOSIS and LILACS, archives of spine meetings and bibliographies of relevant articles.We included RCTs of ACDF versus ACDA in adult patients with single-level cervical spondylosis reporting at least one of the following outcomes: functionality, neurological success, neck pain, arm pain, quality of life, surgery for adjacent level degeneration (ALD, reoperation and dysphonia/dysphagia. We used no language restrictions. We performed title and abstract screening and full text screening independently and in duplicate.We used random-effects model to pool data using mean difference (MD for continuous outcomes and relative risk (RR for dichotomous outcomes. We used GRADE to evaluate the quality of evidence for each outcome.Of 2804 citations, 9 articles reporting on 9 trials (1778 participants were eligible. ACDA is associated with a clinically significant lower incidence of neurologic failure (RR = 0.53, 95% CI = 0.37-0.75, p = 0.0004 and improvement in the Neck pain visual analogue scale (VAS (MD = 6.56, 95% CI = 3.22-9.90, p = 0.0001; Minimal clinically important difference (MCID = 2.5. ACDA is associated with a statistically but not clinically significant improvement in Arm pain VAS and SF-36 physical component summary. ACDA is associated with non-statistically significant higher improvement in the Neck Disability Index Score and lower incidence of ALD requiring surgery, reoperation, and dysphagia/dysphonia.There is no strong evidence to support the routine use of ACDA over ACDF in single-level cervical spondylosis. Current trials lack long-term data required to assess safety as well as surgery for ALD. We suggest that ACDA in patients with single

  6. Nonoperative modalities to treat symptomatic cervical spondylosis.

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    Hirpara, Kieran Michael

    2012-01-01

    Cervical spondylosis is a common and disabling condition. It is generally felt that the initial management should be nonoperative, and these modalities include physiotherapy, analgesia and selective nerve root injections. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. A review of the literature supporting various modalities of conservative management is presented, and it is concluded that although effective, nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis.

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

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

    2017-06-01

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

  8. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion.

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    Sheng Shi

    Full Text Available Cervical disc arthroplasty (CDA with Discover prosthesis or anterior cervical discectomy and fusion (ACDF with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM. However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM.A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA score and Neck Disability Index (NDI. For radiographic assessment, the overall sagittal alignment (OSA, functional spinal unit (FSU angle, and range of motion (ROM at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded.Both treatments significantly improved all clinical parameters (P 0.05. Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05. However, significant differences occurred in prosthesis migration in CDA group.The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up.

  9. Spinal Surgeon Variation in Single-Level Cervical Fusion Procedures: A Cost and Hospital Resource Utilization Analysis.

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    Hijji, Fady Y; Massel, Dustin H; Mayo, Benjamin C; Narain, Ankur S; Long, William W; Modi, Krishna D; Burke, Rory M; Canar, Jeff; Singh, Kern

    2017-07-01

    Retrospective analysis. To compare perioperative costs and outcomes of patients undergoing single-level anterior cervical discectomy and fusions (ACDF) at both a service (orthopedic vs. neurosurgical) and individual surgeon level. Hospital systems are experiencing significant pressure to increase value of care by reducing costs while maintaining or improving patient-centered outcomes. Few studies have examined the cost-effectiveness cervical arthrodesis at a service level. A retrospective review of patients who underwent a primary 1-level ACDF by eight surgeons (four orthopedic and four neurosurgical) at a single academic institution between 2013 and 2015 was performed. Patients were identified by Diagnosis-Related Group and procedural codes. Patients with the ninth revision of the International Classification of Diseases coding for degenerative cervical pathology were included. Patients were excluded if they exhibited preoperative diagnoses or postoperative social work issues affecting their length of stay. Comparisons of preoperative demographics were performed using Student t tests and chi-squared analysis. Perioperative outcomes and costs for hospital services were compared using multivariate regression adjusted for preoperative characteristics. A total of 137 patients diagnosed with cervical degeneration underwent single-level ACDF; 44 and 93 were performed by orthopedic surgeons and neurosurgeons, respectively. There was no difference in patient demographics. ACDF procedures performed by orthopedic surgeons demonstrated shorter operative times (89.1 ± 25.5 vs. 96.0 ± 25.5 min; P = 0.002) and higher laboratory costs (Δ+$6.53 ± $5.52 USD; P = 0.041). There were significant differences in operative time (P = 0.014) and labor costs (P = 0.034) between individual surgeons. There was no difference in total costs between specialties or individual surgeons. Surgical subspecialty training does not significantly affect total costs of

  10. Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy

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    Farzad Omidi-Kashani

    2014-01-01

    Full Text Available We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF. We retrospectively evaluated 68 patients (48 female and 20 male with a mean age of 41.2±4.3 (ranged from 24 to 72 years old in our Orthopedic Department, Imam Reza Hospital. They were followed up for 31.25±4.1 months (ranged from 25 to 65 months. Pain and disability were assessed by Visual Analogue Scale (VAS and Neck Disability Index (NDI questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom’s criteria. Surgery could significantly improve pain and disability from preoperative 6.2±1.4 and 22.2±6.2 to 3.5±2.0 and 8.7±5.2 (1–21 at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (P=0.032, although pain improvement was similar in the two groups.

  11. Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy.

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    Omidi-Kashani, Farzad; Ghayem Hasankhani, Ebrahim; Ghandehari, Reza

    2014-01-01

    We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR) who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF). We retrospectively evaluated 68 patients (48 female and 20 male) with a mean age of 41.2 ± 4.3 (ranged from 24 to 72 years old) in our Orthopedic Department, Imam Reza Hospital. They were followed up for 31.25 ± 4.1 months (ranged from 25 to 65 months). Pain and disability were assessed by Visual Analogue Scale (VAS) and Neck Disability Index (NDI) questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom's criteria. Surgery could significantly improve pain and disability from preoperative 6.2 ± 1.4 and 22.2 ± 6.2 to 3.5 ± 2.0 and 8.7 ± 5.2 (1-21) at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (P = 0.032), although pain improvement was similar in the two groups.

  12. Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review.

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    Lim, Anita Ww; Landy, Rebecca; Castanon, Alejandra; Hollingworth, Antony; Hamilton, Willie; Dudding, Nick; Sasieni, Peter

    2016-12-01

    Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare. To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women. Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers. Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink. The authors explored the sensitivity and positive predictive value (PPV) of symptomatic cytology (earliest cytology. Cytology has value beyond screening, and could be used as a diagnostic aid for earlier detection of cervical cancer in young women with gynaecological symptoms by ruling in urgent referral. © British Journal of General Practice 2016.

  13. Comparison among perfect-C®, zero-P®, and plates with a cage in single-level cervical degenerative disc disease.

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    Noh, Sung Hyun; Zhang, Ho Yeol

    2018-01-25

    We intended to analyze the efficacy of a new integrated cage and plate device called Perfect-C for anterior cervical discectomy and fusion (ACDF) to cure single-level cervical degenerative disc disease. We enrolled 148 patients who were subjected to single-level ACDF with one of the following three surgical devices: a Perfect-C implant (41 patients), a Zero-P implant (36 patients), or a titanium plate with a polyetheretherketone (PEEK) cage (71 patients). We conducted a retrospective study to compare the clinical and radiological results among the three groups. The length of the operation, intraoperative blood loss, and duration of hospitalization were significantly lower in the Perfect-C group than in the Zero-P and plate-with-cage groups (P Zero-P groups but was noted in 21 cases (30%) in the plate-with-cage group. The cephalad and caudal plate-to-disc distance (PDD) and the cephalad and caudal PDD/anterior body height (ABH) were significantly greater in the Perfect-C and Zero-P groups than in the plate-with-cage group (P Zero-P group, and in 15 cases (21%) in the plate-with-cage group. Fusion occurred in 37 cases (90%) in the Perfect-C group, in 31 cases (86%) in the Zero-P group, and in 68 cases (95%) in the plate-with-cage group. The Perfect-C, Zero-P, and plate-with-cage devices are effective for treating single-level cervical degenerative disc disease. However, the Perfect-C implant has many advantages over both the Zero-P implant and conventional plate-cage treatments. The Perfect-C implant was associated with shorter operation times and hospitalization durations, less blood loss, and lower subsidence rates compared with the Zero-P implant or the titanium plate with a PEEK cage.

  14. Cervical myelopathy due to single level disc herniation presenting as intramedullary mass lesion: What to do first?

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    Murat Sakir Eksi

    2015-01-01

    Full Text Available Cervical myelopathy (CM is mostly a degenerative process ending in myelopathic and/or radiculopathic syndromes. On T2-weighted magnetic resonance imaging (MRI, CM appears as a hyperintense area near the spondylotic spine. This high intensity signal depends on the impact of outer forces and their duration. It also determines the prognosis of the surgical candidate. A 40-year-old male patient admitted to our clinic with right upper extremity weakness and hypoesthesia that had started 2 months earlier. On neurological examination there was 2/5 motor weakness of right biceps brachii, and hypoesthesia over right C6 dermatome. Right upper extremity deep tendon reflexes were hypoactive, but lower ones were hyperactive. After clinical and radiological work-up, preliminary diagnosis was directed to a spinal intramedullary tumor. Total resection of the herniated cervical disc fragment and the mass lesion was managed. Pathology of the mass lesion was compatible with subacute infarct tissue and inflammatory response. Final diagnosis was CM under effect of cervical disc herniation. Contrast-enhanced spinal cord myelopathic lesions are very rare and resemble much more tumors and inflammatory processes. However, the principal treatment approach totally differs depending on pathology. When there are both a disc herniation and a high clinical suspicion; biopsy should be delayed. The most probable solution will be surgery for the disc disease with thorough preoperative scanning of vascular malformations; clinical and radiological close follow-up after surgery. Biopsy or surgical resection can be performed if patient deteriorates despite the primary surgery.

  15. Quantitative fetal fibronectin and cervical length in symptomatic women: results from a prospective blinded cohort study.

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    Levine, Lisa D; Downes, Katheryne L; Romero, Julie A; Pappas, Hope; Elovitz, Michal A

    2018-05-15

    Our objectives were to determine whether quantitative fetal fibronectin (fFN) and cervical length (CL) screening can be used alone or in combination as prognostic tests to identify symptomatic women at the highest or lowest risk for spontaneous preterm birth (sPTB). A prospective, blinded cohort study of women presenting with a singleton gestation to our triage unit between 22-33w6d with preterm labor symptoms was performed. Women with ruptured membranes, moderate/severe bleeding, and dilation >2 cm were excluded. The primary outcome was sPTB quantitative fFN and CL assessment, both separately and in combination, considering traditionally reported cut-points (fFN ≥50 and CL 50 and CL quantitative level chosen. For all women, a shorter CL was associated with an increased sPTB risk. Among nulliparas and multiparas without a prior sPTB, a CL quantitative fFN or cervical length assessment can be utilized, depending on resources available, but a lower cut-point of 20 ng/mL should be used for quantitative fFN. For multiparous women, fFN is not useful and cervical length assessment should be the main screening tool utilized when there is clinical uncertainty. Regardless of parity, the PPV of fFN and CL is low and therefore the greatest clinical utility remains in its NPV.

  16. Comparison Between Acrylic Cage and Polyetheretherketone (PEEK) Cage in Single-level Anterior Cervical Discectomy and Fusion: A Randomized Clinical Trial.

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    Farrokhi, Majid R; Nikoo, Zahra; Gholami, Mehrnaz; Hosseini, Khadijeh

    2017-02-01

    Prospective, single-blind randomized-controlled clinical study. To compare polyetheretherketone (PEEK) cage with a novel Acrylic cage to find out which fusion cage yielded better clinical outcomes following single-level anterior cervical discectomy and fusion (ACDF). ACDF is considered a standard neurosurgical treatment for degenerative diseases of cervical intervertebral disks. There are many options, including bone grafts, bone cement, and spacers made of titanium, carbon fiber, and synthetic materials, used to restore physiological disk height and enhance spinal fusion, but the ideal device, which would provide immediate structural support and subsequent osteointegration and stability, has not been identified yet. To overcome this, we designed a new, inexpensive Acrylic cage. A total of 64 patients were eligible to participate and were randomly allocated to undergo ACDF either with Acrylic interbody fusion cage filled with bone substitute (n=32) or PEEK cage (n=32). Nurick's grading was used for quantifying the neurological deficit. Clinical and radiologic outcome was assessed preoperatively, immediately after surgery, and subsequently at 2, 6, and 12 months of follow-up using Odom's criteria and dynamic radiographs (flexion-extension) and computed tomography scans, respectively. There was a statistically significant improvement in the clinical outcomes of the Acrylic cage group compared with the PEEK cage group (mean difference: -0.438; 95% confidence interval, -0.807 to -0.068; P=0.016). There was a statistically significant difference in disk space height increase between the 2 groups at the 6- and 12-month follow-up. The Acrylic cage achieved higher fusion rate (good fusion) than the PEEK cage (96.9% vs. 93.8%). Intervertebral angle demonstrated a significant difference among the 2 treated groups throughout the follow-up period. This study suggests that the use of Acrylic cage is associated with good clinical and radiologic outcomes and it can be therefore a

  17. Prevalence and distribution of ossification of the supra/interspinous ligaments in symptomatic patients with cervical ossification of the posterior longitudinal ligament of the spine: a CT-based multicenter cross-sectional study.

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    Mori, Kanji; Yoshii, Toshitaka; Hirai, Takashi; Iwanami, Akio; Takeuchi, Kazuhiro; Yamada, Tsuyoshi; Seki, Shoji; Tsuji, Takashi; Fujiyoshi, Kanehiro; Furukawa, Mitsuru; Nishimura, Soraya; Wada, Kanichiro; Koda, Masao; Furuya, Takeo; Matsuyama, Yukihiro; Hasegawa, Tomohiko; Takeshita, Katsushi; Kimura, Atsushi; Abematsu, Masahiko; Haro, Hirotaka; Ohba, Tetsuro; Watanabe, Masahiko; Katoh, Hiroyuki; Watanabe, Kei; Ozawa, Hiroshi; Kanno, Haruo; Imagama, Shiro; Ito, Zenya; Fujibayashi, Shunsuke; Yamazaki, Masashi; Matsumoto, Morio; Nakamura, Masaya; Okawa, Atsushi; Kawaguchi, Yoshiharu

    2016-12-01

    Supra/interspinous ligaments connect adjacent spinous processes and act as a stabilizer of the spine. As with other spinal ligaments, it can become ossified. However, few report have discussed ossification supra/interspinous ligaments (OSIL), so its epidemiology remains unknown. We therefore aimed to investigate the prevalence and distribution of OSIL in symptomatic patients with cervical ossification of the posterior longitudinal ligament (OPLL). The participants of our study were symptomatic patients with cervical OPLL who were diagnosed by standard radiographs of the cervical spine. The whole spine CT data as well as clinical parameters such as age and sex were obtained from 20 institutions belong to the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament (JOSL). The prevalence and distribution of OSIL and the association between OSIL and clinical parameters were reviewed. The sum of the levels involved by OPLL (OP-index) and OSIL (OSI-index) as well as the prevalence of ossification of the nuchal ligament (ONL) were also investigated. A total of 234 patients with a mean age of 65 years was recruited. The CT-based evidence of OSIL was noted in 68 (54 males and 14 females) patients (29%). The distribution of OSIL showed a significant thoracic preponderance. In OSIL-positive patients, single-level involvement was noted in 19 cases (28%), whereas 49 cases (72%) presented multi-level involvement. We found a significant positive correlation between the OP-index grade and OSI-index. ONL was noted at a significantly higher rate in OSIL-positive patients compared to negative patients. The prevalence of OSIL in symptomatic patients with cervical OPLL was 29%. The distribution of OSIL showed a significant thoracic preponderance.

  18. Congenital midline cleft of the posterior arch of atlas: a rare cause of symptomatic cervical canal stenosis

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    Connor, S.E.J.; Chandler, C.; Robinson, S.; Jarosz, J.M.

    2001-01-01

    Developmental symptomatic C1 canal stenosis is very rare. We describe the computed tomography (CT) and magnetic resonance imaging (MRI) appearances in a 8-year-old child who presented with progressive upper and lower limb neurological symptoms and in whom imaging revealed the medial posterior hemiarches of a bifid C1 to be inturned and compressing the cervical cord. This particular configuration of the posterior arch of atlas is frequently associated with other craniocervical bony anomalies and presents with neurological symptoms early in life. Early CT or MRI examination of patients with symptomatic posterior arch of C1 defects is necessary, in order to detect such an appearance, since surgical treatment may prevent neurological deterioration. (orig.)

  19. Utility of plain radiographs and MRI in cervical spine clearance in symptomatic non-obtunded pediatric patients without high-impact trauma.

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    Moore, Justin M; Hall, Jonathan; Ditchfield, Michael; Xenos, Christopher; Danks, Andrew

    2017-02-01

    The optimal imaging modality for evaluating cervical spine trauma and optimizing management in the pediatric population is controversial. In pediatric populations, there are no well-established guidelines for cervical spine trauma evaluation and treatment. Currently, there is virtually no literature regarding imaging and management of symptomatic pediatric patients who present with cervical spine trauma without high-impact mechanism. This study aims to establish an optimal imaging strategy for this subgroup of trauma patients. We performed a retrospective review of pediatric patients (aged below 18 years) who were admitted to Monash Medical Centre, Melbourne, Australia between July 2011 and June 2015, who did not suffer a high-impact trauma but were symptomatic for cervical spine injury following cervical trauma. Imaging and management strategies were reviewed and results compared. Forty-seven pediatric patients were identified who met the inclusion criteria. Of these patients, 46 underwent cervical spine series (CSS) plain radiograph imaging. Thirty-four cases underwent magnetic resonance imaging (MRI) and 9 patients underwent CT. MRI was able to detect 4 cases of ligamentous injury, which were not seen in CSS imaging and was able to facilitate cervical spine clearance in a further two patients whose CSS radiographs were abnormal. In this study, MRI has a greater sensitivity and specificity when compared to CSS radiography in a symptomatic pediatric low-impact trauma population. Our data call in to question the routine use of CSS radiographs in children.

  20. Efficacy and safety of Mobi-C cervical artificial disc versus anterior discectomy and fusion in patients with symptomatic degenerative disc disease: A meta-analysis.

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    Lu, Hui; Peng, Lihua

    2017-12-01

    Total disc replacement (TDR) using Mobi-C cervical artificial disc might be promising to treat symptomatic degenerative disc disease. However, the results remained controversial. We conducted a systematic review and meta-analysis to compare the efficacy and safety of Mobi-C cervical artificial disc and anterior cervical discectomy and fusion (ACDF) in patients with symptomatic degenerative disc disease. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of Mobi-C versus ACDF on the treatment of symptomatic degenerative disc disease were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were neck disability index (NDI) score, patient satisfaction, and subsequent surgical intervention. Meta-analysis was performed using the random-effect model. Four RCTs were included in the meta-analysis. Overall, compared with ACDF surgery for symptomatic degenerative disc disease, TDR using Mobi-C was associated with a significantly increased NDI score (Std. mean difference = 0.32; 95% CI = 0.10-0.53; P = .004), patient satisfaction (odds risk [OR] = 2.75; 95% confidence interval [CI] = 1.43-5.27; P = .002), and reduced subsequent surgical intervention (OR = 0.20; 95% CI = 0.11-0.37; P degenerative disc disease, TDR using Mobi-C cervical artificial disc resulted in a significantly improved NDI score, patient satisfaction, and reduced subsequent surgical intervention. There was no significant difference of neurological deterioration, radiographic success, and overall success between TDR using Mobi-C cervical artificial disc versus ACDF surgery. TDR using Mobi-C cervical artificial disc should be recommended for the treatment of symptomatic degenerative disc disease.

  1. The predictive value of quantitative fibronectin testing in combination with cervical length measurement in symptomatic women

    NARCIS (Netherlands)

    Bruijn, Merel M. C.; Kamphuis, Esme I.; Hoesli, Irene M.; Martinez de Tejada, Begoña; Loccufier, Anne R.; Kühnert, Maritta; Helmer, Hanns; Franz, Marie; Porath, Martina M.; Oudijk, Martijn A.; Jacquemyn, Yves; Schulzke, Sven M.; Vetter, Grit; Hoste, Griet; Vis, Jolande Y.; Kok, Marjolein; Mol, Ben W. J.; van Baaren, Gert-Jan

    2016-01-01

    The combination of the qualitative fetal fibronectin test and cervical length measurement has a high negative predictive value for preterm birth within 7 days; however, positive prediction is poor. A new bedside quantitative fetal fibronectin test showed potential additional value over the

  2. MRI findings of cervical spine lesions among symptomatic patient and their risk factors

    International Nuclear Information System (INIS)

    Hashemi, H.; Firouznia, K.; Soroush, H.; Amir orang, J.; Foghani, A.; Pakravan, M.

    2003-01-01

    Background: Cervical spine and intervertebral discs are potentially prone to functional disorders. Objectives: This study sought type and distribution of different pathologies in the cervical spine and a possible relationship between the MRI findings and the probable risk factors of the degenerative disorders. Materials and Methods: This descriptive cross-sectional research was carried out from october 2000 to january 2002 in three referral centers in Tehran. All the patients had referred for cervical MRI for neck pain and/or radicular pain. Results: Totally 342 patients entered the study. Sixty percent of patients were male. The mean age was 55.1± 12.1 years. Seventy-nine percent of patients had abnormal MRI findings (238 patients (70%) had signs of degenerative processes and 31 patients (9%) had the other findings ) with a total 308 pathologies. The most common findings were disc bulging /protrusion (%21.1), disc dehydration (%20.1), disc herniation (%18.1), and canal stenosis (%17.5). Older age, male gender and history of neck trauma were associated with increasing probability of degenerative changes (P-values<0.05). Conclusion: Types of cervical spine pathologies are comparable to other reports. The anatomical distribution of disc bulging and protrusion in our study are similar to other reports. Likewise age, gender and a history of trauma the neck were closely associated with the degenerative signs on the MR images

  3. Quality of life in symptomatic cervical myelopathy after open-door laminoplasty

    Directory of Open Access Journals (Sweden)

    Rodrigo Yuiti Nakao

    2015-06-01

    Full Text Available OBJECTIVE: To analyze the results obtained by open-door laminoplasty using the Newbridge(r/Blackstone plate, in cases of myelopathy associated with cervical lordosis.METHODS: From December 2010 to October 2012, eight patients between the ages of 49 and 68 underwent open-door laminoplasty with the use of the Newbridge(r fixation system for maintenance and stabilization of the cervical laminoplasty. Minimum follow-up was four months. For the evaluation of quality of life the questionnaire SF-36 was applied at the following times: preoperative, one month and three months after surgery associated with the subjective assessment of the patient regarding satisfaction with the procedure and with the Nurick neurological scale applied prior to surgery and three months later.RESULTS: According to the SF-36, there was significant improvement in the domains functional ability, general health perceptions and emotional aspects over time; regarding physical limitations and social aspects there was no improvement in the first postoperative month, only in the third month. There were no statistically significant changes observed during the period covered by this study related to pain, vitality and mental health. According to Nurick scale, there was evidence of improvement in symptoms of cervical myelopathy. Based on the subjective evaluation of the patients, surprisingly, all patients were satisfied with the surgical procedure and the results.CONCLUSION: The open-door laminoplasty technique with rigid fixation to maintain the opening is useful in improving the symptoms of cervical myelopathy associated with lordosis, leading to improved quality of life and with a high degree of patient satisfaction and fewer complications.

  4. MRI changes of cervical spine in asymptomatic and symptomatic young adults

    OpenAIRE

    Siivola, Sari M.; Levoska, Sinikka; Tervonen, Osmo; Ilkko, Eero; Vanharanta, Heikki; Keinänen-Kiukaanniemi, Sirkka

    2002-01-01

    Several work-related, psychosocial and individual factors have been verified as being related to neck and shoulder pain, but the role of pathology visualized by magnetic resonance imaging (MRI) remains unclear. In this study, the relationship between neck and shoulder pain and cervical high-field MRI findings was investigated in a sample of persons in a longitudinal survey. The study aimed to determine whether subjects with persistent or recurrent neck and shoulder pain were more likely to ha...

  5. Cervicitis

    Science.gov (United States)

    ... that does not go away: discharge may be gray, white or yellow in color Painful sexual intercourse ... Names Cervical inflammation; Inflammation - cervix Images Female reproductive anatomy Cervicitis Uterus References Eckert LO, Lentz GM. Infections ...

  6. Cervical Infection with Herpes simplex Virus, Chlamydia trachomatis, and Neisseria gonorrhoeae among Symptomatic Women, Dubai, UAE: A Molecular Approach

    Directory of Open Access Journals (Sweden)

    Davood Mehrabani

    2014-01-01

    Full Text Available Tragically, genital tract infections are still a major public health problem in many regions. This study was undertaken to determine the prevalence of cervical infection with Herpes simplex virus (HSV, Chlamydia trachomatis (CT, and Neisseria gonorrhoeae (NG among married women referring to Iranian Hospital, Dubai, UAE. In a retrospective cross-sectional survey, 201 female patients aged 16–80 years who referred to the Obstetrics and Gynecology Department of Iranian Hospital, Dubai, UAE, in 2010 were enrolled. The patients were categorized into three age groups: 15–30 (group I, 31–40 (group II, and ≥41 years old (group III. A cervical swab sample was collected from each woman and the prevalence of cervical infection with HSV, CT, and NG was determined by PCR method. HSV, CT, and NG were detected in 6.5%, 10.4%, and 5.5% of swab samples, respectively. Regarding age, a significant difference was noticed for prevalence of NG and HSV between groups I and III. Because of public health importance of sexual transmitted diseases (STDs, their long-lasting impact on quality of life, and their economic burden, preventing measures and education of women seem necessary.

  7. Cost-effectiveness of cervical total disc replacement vs fusion for the treatment of 2-level symptomatic degenerative disc disease.

    Science.gov (United States)

    Ament, Jared D; Yang, Zhuo; Nunley, Pierce; Stone, Marcus B; Kim, Kee D

    2014-12-01

    Cervical total disc replacement (CTDR) was developed to treat cervical spondylosis, while preserving motion. While anterior cervical discectomy and fusion (ACDF) has been the standard of care for 2-level disease, a randomized clinical trial (RCT) suggested similar outcomes. Cost-effectiveness of this intervention has never been elucidated. To determine the cost-effectiveness of CTDR compared with ACDF. Data were derived from an RCT that followed up 330 patients over 24 months. The original RCT consisted of multi-institutional data including private and academic institutions. Using linear regression for the current study, health states were constructed based on the stratification of the Neck Disability Index and a visual analog scale. Data from the 12-item Short-Form Health Survey questionnaires were transformed into utilities values using the SF-6D mapping algorithm. Costs were calculated by extracting Diagnosis-Related Group codes from institutional billing data and then applying 2012 Medicare reimbursement rates. The costs of complications and return-to-work data were also calculated. A Markov model was built to evaluate quality-adjusted life-years (QALYs) for both treatment groups. The model adopted a third-party payer perspective and applied a 3% annual discount rate. Patients included in the original RCT had to be diagnosed as having radiculopathy or myeloradiculopathy at 2 contiguous levels from C3-C7 that was unresponsive to conservative treatment for at least 6 weeks or demonstrated progressive symptoms. Incremental cost-effectiveness ratio of CTDR compared with ACDF. A strong correlation (R2 = 0.6864; P sensitivity analysis, the incremental cost-effectiveness ratio value stays below the threshold of $50,000 per QALY in most scenarios (range, -$58,194 to $147,862 per QALY). The incremental cost-effectiveness ratio of CTDR compared with traditional ACDF is lower than the commonly accepted threshold of $50,000 per QALY. This remains true with varying input

  8. Cervicitis

    Science.gov (United States)

    ... of a woman getting HIV from an infected sexual partner. Prevention To reduce your risk of cervicitis from sexually transmitted infections, use condoms consistently and correctly each time you have sex. ...

  9. Symptomatic cervical disc herniation following a motor vehicle collision: return to work comparative study of workers' compensation versus personal injury insurance status.

    Science.gov (United States)

    Scuderi, Gaetano J; Sherman, Andrew L; Brusovanik, Georgiy V; Pahl, Michael A; Vaccaro, Alexander R

    2005-01-01

    Patients with approved workers' compensation injuries receive guaranteed compensation for the duration of their injury, whereas patients with personal injury claims are only compensated, if at all, at the time of a successful settlement or trial verdict at a time point distant from their injury. This study compares the financial impact and loss of work patterns due to a workers' compensation (WC) claim or personal injury in patients with a symptomatic cervical disc herniation resulting from a motor vehicle collision. A prospective study of patients who were seen by a single spine specialist between 1/2/96 and 9/1/01. A consecutive evaluation of 531 patients who were treated for a cervical pain syndrome caused by a motor vehicle collision. Mechanism of injury and insurance type, ie, workers' compensation or personal injury, was recorded for each patient as well as treatment response and return to work patterns. The data were analyzed using the two-way Z test. All patients were managed in a similar manner with noninvasive treatment initially, followed by injections, and finally surgical intervention in those who failed conservative measures. Return to work rates and work disability were determined at either final follow-up or at the last doctor's visit before loss to follow-up. 270 of 531 patients were diagnosed with a symptomatic one or two level disc herniation by a cervical magnetic resonance imaging scan. Fifty-four patients were insured through the workers' compensation board, and 216 reported their crash as a personal injury claim. In the WC group the work disability at 3 months follow-up revealed a cumulative 2,262 total lost days of work (average 37.1 days per person). At the point of maximal medical improvement (MMI) or 2-year follow-up, total days lost from work were 7,107 (average 131.6 days per person.) In the personal injury non-WC group, the 3-month follow-up of lost days of work was 1,093 days (average 5.1 days per person.) At 2 years follow-up, the

  10. Radiation tolerance of the cervical spinal cord: incidence and dose-volume relationship of symptomatic and asymptomatic late effects following high dose irradiation of paraspinal tumors

    International Nuclear Information System (INIS)

    Liu, Mitchell C.C.; Munzenrider, John E.; Finkelstein, Dianne; Liebsch, Norbert; Adams, Judy; Hug, Eugen B.

    1997-01-01

    changes was between 2 and 8.5 months after radiation therapy. Two risk factors appeared to have significant impact when all incidences were considered: proton portion of tumor dose > 55 CGE (p=.023), and spinal cord surface dose ≥ 60 CGE (p=.045). For patients receiving 55 CGE to >1.5cc of spinal cord, the risk of developing imaging changes was significantly higher (p=.0074). Age < 40 years was found to be correlated with higher incidence of Lhermitt's syndrome (p=.002). No variable was significant for predicting incidence of sensory or motor deficits. Conclusions: For chordomas and chondrosarcomas of the cervical spine, requiring high radiation doses, the guidelines of limiting maximum spinal cord surface dose to ≤ 64 CGE and maximum spinal cord center dose to ≤ 53 CGE appears safe. For the patients who had been treated within the above tolerance dose, none of them had developed motor deficits. Both a significant dose response relationship as well as volume effect for symptomatic or asymptomatic spinal cord changes were observed. The incidence of 1 patient, who developed motor damage after higher radiation doses to the spinal cord than generally allowed, emphasizes the importance of strict guidelines for critical, normal tissues in high dose, conformal radiation treatment

  11. Single-Level and Multilevel Mediation Analysis

    Science.gov (United States)

    Tofighi, Davood; Thoemmes, Felix

    2014-01-01

    Mediation analysis is a statistical approach used to examine how the effect of an independent variable on an outcome is transmitted through an intervening variable (mediator). In this article, we provide a gentle introduction to single-level and multilevel mediation analyses. Using single-level data, we demonstrate an application of structural…

  12. Cost Utility Analysis of the Cervical Artificial Disc vs Fusion for the Treatment of 2-Level Symptomatic Degenerative Disc Disease: 5-Year Follow-up.

    Science.gov (United States)

    Ament, Jared D; Yang, Zhuo; Nunley, Pierce; Stone, Marcus B; Lee, Darrin; Kim, Kee D

    2016-07-01

    The cervical total disc replacement (cTDR) was developed to treat cervical degenerative disc disease while preserving motion. Cost-effectiveness of this intervention was established by looking at 2-year follow-up, and this update reevaluates our analysis over 5 years. Data were derived from a randomized trial of 330 patients. Data from the 12-Item Short Form Health Survey were transformed into utilities by using the SF-6D algorithm. Costs were calculated by extracting diagnosis-related group codes and then applying 2014 Medicare reimbursement rates. A Markov model evaluated quality-adjusted life years (QALYs) for both treatment groups. Univariate and multivariate sensitivity analyses were conducted to test the stability of the model. The model adopted both societal and health system perspectives and applied a 3% annual discount rate. The cTDR costs $1687 more than anterior cervical discectomy and fusion (ACDF) over 5 years. In contrast, cTDR had $34 377 less productivity loss compared with ACDF. There was a significant difference in the return-to-work rate (81.6% compared with 65.4% for cTDR and ACDF, respectively; P = .029). From a societal perspective, the incremental cost-effective ratio (ICER) for cTDR was -$165 103 per QALY. From a health system perspective, the ICER for cTDR was $8518 per QALY. In the sensitivity analysis, the ICER for cTDR remained below the US willingness-to-pay threshold of $50 000 per QALY in all scenarios (-$225 816 per QALY to $22 071 per QALY). This study is the first to report the comparative cost-effectiveness of cTDR vs ACDF for 2-level degenerative disc disease at 5 years. The authors conclude that, because of the negative ICER, cTDR is the dominant modality. ACDF, anterior cervical discectomy and fusionAWP, average wholesale priceCE, cost-effectivenessCEA, cost-effectiveness analysisCPT, Current Procedural TerminologycTDR, cervical total disc replacementCUA, cost-utility analysisDDD, degenerative disc disease

  13. Dural diverticulum with a symptomatic cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Nicholas Armstrong, MD

    2016-03-01

    Full Text Available A case report of a 63-year-old female patient with a cervical spinal dural diverticulum and intracranial hypotension secondary to a symptomatic CSF leak after minor trauma. The patient responded well after the cervical approach epidural blood patch procedure.

  14. Cervical Cap

    Science.gov (United States)

    ... Videos for Educators Search English Español The Cervical Cap KidsHealth / For Teens / The Cervical Cap What's in ... Call the Doctor? Print What Is a Cervical Cap? A cervical cap is a small cup made ...

  15. Single-level resonance parameters fit nuclear cross-sections

    Science.gov (United States)

    Drawbaugh, D. W.; Gibson, G.; Miller, M.; Page, S. L.

    1970-01-01

    Least squares analyses of experimental differential cross-section data for the U-235 nucleus have yielded single level Breit-Wigner resonance parameters that fit, simultaneously, three nuclear cross sections of capture, fission, and total.

  16. Cervical Cap

    Science.gov (United States)

    ... giving birth vaginally, which means the cervical cap may not fit as well. Inconsistent or incorrect use of the cervical cap increases your risk of pregnancy. For example, you may get pregnant when using the cervical cap if: ...

  17. GOTHIC memory management : a multiprocessor shared single level store

    OpenAIRE

    Michel , Béatrice

    1990-01-01

    Gothic purpose is to build an object-oriented fault-tolerant distributed operating system for a local area network of multiprocessor workstations. This paper describes Gothic memory manager. It realizes the sharing of the secondary memory space between any process running on the Gothic system. Processes on different processors can communicate by sharing permanent information. The manager implements a shared single level storage with an invalidation protocol working on disk-pages to maintain s...

  18. Cervical cancer

    Science.gov (United States)

    ... bleeding between periods, after intercourse, or after menopause Vaginal discharge that does not stop, and may be pale, ... Instructions Hysterectomy - abdominal - discharge Hysterectomy - laparoscopic - ... Images Cervical cancer Cervical neoplasia ...

  19. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  20. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  1. Cervical Myomas

    Science.gov (United States)

    ... Adnexal Torsion Bartholin Gland Cysts Cervical Myomas Cervical Stenosis Endometriomas of the Vulva Inclusion and Epidermal Cysts of the Vulva Noncancerous Ovarian Growths Polyps of the Cervix Skene Duct Cyst Cervical myomas are smooth, benign tumors in the cervix. A myoma may bleed, ...

  2. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.

  3. Do intraoperative radiographs predict final lumbar sagittal alignment following single-level transforaminal lumbar interbody fusion?

    Science.gov (United States)

    Salem, Khalid M I; Eranki, Aditya P; Paquette, Scott; Boyd, Michael; Street, John; Kwon, Brian K; Fisher, Charles G; Dvorak, Marcel F

    2018-05-01

    OBJECTIVE The study aimed to determine if the intraoperative segmental lordosis (as calculated on a cross-table lateral radiograph following a single-level transforaminal lumbar interbody fusion [TLIF] for degenerative spondylolisthesis/low-grade isthmic spondylolisthesis) is maintained at discharge and at 6 months postsurgery. METHODS The authors reviewed images and medical records of patients ≥ 16 years of age with a diagnosis of an isolated single-level, low-grade spondylolisthesis (degenerative or isthmic) with symptomatic spinal stenosis treated between January 2008 and April 2014. Age, sex, surgical level, surgical approach, and facetectomy (unilateral vs bilateral) were recorded. Upright standardized preoperative, early, and 6-month postoperative radiographs, as well as intraoperative lateral radiographs, were analyzed for the pelvic incidence, segmental lumbar lordosis (SLL) at the TILF level, and total LL (TLL). In addition, the anteroposterior position of the cage in the disc space was documented. Data are presented as the mean ± SD; a p value level using a bullet-shaped cage. A bilateral facetectomy was performed in 17 patients (20.2%), and 89.3% of procedures were done at the L4-5 and L5-S1 segments. SLL significantly improved intraoperatively from 15.8° ± 7.5° to 20.9° ± 7.7°, but the correction was lost after ambulation. Compared with preoperative values, at 6 months the change in SLL was modest at 1.8° ± 6.7° (p = 0.025), whereas TLL increased by 4.3° ± 9.6° (p level of surgery, and use of a bilateral facetectomy did not significantly affect postoperative LL. CONCLUSIONS Following a single-level TLIF procedure using a bullet-shaped cage, the intraoperative improvement in SLL is largely lost after ambulation. The improvement in TLL over time is probably due to the decompression part of the procedure. The approach, level of surgery, bilateral facetectomy, and position of the cage do not seem to have a significant effect on LL achieved

  4. MRI of symptomatic shoulders

    International Nuclear Information System (INIS)

    Kikukawa, Kenshi; Segata, Tateki; Kunitake, Katsuhiko; Morisawa, Keizo; Harada, Masataka; Hirano, Mako

    2004-01-01

    The purpose of this study was to determine the prevalence of cuff tear and acromioclavicular joint (ACJ) osteoarthrosis by magnetic resonance imaging (MRI) evaluation in symptomatic shoulders. MRI was performed on 124 shoulders in 115 patients whose age ranged from 16 to 83 years (average: 58.0 years). There were 74 men (79 shoulders) and 41 women (45 shoulders). The patients were divided into three groups according to age; A group (10 shoulders: 16-29 years), B group (43 shoulders: 30-59 years), and C group (71 shoulders: 60-83 years). Rotator cuff tears and ACJ osteoarthrosis were graded on scales 0 to 3 (normal, increased signal intensity, incomplete, complete), and 1 to 4 (none, mild, moderate, severe), respectively. There was a significant difference in the severity of the cuff tears and the ACJ osteoarthrosis with respect to age. Twenty percent of the shoulders were graded incomplete or complete cuff tears in group A, 88% in group B, and 93% in group C. No shoulders were graded moderate or severe ACJ changes in group A, 63% in group B, and 93% in group C. There was a definite correlation between the cuff tears and ACJ osteoarthrosis. MRI of the symptomatic shoulders indicated well correlation between the rotator cuff tears and ACJ osteoarthrosis. (author)

  5. Aggressive discectomy for single level lumbar disk herniation

    Directory of Open Access Journals (Sweden)

    Md. Kamrul Ahsan

    2017-09-01

    Full Text Available Aggressive open lumbar discectomy is the most commonly performed surgical procedure for patients with persistent low back and leg pain. In this retrospective study,  1,380 patients were evaluated for long-term results of aggressive discectomy for the single level lumbar disk herniation. Demographic data, surgical data, complications and reherniation rate were collected and clinical outcomes were assessed using visual analogue score (VAS, Oswestry disability index (ODI and modified Mcnab criteria. The mean follow-up period was 28.8 months. According to the modified Mcnab criteria, the long-term results were excellent in 640 cases, good in 445 cases, fair in 255 cases, and poor in 40 cases. The mean VAS scores for back and radicular pains and ODI at the end of 2 years were 1.1 ± 1.0, 1.5 ± 0.5 and 6.6 ± 3.1% respectively. The complications were foot drop (n=7, dural tear (n=14, superficial wound infection (n=17, discitis (n=37 and reherniation (n=64. The dural tear and superficial wound infections resolved after treatment but 28 discitis patients were treated by conservatively and the remaining 9 underwent surgery. Among reherniation patients, 58 underwent revision discectomy and 4 underwent transforaminal lumbar interbody fusion and stabilization. Aggressive discectomy is an effective treatment of lumbar disk herniation and maintains a lower incidence of reherniation but leads to a collapse of disc height and in long run gives rise to intervertebral instability and accelerates spondylosis.

  6. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview Cervical Cancer Cervical ... Cervical Cancer 1 of 5 sections The Basics: Cervical Cancer What is cervical cancer? Cervical cancer is cancer ...

  7. Magnetic Resonance Enhancement Patterns at the Different Ages of Symptomatic Osteoporotic Vertebral Compression Fractures

    Energy Technology Data Exchange (ETDEWEB)

    You, Ja Yeon; Lee, Joon Woo; Kim, Jung Eun; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2013-06-15

    To investigate the magnetic resonance (MR) enhancement patterns of symptomatic osteoporotic vertebral compression fracture (VCF) according to the fracture age, based on the successful single-level percutaneous vertebroplasty (PVP) cases. The study included 135 patients who underwent contrast-enhanced MR imaging and successful PVP from 2005 to 2010 due to a single- level osteoporotic VCF. Two radiologists blinded to the fracture age evaluated the MR enhancement patterns in consensus. The MR enhancement patterns were classified according to the enhancing proportion to the vertebral height and the presence or extent of a non-enhancing cleft within the enhancing area on sagittal plane. The Fisher' exact test, Kruskal-Wallis test and Mann-Whitney U test were performed to assess the differences in the MR enhancement patterns according to the fracture age. Symptomatic VCFs show variable MR enhancement patterns in all fracture ages. A diffuse enhancing area can be seen in not only the hyperacute and acute VCFs but also the chronic symptomatic VCFs. Symptomatic VCFs having a segmental enhancing area were all included in the hyperacute or acute stage. Most symptomatic osteoporotic VCFs had a non-enhancing cleft in the enhanced vertebral body (128/135, 94.8%). There was no statistical difference of the enhancement pattern according to the fracture age. Symptomatic VCFs show variable MR enhancement patterns in all fracture ages. The most common pattern is a non-enhancing cleft within a diffuse enhanced vertebra.

  8. Magnetic Resonance Enhancement Patterns at the Different Ages of Symptomatic Osteoporotic Vertebral Compression Fractures

    International Nuclear Information System (INIS)

    You, Ja Yeon; Lee, Joon Woo; Kim, Jung Eun; Kang, Heung Sik

    2013-01-01

    To investigate the magnetic resonance (MR) enhancement patterns of symptomatic osteoporotic vertebral compression fracture (VCF) according to the fracture age, based on the successful single-level percutaneous vertebroplasty (PVP) cases. The study included 135 patients who underwent contrast-enhanced MR imaging and successful PVP from 2005 to 2010 due to a single- level osteoporotic VCF. Two radiologists blinded to the fracture age evaluated the MR enhancement patterns in consensus. The MR enhancement patterns were classified according to the enhancing proportion to the vertebral height and the presence or extent of a non-enhancing cleft within the enhancing area on sagittal plane. The Fisher' exact test, Kruskal-Wallis test and Mann-Whitney U test were performed to assess the differences in the MR enhancement patterns according to the fracture age. Symptomatic VCFs show variable MR enhancement patterns in all fracture ages. A diffuse enhancing area can be seen in not only the hyperacute and acute VCFs but also the chronic symptomatic VCFs. Symptomatic VCFs having a segmental enhancing area were all included in the hyperacute or acute stage. Most symptomatic osteoporotic VCFs had a non-enhancing cleft in the enhanced vertebral body (128/135, 94.8%). There was no statistical difference of the enhancement pattern according to the fracture age. Symptomatic VCFs show variable MR enhancement patterns in all fracture ages. The most common pattern is a non-enhancing cleft within a diffuse enhanced vertebra.

  9. Is cervical discography of any value

    Energy Technology Data Exchange (ETDEWEB)

    Merriam, W F; Stockdale, H R

    1983-05-01

    Following the successful use of lumbar discography in the management of lumbo-sciatic pain, attention focussed on the possibility of using such intradiscal injections in the management of cervico-brachial disorders. Much has been written on the subject of cervical discography. However, little is of use to the clinician seeking objective validation of this procedure. Many papers relate to specific workers' own experiences and one cannot but be disturbed at the wide diversity of opinion that has been expressed on the efficacy of cervical discography. In this paper, we review the extensive literature on cervical discography and present our own findings from both in vitro and clinical studies. We conclude that as a technique to locate symptomatic levels, cervical discography is worthless but that the findings of a normal nuclear image will probably indicate an asymptomatic level. Also, we feel that reliance on pain reproduction during injection is doubtful.

  10. Is cervical discography of any value

    International Nuclear Information System (INIS)

    Merriam, W.F.; Stockdale, H.R.

    1983-01-01

    Following the successful use of lumbar discography in the management of lumbo-sciatic pain, attention focussed on the possibility of using such intradiscal injections in the management of cervico-brachial disorders. Much has been written on the subject of cervical discography. However, little is of use to the clinician seeking objective validation of this procedure. Many papers relate to specific workers' own experiences and one cannot but be disturbed at the wide diversity of opinion that has been expressed on the efficacy of cervical discography. In this paper, we review the extensive literature on cervical discography and present our own findings from both in vitro and clinical studies. We conclude that as a technique to locate symptomatic levels, cervical discography is worthless but that the findings of a normal nuclear image will probably indicate an asymptomatic level. Also, we feel that reliance on pain reproduction during injection is doubtful. (orig.)

  11. [Cervical cerclage].

    Science.gov (United States)

    Akladios, C Y; Sananes, N; Gaudineau, A; Boudier, E; Langer, B

    2015-10-01

    Cervical cerclage aims to strengthen not only the mechanical properties of the cervix, but also its immunological and anti-infectious functions. The demonstration of a strong interrelation between cervical insufficiency as well as decreased cervical length at endo-vaginal ultrasonography and infection has changed the indications cerclage. Actually we can distinguish three indications for cerclage: prophylactic, for obstetrical history; therapeutic, for shortened cervical length at ultrasonography in patients at risk and; emergency cerclage in case of threatening cervix at physical examination. The McDonald's technique is the most recommended. In case of failure, it is proposed to realize cerclage at a higher level on the cervix either by vaginal or abdominal route. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Cervical Cancer

    Science.gov (United States)

    ... I find more information about cervical and other gynecologic cancers? Centers for Disease Control and Prevention: 800-CDC-INFO or www. cdc. gov/ cancer/ gynecologic National Cancer Institute: 800-4-CANCER or www. ...

  13. Cervical Laminoplasty

    Science.gov (United States)

    ... Nerve Tests: EMG, NCV and SEEP Alternative Medicine Acupuncture Herbal Supplements Surgical Options Anterior Cervical Fusion Artifical ... tasks. A NASS physician can perform a thorough history to evaluate your symptoms and any recent changes. ...

  14. Cervical spondylosis

    Science.gov (United States)

    Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease ... therapist). Sometimes, a few visits will help with neck pain. Cold packs and heat therapy may help your ...

  15. Cervical bracing practices after degenerative cervical surgery: a survey of cervical spine research society members.

    Science.gov (United States)

    Lunardini, David J; Krag, Martin H; Mauser, Nathan S; Lee, Joon Y; Donaldson, William H; Kang, James D

    2018-05-21

    Context: Prior studies have shown common use of post-operative bracing, despite advances in modern day instrumentation rigidity and little evidence of brace effectiveness. To document current practice patterns of brace use after degenerative cervical spine surgeries among members of the Cervical Spine Research Society (CSRS), to evaluate trends, and to identify areas of further study. A questionnaire survey METHODS: A 10 question survey was sent to members of the Cervical Spine Research Society to document current routine bracing practices after various common degenerative cervical spine surgical scenarios, including fusion and non-fusion procedures. The overall bracing rate was 67%. This included 8.4% who used a hard collar in each scenario. Twenty-two percent of surgeons never used a hard collar, while 34% never used a soft collar, and 3.6% (3 respondents) did not use a brace in any surgical scenario. Bracing frequency for specific surgical scenarios varied from 39% after foraminotomy to 88% after multi-level corpectomy with anterior & posterior fixation. After one, two and three level anterior cervical discectomy & fusion (ACDF), bracing rates were 58%, 65% and 76% for an average of 3.3, 4.3 and 5.3 weeks, respectively. After single level corpectomy, 77% braced for an average of 6.2 weeks. After laminectomy and fusion, 72% braced for an average of 5.4 weeks. Significant variation persists among surgeons on the type and length of post-operative brace usage after cervical spine surgeries. Overall rates of bracing have not changed significantly with time. Given the lack evidence in the literature to support bracing, reconsidering use of a brace after certain surgeries may be warranted. Copyright © 2018. Published by Elsevier Inc.

  16. Misdiagnosing absent pedicle of cervical spine in the acute trauma setting

    Directory of Open Access Journals (Sweden)

    Fahad H. Abduljabbar

    2015-09-01

    Full Text Available Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms.

  17. Nonoperative treatment of symptomatic spondylolysis.

    Science.gov (United States)

    Kurd, Mark F; Patel, Deepan; Norton, Robert; Picetti, George; Friel, Brian; Vaccaro, Alexander R

    2007-12-01

    Symptomatic spondylolysis resulting from a stress fracture of the pars interarticularis is a cause of low back pain in the juvenile and adolescent patient. Treatment is conservative in the majority of cases. To analyze the outcome of patients with symptomatic isthmic spondylolysis treated nonoperatively with a custom fit thoracolumbar orthosis and activity cessation for 3 months followed by an organized physical therapy program. Retrospective case series. Four hundred thirty-six juvenile and adolescent patients with spondylolysis. Pain improvement, hamstring flexibility, range of motion, resolution of back spasms, and return to previous activities. Retrospective review of 436 juvenile and adolescent patients with symptomatic spondylolysis confirmed by single-photon emission computed tomography or computed tomography. Clinical outcomes were assessed through patient history and physical examination. Ninety-five percent of patients achieved excellent results according to a modified Odom's Criteria. The remaining 5% of patients achieved good results as they required occasional nonsteroidal anti-inflammatory drugs to relieve pain. Back spasms were resolved and hamstring tightness and range of motion returned to normal in all patients. All patients returned to their preinjury activity level. No patients went on to surgery. Symptomatic juvenile and adolescent patients with an isthmus spondylolysis may be effectively managed with a custom fit thoracolumbar orthosis brace and activity cessation for approximately 3 months followed by an organized physical therapy program.

  18. Cervical Spondylosis and Hypertension

    OpenAIRE

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

  19. Symptomatic Autism in Childhood and Adolescence

    Science.gov (United States)

    Easson, William M.

    1971-01-01

    The frequency of symptomatic autism in children with severe perceptual or intellectual handicaps is noted and early diagnosis and treatment urged to permit healthy child development. Highlighted are some common causes leading to symptomatic autism. (KW)

  20. Cervical interfacet spacers and maintenance of cervical lordosis.

    Science.gov (United States)

    Tan, Lee A; Straus, David C; Traynelis, Vincent C

    2015-05-01

    OBJECT The cervical interfacet spacer (CIS) is a relatively new technology that can increase foraminal height and area by facet distraction. These offer the potential to provide indirect neuroforaminal decompression while simultaneously enhancing fusion potential due to the relatively large osteoconductive surface area and compressive forces exerted on the grafts. These potential benefits, along with the relative ease of implantation during posterior cervical fusion procedures, make the CIS an attractive adjuvant in the management of cervical pathology. One concern with the use of interfacet spacers is the theoretical risk of inducing iatrogenic kyphosis. This work tests the hypothesis that interfacet spacers are associated with loss of cervical lordosis. METHODS Records from patients undergoing posterior cervical fusion at Rush University Medical Center between March 2011 and December 2012 were reviewed. The FacetLift CISs were used in all patients. Preoperative and postoperative radiographic data were reviewed and the Ishihara indices and cervical lordotic angles were measured and recorded. Statistical analyses were performed using STATA software. RESULTS A total of 64 patients were identified in whom 154 cervical levels were implanted with machined allograft interfacet spacers. Of these, 15 patients underwent anterior-posterior fusions, 4 underwent anterior-posterior-anterior fusions, and the remaining 45 patients underwent posterior-only fusions. In the 45 patients with posterior-only fusions, a total of 110 levels were treated with spacers. There were 14 patients (31%) with a single level treated, 16 patients (36%) with two levels treated, 5 patients (11%) with three levels treated, 5 patients (11%) with four levels treated, 1 patient (2%) with five levels treated, and 4 patients (9%) with six levels treated. Complete radiographic data were available in 38 of 45 patients (84%). On average, radiographic follow-up was obtained at 256.9 days (range 48-524 days

  1. The polymethyl methacrylate cervical cage for treatment of cervical disk disease Part III. Biomechanical properties.

    Science.gov (United States)

    Chen, Jyi-Feng; Lee, Shih-Tseng

    2006-10-01

    In a previous article, we used the PMMA cervical cage in the treatment of single-level cervical disk disease and the preliminary clinical results were satisfactory. However, the mechanical properties of the PMMA cage were not clear. Therefore, we designed a comparative in vitro biomechanical study to determine the mechanical properties of the PMMA cage. The PMMA cervical cage and the Solis PEEK cervical cage were compressed in a materials testing machine to determine the mechanical properties. The compressive yield strength of the PMMA cage (7030 +/- 637 N) was less than that of the Solis polymer cervical cage (8100 +/- 572 N). The ultimate compressive strength of the PMMA cage (8160 +/- 724 N) was less than that of the Solis cage (9100 +/- 634 N). The stiffness of the PMMA cervical cage (8106 +/- 817 N/mm) was greater than that of the Solis cage (6486 +/- 530 N/mm). The elastic modulus of the PMMA cage (623 +/- 57 MPa) was greater than that of the Solis cage (510 +/- 42 MPa). The elongation of PMMA cage (43.5 +/- 5.7%) was larger than that of the Solis cage (36.1 +/- 4.3%). Although the compressive yield strength and ultimate compressive strength of the PMMA cervical cage were less than those of the Solis polymer cage, the mechanical properties are better than those of the cervical vertebral body. The PMMA cage is strong and safe for use as a spacer for cervical interbody fusion. Compared with other cage materials, the PMMA cage has many advantages and no obvious failings at present. However, the PMMA cervical cage warrants further long-term clinical study.

  2. Symptomatic heterotopic suprarenal splenic tissue

    International Nuclear Information System (INIS)

    Heider, J.; Kreft, B.; Winter, P.

    1998-01-01

    We report on a 33-year-old man with symptomatic heterotopic suprarenal splenic tissue. Heterotopic splenic tissue can often be found after posttraumatic splenectomy. It is a result of autotransplantation induced by trauma (splenosis). Additionally it can grow during embryogenic development. Such an accessory spleen is found in 10-44% of all autopsies. In this case report the patient was treated by resection due to increasing flank pain and suspected neoplasm. (orig.) [de

  3. Optimal Treatment of Symptomatic Hemorrhoids

    OpenAIRE

    Song, Seok-Gyu; Kim, Soung-Ho

    2011-01-01

    Hemorrhoids are the most common anorectal complaint, and approximately 10 to 20 percent of patients with symptomatic hemorrhoids require surgery. Symptoms of hemorrhoids, such as painless rectal bleeding, tissue protrusion and mucous discharge, vary. The traditional therapeutic strategies of medicine include surgical, as well as non-surgical, treatment. To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients. Othe...

  4. Percutaneous treatment of cervical and lumbar herniated disc

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, A., E-mail: akelekis@med.uoa.gr; Filippiadis, D.K., E-mail: dfilippiadis@yahoo.gr

    2015-05-15

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4–6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75–94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine.

  5. Percutaneous treatment of cervical and lumbar herniated disc

    International Nuclear Information System (INIS)

    Kelekis, A.; Filippiadis, D.K.

    2015-01-01

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4–6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75–94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine

  6. MR Imaging in symptomatic osteochondromas

    International Nuclear Information System (INIS)

    Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha

    1998-01-01

    The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs

  7. SCREENING FOR CERVICAL CANCER

    African Journals Online (AJOL)

    Enrique

    Cervical cancer remains a major health concern worldwide, especially in devel- ... Important aspects of cervical cancer screening include the age at which .... High-risk types HPV (16,18) are impli- cated in the pathogenesis of cervical cancer.

  8. Cervical Spondylosis and Hypertension

    Science.gov (United States)

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  9. Lateral cervical puncture for cervical myelography

    International Nuclear Information System (INIS)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck

    1985-01-01

    Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media

  10. Lateral cervical puncture for cervical myelography

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1985-12-15

    Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media.

  11. MR Imaging in symptomatic osteochondromas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha [Catholic University of Korea, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : < 5 mm (n=16), 5-10 mm (n=12), and > 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs.

  12. Symptomatic management in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Pushkar Shah

    2015-01-01

    Full Text Available Multiple sclerosis (MS is the commonest cause of disability in young adults. While there is increasing choice and better treatments available for delaying disease progression, there are still, very few, effective symptomatic treatments. For many patients such as those with primary progressive MS (PPMS and those that inevitably become secondary progressive, symptom management is the only treatment available. MS related symptoms are complex, interrelated, and can be interdependent. It requires good understanding of the condition, a holistic multidisciplinary approach, and above all, patient education and empowerment.

  13. Desired Diversity and Symptomatic Anxiety

    DEFF Research Database (Denmark)

    Friis Christensen, Jannick; Muhr, Sara Louise

    2018-01-01

    of diversity that, however, constantly change due to the empty form of diversity. Anxiety manifests itself in the obsession of unobtainable idealised forms of diversity as well as in the uncertainty associated with the traumatic experience of always falling short of what is desired in an object...... – the experience of failed diversity. Conclusively, we discuss the productive potential of the power of lack. The impossibility of diversity is what, at once, conditions the possibility of diversity. We therefore suggest that the symptomatic anxiety provoked by the lack should be enjoyed in order to engage...

  14. An investigation into the validity of cervical spine motion palpation using subjects with congenital block vertebrae as a 'gold standard'

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia K

    2004-06-01

    Full Text Available Abstract Background Although the effectiveness of manipulative therapy for treating back and neck pain has been demonstrated, the validity of many of the procedures used to detect joint dysfunction has not been confirmed. Practitioners of manual medicine frequently employ motion palpation as a diagnostic tool, despite conflicting evidence regarding its utility and reliability. The introduction of various spinal models with artificially introduced 'fixations' as an attempt to introduce a 'gold standard' has met with frustration and frequent mechanical failure. Because direct comparison against a 'gold standard' allows the validity, specificity and sensitivity of a test to be calculated, the identification of a realistic 'gold standard' against which motion palpation can be evaluated is essential. The objective of this study was to introduce a new, realistic, 'gold standard', the congenital block vertebra (CBV to assess the validity of motion palpation in detecting a true fixation. Methods Twenty fourth year chiropractic students examined the cervical spines of three subjects with single level congenital block vertebrae, using two commonly employed motion palpation tests. The examiners, who were blinded to the presence of congenital block vertebrae, were asked to identify the most hypomobile segment(s. The congenital block segments included two subjects with fusion at the C2–3 level and one with fusion at C5-6. Exclusion criteria included subjects who were frankly symptomatic, had moderate or severe degenerative changes in their cervical spines, or displayed signs of cervical instability. Spinal levels were marked on the subject's skin overlying the facet joints from C1 to C7 bilaterally and the motion segments were then marked alphabetically with 'A' corresponding to C1-2. Kappa coefficients (K were calculated to determine the validity of motion palpation to detect the congenitally fused segments as the 'most hypomobile' segments. Sensitivity

  15. Cervical adenocarcinoma

    International Nuclear Information System (INIS)

    Raymond, P.E.; Bonenfant, J.L.; Blais, R.

    1988-01-01

    Glandular neoplasms of the uterine cervix represent a small but important group of cervical carcinomas. Included in the present study were 68 cases of primary adenocarcinomas of the uterine cervix seen from 1972 to 1986 in our Radiation Oncology Center. The complete data set for all patients was analyzed with regard to symptoms, histologic patterns, diagnostic procedures, treatment methods, and prognosis. The authors stress the importance of establishing the primary origin of the lesion in the cervix and of completely investigating patients with an abnormal bleeding pattern, even those with an apparently normal exocervix

  16. TTV and HPV co-infection in cervical smears of patients with cervical lesions

    Directory of Open Access Journals (Sweden)

    Tachezy Ruth

    2009-07-01

    Full Text Available Abstract Background The female lower genital tract is a gateway for pathogens entering the host through the mucous membrane. One of the prevalent human viruses is Torque teno virus (TTV. The major reported routes of TTV transmission are fecal-oral and parenteral. Furthermore, other modes of transmission, e.g. sexual contact, are suggested. To investigate the sexual route of TTV transmission, cervical smears of healthy women and those with cervical lesions were screened for the presence of TTV DNA. Methods TTV DNA was studied in cervical smears of 95 patients with cervical lesions and 55 healthy women. Paired serum samples were available from 55 and 42 women, respectively. All healthy women had normal cytology while 44 patients had histologically confirmed low-grade lesion (LGL and 51 high-grade lesion (HGL. TTV DNA was detected with primers specific for the non-coding region. In 40 paired cervical smears and serum samples, the phylogenetic group of TTV isolates was determined. The presence of HPV DNA in cervical smears was detected by means of PCR with MY09/11 primers. Results The prevalence of TTV DNA in cervical smears of healthy women was 52.7% and was comparable with that in paired serum samples (50%. Symptomatic women had significantly higher prevalence of TTV DNA in cervical smears (74.7% than healthy controls. The TTV DNA prevalence in patient serum samples was 51%. The phylogenetic groups of TTV serum isolates were concordant with those of TTV from cervical smears of the same subjects. In cervical smears, a wider variety of TTV isolates was found. The viral loads in cervical smears were 10 to 1000 times as high as in sera. The HPV-positive study subjects had significantly higher TTV DNA prevalence than HPV negatives. The prevalence of TTV was not associated with disease severity. Conclusion High prevalence of TTV in cervical smears suggests that sexual transmission is another mode of expansion of TTV infection among the population. The

  17. Headache of cervical origin

    International Nuclear Information System (INIS)

    Burguet, J.L.; Wackenheim, A.

    1984-01-01

    The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''. (orig.) [de

  18. Headache of cervical origin

    Energy Technology Data Exchange (ETDEWEB)

    Burguet, J L; Wackenheim, A

    1984-08-01

    The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''.

  19. Anterior cervical fusion: the role of anterior plating.

    Science.gov (United States)

    Daffner, Scott D; Wang, Jeffrey C

    2009-01-01

    Treatment of cervical pathology requires a clear understanding of the biomechanical benefits and limitations of cervical plates, their indications, and their associated complications. The use of anterior cervical plates has evolved significantly since their early application in cervical trauma. They have become widely used for anterior cervical decompression and fusion for cervical spondylosis. Plate design has undergone significant refinement and innovation, from the initial unlocked plates requiring bicortical purchase to the latest rotationally and translationally semiconstrained dynamic plates. Excellent clinical results have been reported for single-level anterior cervical decompression and fusion with or without plate fixation; however, the addition of an anterior cervical plate clearly leads to earlier fusion and better clinical results in longer fusions. Longer fusions should ideally consist of corpectomies and strut grafting because the decreased number of fusion surfaces tends to lead to higher fusion rates. Although anterior plate fixation leads to higher fusion rates in fusions of three or more levels, the associated pseudarthrosis rate is still high. The use of dynamic plates, through increased load sharing across the graft and decreased stress shielding, may improve fusion rates, particularly in long fusions. Nevertheless, adjuvant posterior fixation is recommended for fusions of more than three vertebral levels. Anterior plate fixation may be of particular benefit in the management of traumatic injuries, in revision settings, and in the treatment of smokers. Complications unique to plate fixation include hardware breakage and migration as well as ossification of the adjacent disk levels.

  20. Correlation between cervical lordosis and adjacent segment pathology after anterior cervical spinal surgery.

    Science.gov (United States)

    Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Hyun Jib

    2015-12-01

    To evaluate the incidence and risk factors for adjacent segment pathology (ASP) after anterior cervical spinal surgery. Fourteen patients (12 male, mean age 47.1 years) who underwent single-level cervical disk arthroplasty (CDA group) and 28 case-matched patients (24 male, mean age 53.6 years) who underwent single-level anterior cervical discectomy and fusion (ACDF group) were included. Presence of radiologic ASP (RASP) was based on observed changes in anterior osteophytes, disks, and calcification of the anterior longitudinal ligament on lateral radiographs. The mean follow-up period was 43.4 months in the CDA group and 44.6 months in the ACDF group. At final follow-up, ASP was observed in 5 (35.7%) CDA patients and 16 (57.1%) ACDF patients (p = 0.272). The interval between surgery and ASP development was 33.8 months in the CDA group and 16.3 months in the ACDF group (p = 0.046). The ASP risk factor analysis indicated postoperative cervical angle at C3-7 being more lordotic in non-ASP patients in both groups. Restoration of lordosis occurred in the CDA group regardless of the presence of ASP, but heterotopic ossification development was associated with the presence of ASP in the CDA group. And the CDA group had significantly greater clinical improvements than those in the ACDF group when ASP was present. In both CDA and ACDF patients, RASP developed, but CDA was associated with a delay in ASP development. A good clinical outcome was expected in CDA group, even when ASP developed. Restoration of cervical lordosis was an important factor in anterior cervical spine surgery.

  1. Cervical Vertigo(Vertigo)

    OpenAIRE

    本間, 隆夫; Homma, Takao

    1992-01-01

    Cervical vertigo was reviewed as to its mechanism, diagnosis and treatment, and nine cases which had operation done were briefly presented. Cervical vertigo has been seen occasionaly in the cases of cervical spondylosis, frequently in the cases of traumatic cervical syndrome. The mechanism is attributed to either vertebrobasilar insufficiency caused by compression on vertebral artery or irritation of poterior cervical sympathetic system. The diagnosis consists of reccurent vertigo attack with...

  2. Intrasellar Symptomatic Salivary Gland Rest

    Directory of Open Access Journals (Sweden)

    Chih-Hao Chen

    2007-05-01

    Full Text Available Ectopic salivary gland tissue in sellar turcica is frequently observed in microscopic examination at autopsy. This tissue is considered clinically silent. Only 2 symptomatic cases have been previously reported. Here we report a 28-year-old woman presenting with galactorrhea and hyperprolactinemia. Magnetic resonance imaging revealed a 6×5-mm nodule in the posterior aspect of the pituitary gland. This nodule showed isointensity on T1- and T2-weighted images and less enhancement on post-contrast T1-weighted images. Transsphenoidal exploration revealed a cystic lesion within the pituitary gland, which consisted of a grayish gelatinous content. The pathologic examination confirmed the diagnosis of salivary gland rest.

  3. Optimal Treatment of Symptomatic Hemorrhoids

    Science.gov (United States)

    Kim, Soung-Ho

    2011-01-01

    Hemorrhoids are the most common anorectal complaint, and approximately 10 to 20 percent of patients with symptomatic hemorrhoids require surgery. Symptoms of hemorrhoids, such as painless rectal bleeding, tissue protrusion and mucous discharge, vary. The traditional therapeutic strategies of medicine include surgical, as well as non-surgical, treatment. To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients. Other non-surgical treatments, such as infrared photocoagulation, injection sclerotherapy and rubber band ligation have been used to fixate the hemorrhoid's cushion. If non-surgical treatment has no effect, surgical treatments, such as a hemorrhoidectomy, procedure for prolapsed hemorrhoids, and transanal hemorrhoidal dearterialization are used. PMID:22259741

  4. Outcome of Cloward technique in cervical disc prolapse.

    Science.gov (United States)

    Rehman, Lal; Qayoom Khan, Hina Abdul; Hashim, A Sattar M

    2010-11-01

    To determine the association of pre-operative assessment of MRI findings, neurological status and symptoms with postoperative Cloward surgical outcome in cervical disc prolapse. Descriptive study. The Neurosurgery Department of Jinnah Postgraduate Medical Centre (JPMC), Karachi, from May 2008 to May 2009. Patients presenting with neck pain, brachialgia, limb weakness and spasticity were clinically examined for pre-operative neurological status of power, reflexes and sensation. The exclusion criteria were, cervical disc prolapsed patients, planned for smith-Robinson and micro-discectomy, traumatic cervical disc prolapse and cervical spondylosis. Neuroradiological investigations included cervical spine X-rays and MRI. All patients were surgically treated for cervical prolapsed intervertebral disc with anterior cervical discectomy and interbody fusion with Cloward technique. Postoperative neck immobilization was done with cervical collar for 7-8 weeks. Drain was removed on first postoperative day while check plain cervical X-rays were taken on third day. Results were analysed using chi-square test with significance at p cervical disc prolapse were C 5-6 (43.3%) and C 6-7 (23.3%); 26 (86.6%) patients had disc herniation causing thecal effacement with cord compression and 04 (13.3%) patients showed ischemia of cord. Single-level Cloward surgery done in 26 (86.3%) patients while two-level Cloward surgery performed in 04 (13.3%) only. About 83.3% patients improved and 13.3% did not while 01 patient was re-operated. No complications and mortality was related to the surgical procedure. Statistically different variables identified, related to outcome were pre-operative neurological status (p=0.001) and spinal cord involvement on MRI (p=0.001). Cloward technique for cervical disc prolase was simple and safe surgical procedure with favourable results and few complications; 100% fusion occurred after Cloward surgery, even without instrumentation. Outcome was significantly

  5. Hemodynamics of hepatocellular carcinoma with single-level dynamic computed tomography during hepatic arteriography

    International Nuclear Information System (INIS)

    Tanihata, Hirohiko

    2002-01-01

    The purpose of this study is to verify the hemodynamics of hepatocellular carcinoma (HCC) and to explore the draining pathway using single-level dynamic computed tomography during hepatic arteriography (single-level dynamic CTHA). One hundred one patients with 131 nodules of HCC underwent single level dynamic CTHA. Forty seven nodules were diagnosed by histological specimen and the other eighty four nodules by clinical findings of elevation in AFP and/or PIVKA II and hypervascular tumor in angiography. Single-level dynamic CTHA was performed under insertion of a catheter into proper hepatic artery or the more peripheral hepatic artery with a slice thickness of 3 mm at the same level. Each image of single level dynamic CTHA was continuously taken in a second for 40 seconds during injection of contrast medium at of 2 ml/sec for 10 seconds. The images of single-level dynamic CTHA were differentiated into three phases, as early phase 1 to 10 seconds, middle phase 11 to 20 seconds and late phase 21 to 40 seconds. After the analysis of the vascular pattern in each phase, the hemodynamics of HCC was classified into three patterns; hypovascular pattern in the 24 nodules whose average size was 13.4±4.2 mm, intermediate pattern in the 21 nodules whose average size was 20.8±7.8 mm and hypervascular pattern in 86 nodules whose average size was 31.6±16.3 mm. There were significant correlations between the tumor size and the vascular pattern. In the groups of hypovascular and intermediate pattern, the draining pathways were sinusoids. Of the 86 nodules of the group with hypervascular pattern, blood flow drained into portal vein including bright branch structure in 20 nodules, into portal vein and hepatic vein in 2 nodules, into portal vein and extrahepatic vein in 1 nodule, into hepatic vein in 11 nodules, into extrahepatic vein in 4 nodules and into sinusoids in 48 nodules. In conclusion, from a viewpoint of hemodynamics using single-level dynamic CTHA, I proposed the new

  6. The value of short-term pain relief in predicting the long-term outcome of 'indirect' cervical epidural steroid injections.

    Science.gov (United States)

    Joswig, Holger; Neff, Armin; Ruppert, Christina; Hildebrandt, Gerhard; Stienen, Martin Nikolaus

    2018-05-01

    The predictive value of short-term arm pain relief after 'indirect' cervical epidural steroid injection (ESI) for the 1-month treatment response has been previously demonstrated. It remained to be answered whether the long-term response could be estimated by the early post-interventional pain course as well. Prospective observational study, following a cohort of n = 45 patients for a period of 24 months after 'indirect' ESI for radiculopathy secondary to a single-level cervical disk herniation (CDH). Arm and neck pain on the visual analog scale (VAS), health-related quality of life with the Short Form-12 (SF-12), and functional outcome with the Neck Pain and Disability (NPAD) Scale were assessed. Any additional invasive treatment after a single injection (second injection or surgery) defined treatment outcome as 'non-response'. At 24 months, n = 30 (66.7%) patients were responders and n = 15 (33.3%) were non-responders. Non-responders exited the follow-up at 1 month (n = 10), at 3 months (n = 4), and at 6 months (n = 1). No patients were injected again or operated on between the 6- and 24-month follow-up. Patients with favorable treatment response at 24 months had significantly lower VAS arm pain (p  50% short term pain reduction was not a reliable predictor of the 24-month responder status. SF-12 and NPAD scores were better among treatment responders in the long term. Patients who require a second injection or surgery after 'indirect' cervical ESI for a symptomatic CDH do so within the first 6 months. Short-term pain relief cannot reliably predict the long-term outcome.

  7. Factors associated with symptomatic vulvovaginal candidiasis: a ...

    African Journals Online (AJOL)

    Background: Symptomatic vulvovaginal candidiasis (VVC) is one of the most common problems leading women to seek advice in primary healthcare facilities. Aim: The aim of this study is to describe the associations between some hypothesized factors and the presence of symptomatic VVC. Subjects and Methods: An ...

  8. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  9. Cervical spinal cord, root, and bony spine injuries: a closed claims analysis.

    Science.gov (United States)

    Hindman, Bradley J; Palecek, John P; Posner, Karen L; Traynelis, Vincent C; Lee, Lorri A; Sawin, Paul D; Tredway, Trent L; Todd, Michael M; Domino, Karen B

    2011-04-01

    The aim of this study was to characterize cervical cord, root, and bony spine claims in the American Society of Anesthesiologists Closed Claims database to formulate hypotheses regarding mechanisms of injury. All general anesthesia claims (1970-2007) in the Closed Claims database were searched to identify cervical injuries. Three independent teams, each consisting of an anesthesiologist and neurosurgeon, used a standardized review form to extract data from claim summaries and judge probable contributors to injury. Cervical injury claims (n = 48; mean ± SD age 47 ± 15 yr; 73% male) comprised less than 1% of all general anesthesia claims. When compared with other general anesthesia claims (19%), cervical injury claims were more often permanent and disabling (69%; P cervical stenosis) were often present, cord injuries usually occurred in the absence of traumatic injury (81%) or cervical spine instability (76%). Cord injury occurred with cervical spine (65%) and noncervical spine (35%) procedures. Twenty-four percent of cord injuries were associated with the sitting position. Probable contributors to cord injury included anatomic abnormalities (81%), direct surgical complications (24% [38%, cervical spine procedures]), preprocedural symptomatic cord injury (19%), intraoperative head/neck position (19%), and airway management (11%). Most cervical cord injuries occurred in the absence of traumatic injury, instability, and airway difficulties. Cervical spine procedures and/or sitting procedures appear to predominate. In the absence of instability, cervical spondylosis was the most common factor associated with cord injury.

  10. Symptomatic splenomegaly and palliative radiotherapy

    International Nuclear Information System (INIS)

    Yaneva, M.; Vlaikova, M.

    2005-01-01

    We analysed the effect of irradiation of an enlarged spleen in some hematologic diseases: chronic myelaemia, osteomyelophybrosis and chronic lymphadenosis, where splenectomy had been contraindicated and where pain has been a leading symptom and also the discomfort because of an enlarged spleen. For 20 years in the Clinic of Radiotherapy have been treated 23 patients with the above mentioned diseases. We have irradiated all patients using X-ray and later- Co-60. To reach a palliative effect we have irradiated patients with single doses from 50 cGy to 100 cGy with an interval of 2-3 days between each fraction, but the total doses have been different- from 400 cGy to 1500 cGy. The enlarged spleen has reached the pelvis in 3 cm to 17 cm below the costal margin, and in some patients has crossed the median line of the body going in some centimetres on the other side. The reduction of splenic size and volume is as follows: full reduction in 6 patients (26.1%) and partial in 17 (73.9%). All patients resulted in decreases in pain and tension in abdomen and the total discomfort. No serious side haematologic effects were encountered. Our experience indicates that cautious splenic irradiation can be a safe and useful therapeutic alternative. The symptomatic palliation in patients, where splenectomy is not an option, is effective and is an additional alternative for an improvement of their general condition

  11. SURGERY OF SYMPTOMATIC MYOCARDIAL BRIDGING

    Directory of Open Access Journals (Sweden)

    N. Maghamipour N. Safaei

    2007-06-01

    Full Text Available Myocardial bridging with systolic compression of the left anterior descending coronary artery (LAD may be associated with myocardial ischemia. In symptomatic myocardial bridging unresponsive to medical treatment, surgical unroofing of the left LAD can be performed. Little information is available about the long-term prognosis of patients with this coronary anomaly after the surgical unroofing, so we decided to evaluate the result of this operation. A total of 26 patients underwent surgical unroofing of myocardial bridging. Patients had a myocardial bridge of at least 3 cm in length in the middle of LAD and with more than 70% compression during systole. Unroofing was performed with cardiopulmonary bypass in 16 and with off pump technique in 10 patients. In 6 patients repeat angiographies for control of myotomy were done. In one of them a nonsignificant 20% narrowing was seen. Postoperative scintigraphic and angiographic studies demonstrated restoration of coronary flow and myocardial perfusion without residual myocardial bridges under beta-stimulation in 24 patients. Two patients had residual narrowing. With off pump technique, 1 patient had perforation of the right ventricle and 1 patient underwent reoperation because of incomplete unroofing during the first operation. None of the patients with cardiopulmonary bypass technique had residual chest pain or other complications. Surgical unroofing of myocardial bridging with the aid of cardiopulmonary bypass is a safe and easy procedure with low operative risk and with excellent functional results.

  12. Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study

    OpenAIRE

    Gokaslan, Ziya L.; Bydon, Mohamad; De la Garza-Ramos, Rafael; Smith, Zachary A.; Hsu, Wellington K.; Qureshi, Sheeraz A.; Cho, Samuel K.; Baird, Evan O.; Mroz, Thomas E.; Fehlings, Michael; Arnold, Paul M.; Riew, K. Daniel

    2017-01-01

    Study Design: Multicenter retrospective study. Objectives: To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. Methods: A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patient...

  13. Cervical Cancer Stage IIIB

    Science.gov (United States)

    ... by the cancer. This blockage can cause the kidney to enlarge or stop working. Stage IIIB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, ...

  14. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  15. Prevent Cervical Cancer

    Science.gov (United States)

    ... professional printing [PDF-1.5MB] Cancer Home “Prevent Cervical Cancer” Infographic Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Prevent Cervical Cancer with the Right Test at the Right Time ...

  16. Screening for Cervical Cancer

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Cervical Cancer The U.S. Preventive Services Task Force (Task Force) has issued final recommendations on Screening for Cervical Cancer . These recommendations are for women ...

  17. Stages of Cervical Cancer

    Science.gov (United States)

    ... cancer is found early. Signs and symptoms of cervical cancer include vaginal bleeding and pelvic pain. These and other signs and symptoms may be caused by cervical cancer or by other conditions . Check with your ...

  18. Cervical Dystonia (Spasmodic Torticollis)

    Science.gov (United States)

    ... Many people who have cervical dystonia also experience neck pain that can radiate into the shoulders. The disorder also can cause headaches. In some people, the pain from cervical dystonia can be exhausting and disabling. Causes In ...

  19. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  20. Cervical Cancer Stage IIIA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View /Download : ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; drawing ...

  1. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing ...

  2. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View /Download : ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; drawing ...

  3. Cervical Cancer Stage IB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View /Download : ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 cervical ...

  4. IMMEDIATE RECIPROCAL CHANGES AT ADJACENT LEVEL FOLLOWING SINGLE-LEVEL ALIF

    OpenAIRE

    Uribe, Enrique Vargas; Amaral, Rodrigo; Marchi, Luis; Jensen, Rubens; Oliveira, Leonardo; Fortti, Fernanda; Coutinho, Etevaldo; Pimenta, Luiz

    2015-01-01

    Objective : To assess the segmental sagittal parameters and the adjacent mobile segment after interbody fusion by anterior approach in single-level L5-S1. Methods : Retrospective study. Inclusion: Interbody fusion by anterior approach (10°/15° angle), due to DDD, low-grade spondylolisthesis and/or stenosis without prior lumbar fusion. Thirty-five cases were included (25 women; mean age 47±15 years). Analysis of lumbar radiographs were performed preoperatively and 3 months after surgery. The ...

  5. Ehler Danlos syndrome with cervical dislocation: An unusual case

    OpenAIRE

    Neeraj Awasthy; Karam Chand

    2008-01-01

    Ehler-Danlos syndrome (EDS) is heritable connective tissue disorders with varied manifestations whose primary clinical features include soft, hyperextensible skin, dystrophic scarring, easy bruising, and joint hypermobility. Os odontoideum describes a condition in which the dens is separated from the axis body. The exact frequency is unknown. Known cases are either incidentally detected or are diagnosed when patients become symptomatic. Cervical dislocation has been described with type VI les...

  6. Cognitive bias in symptomatic and recovered agoraphobics.

    Science.gov (United States)

    Stoler, L S; McNally, R J

    1991-01-01

    Symptomatic agoraphobics, recovered agoraphobics, and normal control subjects completed a series of sentence stems that had either ambiguous or unambiguous meanings, and had either a potentially threatening or a nonthreatening connotation. The written completions made by subjects to these stems were classified as indicating either a biased (i.e. threat-related) or unbiased interpretation of the meaning of the stem, and if a biased interpretation was made, whether the subject indicated efforts at adaptive coping with the perceived threat. Results indicated that symptomatic agoraphobics exhibited strong biases for interpreting information as threatening, relative to normal control subjects. Moreover, recovered agoraphobics resembled symptomatic agoraphobics more than normal control subjects, thus indicating that cognitive biases may persist following cessation of panic attacks and reductions in avoidance behavior. However, recovered agoraphobics also exhibited tendencies to cope adaptively with perceived threats whereas symptomatic agoraphobics did not.

  7. Prevalence of significant bacteriuria among symptomatic and ...

    African Journals Online (AJOL)

    2013-06-10

    Jun 10, 2013 ... bacteriuria in symptomatic and asymptomatic sickle cell patients in Lagos. Materials and Methods: .... over 65 years, treatment with immunosuppressive drugs, the presence of .... toxemia of pregnancy.[7,13] A positive urine ...

  8. Restenosis after stenting in symptomatic vertebral arterial orifice disease and considerations for better outcome

    Science.gov (United States)

    Chang, Jun Young; Park, Hyun; Kwon, Oki

    2017-01-01

    We have performed stenting in 11 patients with symptomatic vertebral arterial orifice stenosis refractory to medical treatment or impairment in anterior circulation. Three of the 11 patients experienced asymptomatic severe in-stent restenosis or occlusion. Bare metal stents were used in those three patients, two of whom received revascularization therapy. Development of sufficient cervical collateral channels reconstituting the distal vertebral artery was the common feature in patients with asymptomatic in-stent restenosis. In selecting appropriate stents, consideration of mechanical strength and drug-eluting properties of a stent according to characteristics of the target vessel is important to reduce the risk of in-stent restenosis. Any decision to perform revascularization should be based on the presence of abundant cervical collaterals as well as clinical symptoms of vertebrobasilar ischemia. PMID:28304206

  9. Epidural Hematoma Following Cervical Spine Surgery.

    Science.gov (United States)

    Schroeder, Gregory D; Hilibrand, Alan S; Arnold, Paul M; Fish, David E; Wang, Jeffrey C; Gum, Jeffrey L; Smith, Zachary A; Hsu, Wellington K; Gokaslan, Ziya L; Isaacs, Robert E; Kanter, Adam S; Mroz, Thomas E; Nassr, Ahmad; Sasso, Rick C; Fehlings, Michael G; Buser, Zorica; Bydon, Mohamad; Cha, Peter I; Chatterjee, Dhananjay; Gee, Erica L; Lord, Elizabeth L; Mayer, Erik N; McBride, Owen J; Nguyen, Emily C; Roe, Allison K; Tortolani, P Justin; Stroh, D Alex; Yanez, Marisa Y; Riew, K Daniel

    2017-04-01

    A multicentered retrospective case series. To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified. A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment ( P = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation. This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements.

  10. LEARNING CURVE IN SINGLE-LEVEL MINIMALLY INVASIVE TLIF: EXPERIENCE OF A NEUROSURGEON

    Directory of Open Access Journals (Sweden)

    Samuel Romano-Feinholz

    Full Text Available ABSTRACT Objective: To describe the learning curve that shows the progress of a single neurosurgeon when performing single-level MI-TLIF. Methods: We included 99 consecutive patients who underwent single-level MI-TLIF by the same neurosurgeon (JASS. Patient’s demographic characteristics were analyzed. In addition, surgical time, intraoperative blood loss and hospital stay were evaluated. The learning curves were calculated with a piecewise regression model. Results: The mean age was 54.6 years. The learning curves showed an inverse relationship between the surgical experience and the variable analyzed, reaching an inflection point for surgical time in case 43 and for blood loss in case 48. The mean surgical time was 203.3 minutes (interquartile range [IQR] 150-240 minutes, intraoperative bleeding was 97.4ml (IQR 40-100ml and hospital stay of four days (IQR 3-5 days. Conclusions: MI-TLIF is a very frequent surgical procedure due to its effectiveness and safety, which has shown similar results to open procedure. According to this study, the required learning curve is slightly higher than for open procedures, and is reached after about 45 cases.

  11. Vertebral metastases with high risk of symptomatic malignant spinal cord compression

    International Nuclear Information System (INIS)

    Hamamoto, Yasushi; Kataoka, Masaaki; Senba, Takatoshi

    2009-01-01

    To find vertebral metastases with high risk of symptomatic malignant spinal cord compression (MSCC), features of vertebral metastases caused motor deficits of the lower extremities were examined. From 2004 through 2006, 78 patients with metastases of the thoracic and/or the cervical spine were treated with radiation therapy (RT). Of these, 86 irradiated lesions in 73 patients were evaluable by magnetic resonance imaging and/or computed tomography at the initiation of RT and were reviewed retrospectively in this study. Twenty-eight patients (38%) had motor deficits at the initiation of RT. Assessed factors were age, sex, primary disease (lung, breast, digestive system and other cancer), lamina involvement, main level of tumor location and vertebral-body involvement. Incidence of motor deficits at the initiation of RT was 55% for lesions with lamina involvement and 5% for lesions without lamina involvement (P 0.9999, P=0.7798, P=0.1702 and P=0.366, respectively). Vertebral metastases with lamina involvement tended to cause symptomatic MSCC. Latent development of MSCC occurred more frequently in the MTS compared with other levels of the thoracic and the cervical spine. (author)

  12. Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States.

    Science.gov (United States)

    Lao, Lifeng; Cohen, Jeremiah R; Buser, Zorica; Brodke, Darrel S; Yoon, S Tim; Youssef, Jim A; Park, Jong-Beom; Meisel, Hans-Joerg; Wang, Jeffrey C

    2018-04-01

    Retrospective case study. To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States. Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient. A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization.

  13. Surgically Treated Symptomatic Prolapsed Lumbar and Sacral ...

    African Journals Online (AJOL)

    Background and Objective: There are various postulated possible causes of surgically symptomatic prolapsed intervertebral discs in the lumbar and sacral regions. They may be acting singularly or collectively. Yet, these factors, which could vary in different environments, have not been satisfactorily confirmed. The intention ...

  14. Distribution pattern of surgically treated symptomatic prolapsed ...

    African Journals Online (AJOL)

    Background: The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published. Materials and Methods: We treated 88 locations ...

  15. Pathophysiology of cervical myelopathy.

    Science.gov (United States)

    Baptiste, Darryl C; Fehlings, Michael G

    2006-01-01

    Cervical myelopathy is a group of closely related disorders usually caused by spondylosis or by ossification of the posterior longitudinal ligament and is characterized by compression of the cervical spinal cord or nerve roots by varying degrees and number of levels. The decrease in diameter of the vertebral canal secondary to disc degeneration and osteophytic spurs compresses the spinal cord and nerve roots at one or several levels, producing direct damage and often secondary ischemic changes. Clinicians who treat cervical myelopathy cord injuries should have a basic understanding of the pathophysiology and the processes that are initiated after the spinal cord has been injured. Literature review. Literature review of human cervical myelopathy and clinically relevant animal models to further our understanding of the pathological mechanisms involved. The pathophysiology of cervical myelopathy involves static factors, which result in acquired or developmental stenosis of the cervical canal and dynamic factors, which involve repetitive injury to the cervical cord. These mechanical factors in turn result in direct injury to neurons and glia as well as a secondary cascade of events including ischemia, excitotoxicity, and apoptosis; a pathobiology similar to that occurring in traumatic spinal cord injury. This review summarizes some of the significant pathophysiological processes involved in cervical myelopathy.

  16. Imaging in cervical cancer.

    NARCIS (Netherlands)

    Follen, M.; Levenback, C.F.; Iyer, R.B.; Grigsby, P.W.; Boss, E.A.; Delpassand, E.S.; Fornage, B.D.; Fishman, E.K.

    2003-01-01

    Cervical cancer traditionally has been staged clinically. Advances in imaging could improve the staging of cervical cancer by facilitating the detection of lymph node metastases and micrometastases in distant organs. Such progress could lead to improvements in treatment selection and therefore

  17. Cervical peridural calcification in dialysed patients. Report of seven cases

    International Nuclear Information System (INIS)

    Okubo, Yasuhiro; Komura, Masayoshi; Fukuda, Minoru; Yamanaka, Mariko; Inose, Kazuto; Honda, Masanori; Shiraishi, Tateru

    2007-01-01

    Though a variety of bone joint complications are widely recognized in long-term dialysis patients, myelopathy caused by ectopic calcification surrounding the cervical spinal dura has not been reported. We encountered seven patients with the cervical peridural calcification (CPC) and performed surgery on four. The present study investigated the clinical features of this condition. All seven had a dialysis history over 20 years, and the Ca X P product was high. Plain cervical CT scan was the most useful diagnostic tool for CPC, though was quite difficult to establish the diagnosis by plain X-ray, MRI or myelography. Clinical symptoms of CPC resembled those of spinal canal stenosis caused by thickening or ossification of the ligament. The spinal cord in the area of CPC was comppressed with calcified fibrous membrane surrounding the cervical dura mater, swelling and pulsation of spinal cord was obtained after not only excising the vertebral arch but also opening and removing the calcified membrane from the dura. Clinical improvement was obtained only in two patients with a short symptomatic period. Based on these findings, CPC should be recognized as an important complication in dialysed patients. Patients demonstrating any sign of numbness and/or muscle weakness in upper and/or lower limbs should be examined by plain cervical CT scan. If calcification around the spinal dura is identified, surgery should be considered in the early stage. (author)

  18. Trends Analysis of rhBMP Utilization in Single-Level Posterior Lumbar Interbody Fusion in the United States.

    Science.gov (United States)

    Lao, Lifeng; Cohen, Jeremiah R; Buser, Zorica; Brodke, Darrel S; Youssef, Jim A; Park, Jong-Beom; Yoon, S Tim; Wang, Jeffrey C; Meisel, Hans-Joerg

    2017-10-01

    Retrospective study. Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used in spinal fusion surgery, but there is little information on rhBMP-2 utilization in single-level posterior lumbar interbody fusion (PLIF). The purpose of our study was to evaluate the trends and demographics of rhBMP-2 utilization in single-level PLIF. Patients who underwent single-level PLIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database, a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were recorded for each patient. Results were reported for each variable as the incidence of procedures identified per 100 000 patients searched in the database. A total of 2735 patients had single-level PLIF. The average rate of single-level PLIF with rhBMP-2 maintained at a relatively stable level (28% to 31%) from 2005 to 2009, but decreased in 2010 (9.9%) and 2011 (11.8%). The overall incidence of single-level PLIF without rhBMP-2 (0.68 cases per 100 000 patients) was statistically higher ( P level PLIF with rhBMP-2 (0.21 cases per 100 000 patients). The average rate of single-level PLIF with rhBMP-2 utilization was the highest in West (30.1%), followed by Midwest (26.9%), South (20.5%), and Northeast (17.8%). The highest incidence of single-level PLIF with rhBMP-2 was observed in the age group level PLIF. There was a 3-fold increase in the rate of PLIF without rhBMP-2 compared to PLIF with rhBMP-2, with both procedures being mainly done in patients less than 65 years of age.

  19. Symptomatic Non-parasitic benign hepatic cyst: Evaluation of ...

    African Journals Online (AJOL)

    HussamHassan

    Rarely, however, the cysts become symptomatic and are then best treated surgically. The optimal surgical treatment is debatable. ... the liver, including multiple cysts arising in the ..... aspiration and ethanol sclerosis of a large, symptomatic,.

  20. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  1. SLP - A single level Breit-Wigner cross-section generating programme

    International Nuclear Information System (INIS)

    Doherty, G.

    1965-06-01

    Unbroadened cross-sections are calculated from a single level Breit-Wigner approximation which allows for resonance-potential interference but not resonance-resonance interference. Doppler broadening, and instrumental resolution broadening for thin samples, are optionally performed by successive numerical convolutions. An energy point selection and discard system enables the cross-section over a specified energy range to be represented to a required degree of accuracy using the minimum number of energy points. An energy grid prepared by the user can be incorporated in the calculation but the programme will usually be more efficient if only the end points of the energy range of interest are specified by the user and the intermediate energy points left to the programme to organise. The capacity of the programme varies with the energy range and type of resonance (narrow or broad). About fifty resonances may be sufficient to generate an energy grid of 4000 energy points, which is the maximum allowable energy vector. The programme is written in KDF9 EGTRAN (a FORTRAN dialect); output is printed and may be copied on cards, and intermediate results are stored on magnetic disc. (author)

  2. Anterior pseudoarthrectomy for symptomatic Bertolotti's syndrome.

    Science.gov (United States)

    Malham, Gregory M; Limb, Rebecca J; Claydon, Matthew H; Brazenor, Graeme A

    2013-12-01

    Painful L5/S1 pseudoarthrosis has been previously managed with posterior excision and/or lumbar fusion. To our knowledge, the anterior approach for L5/S1 pseudoarthrectomy in the treatment of Bertolotti's syndrome has not been described. We present two patients with severe symptomatic L5/S1 pseudoarthroses that were successfully excised via an anterior retroperitoneal approach with 2 year clinical and radiological follow-up. The literature regarding surgical treatments for Bertolotti's syndrome is reviewed. The technique for an anterior retroperitoneal approach is described. This approach has been safe and effective in providing long term symptomatic relief to our two patients. Further studies comparing the outcomes of anterior versus posterior pseudoarthrectomy will guide the management of this condition. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Cervical osteophyte induced dysphagia

    International Nuclear Information System (INIS)

    Davies, R.P.; Sage, M.R.; Brophy, B.P.

    1989-01-01

    Although cervical spondylosis is a common disorder, dysphagia induced by osteophyte formation is uncommon. Fewer than one hundred cases of cervical osteophyte induced dysphagia have been reported, with little attention to the diagnosis by barium swallow. The radiological features of two cases treated surgically with good results are described. Both cases complained of dysphagia while one had associated respiratory obstruction on forward flexion of his neck. The features on barium study of cervical osteophytes causing dysphagia include deformity at the level of osteophyte formation, in both AP and lateral projections. Tracheal aspirations due to deformity at the laryngeal inlet and interference with epiglottic retroversion may be present. 8 refs., 3 figs

  4. Cervical lung hernia

    Science.gov (United States)

    Lightwood, Robin G.; Cleland, W. P.

    1974-01-01

    Lightwood, R. G., and Cleland, W. P. (1974).Thorax, 29, 349-351. Cervical lung hernia. Lung hernias occur in the cervical position in about one third of cases. The remainder appear through the chest wall. Some lung hernias are congenital, but trauma is the most common cause. The indications for surgery depend upon the severity of symptoms. Repair by direct suture can be used for small tears in Sibson's (costovertebral) fascia while larger defects have been closed using prosthetic materials. Four patients with cervical lung hernia are described together with an account of their operations. PMID:4850946

  5. The impact of a cervical spine diagnosis on the careers of National Football League athletes.

    Science.gov (United States)

    Schroeder, Gregory D; Lynch, T Sean; Gibbs, Daniel B; Chow, Ian; LaBelle, Mark W; Patel, Alpesh A; Savage, Jason W; Nuber, Gordon W; Hsu, Wellington K

    2014-05-20

    Cohort study. To determine the effect of cervical spine pathology on athletes entering the National Football League. The association of symptomatic cervical spine pathology with American football athletes has been described; however, it is unknown how preexisting cervical spine pathology affects career performance of a National Football League player. The medical evaluations and imaging reports of American football athletes from 2003 to 2011 during the combine were evaluated. Athletes with a cervical spine diagnosis were matched to controls and career statistics were compiled. Of a total of 2965 evaluated athletes, 143 players met the inclusion criteria. Athletes who attended the National Football League combine without a cervical spine diagnosis were more likely to be drafted than those with a diagnosis (P = 0.001). Players with a cervical spine diagnosis had a decreased total games played (P = 0.01). There was no difference in the number of games started (P = 0.08) or performance score (P = 0.38). In 10 athletes with a sagittal canal diameter of less than 10 mm, there was no difference in years, games played, games started, or performance score (P > 0.24). No neurological injury occurred during their careers. In 7 players who were drafted with a history of cervical spine surgery (4 anterior cervical discectomy and fusion, 2 foraminotomy, and 1 suboccipital craniectomy with a C1 laminectomy), there was no difference in career longevity or performance when compared with matched controls. This study suggests that athletes with preexisting cervical spine pathology were less likely to be drafted than controls. Players with preexisting cervical spine pathology demonstrated a shorter career than those without; however, statistically based performance and numbers of games started were not different. Players with cervical spinal stenosis and those with a history of previous surgery demonstrated no difference in performance-based outcomes and no reports of neurological

  6. Rare cause of neck pain: tumours of the posterior elements of the cervical spine.

    Science.gov (United States)

    Katsuura, Yoshihiro; Cason, Garrick; Osborn, James

    2016-12-15

    Here we present two cases of primary bone tumours of the cervical spine in patients who had persistent neck pain-in one case, lasting 8 years. In each case, there was a delay in diagnosis and referral to a spine specialist was prolonged. Primary bone tumours of the spine are rare, which is in contrast to the wide prevalence of cervical neck pain. Many primary care providers may go an entire career without encountering a symptomatic primary cervical spine tumour. In this paper, we discuss the clinical course and treatment of each patient and review the current literature on primary bone tumours of the spine. Owing to the subtle roentgenographic findings of primary cervical tumours, we highlight the importance of advanced imaging in the clinical work-up of simple axial neck pain lasting >6 weeks to avoid misdiagnosis of serious pathology. 2016 BMJ Publishing Group Ltd.

  7. IMMEDIATE RECIPROCAL CHANGES AT ADJACENT LEVEL FOLLOWING SINGLE-LEVEL ALIF

    Directory of Open Access Journals (Sweden)

    Enrique Vargas Uribe

    2015-12-01

    Full Text Available Objective : To assess the segmental sagittal parameters and the adjacent mobile segment after interbody fusion by anterior approach in single-level L5-S1. Methods : Retrospective study. Inclusion: Interbody fusion by anterior approach (10°/15° angle, due to DDD, low-grade spondylolisthesis and/or stenosis without prior lumbar fusion. Thirty-five cases were included (25 women; mean age 47±15 years. Analysis of lumbar radiographs were performed preoperatively and 3 months after surgery. The following parameters were evaluated: lumbar lordosis; segmental lordosis L4-L5 and L5-S1; sacral and L5 slope. Two independent evaluators made the measurements. Student's t test was used. Results : There was correction of lordosis at the L5-S1 level, from an average of 19° prior to surgery to 28° three months after surgery (p<0.001. It was observed reduction of the L4-L5 angle from 17° to 14° (p <0.001. Moreover, there was a small, but statistically significant, reduction of L5 inclination from 17 ° to 13 ° (p=0.007 and increase in the sacral slope from 37° to 40° (p=0.002. The change of total lumbar lordosis was not significant: 52° versus 53° (p=0.461. Before surgical correction, lordosis of the L5-S1 level contributed, on average, 37% of lumbar lordosis, and after, 54% (p<0.001. The L4-L5 level accounted for 34% and decreased to 24% (p<0.001. Conclusion : In the group studied, it was observed a decrease in lordosis of the adjacent mobile level following the treatment of the degenerate level by anterior interbody fusion and concomitant increase in lordosis.

  8. Single-level dynamic spiral CT of hepatocellular carcinoma: correlation between imaging features and tumor angiogenesis

    International Nuclear Information System (INIS)

    Chen Weixia; Min Pengqiu; Song Bin; Xiao Bangliang; Liu Yan; Wang Wendong; Chen Xian; Xu Jianying

    2001-01-01

    Objective: To investigate the correlation of the enhancement imaging features of hepatocellular carcinoma (HCC) and relevant parameters revealed by single-level dynamic spiral CT scanning with tumor microvessel counting (MVC). Methods: The study included 26 histopathologically proven HCC patients. Target-slice dynamic scanning and portal venous phase scanning were performed for all patients. The time-density curves were generated with measurement of relevant parameters including: peak value (PV) and contrast enhancement ratio (CER), and the gross enhancement morphology analyzed. Histopathological slides were carefully prepared for the standard F8RA and VEGF immunohistochemical staining and tumor microvessel counting and calculation of VEGF expression percentage of tumor cells. The enhancement imaging features of HCC lesions were correlatively studied with tumor MVC and VEGF expression. Results: Peak value of HCC lesions were 7.9 to 75.2 HU, CER were 3.8% to 36.0%. MVC were 6 to 91, and the VEGF expression percentage were 32.1% to 78.3%. The PV and CER were significantly correlated with tumor tissue MVC (r = 0.508 and 0.423, P < 0.01 and 0.05 respectively). There were no correlations between PV and CER and VEGF expression percentage. Both the patterns of time-density curve and the gross enhancement morphology of HCC lesions were also correlated with tumor MVC, and reflected the distribution characteristics of tumor microvessels within HCC lesions. A close association was found between the likelihood of intrahepatic metastasis of HCC lesions with densely enhanced pseudo capsules and the presence of rich tumor microvessels within these pseudo capsules. Conclusion: The parameters and the enhancement imaging features of HCC lesions on target-slice dynamic scanning are correlated with tumor MVC, and can reflect the distribution characteristics of tumor microvessels within HCC lesions. Dynamic spiral CT scanning is a valuable means to assess the angiogenic activity and

  9. Tramadol-Paracetamol Combination for Postoperative Pain Relief in Elective Single-level Microdisectomy Surgery.

    Science.gov (United States)

    Dogar, Samie A; Khan, Fauzia A

    2017-04-01

    The tramadol and paracetamol combination is used frequently for postoperative pain management. The literature on the use of this combination for vertebral surgery is limited. Our objective was to compare a combination of paracetamol 1 g and a lower dose of tramadol (1 mg/kg: group 1T) with a combination of paracetamol 1 g and a higher dose of tramadol (1.5 mg/kg: group 1.5T) for postoperative pain after microdisectomy surgery. Our main outcome measure was Visual Analogue Scale pain scores for 4 hours postoperatively. This prospective randomized triple-blind clinical trial was conducted at Aga Khan University Hospital, Karachi. Ninety-four patients aged between 18 and 50 years scheduled for elective single-level microdisectomy were allocated randomly into 1 of 2 groups. Twenty minutes before the end of the surgery, patients received the study drugs. There was no significant demographic difference between groups. None of the patients experienced severe pain (VAS>6). There was no significant difference in the mean pain score between groups. The mean score at 4 hours was 2.17 (1.38) in group 1.5T and 1.74 (1.37) in group 1T. The difference was not statistically significant (P=0.14). In group 1.5T, 13 patients reported having nausea and vomiting compared with 2 patients in group 1T. This was a statistically significant difference (P=0.004). The sedation score was similar between groups. The combination of low-dose tramadol (1 mg/kg) and paracetamol has comparable analgesia and a decreased incidence of nausea and vomiting compared with the higher dose of tramadol (1.5 mg/kg) and paracetamol combination.

  10. Cervical spondylotic myelopathy

    African Journals Online (AJOL)

    function. Seventy-five per cent of patients with mild symptoms (sensory changes but no functional ... of both motor and sensory function as well as ... pathological and compressive) structures, ... management of cervical degenerative disease:.

  11. Cervical MRI scan

    Science.gov (United States)

    ... the bones and cartilage in the neck ( cervical spondylosis ) Abnormal results may also be due to: Bone ... Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, Canale ST, ...

  12. Cervical Chondrocutaneous Branchial Remnants.

    Science.gov (United States)

    Klockars, Tuomas; Kajosaari, Lauri

    2017-03-01

    Cervical chondrocutaneous branchial remnants are rare malformations usually found in the lower neck. As high as 76% of patients have been reported to have associated anomalies. We review the literature and report a case series of seven patients with cervical cartilaginous remnants.   A retrospective case series of seven patients identified from the electronic hospital records.   Seven patients with cervical chondrocutaneous branchial remnants were identified (six boys and one girl). Only one of the patients had associated anomalies.   A review of the literature revealed no evidence for sinuses or cysts related to cervical chondrocutaneous branchial remnants. Operative treatment can be postponed to a suitable and safe age. There is marked variation in the reported prevalence of associated anomalies, ranging from 11% to 76%.

  13. CDC's Cervical Cancer Study

    Science.gov (United States)

    ... Materials Infographics Cancer and Alcohol Web Features Breast Cancer Awareness Breast Cancer in Young Women Cancer and Men ... in Childhood Cancer, the Flu, and You Cervical Cancer Awareness Colorectal Cancer Awareness Gynecologic Cancer Awareness Health Disparities ...

  14. The cervical cap (image)

    Science.gov (United States)

    The cervical cap is a flexible rubber cup-like device that is filled with spermicide and self-inserted over the cervix ... left in place several hours after intercourse. The cap is a prescribed device fitted by a health ...

  15. Future Directions - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about possible changes in cervical cancer screening and management.

  16. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  17. Herniated Cervical Disc

    Science.gov (United States)

    ... are sometimes prescribed for more severe arm and neck pain because of their very powerful anti-inflammatory effect. ... caused by a herniated cervical disc. However, some neck pain may persist. Most patients respond well to discectomy; ...

  18. Dolor cervical incoercible

    Directory of Open Access Journals (Sweden)

    Adrián F Narváez-Muñoz

    2014-03-01

    Astrocytomas are relatively common glial neoplasm of the central nervous system, but only a small percentage of them are located in the spinal cord, with a predilection for the cervical and dorsal regions. In most cases, extend longitudinally, affecting several cord segments. Pain is a frequent symptom of local character bone segments involving the tumor, associated with sensory deficit and / or motor. The following is the case of a 60 year old woman with cervical cord astrocytoma extended to the brainstem.

  19. KYSTE THYMIQUE CERVICAL CERVICAL THYMIC CYST

    African Journals Online (AJOL)

    tic est souvent de découverte histologique après l'examen de la pièce opératoire. Nous rapportons un cas de kyste thymique cervical et nous exposons les particularités em- bryologiques, cliniques et thérapeutiques de cette entité pathologique. OBSERVATION CLINIQUE. Il s'agit d'une patiente, âgée de sept ans, qui nous ...

  20. What is the superior surgical strategy for bi-level cervical spondylosis-anterior cervical disc replacement or anterior cervical decompression and fusion?: A meta-analysis from 11 studies.

    Science.gov (United States)

    Zhao, He; Duan, Li-Jun; Gao, Yu-Shan; Yang, Yong-Dong; Tang, Xiang-Sheng; Zhao, Ding-Yan; Xiong, Yang; Hu, Zhen-Guo; Li, Chuan-Hong; Yu, Xing

    2018-03-01

    Nowadays, anterior cervical artificial disc replacement (ACDR) has achieved favorable outcomes in treatment for patients with single-level cervical spondylosis. However, It is still controversial that whether or not it will become a potent therapeutic alternation in treating 2 contiguous levels cervical spondylosis compared with anterior cervical decompression and fusion (ACDF). Therefore, we conducted a systematic review and meta-analysis to compare the efficacy and safety of ACDR and ACDF in patients with 2 contiguous levels cervical spondylosis. According to the computer-based online search, PubMed, Embase, Web of Science, and Cochrane Library for articles published before July 1, 2017 were searched. The following outcome measures were extracted: neck disability index (NDI), visual analog scale (VAS) neck, VAS arm, Short Form (SF)-12 mental component summary (MCS), SF-12 physical component summary (PCS), overall clinical success (OCS), patient satisfaction (PS), device-related adverse event (DRAE), subsequent surgical intervention (SSI), neurological deterioration (ND), and adjacent segment degeneration (ASD). Methodological quality was evaluated independently by 2 reviewers using the Furlan for randomized controlled trial (RCT) and MINORS scale for clinical controlled trials (CCT). The chi-squared test and Higgin I test were used to evaluate the heterogeneity. A P bi-level cervical spondylosis, ACDR appears to provide superior clinical effectiveness and safety effects than ACDF. In the future, more high-quality RCTs are warranted to enhance this conclusion.

  1. Cervical syphilitic lesions mimicking cervical cancer: a rare case report

    Directory of Open Access Journals (Sweden)

    Xiaoqing Zhu

    2015-02-01

    Full Text Available A woman presented to the hospital due to postcoital vaginal bleeding. The patient was initially diagnosed with cervical carcinoma by clinicians at a local hospital. However, a biopsy of the cervical lesions revealed chronic inflammation and erosion of the cervical mucosa, and the rapid plasma reagin ratio titer was 1:256. The patient was eventually diagnosed with syphilitic cervicitis and treated with minocycline 0.1 g twice a day. The patient was cured with this treatment.

  2. Localizing value of pain distribution patterns in cervical spondylosis.

    Science.gov (United States)

    Bunyaratavej, Krishnapundha; Montriwiwatnchai, Peerapong; Siwanuwatn, Rungsak; Khaoroptham, Surachai

    2015-04-01

    Prospective observational study. To investigate the value of pain distribution in localizing appropriate surgical levels in patients with cervical spondylosis. Previous studies have investigated the value of pain drawings in its correlation with various features in degenerative spine diseases including surgical outcome, magnetic resonance imaging findings, discographic study, and psychogenic issues. However, there is no previous study on the value of pain drawings in identifying symptomatic levels for the surgery in cervical spondylosis. The study collected data from patients with cervical spondylosis who underwent surgical treatment between August 2009 and July 2012. Pain diagrams drawn separately by each patient and physician were collected. Pain distribution patterns among various levels of surgery were analyzed by the chi-square test. Agreement between different pairs of data, including pain diagrams drawn by each patient and physician, intra-examiner agreement on interpretation of pain diagrams, inter-examiner agreement on interpretation of pain diagrams, interpretation of pain diagram by examiners and actual surgery, was analyzed by Kappa statistics. The study group consisted of 19 men and 28 women with an average age of 55.2 years. Average duration of symptoms was 16.8 months. There was no difference in the pain distribution pattern at any level of surgery. The agreement between pain diagram drawn by each patient and physician was moderate. Intra-examiner agreement was moderate. There was slight agreement of inter-examiners, examiners versus actual surgery. Pain distribution pattern by itself has limited value in identifying surgical levels in patients with cervical spondylosis.

  3. January Monthly Spotlight: Cervical Health and Cervical Cancer Disparities

    Science.gov (United States)

    In January, CRCHD joins the nation in raising awareness for Cervical Health and Cervical Cancer Disparities. This month we share a special focus on NCI/CRCHD research programs that are trying to reduce cervical cancer disparities in underserved communities and the people who are spreading the word about the importance of early detection.

  4. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... women. Human papillomavirus (HPV) infection is the major risk factor for cervical cancer. Although most women with ... clinical trials is available from the NCI website . Risks of Cervical Cancer Screening Key Points Screening tests ...

  5. General Information about Cervical Cancer

    Science.gov (United States)

    ... cancer is found early. Signs and symptoms of cervical cancer include vaginal bleeding and pelvic pain. These and other signs and symptoms may be caused by cervical cancer or by other conditions . Check with your ...

  6. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... cancer is found early. Signs and symptoms of cervical cancer include vaginal bleeding and pelvic pain. These and other signs and symptoms may be caused by cervical cancer or by other conditions . Check with your ...

  7. Palliative radiotherapy for symptomatic osseous metastases

    International Nuclear Information System (INIS)

    Shigematsu, Naoyuki; Ito, Hisao; Toya, Kazuhito; Ko, Weijey; Kutsuki, Shouji; Tsukamoto, Nobuhiro; Kubo, Atsushi; Dokiya, Takushi; Yorozu, Atsunori.

    1995-01-01

    Bone matastases are one of the most common and serious conditions requiring radiotherapy, but there is still a considerable lack of agreement on optimal radiation schedule. We analyzed patients with symptomatic osseous matastases from lung (72 patients) and breast (63 patients) carcinoma treated by palliative radiotherapy between 1983 and 1992. In this series, the incidences of symptomatic bone metastases appearing within 2 years after the first diagnosis of the primary lesion were 96% and 36% for lung and breast carcinomas, respectively. Thirty percent of bone metastases from breast carcinoma were diagnosed more than 5 years after the first diagnosis. Thus careful follow-up must be carried out for a prolonged period. Pain relief was achieved at almost the same rate for bone metastases from lung and breast carcinomas (81% and 85%, respectively), an the rapid onset of pain relief (15 Gy or less) was obtained in about half the patients for both diseases. The rapid onset of pain relief and the lack of association between the onset of pain relief and primary tumor argued against the conventional theory that tumor shrinkage is a component of the initial response. In contrast to the fact that almost all lung carcinoma patients had very poor prognoses, one third of the breast carcinoma patients were alive more than 2 years after palliative radiotherapy. Thust, the late effects of radiation, such as radiation myelopathy, must be always considered especially in breast carcinoma patients even when it is 'just' palliative radiotherapy for bone metastases. (author)

  8. Symptomatic subsyndromal depression in hospitalized hypertensive patients.

    Science.gov (United States)

    Chiaie, Roberto Delle; Iannucci, Gino; Paroli, Marino; Salviati, Massimo; Caredda, Maria; Pasquini, Massimo; Biondi, Massimo

    2011-12-01

    Clinicians generally agree on the association between depression and hypertension. Less clear is if the nature of the link is direct or indirect and if this should be considered confined only to syndromal forms or if it concerns also subsyndromal affective presentations. This study investigated the nature of the association between hypertension and subsyndromal depression in hospitalized hypertensive patients. 196 hypertensive and 96 non hypertensive inpatients underwent a SCID interview, to exclude patients positive for any Axis I or Axis II diagnosis. Symptomatic Subsyndromal Depression (SSD) was identified according to criteria proposed by Judd. Psychopathological assessment was performed with Anxiety Sensitivity Index (ASI) and Hopkins Symptom Checklist-90 (SCL-90). Clinical assessments included blood pressure measurement, evaluation of general health conditions and screening cardiovascular risk factors (smoke, alcohol, body weight, sedentary life style). Hypertensives met more frequently criteria for SSD. They also scored higher on ASI and SCL-90. However, those with more severe physical conditions, if compared with more healthy patients, did not show increased psychopathological severity. Similarly, psychopathological symptom severity did not differ among hypertensives positive for other cardiovascular risk factors, commonly more frequent among depressed subjects. Further analyses are needed to explore the potential advantage obtained on blood pressure control by treating SSD. Hospitalized hypertensives, more frequently satisfied criteria for Symptomatic Subsyndromal Depression. These milder affective forms are probably directly linked to the presence of hypertension, rather than being indirectly associated to physical impairment or to higher prevalence of other cardiovascular risk factors. Copyright © 2011. Published by Elsevier B.V.

  9. Radiological features of a symptomatic splenic hamartoma

    International Nuclear Information System (INIS)

    Thompson, S.E.; Walsh, E.A.; Cramer, B.C.; Pushpanathan, C.C.; Hollett, P.; Ingram, L.; Price, D.

    1996-01-01

    Symptomatic splenic hamartomas are rare in the pediatric age group, with only four previous reports in the literature. Splenic hamartoma has been reported as a solid homogeneous mass without calcification on CT and ultrasound (US), and only one previous report of the findings on MRI has been published. We report a case of a large symptomatic splenic hamartoma in a 14-year-old girl who presented with splenomegaly, pancytopenia and growth retardation. A solid mass with multiple punctate foci resembling calcifications was seen on US. The mass was heterogeneous and better demarcated on enhanced CT. Radiocolloid scintigraphy demonstrated uptake within the lesion, but less than that of normal spleen. The mass was isointense relative to normal splenic tissue on T1-weighted MRI (0.5 T) and of increased intensity with T2 weighting. At splenectomy, a red pulp hamartoma was identified, which contained nodules of hyalinization and necrosis thought to account for the punctate foci seen on US. (orig.). With 4 figs

  10. Review of acute symptomatic urolithiasis in Auckland.

    Science.gov (United States)

    Loeff, Stephanie; Saluja, Manmeet; Rice, Michael

    2018-02-02

    To evaluate the incidence of acute symptomatic urolithiasis in the Auckland region. Associated epidemiological factors and stone characteristics were also studied and compared to previous research conducted in order to analyse trends. All patients that presented acutely with symptomatic urolithiasis to the Auckland District Health Board (AHDB) between July 2014 and June 2015 were studied. Clinical data was obtained from medical records and population data was based on estimates provided by the Ministry of Health. Two-tailed tests and the Pearson Chi-Square tests were used for analysis. Overall, 1,125 patients (1,328 events) presented with an incidence of 85 per 100,000 per year, which was lower than that reported in 2006. The highest incidence was found among the Middle Eastern ethnic subgroup (0.130 %), followed by Māori (0.102%), Asian (0.087%), European (0.084%) and Pacific (0.041%) ethnicity. Males were more likely to be affected than females. Urolithiasis was most common in the fifth decade of life (25%). Forty-seven percent of the study population presented with multiple stones and 64% had recurrent urolithiasis or were 'high risk' stone formers. Distal ureteric stones Auckland. This deviation could be attributed to the large influx of Asian immigrants observed in this period of time. A caucasian male, between 40-49 years, with a calculus <5mm in the distal ureter with a history of a previous urolithiasis has the highest chance to present with renal colic.

  11. Radiological features of a symptomatic splenic hamartoma

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.E. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Walsh, E.A. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Cramer, B.C. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Pushpanathan, C.C. [Department of Pathology, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Hollett, P. [Department of Nuclear Medicine, Health Sciences Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Ingram, L. [Department of Pediatrics, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Price, D. [Department of Surgery, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada)

    1996-09-01

    Symptomatic splenic hamartomas are rare in the pediatric age group, with only four previous reports in the literature. Splenic hamartoma has been reported as a solid homogeneous mass without calcification on CT and ultrasound (US), and only one previous report of the findings on MRI has been published. We report a case of a large symptomatic splenic hamartoma in a 14-year-old girl who presented with splenomegaly, pancytopenia and growth retardation. A solid mass with multiple punctate foci resembling calcifications was seen on US. The mass was heterogeneous and better demarcated on enhanced CT. Radiocolloid scintigraphy demonstrated uptake within the lesion, but less than that of normal spleen. The mass was isointense relative to normal splenic tissue on T1-weighted MRI (0.5 T) and of increased intensity with T2 weighting. At splenectomy, a red pulp hamartoma was identified, which contained nodules of hyalinization and necrosis thought to account for the punctate foci seen on US. (orig.). With 4 figs.

  12. Cervical Cancer—Patient Version

    Science.gov (United States)

    Cervical cancer is the fourth most common cancer in women worldwide. The primary risk factor for cervical cancer is human papillomavirus (HPV) infection. Start here to find evidence-based information on cervical cancer treatment, causes and prevention, screening, research, and statistics.

  13. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients☆

    Science.gov (United States)

    Canella, Richard Prazeres; Adam, Guilherme Pradi; de Castillo, Roberto André Ulhôa; Codonho, Daniel; Ganev, Gerson Gandhi; de Vicenzi, Luiz Fernando

    2016-01-01

    Objective To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). Methods We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. Results There were inverse correlations between the following angles: (1) acetabular coverage versus alpha angle (p = 0.019); (2) acetabular version (supraequatorial) versus alpha angle (p = 0.049). For patients with femoral anteversion lower than 15 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.026); (2) acetabular version (middle third) versus alpha angle (p = 0.02). For patients with acetabular version (supraequatorial) lower than 10 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.004); (2) acetabular version (middle third) versus alpha angle (p = 0.009). Conclusion There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was) in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases. PMID:27069890

  14. Current management of symptomatic intracranial stenosis.

    Science.gov (United States)

    Taylor, Robert A; Weigele, John B; Kasner, Scott E

    2011-08-01

    Intracranial arterial stenosis (IAS) is the cause of about 10% of all ischemic strokes in the United States, but may account for about 40% of strokes in some populations. After a stroke or transient ischemic attack due to IAS, patients face a 12% annual risk of recurrent stroke on medical therapy, with most strokes occurring in the first year. Warfarin is no better than aspirin in preventing recurrent strokes but poses a higher risk of serious bleeding and death. Groups with the highest risk of recurrent stroke are those with high-grade (≥ 70%) stenosis, those with recent symptom onset, those with symptoms precipitated by hemodynamic maneuvers, and women. Endovascular treatment of IAS is a rapidly evolving therapeutic option. Antiplatelet agents are currently recommended as the primary treatment for symptomatic IAS, with endovascular therapy reserved for appropriate high-risk cases refractory to medical therapy.

  15. Subsyndromal symptomatic depression: a new concept.

    Science.gov (United States)

    Sadek, N; Bona, J

    2000-01-01

    Although DSM-IV acknowledged the clinical significance of some subthreshold forms of unipolar depression, such as minor depression (MinD) and recurrent brief depression (RBD), clinicians continued to struggle with the concept of "subthreshold" depression. A substantial number of patients continued to present with depressive symptoms that still did not satisfy any DSM-IV diagnosis. Generally, these patients failed to complain of anhedonia and depressed mood, a criterion that DSM-IV mandates for any diagnosis of depression. Therefore, researchers reexamined the question of whether this cluster of depressive symptoms, in the absence of anhedonia and depressed mood, was clinically significant. Some researchers labeled this cluster of symptoms, "subsyndromal symptomatic depression" (SSD). Specifically, SSD is defined as a depressive state having two or more symptoms of depression of the same quality as in major depression (MD), excluding depressed mood and anhedonia. The symptoms must be present for more than 2 weeks and be associated with social dysfunction. Using Medline Search, the authors reviewed the literature on the epidemiology, demographics, clinical characteristics, and psychosocial impairment of SSD. SSD is found to be comparable in demographics and clinical characteristics to MD, MinD, and dysthymia. SSD is also associated with significant psychosocial dysfunction as compared with healthy subjects. Further; it has significant risk for suicide and future MD. Few studies have been conducted on the treatment of SSD. The high prevalence of SSD, the significant psychosocial impairment associated with it, and the chronicity of its course make subsyndromal symptomatic depression a matter for serious consideration by clinicians and researchers.

  16. Alternative treatment of symptomatic pancreatic fistula.

    Science.gov (United States)

    Wiltberger, Georg; Schmelzle, Moritz; Tautenhahn, Hans-Michael; Krenzien, Felix; Atanasov, Georgi; Hau, Hans-Michael; Moche, Michael; Jonas, Sven

    2015-06-01

    The management of symptomatic pancreatic fistula after pancreaticoduodenectomy is complex and associated with increased morbidity and mortality. We here report continuous irrigation and drainage of the pancreatic remnant to be a feasible and safe alternative to total pancreatectomy. Between 2005 and 2011, patients were analyzed, in which pancreaticojejunal anastomosis was disconnected because of grade C fistula, and catheters for continuous irrigation and drainage were placed close to the pancreatic remnant. Clinical data were monitored and quality of life was evaluated. A total of 13 of 202 patients undergoing pancreaticoduodenectomy required reoperation due to symptomatic pancreatic fistula. Ninety-day mortality of these patients was 15.3%. Median length of stay on the intensive care unit and total length of stay was 18 d (range 3-45) and 46 d (range 33-96), respectively. Patients with early reoperation (<10 d) had significantly decreased length of stay on the intensive care unit and operation time (P < 0.05). Global health status after a median time of 22 mo (range 6-66) was nearly identical, when compared with that of a healthy control group. Mean follow-up was 44.4 mo (±27.2). Four patients (36.6 %) died during the follow-up period; two patients from tumor recurrence, one patient from pneumonia, and one patient for unknown reasons. Treatment of pancreatic fistula by continuous irrigation and drainage of the preserved pancreatic remnant is a simple and feasible alternative to total pancreatectomy. This technique maintains a sufficient endocrine function and is associated with low mortality and reasonable quality of life. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Anterior cervical spine surgery-associated complications in a retrospective case-control study.

    Science.gov (United States)

    Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N

    2017-09-01

    Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded. The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF). Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

  18. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.

  19. Preventing cervical cancer

    African Journals Online (AJOL)

    (HPV) will hopefully reduce cervical cancer rates globally even ... active people will get HPV at some time in their lives', making it ... cells due to HPV infection of the cervix are the first step in a series ..... A randomised controlled study of purified air administered to the 'breathing zone' at night to people with allergic asthma ...

  20. Prevent Cervical Cancer!

    Centers for Disease Control (CDC) Podcasts

    2015-01-08

    Cervical cancer can be prevented. Listen as two friends—one a doctor—talk about screening tests and early detection. Learn what test you might need.  Created: 1/8/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/8/2015.

  1. Symptomatic Chiari malformation in infancy and adolescence

    International Nuclear Information System (INIS)

    Fukushima, Takeo; Matsuda, Toshihiro; Tsugu, Hitoshi; Sakamoto, Seisaburou; Tomonaga, Masamichi; Asakawa, Koji; Mitsudome, Akihisa; Hashimoto, Takahisa.

    1994-01-01

    Of the 7 children and adolescents with Chiari malformation reported here 5 had Chiari type 1 and 2 had Chiari type 2 disease. All 5 Chiari type 1 patients had syringomyelia and scoliosis, but the Chiari type 2 patients did not. All the patients except one with localized syringomyelia (case 3) underwent posterior decompression with suboccipital craniectomy, upper cervical laminectomy and duraplasty, and their clinical signs and symptoms improved. Case 3 received a syringo-subarachnoid shunt and improved clinically. Motor function was restored better than sensory function. Cranial nerve signs were cleared up in the Chiari type 2 patients. In the Chiari type 1 patients postoperative neurological improvement correlated well with the collapse of syringomyelia. Cine MR imaging was useful in the evaluation of CSF dynamics at the cranio-vertebral junction and in the syringomyelic cavity before and after surgery. (author)

  2. Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus: case report.

    Science.gov (United States)

    Komotar, Ricardo J; Zacharia, Brad E; Mocco, J; Kaiser, Michael G; Frucht, Stephen J; McKhann, Guy M

    2008-10-01

    In this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis. An 80-year-old woman presented with classic symptoms of normal pressure hydrocephalus as well as evidence of cervical myelopathy. Magnetic resonance imaging of the brain and spine showed enlarged ventricles and single-level cervical canal narrowing. An initial lumbar drainage trial was performed, which revealed negative results. The patient then underwent cervical decompression and fusion. Despite this procedure, the patient's symptoms continued to worsen. A repeat lumbar drainage trial was performed with positive results. Subsequently, a ventriculoperitoneal shunt was placed, resulting in significant improvement of her symptoms. This case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy of the lumbar spinal drainage trial in patients with normal pressure hydrocephalus.

  3. Symptomatic relapse of HIV-associated cryptococcal meningitis in ...

    African Journals Online (AJOL)

    Objectives. Cryptococcal meningitis is the most common cause of adult meningitis in southern Africa. Much of this disease burden is thought to be due to symptomatic relapse of previously treated infection. We studied the contribution of inadequate secondary fluconazole prophylaxis to symptomatic relapses of cryptococcal ...

  4. Symptomatic unruptured cerebral aneurysms. Features and surgical outcome

    International Nuclear Information System (INIS)

    Date, Isao

    2010-01-01

    Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of 'symptomatic' aneurysms is higher than for 'asymptomatic' aneurysms; so 'symptomatic' aneurysms are more often surgically treated. Many reviews examine 'asymptomatic' unruptured cerebral aneurysms, but few evaluate 'symptomatic' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms. (author)

  5. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M. [AORNA Cardarelli, Neuroradiology Service, Naples (Italy); Pezzullo, M.G. [Seconda Universita degli studi di Napoli - SUN, Radiology Service, Naples (Italy)

    2009-07-15

    This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

  6. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

    International Nuclear Information System (INIS)

    Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M.; Pezzullo, M.G.

    2009-01-01

    This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

  7. Osteosynthesis for symptomatic ulnar styloid nonunion

    International Nuclear Information System (INIS)

    Kajiwara, Ryoji; Kimori, Kenji; Kawagoe, Hiroyuki; Tsuge, Kenya; Ikuta, Yosikazu

    2008-01-01

    We reviewed cases of osteosynthesis for symptomatic ulnar styloid nonunion. Since 1998, 13 cases of ulnar styloid nonunion have been treated by osteosynthesis. The patients were 10 men and 3 women, with a mean age of 27 years (range 11-65). The nonunion site was located in the middle in one case, in the base in 8 cases, and in the epiphyseal region in 4 cases. Osteosynthesis was performed with tension band wiring in all cases, and cancellous bone graft was performed in 12 of 13 cases. Distal radioulnar joint (DRUJ) instability was found by radiograph or CT in four cases; in two of these, osteosynthesis alone did not improve DRUJ instability and additional DRUJ stabilization was performed. One patient whose treatment failed to correct nonunion did not seek further treatment. In another case, an additional surgery was performed 1 week after the initial surgery to correct displacement of the fragment. The mean follow-up period was 15 months (range 8-45 months). According to Hauck's criteria, final pain was evaluated as excellent in nine cases, good in three cases, including the case resulting in nonunion, and fair in one case. (author)

  8. Acute symptomatic hyponatremia in a flight attendant.

    Science.gov (United States)

    Madero, Magdalena; Monares, Enrique; Domínguez, Aurelio Méndez; Ayus, Juan Carlos

    2015-08-01

    Acute symptomatic hyponatremia after thiazide diuretic initiation is a medical emergency. Here we describe the case of a flight attendant who developed acute hyponatremia during a flight and the potential risk factors for developing this condition. A 57-year-old flight attendant with history of essential hypertension was recently started on a thiazide diuretic. As she did routinely when working, she increased her water intake during a flight from London to Mexico City. She complained of nausea and headache during the flight. Upon arrival, she developed severe disorientation and presented to the hospital emergency room (ER) with a Glasgow scale of 12, hypoxia, and a generalized tonic clonic seizure. Her laboratory results on arrival were consistent with severe hyponatremia (serum Na 116 mEql/L) and severe cerebral edema by CT scan. She was treated with hypertonic saline, with complete resolution of the neurologic symptoms. We describe high water intake and hypoxia related to decreased partial pressure of oxygen in the cabin as the two main risk factors for thiazide-induced acute hyponatremia in this case.

  9. Reduction of microhemorrhages in the spinal cord of symptomatic ALS mice after intravenous human bone marrow stem cell transplantation accompanies repair of the blood-spinal cord barrier

    Science.gov (United States)

    Eve, David J.; Steiner, George; Mahendrasah, Ajay; Sanberg, Paul R.; Kurien, Crupa; Thomson, Avery; Borlongan, Cesar V.; Garbuzova-Davis, Svitlana

    2018-01-01

    Blood-spinal cord barrier (BSCB) alterations, including capillary rupture, have been demonstrated in animal models of amyotrophic lateral sclerosis (ALS) and ALS patients. To date, treatment to restore BSCB in ALS is underexplored. Here, we evaluated whether intravenous transplantation of human bone marrow CD34+ (hBM34+) cells into symptomatic ALS mice leads to restoration of capillary integrity in the spinal cord as determined by detection of microhemorrhages. Three different doses of hBM34+ cells (5 × 104, 5 × 105 or 1 × 106) or media were intravenously injected into symptomatic G93A SOD1 mice at 13 weeks of age. Microhemorrhages were determined in the cervical and lumbar spinal cords of mice at 4 weeks post-treatment, as revealed by Perls’ Prussian blue staining for ferric iron. Numerous microhemorrhages were observed in the gray and white matter of the spinal cords in media-treated mice, with a greater number of capillary ruptures within the ventral horn of both segments. In cell-treated mice, microhemorrhage numbers in the cervical and lumbar spinal cords were inversely related to administered cell doses. In particular, the pervasive microvascular ruptures determined in the spinal cords in late symptomatic ALS mice were significantly decreased by the highest cell dose, suggestive of BSCB repair by grafted hBM34+ cells. The study results provide translational outcomes supporting transplantation of hBM34+ cells at an optimal dose as a potential therapeutic strategy for BSCB repair in ALS patients. PMID:29535831

  10. The relationship between temporomandibular dysfunction and head and cervical posture.

    Science.gov (United States)

    Matheus, Ricardo Alves; Ramos-Perez, Flávia Maria de Moraes; Menezes, Alynne Vieira; Ambrosano, Gláucia Maria Bovi; Haiter-Neto, Francisco; Bóscolo, Frab Norberto; de Almeida, Solange Maria

    2009-01-01

    This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used. Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

  11. The relationship between temporomandibular dysfunction and head and cervical posture

    Directory of Open Access Journals (Sweden)

    Ricardo Alves Matheus

    2009-06-01

    Full Text Available OBJECTIVE: This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. MATERIAL AND METHODS: The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K statistics was used. RESULTS: Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04 and asymptomatic (p=0.02. No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. CONCLUSIONS: Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

  12. Imaging of cervical carcinomas

    International Nuclear Information System (INIS)

    Soyer, P.; Michel, G.; Masselot, J.

    1990-01-01

    Recently, magnetic resonance imaging (MRI) and transrectal or transvaginal ultrasound (TRUS, TVUS) had an important place in imaging techniques of cervical carcinomas and raise the question of modifying the imaging strategies. For the diagnosis of primitive tumor, those techniques cannot take the place of clinical examination and gross examination. In the assessment of parametrial involvement, TRUS which has better accuracy than clinical examination, and MRI which is considered as the most accurate technique, have an important role to play. In the follow-up and the detection of recurrences, MRI is actually considered as the best imaging technique. The authors, according to recent data in literature and their own experience, present basic concepts of imaging strategies for staging and follow-up of cervical carcinomas [fr

  13. Cytology of treated cervical carcinoma

    International Nuclear Information System (INIS)

    Shibata, Hideo

    1982-01-01

    The vaginal smear specimens of the patients who received operative therapy, irradiation or chemotherapy for cervical carcinoma were examined. Long-term follow-up vaginal cytology following treatment of cervical carcinoma is effective for the detection of local recurrence in an early stage. Serial cytology is also useful in evaluation of the effects of irradiation and chemotherapy for cervical carcinoma. Radiosensitive and prognostic significance of vaginal smears before and after radiation therapy was discussed. (author)

  14. Amitriptyline induced cervical dystonia

    Directory of Open Access Journals (Sweden)

    Shivanand B Hiremath

    2016-01-01

    Full Text Available Tricyclic antidepressants (TCAs, such as amitriptyline, have many side effects. But extrapyramidal tract symptom is an uncommon side effect of these drugs. Here, we report a case of a 28-year-old male who is suffering from amitriptyline induced cervical dystonia. Though rare, this side effect is an uncomfortable condition and may influence drug compliance. So clinicians should be aware of this side effect while treating a patient with amitriptyline.

  15. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  16. Future Directions - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about possible changes in cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  17. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  18. [Cervical spine trauma].

    Science.gov (United States)

    Yilmaz, U; Hellen, P

    2016-08-01

    In the emergency department 65 % of spinal injuries and 2-5 % of blunt force injuries involve the cervical spine. Of these injuries approximately 50 % involve C5 and/or C6 and 30 % involve C2. Older patients tend to have higher spinal injuries and younger patients tend to have lower injuries. The anatomical and development-related characteristics of the pediatric spine as well as degenerative and comorbid pathological changes of the spine in the elderly can make the radiological evaluation of spinal injuries difficult with respect to possible trauma sequelae in young and old patients. Two different North American studies have investigated clinical criteria to rule out cervical spine injuries with sufficient certainty and without using imaging. Imaging of cervical trauma should be performed when injuries cannot be clinically excluded according to evidence-based criteria. Degenerative changes and anatomical differences have to be taken into account in the evaluation of imaging of elderly and pediatric patients.

  19. Cervical Myelopathy in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    N. Mukerji

    2011-01-01

    Full Text Available Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common.

  20. Vegetarian diet as a risk factor for symptomatic gallstone disease.

    Science.gov (United States)

    McConnell, T J; Appleby, P N; Key, T J

    2017-06-01

    Previous small studies have shown either no difference or a lower risk of symptomatic gallstone disease in vegetarians than in non-vegetarians. This study examined the incidence of symptomatic gallstone disease in a cohort of British vegetarians and non-vegetarians, and investigated the associations between nutrient intake and risk of symptomatic gallstone disease. The data were analysed from 49 652 adults enroled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, one-third of whom were vegetarian. The linked databases of hospital records were used to identify incident cases. Risk by diet group was estimated using Cox proportional hazards models. Further analysis quantified risk by intakes of selected macronutrients. There were 1182 cases of symptomatic gallstone disease during 687 822 person-years of follow-up (mean=13.85 years). There was a large significant association between increasing body mass index (BMI) and risk of developing symptomatic gallstone disease (overall trend Pvegetarians had a moderately increased risk compared with non-vegetarians (HR: 1.22; 95% CI: 1.06-1.41; P=0.006). Although starch consumption was positively associated with gallstones risk (P=0.002 for trend), it did not explain the increased risk in vegetarians. There is a highly significant association of increased BMI with risk of symptomatic gallstone disease. After adjusting for BMI, there is a small but statistically significant positive association between vegetarian diet and symptomatic gallstone disease.

  1. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    Directory of Open Access Journals (Sweden)

    ZHANG Ling

    2012-04-01

    Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

  2. Pediatric intracerebral hemorrhage: acute symptomatic seizures and epilepsy.

    Science.gov (United States)

    Beslow, Lauren A; Abend, Nicholas S; Gindville, Melissa C; Bastian, Rachel A; Licht, Daniel J; Smith, Sabrina E; Hillis, Argye E; Ichord, Rebecca N; Jordan, Lori C

    2013-04-01

    Seizures are believed to be common presenting symptoms in neonates and children with spontaneous intracerebral hemorrhage (ICH). However, few data are available on the epidemiology of acute symptomatic seizures or the risk for later epilepsy. To define the incidence of and explore risk factors for seizures and epilepsy in children with spontaneous ICH. Our a priori hypotheses were that younger age at presentation, cortical involvement of ICH, acute symptomatic seizures after presentation, ICH due to vascular malformation, and elevated intracranial pressure requiring urgent intervention would predict remote symptomatic seizures and epilepsy. Prospective cohort study conducted between March 1, 2007, and January 1, 2012. Three tertiary care pediatric hospitals. Seventy-three pediatric subjects with spontaneous ICH including 20 perinatal (≥37 weeks' gestation to 28 days) and 53 childhood subjects (>28 days to Acute symptomatic seizures (clinically evident and electrographic-only seizures within 7 days), remote symptomatic seizures, and epilepsy. Acute symptomatic seizures occurred in 35 subjects (48%). Acute symptomatic seizures as a presenting symptom of ICH occurred in 12 perinatal (60%) and 19 childhood (36%) subjects (P = .07). Acute symptomatic seizures after presentation occurred in 7 children. Electrographic-only seizures were present in 9 of 32 subjects (28%) with continuous electroencephalogram monitoring. One-year and 2-year remote symptomatic seizure-free survival rates were 82% (95% CI, 68-90) and 67% (95% CI, 46-82), respectively. One-year and 2-year epilepsy-free survival rates were 96% (95% CI, 83-99) and 87% (95% CI, 65-95), respectively. Elevated intracranial pressure requiring acute intervention was a risk factor for seizures after presentation (P = .01; Fisher exact test), remote symptomatic seizures, and epilepsy (P = .03, and P = .04, respectively; log-rank test). Presenting seizures are common in perinatal and childhood ICH. Continuous

  3. Spondilitis Tuberkulosa Cervical

    Directory of Open Access Journals (Sweden)

    Roni Eka Saputra

    2015-05-01

    Full Text Available Abstrak Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dariseluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifikhingga komplikasi neurologis yang berat. Seorang wanita berusia 29 tahun datang dengan keluhan lemah keempatanggota gerak yang semakin memberat dalam 10 hari terakhir yang didahului oleh nyeri leher yang menjalar ke bahudan lengan sejak 6 bulan sebelumnya. Nyeri awalnya dirasakan sebagai keterbatasan gerakan leher saat menolehkesamping kiri dan kanan serta menundukkan kepala. Nyeri dirasakan semakin berat dengan pergerakan danberkurang jika istirahat. Pasien mengalami penurunan berat badan sejak 2 bulan terakhir. Tidak dijumpai riwayat batukatau nyeri dada. Pemeriksaan neurologis menunjukkan kelemahan  pada keempat ekstremitas. Hasil laboratoriumditemukan peningkatan Laju Endap Darah (LED. Rontgen foto toraks dalam batas normal. Roentgen foto cervicalmenunjukkan destruksi setinggi C5. MRI cervical menunjukkan destruksi pada korpus C5-6 dengan penyempitan padadiscus intervertebrae C5-6 disertai dengan  massa/abses paravertebral dengan penekanan ke posterior. MRI Thorakaltampak destruksi corpus verebre T4,5 dengan diskus intervertebralis yang menyempit. Sugestif suatu spondilitistuberkulosa. Pasien dilakukan tindakan pembedahan anterior corpectomi melalui microscopic surgery dengan graftdari iliac sinistra, serta insersi anterior plate 1 level. Hasil pemeriksaan patologi anatomi menunjukkan spodilitis TBCkaseosa. Pada spondilitis vertebre T4,5 dilakukan laminectomi, debridement costotrasversektomi, dan stabilisasidengan pedicle screw T2, T3, dan T5. Pasien diterapi dengan obat antituberkulosis. Keadaan pasien saat ini, pasiensudah bisa beraktifitas normal dengan motorik dan sensorik baik. Spondilitis tuberkulosa merupakan bentuktuberkulosa tulang yang paling sering dijumpai. Spondilitis tuberkulosa cervical berkisar 2

  4. Sagittal alignment after single cervical disc arthroplasty.

    Science.gov (United States)

    Guérin, Patrick; Obeid, Ibrahim; Gille, Olivier; Bourghli, Anouar; Luc, Stéphane; Pointillart, Vincent; Vital, Jean-Marc

    2012-02-01

    Prospective study. To analyze the sagittal balance after single-level cervical disc replacement (CDR) and range of motion (ROM). To define clinical and radiologic parameters those have a significant correlation with segmental and overall cervical curvature after CDR. Clinical outcomes and ROM after CDR with Mobi-C (LDR, Troyes, France) prosthesis have been documented in few studies. No earlier report of this prosthesis has studied correlations between static and dynamic parameters or those between static parameters and clinical outcomes. Forty patients were evaluated. Clinical outcome was assessed using the Short Form-36 questionnaire, Neck Disability Index, and a Visual Analog Scale. Spineview software (Surgiview, Paris, France) was used to investigate sagittal balance parameters and ROM. The mean follow-up was 24.3 months (range: 12 to 36 mo). Clinical outcomes were satisfactory. There was a significant improvement of Short Form-36, Neck Disability Index, and Visual Analog Scale scores. Mean ROM was 8.3 degrees preoperatively and 11.0 degrees postoperatively (P=0.013). Mean preoperative C2C7 curvature was 12.8 and 16.0 degrees at last follow-up (P=0.001). Mean preoperative functional spinal unit (FSU) angle was 2.3 and 5.3 degrees postoperatively (P<0.0001). Mean postoperative shell angle was 5.5 degrees. There was a significant correlation between postoperative C2C7 alignment and preoperative C2C7 alignment, change of C2C7 alignment, preoperative and postoperative FSU angle, and prosthesis shell angle. There was also a significant correlation between postoperative FSU angle and preoperative C2C7 alignment, preoperative FSU angle, change of FSU angle, and prosthesis shell angle. Regression analysis showed that prosthesis shell angle and preoperative FSU angle contributed significantly to postoperative FSU angle. Moreover, preoperative C2C7 alignment, preoperative FSU angle, postoperative FSU angle, and prosthesis shell angle contributed significantly to

  5. Multilayer, Stacked Spiral Copper Inductors on Silicon with Micro-Henry Inductance Using Single-Level Lithography

    Directory of Open Access Journals (Sweden)

    Timothy Reissman

    2012-01-01

    Full Text Available We present copper structures composed of multilayer, stacked inductors (MLSIs with tens of micro-Henry inductance for use in low frequency (sub 100 MHz, power converter technology. Unique to this work is the introduction of single-level lithography over the traditional two-level approach to create each inductor layer. The result is a simplified fabrication process which results in a reduction in the number of lithography steps per inductor (metal layer and a reduction in the necessary alignment precision. Additionally, we show that this fabrication process yields strong adhesion amongst the layers, since even after a postprocess abrasion technique at the inner diameter of the inductors, no shearing occurs and connectivity is preserved. In total, three separate structures were fabricated using the single-level lithography approach, each with a three-layered, stacked inductor design but with varied geometries. Measured values for each of the structures were extracted, and the following results were obtained: inductance values of 24.74, 17.25, and 24.74 μH, self-resonances of 9.87, 5.72, and 10.58 MHz, and peak quality factors of 2.26, 2.05, and 4.6, respectively. These values are in good agreement with the lumped parameter model presented.

  6. ACUTE NEUROINFECTIONS AND SYMPTOMATIC EPILEPSY IN CHILDREN: CAUSAL RELATIONSHIP (review

    Directory of Open Access Journals (Sweden)

    E. Yu. Gorelik

    2017-01-01

    Full Text Available Convulsions in case of acute neuroinfections can both complicate the disease course and transfer to symptomatic epilepsy which is one of the most important medical and social problems. The review article presents the data on epidemiology of convulsive disorder and symptomatic epilepsy in case of neuroinfections in children. There are considered the current immune and biochemical aspects of epileptogenesis in case of infectious pathology. There is given the information on neurophysiological and radial features of symptomatic epilepsy developed in case of neuroinfections of different etiology. There is underlined the practical significance of timely complex etio-pathogenetic therapy for neuroinfections complicated by convulsion that allows to reduce the frequency of symptomatic epilepsy development. There are presented the data on the results of transcranial magnetic stimulation in case of refractory epilepsy.

  7. Radiology of the cervical spine

    International Nuclear Information System (INIS)

    Wackenheim, A.

    1989-01-01

    The author describes some particularities seen in the abnormal or pathological image of the cervical spine: The osteolysis of the cortical bone in the spinous processes, the 'Y' shaped course of the corporeal veins, the notch in interspinous bursitis, and the main forms of constitutional stenosis of the cervical canal. (orig.) [de

  8. Cervical plexus block for thyroidectomy

    African Journals Online (AJOL)

    Adele

    RESEARCH. Southern African Journal of Anaesthesia & Analgesia - November 2003 ... Cervical plexus block has also been found useful for thy- .... lar, transverse cervical and supraclavicular nerves. ... administration of midazolam and pentazocine as required. ... find out if there were postoperative complications specific to.

  9. Cervical Stenosis, Myelopathy and Radiculopathy

    Science.gov (United States)

    ... and rarely changes in bowel or bladder control. Cervical radiculopathy will manifest itself as pain traveling from the neck into a specific region ... physician feels that this is related to your cervical spine. If you have persistent pain, numbness or weakness in one of your arms ...

  10. Arthroscopic treatment of symptomatic type D medial plica

    OpenAIRE

    Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N.

    2007-01-01

    We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our...

  11. The incidence of symptomatic malrotation post gastroschisis repair.

    LENUS (Irish Health Repository)

    Abdelhafeez, A

    2011-12-01

    Gastroschisis is known to be associated with abnormal bowel rotation. Currently, the broadly accepted practice is not to perform Ladd\\'s procedure routinely at the time of closure of gastroschisis defects. However the incidence of symptomatic malrotation and volvulus post gastroschisis repair is unknown; this incidence is important in view of the current practice of bedside gastroschisis closure. This study examined the incidence of symptomatic malrotation and volvulus following gastroschisis repair.

  12. A new classification for cervical vertebral injuries: influence of CT

    International Nuclear Information System (INIS)

    Daffner, R.H.; Brown, R.R.; Goldberg, A.L.

    2000-01-01

    Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

  13. A new classification for cervical vertebral injuries: influence of CT

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Brown, R.R.; Goldberg, A.L. [Department of Diagnostic Radiology, Allegheny University Hospitals, Allegheny General, Pittsburgh, PA (United States)

    2000-03-30

    Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

  14. The immediate and long-term effects of exercise and patient education on physical, functional, and quality-of-life outcome measures after single-level lumbar microdiscectomy: a randomized controlled trial protocol.

    Science.gov (United States)

    Selkowitz, David M; Kulig, Kornelia; Poppert, Elizabeth M; Flanagan, Sean P; Matthews, Ndidiamaka D; Beneck, George J; Popovich, John M; Lona, Jose R; Yamada, Kimiko A; Burke, Wendy S; Ervin, Carolyn; Powers, Christopher M

    2006-08-25

    Low back pain remains a costly quality-of-life-related health problem. Microdiscectomy is often the surgical procedure of choice for a symptomatic, single-level, lumbar disc herniation in younger and middle-aged adults. The question of whether a post-microdiscectomy exercise program enhances function, quality of life, and disability status has not been systematically explored. Thus, the overall purpose of this study is to assess immediate and long-term outcomes of an exercise program, developed at University of Southern California (USC), targeting the trunk and lower extremities (USC Spine Exercise Program) for persons who have undergone a single-level microdiscectomy for the first time. One hundred individuals between the ages of 18 and 60 who consent to undergo lumbar microdiscectomy will be recruited to participate in this study. Subjects will be randomly assigned to one of two groups: 1) one session of back care education, or 2) a back care education session followed by the 12-week USC Spine Exercise Program. The outcome examiners (evaluators), as well as the data managers, will be blinded to group allocation. Education will consist of a one-hour "one-on-one" session with the intervention therapist, guided by an educational booklet specifically designed for post-microdiscectomy care. This session will occur four to six weeks after surgery. The USC Spine Exercise Program consists of two parts: back extensor strength and endurance, and mat and upright therapeutic exercises. This exercise program is goal-oriented, performance-based, and periodized. It will begin two to three days after the education session, and will occur three times a week for 12 weeks. Primary outcome measures include the Oswestry Disability Questionnaire, Roland-Morris Disability Questionnaire, SF-36 quality of life assessment, Subjective Quality of Life Scale, 50-foot Walk, Repeated Sit-to-Stand, and a modified Sorensen test. The outcome measures in the study will be assessed before and after

  15. The Biomechanics of Cervical Spondylosis

    Directory of Open Access Journals (Sweden)

    Lisa A. Ferrara

    2012-01-01

    Full Text Available Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

  16. Investigating the loss of work productivity due to symptomatic leiomyoma.

    Science.gov (United States)

    Hasselrot, Klara; Lindeberg, Mia; Konings, Peter; Kopp Kallner, Helena

    2018-01-01

    Leiomyoma affects up to 50% of fertile women, leading to morbidity such as bleeding or pain. The effect of symptomatic leiomyoma on the productivity of employed women is understudied. The present study investigates productivity loss in a Swedish setting in women with symptomatic leiomyoma compared to healthy women. Women seeking care for leiomyoma and heavy menstrual bleeding (HMB) were recruited at nine Swedish sites. Healthy controls with self-perceived mild to normal menstruation were recruited at routine visits. Cases and controls were employed without option to work from home. After recruitment, all women reported the work productivity and activity impairment (WPAI) questionnaire, the pictorial blood assessment chart (PBAC) and pain on the visual analog scale (VAS). Women with symptomatic leiomyoma (n = 88) missed more working time during menses compared to asymptomatic controls (n = 34): 7.6 vs 0.2% p = 0.003. The proportion of impairment while working was also significantly higher in women with symptomatic leiomyoma (43.8 vs 12.1% p100). Symptomatic leiomyoma leads to loss of working hours as well as loss of productivity during working hours, and affects women in other daily activities. Increased awareness of the impact of leiomyomas on women's lives is needed, and timely and appropriate management of the symptomatic leiomyomas could improve work productivity and quality of life.

  17. Efficacy of limited CT for nonvisualized lower cervical spine in patients with blunt trauma

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, J. (Dept. of Radiological Sciences, Univ. of California, Irvine, Medical Center, Orange, CA (United States)); Bonk, R.T. (Dept. of Radiological Sciences, Univ. of California, Irvine, Medical Center, Orange, CA (United States)); Ansari, A. (Dept. of Radiological Sciences, Univ. of California, Irvine, Medical Center, Orange, CA (United States)); Mesgarzadeh, M. (Dept. of Diagnostic Imaging, Temple Univ., Health Sciences Center, Philadelphia, PA (United States))

    1994-07-01

    Records of 100 patients with blunt injury and nonvisualization of C7 and T1 on cross-table lateral and swimmer's views were reviewed to evaluate the usefulness of limited computed tomographic (CT) scans in ''clearing'' the lower cervical vertebrae of injury. CT was deemed necessary and performed in all of these cases because the lower cervical spine could not be evaluated clinically or with plain radiographs. Ninety-seven of these 100 patients had normal findings on CT and only three patients showed cervical spine fractures. All three had isolated and stable fractures. Two of these patients had ''clay-shoveler'' fractures at C6 and C7, respectively, and one had a single laminar fracture at C7. All three patients were conservatively treated. This study emphasizes the value of clinical correlation in the evaluation of cervical spine trauma. When deemed necessary in symptomatic patients, CT is useful to exclude skeletal injury in the lower cervical spine thus avoiding delay in the patient's workup and unnecessary hospitalization, and expediting patient discharge. Lack of pain and neurological findings in nonintoxicated, conscious, and alert patients is generally not associated with significant soft tissue or skeletal injury. (orig.)

  18. Knot positioning during McDonald cervical cerclage, does it make a difference? A cohort study.

    Science.gov (United States)

    Atia, Hytham; Ellaithy, Mohamed; Altraigey, Ahmed; Ibrahim, Heba

    2018-05-15

    To study the effect of McDonald cerclage knot position on the different maternal and neonatal outcomes. This historical cohort study included women with singleton pregnancy who had a prophylactic McDonald cervical cerclage between 1 May 2010 and 31 September 2017. Maternal and neonatal outcome parameters were compared between the anterior and posterior knot cerclage procedures. The primary outcome measure was the rate of term birth. 550 Women had a prophylactic McDonald cervical cerclage, 306 with anterior knot (Group A) and 244 with posterior knot (Group B). There were no statistically significant differences regarding gestational age (GA) at delivery (36.3 ± 4.2 versus 35.8 ± 5.3 for groups A and B respectively), term birth rate, post-cerclage cervical length, symptomatic vaginitis, urinary tract infection, difficult cerclage removal and cervical lacerations. Similarly, there were no statistically significant differences as regards the studied neonatal outcomes including take home babies, neonatal intensive care admission, respiratory distress syndrome and neonatal sepsis. Survival analysis on GA at delivery demonstrated no statistically significant difference as regards the proportion of term deliveries in the anterior and posterior knot cerclage groups (log-rank test p-value = .478). Knot positioning during McDonald cervical cerclage, anteriorly or posteriorly, didn't significantly impact the studied maternal and neonatal outcomes.

  19. Efficacy of limited CT for nonvisualized lower cervical spine in patients with blunt trauma

    International Nuclear Information System (INIS)

    Tehranzadeh, J.; Bonk, R.T.; Ansari, A.; Mesgarzadeh, M.

    1994-01-01

    Records of 100 patients with blunt injury and nonvisualization of C7 and T1 on cross-table lateral and swimmer's views were reviewed to evaluate the usefulness of limited computed tomographic (CT) scans in ''clearing'' the lower cervical vertebrae of injury. CT was deemed necessary and performed in all of these cases because the lower cervical spine could not be evaluated clinically or with plain radiographs. Ninety-seven of these 100 patients had normal findings on CT and only three patients showed cervical spine fractures. All three had isolated and stable fractures. Two of these patients had ''clay-shoveler'' fractures at C6 and C7, respectively, and one had a single laminar fracture at C7. All three patients were conservatively treated. This study emphasizes the value of clinical correlation in the evaluation of cervical spine trauma. When deemed necessary in symptomatic patients, CT is useful to exclude skeletal injury in the lower cervical spine thus avoiding delay in the patient's workup and unnecessary hospitalization, and expediting patient discharge. Lack of pain and neurological findings in nonintoxicated, conscious, and alert patients is generally not associated with significant soft tissue or skeletal injury. (orig.)

  20. Efficacy of limited CT for nonvisualized lower cervical spine in patients with blunt trauma

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, J [Dept. of Radiological Sciences, Univ. of California, Irvine, Medical Center, Orange, CA (United States); Bonk, R T [Dept. of Radiological Sciences, Univ. of California, Irvine, Medical Center, Orange, CA (United States); Ansari, A [Dept. of Radiological Sciences, Univ. of California, Irvine, Medical Center, Orange, CA (United States); Mesgarzadeh, M [Dept. of Diagnostic Imaging, Temple Univ., Health Sciences Center, Philadelphia, PA (United States)

    1994-07-01

    Records of 100 patients with blunt injury and nonvisualization of C7 and T1 on cross-table lateral and swimmer's views were reviewed to evaluate the usefulness of limited computed tomographic (CT) scans in ''clearing'' the lower cervical vertebrae of injury. CT was deemed necessary and performed in all of these cases because the lower cervical spine could not be evaluated clinically or with plain radiographs. Ninety-seven of these 100 patients had normal findings on CT and only three patients showed cervical spine fractures. All three had isolated and stable fractures. Two of these patients had ''clay-shoveler'' fractures at C6 and C7, respectively, and one had a single laminar fracture at C7. All three patients were conservatively treated. This study emphasizes the value of clinical correlation in the evaluation of cervical spine trauma. When deemed necessary in symptomatic patients, CT is useful to exclude skeletal injury in the lower cervical spine thus avoiding delay in the patient's workup and unnecessary hospitalization, and expediting patient discharge. Lack of pain and neurological findings in nonintoxicated, conscious, and alert patients is generally not associated with significant soft tissue or skeletal injury. (orig.)

  1. Modic changes of the cervical spine: T1 slope and its impact on axial neck pain.

    Science.gov (United States)

    Li, Jia; Qin, Shuhui; Li, Yongqian; Shen, Yong

    2017-01-01

    The purpose of the research was to evaluate cervical sagittal parameters on magnetic resonance imaging (MRI) in patients with Modic changes and its impact on axial neck pain. This study consisted of 266 consecutive asymptomatic or symptomatic patients with Modic changes, whose average age was 50.9±12.6 years from January 2015 to December 2016. Cervical sagittal parameters included sagittal alignment of the cervical spine (SACS), T1 slope, thoracic inlet angle (TIA), and neck tilt (NT). The Modic changes group was compared with an asymptomatic control group of 338 age- and gender-matched adults. In the Modic changes group, T1 slope was significantly higher (25.8°±6.3°) compared with that in the control group (22.5°±6.8°) ( P =0.000). However, there was no significant difference of the NT, TIA, and SACS between the two groups. Patients in the Modic changes group were more likely to have experienced historical axial neck pain compared with the control group ( P =0.000). With regard to the disc degeneration, it indicated that the disc in the Modic changes group had more severe disc degeneration ( P =0.032). T1 slope in the Modic changes group was significantly higher compared to that of the control group. The findings suggested that a higher T1 slope with broken compensation of cervical sagittal mechanism may be associated with the development of Modic changes in the cervical spine.

  2. Fenda cervical mediana Midline cervical cleft

    Directory of Open Access Journals (Sweden)

    José V. Tagliarini

    2004-10-01

    Full Text Available A fenda mediana congênita do pescoço é anomalia rara da parte ventral do pescoço. Em torno de 100 casos foram relatados na literatura, sendo o primeiro caso descrito por Bailey em 1924. Este defeito é relatado em associação com fenda mediana do lábio inferior, fenda da mandíbula e da língua, e hipoplasia de outras estruturas cervicais medianas. Acredita-se que seja uma malformação originada dos dois primeiros arcos branquiais. O tratamento da lesão consiste na excisão vertical da lesão e reparação do defeito resultante. A maioria dos autores recomenda evitar a reparação simples da lesão, preferindo a fechamento com a utilização de zetaplastia múltiplas, com o intuito de evitar fibrose e retração local. Neste artigo relatamos dois casos dessa anomalia e realizamos revisão bibliográfica.The midline cervical cleft is an unusual congenital anomaly of the ventral neck and fewer than 100 cases have been reported overall and the first described by Bailey in 1924. This anomaly is report in association with median cleft of lower lip, cleft mandible and tongue, and hypoplasia of other midline neck structures. Its considered an anomaly originated from the two first branchial arches. The treatment of this cleft is a vertical complete excision and a closure with multiple Z-plasty. Many authors recommend avoid linear closure and prefer multiple Z-plasty for evicted fibrosis and local retraction. In this paper we report 2 case of this anomaly and the literature is reviewed.

  3. Analytical determination of Kondo and Fano resonances of electron Green's function in a single-level quantum dot

    International Nuclear Information System (INIS)

    Nguyen Bich Ha; Nguyen Van Hop

    2009-01-01

    The Kondo and Fano resonances in the two-point Green's function of the single-level quantum dot were found and investigated in many previous works by means of different numerical calculation methods. In this work we present the derivation of the analytical expressions of resonance terms in the expression of the two-point Green's function. For that purpose the system of Dyson equations for the two-point nonequilibrium Green's functions in the complex-time Keldysh formalism was established in the second order with respect to the tunneling coupling constants and the mean field approximation. This system of Dyson equations was solved exactly and the analytical expressions of the resonance terms are derived. The conditions for the existence of Kondo or Fano resonances are found.

  4. An enhanced unified uncertainty analysis approach based on first order reliability method with single-level optimization

    International Nuclear Information System (INIS)

    Yao, Wen; Chen, Xiaoqian; Huang, Yiyong; Tooren, Michel van

    2013-01-01

    In engineering, there exist both aleatory uncertainties due to the inherent variation of the physical system and its operational environment, and epistemic uncertainties due to lack of knowledge and which can be reduced with the collection of more data. To analyze the uncertain distribution of the system performance under both aleatory and epistemic uncertainties, combined probability and evidence theory can be employed to quantify the compound effects of the mixed uncertainties. The existing First Order Reliability Method (FORM) based Unified Uncertainty Analysis (UUA) approach nests the optimization based interval analysis in the improved Hasofer–Lind–Rackwitz–Fiessler (iHLRF) algorithm based Most Probable Point (MPP) searching procedure, which is computationally inhibitive for complex systems and may encounter convergence problem as well. Therefore, in this paper it is proposed to use general optimization solvers to search MPP in the outer loop and then reformulate the double-loop optimization problem into an equivalent single-level optimization (SLO) problem, so as to simplify the uncertainty analysis process, improve the robustness of the algorithm, and alleviate the computational complexity. The effectiveness and efficiency of the proposed method is demonstrated with two numerical examples and one practical satellite conceptual design problem. -- Highlights: ► Uncertainty analysis under mixed aleatory and epistemic uncertainties is studied. ► A unified uncertainty analysis method is proposed with combined probability and evidence theory. ► The traditional nested analysis method is converted to single level optimization for efficiency. ► The effectiveness and efficiency of the proposed method are testified with three examples

  5. [Primary cervical cancer screening].

    Science.gov (United States)

    Vargas-Hernández, Víctor Manuel; Vargas-Aguilar, Víctor Manuel; Tovar-Rodríguez, José María

    2015-01-01

    Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  6. Ultrasound-guided radiofrequency neurotomy in cervical spine: sonoanatomic study of a new technique in cadavers

    International Nuclear Information System (INIS)

    Lee, S.-H.; Kang, C.H.; Lee, S.-H.; Derby, R.; Yang, S.N.; Lee, J.E.; Kim, J.H.; Kim, S.S.; Lee, J.-H.

    2008-01-01

    Aim: To develop an ultrasound-guided technique for radiofrequency (RF) cervical medial branch neurotomy and to validate the accuracy of this new method. Materials and methods: Five non-embalmed, fresh cadavers were used; three male and two female cadavers with a median age at death of 67.2 years (range 50-84 years). This study was conducted in two parts. First, two of the cadavers were used to define the sonographic target point for RF cervical medial branch neurotomy using high-resolution ultrasound (12 to 5 MHz). The needles were guided to five consecutive cervical medial branches in the cadavers under ultrasound guidance. Subsequently, the position of the ultrasound-guided needle was verified using C-arm fluoroscopy. Ultrasound-guided RF neurotomy was performed to the C5 medial branches in all five cadavers. In the three cadavers not used in the first part of the study, ultrasound-guided RF neurotomy without C-arm fluoroscopic confirmation was performed to the C3-C7 medial branches. The accuracy of neurotomy was assessed by pathological examination of the cervical medial branches obtained through cadaver dissection. Results: In all five cadavers, the sonographic target point was identified in all C3-C7 segments with the 12 to 5 MHz linear transducer. In all 20 needle placements for the first and second cadavers, C-arm fluoroscopy validated proper needle tip positions. In all five cadavers, successful neurotomy was pathologically confirmed in 30 of 34 cervical medial branches. Conclusions: Ultrasound-guided cervical medial branch neurotomy was successfully performed in 30 of 34 cervical medial branches in five cadavers. However, before eliminating fluoroscopic validation of final needle tip positioning, the technique should be validated in symptomatic patients

  7. Multi-channel motor evoked potential monitoring during anterior cervical discectomy and fusion

    Directory of Open Access Journals (Sweden)

    Dong-Gun Kim

    Full Text Available Objectives: Anterior cervical discectomy and fusion (ACDF surgery is the most common surgical procedure for the cervical spine with low complication rate. Despite the potential prognostic benefit, intraoperative neurophysiological monitoring (IONM, a method for detecting impending neurological compromise, is not routinely used in ACDF surgery. The present study aimed to identify the potential benefits of monitoring multi-channel motor evoked potentials (MEPs during ACDF surgery. Methods: We retrospectively reviewed 200 consecutive patients who received IONM with multi-channel MEPs and somatosensory evoked potentials (SSEPs. On average, 9.2 muscles per patient were evaluated under MEP monitoring. Results: The rate of MEP change during surgery in the multi-level ACDF group was significantly higher than the single-level group. Two patients from the single-level ACDF group (1.7% and four patients from the multi-level ACDF group (4.9% experienced post-operative motor deficits. Multi-channel MEPs monitoring during single and multi-level ACDF surgery demonstrated higher sensitivity, specificity, positive predictive and negative predictive value than SSEP monitoring. Conclusions: Multi-channel MEP monitoring might be beneficial for the detection of segmental injury as well as long tract injury during single- and multi-level ACDF surgery. Significance: This is first large scale study to identify the usefulness of multi-channel MEPs in monitoring ACDF surgery. Keywords: Disc disease, Somatosensory evoked potentials, Intraoperative neurophysiological monitoring, Motor evoked potentials, Anterior cervical discectomy and fusion

  8. Tuina treatment in cervical spondylosis

    Directory of Open Access Journals (Sweden)

    Florin Mihai Hinoveanu

    2010-12-01

    Full Text Available Cervical spondylosis is a common, chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck as well as the contents of the spinal canal. Common clinical syndromes associated with cervical spondylosis include cervical pain, cervical radiculopathy and/or mielopathy. This study show the main principles, indication and side effects of tuina in cervical spondylosis´ treatment; tuina is one of the external methods based on the principles of Traditional Chinese Medicine (TCM, especially suitable for use on the elderly population and on infants. While performing Tuina, the therapist concentrates his mind, regulates his breathing, and actuates the Qi and power of his entire body towards his hands. For a better result is recommended to try to combine acupuncture with tuina treatment. Tuina can help relieve the pain associated with spondylosis. After this kind of treatment, the symptomes produced by irritated nerves and sore muscles can find some relief. Tuina helps patients with cervical spondylosis regain muscle control, nerve function and flexibility, all through the restoration of the life force flow.

  9. Solitary, spontaneous cervical and large bone fractures in aluminium osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, M.; Dessner, D. (Saint Louis Univ. Medical Center, MI (USA). Dept. of Radiology); Ballal, S. (Saint Louis Univ. Medical Center, MI (USA). Div. of Nephrology)

    1991-02-01

    Aluminum-induced bone disease in uremic patients receiving dialysis was first described a little more than 10 years ago. The epidemic form of the disease was seen in centers where there was a high aluminum content in the water dialysate. Although this problem has been corrected, sporadic forms of the disease continue to be noted in dialyzed and nondialyzed patients. Multiple fractures are a radiological feature of aluminum-related bone disease. We present four patients whose nontraumatic fractures involved large bones, without evidence of multiple fractures. Healing was not seen in any of the fractures. In patients receiving dialysis the presence of spontaneous fractures of large bones or cervical vertebrae, which may be clinically silent or vaguely symptomatic, should raise the possibility of aluminum-induced osteomalacia even if these fractures are solitary. (orig./GDG).

  10. Advances in cervical screening technology.

    Science.gov (United States)

    Stoler, M H

    2000-03-01

    The Pap smear unquestionably is a successful screening test for cervical cancer. However, recent advances in technology have raised questions regarding whether the conventional Pap smear is still the standard of care. This article relates issues of screening and cost-effectiveness to the state of the art in thin layer preparations, cytology automation, human papillomavirus screening, human papillomavirus vaccines, and other cervical screening adjuncts. Perhaps nowhere in medicine is clinical decision making being more strongly influenced by market and other external forces than in cervical cytopathology.

  11. Mind the gaps: a qualitative study of perceptions of healthcare professionals on challenges and proposed remedies for cervical cancer help-seeking in post conflict northern Uganda.

    Science.gov (United States)

    Mwaka, Amos D; Wabinga, Henry R; Mayanja-Kizza, Harriet

    2013-12-17

    There are limited data on perceptions of health professionals on challenges faced by cervical cancer patients seeking healthcare in the developing countries. We explored the views of operational level health professionals on perceived barriers to cervical screening and early help-seeking for symptomatic cervical cancer and the proposed remedies to the challenges. Fifteen key informant interviews were held with health professionals including medical directors, gynecologists, medical officers, nurses and midwives in the gynecology and obstetrics departments of two hospitals in northern Uganda during August 2012 to April 2013. We used content analysis techniques to analyze the data. Health professionals' perceived barriers to cervical cancer care included: (i) patients and community related barriers e.g. lack of awareness on cervical cancer and available services, discomfort with exposure of women's genitals and perceived pain during pelvic examinations, and men's lack of emotional support to women (ii) individual healthcare professional's challenges e.g. inadequate knowledge and skills about cervical cancer management; (iii) health facility related barriers e.g. long distances and lack of transport to cervical cancer screening and care centers, few gynecologists and lack of pathologists, delayed histology results, lack of established palliative care services and inadequate pain control; and (iv) health policy challenges e.g. lack of specialized cancer treatment services, and lack of vaccination for human papilloma virus. Other challenges included increased number of cervical cancer patients and late stage of cervical cancer at presentations. Operational level healthcare professionals in northern Uganda reported several practical challenges facing cervical cancer care that influence their decisions, management goals and practices. The challenges and proposed remedies can inform targeted interventions for early detection, management, and control of cervical cancer in

  12. MERRA 2D IAU Ocean Surface Diagnostic, Single Level, Time Avg 1-hr (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MAT1NXOCN or tavg1_2d_ocn_Nx data product is the MERRA Data Assimilation System 2-Dimensional ocean surface single-level diagnostics that is time averaged...

  13. MERRA 2D IAU Ocean Surface Diagnostic, Single Level, Monthly Mean (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATMNXOCN or tavgM_2d_ocn_Nx data product is the MERRA Data Assimilation System 2-Dimensional ocean surface single-level diagnostics that is monthly mean...

  14. MERRA 2D IAU Diagnostic, Single Level Meteorology, Diurnal (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATUNXSLV or tavgU_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  15. MERRA 2D IAU Ocean Surface Diagnostic, Single Level, Diurnal (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATUNXOCN or tavgU_2d_ocn_Nx data product is the MERRA Data Assimilation System 2-Dimensional ocean surface single-level diagnostics that is monthly mean...

  16. MERRA 2D IAU Diagnostic, Single Level Meteorology, Time Average 1-hourly (2/3x1/2L1) V5.2.0

    Data.gov (United States)

    National Aeronautics and Space Administration — The MAT1NXSLV or tavg1_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  17. Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy

    Directory of Open Access Journals (Sweden)

    Grotenhuis J André

    2007-11-01

    Full Text Available Abstract Background laminectomy is a valuable surgical treatment for some patients with a cervical radiculomyelopathy due to cervical spinal stenosis. More recently attention has been given to motion of the spinal cord over spondylotic spurs as a cause of myelopathic changes. Immobilisation by fusion could have a positive effect on the recovery of myelopathic signs or changes. This has never been investigated in a prospective, randomised trial. Lamifuse is an acronyme for laminectomy and fusion. Methods/Design Lamifuse is a multicentre, randomised controlled trial comparing laminectomy with and without fusion in patients with a symptomatic cervical canal stenosis. The study population will be enrolled from patients that are 60 years or older with myelopathic signs and/or symptoms due to a cervical canal stenosis. A kyphotis shape of the cervical spine is an exclusion criterium. Each treatment arm needs 30 patients. Discussion This study will contribute to the discussion whether additional fusion after a cervical laminectomy results in a better clinical outcome. ISRCT number ISRCTN72800446

  18. MR imaging of symptomatic osteochondromas with pathological correlation

    International Nuclear Information System (INIS)

    Mehta, M.; Knapp, T.; White, L.M.; Wunder, J.S.; Bell, R.S.

    1998-01-01

    Objective. To demonstrate the value of MR imaging in the diagnosis and differentiation of the various symptomatic complications of osteochondromas, providing pathological correlation with emphasis on the usefulness of MR imaging as a single imaging modality in these patients. Design. We retrospectively reviewed all MR examinations of clinically symptomatic osteochondromas (30 patients) performed at our institution between March 1990 and October 1997. Patients. Thirty patients had clinically symptomatic osteochondromas during the study period. Twenty patients were male and 10 were female. There were five cases of multiple osteochondromatosis. Pathological correlation was available in 24 patients. Results and conclusion. Symptomatic complications included fracture (7%), osseous deformity limiting range of motion (23%), vascular injury (7%), neurological compromise (10%), bursa formation (27%) and malignant transformation (27%). MR imaging was able to diagnose or suggest the etiology for the clinical symptomatology in all cases, demonstrating that it is an ideal imaging modality in the diagnostic evaluation of symptomatic complications of osteochondromas and often avoids the need for further imaging. (orig.)

  19. Tuberculosis ganglionar cervical

    Directory of Open Access Journals (Sweden)

    Osmany Leonel Mendoza Cruz

    2014-08-01

    Full Text Available La tuberculosis es una enfermedad reemergente en la actual sociedad globalizada y puede presentarse prácticamente ante cualquier especialista. Las formas extrapulmonares pueden representar hasta la cuarta parte de los casos, y entre ellos la afectación ganglionar se ubica entre las más frecuentes. Se reportan dos pacientes estudiados y tratados en el Servicio de Otorrinolaringología del Hospital General de Bata, Litoral de Guinea Ecuatorial, África Central, afectados por tumoraciones laterocervicales subagudas, con escasos síntomas y excelente evolución, tras su diagnóstico de tuberculosis ganglionar cervical y terapéutica antibiótica. Aunque la punción y aspiración con aguja fina no fue concluyente, ambos casos resultaron positivos por medio de la tinción de Ziehl-Neelsen

  20. Current Cervical Carcinoma Screening Guidelines

    Directory of Open Access Journals (Sweden)

    Megan J. Schlichte

    2015-05-01

    Full Text Available A formidable threat to the health of women, cervical carcinoma can be prevented in many cases with adequate screening. The current guidelines for cervical carcinoma screening were created as joint recommendations of the American Cancer Society (ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP and the American Society for Clinical Pathology (ASCP in 2012, and later accepted and promoted by the American Congress of Obstetricians and Gynecologists (ACOG. The 2012 recommendations underscore the utility of molecular testing as an adjunct to cytology screening for certain women and provide guidance to clinicians based on different risk-benefit considerations for different ages. This manuscript will review screening techniques and current recommendations for cervical cancer screening and human papilloma virus (HPV testing, as well as possible future screening strategies.

  1. Cervical cancer screening at crossroads

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada

    2014-01-01

    Cervical screening has been one of the most successful public health prevention programmes. For 50 years, cytology formed the basis for screening, and detected cervical intraepithelial lesions (CIN) were treated surgically to prevent progression to cancer. In a high-risk country as Denmark......, screening decreased the incidence of cervical cancer from 34 to 11 per 100,000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented...... cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT...

  2. CERVICAL SPONDYLOTIC MYELOPATHY WITH FUNCTIONAL ...

    African Journals Online (AJOL)

    CERVICAL SPONDYLOTIC MYELOPATHY WITH FUNCTIONAL DISABILITY. LONG TERM RESULTS CONCERNING 18 PATIENTS OPERATED ON BY ANTERIOR APPROACH IN GABON MYELOPATHIES CERVICARTHROSIQUES INVALIDANTES. RESULTATS A LONG TERME DE 18 PATIENTS OPERES PAR VOIE ...

  3. Does rehabilitation of cervical lordosis influence sagittal cervical spine flexion extension kinematics in cervical spondylotic radiculopathy subjects?

    Science.gov (United States)

    Moustafa, Ibrahim Moustafa; Diab, Aliaa Attiah Mohamed; Hegazy, Fatma A; Harrison, Deed E

    2017-01-01

    To test the hypothesis that improvement of cervical lordosis in cervical spondylotic radiculopathy (CSR) will improve cervical spine flexion and extension end range of motion kinematics in a population suffering from CSR. Thirty chronic lower CSR patients with cervical lordosis lordosis (p lordosis in the study group was associated with significant improvement in the translational and rotational motions of the lower cervical spine. This finding provides objective evidence that cervical flexion/extension is partially dependent on the posture and sagittal curve orientation. These findings are in agreement with several other reports in the literature; whereas ours is the first post treatment analysis identifying this relationship.

  4. Cervical chordoma: a case report

    International Nuclear Information System (INIS)

    Romera, C.; Wiehoff, A.; Candela, V. P.; Perera, J.

    2002-01-01

    Chordomas, lesions that develop from notochordal remnants, can arise at any site ranging from the clivus to the sacrum: they represent 3% to 4% of all primary bone tumors. We present the cases of a 45-year-old man with cervical chordoma at the C2 level, the site least frequently reported in the literature. We provide the radiological findings resulting from cervical computed tomography and magnetic resonance imaging. (Author) 11 refs

  5. Hyper-attenuating nodules on CT during arterial portography (CTAP). Analysis using single-level dynamic CTAP

    International Nuclear Information System (INIS)

    Nasu, Akihiro; Kita, Ryuichi; Sakamoto, Yasuaki

    2007-01-01

    Recently several cases of hyper-attenuating nodules on CT during arterial portography (CTAP) have been reported as the chance of meticulous examination has been increasing. For the study reported here, seven cases of hyper-attenuating nodules on CTAP were analyzed by means of single-level dynamic CTAP (sCTAP). Peak values of the time-density curve from the 7 cases were 110, 106, 71, 75, 65, 45, 246 Hounsfield unit (HU) for the ROIs (regions of interest) placed on the nodule, and 63, 73, 41, 35, 20, 28, 22 HU for those placed on the surrounding liver parenchyma, respectively. Average peak value in another set of 46 cases as a control, including chronic hepatitis, liver cirrhosis and normal liver, was 55.3±17.6 HU. These results seem to indicate that portal flow shows an absolute increase in some cases of hyper-attenuating nodules on CTAP and that a decreased portal flow in the surrounding parencyma may cause the visual effect of hyper-attenuation on CTAP in some cases. (author)

  6. A 90-day Bundled Payment for Primary Single-level Lumbar Discectomy/Decompression: What Does "Big Data" Say?

    Science.gov (United States)

    Jain, Nikhil; Virk, Sohrab S; Phillips, Frank M; Yu, Elizabeth; Khan, Safdar N

    2018-04-01

    Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59.7% to 73.6% of total payments, followed by surgeon's fees, which accounted for 13.7% to 18.5%. Postacute services made up 8.8% to 15.8% of the total reimbursement. Surgeries performed in the inpatient setting were significantly more expensive as compared with surgeries performed in the outpatient setting (P<0.01). The average 90-day bundle amount was estimated at $11,091, $6571, and $6239 for Commercial payers, Medicare Advantage, and Medicare, respectively. Overall, service providers in the Southern region were reimbursed the lowest from Commercial payers and Medicare, compared with other regions. Postacute services are not as major cost drivers after discectomy as after total joint arthroplasty or hip fracture repair.

  7. Does pain relief by CT-guided indirect cervical nerve root injection with local anesthetics and steroids predict pain relief after decompression surgery for cervical nerve root compression?

    Science.gov (United States)

    Antoniadis, Alexander; Dietrich, Tobias J; Farshad, Mazda

    2016-10-01

    The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post-injection effects to the short- and long-term outcomes after surgical decompression, specifically in regard to pain relief. Patients (n = 39, age 47 ± 10 years) who had undergone CT-guided indirect injection with local anesthetics and steroids as an initial treatment for single cervical nerve root radiculopathy and who subsequently needed surgical decompression were included retrospectively. Pain levels (VAS scores) were monitored before, immediately after, and 6 weeks after injection (n = 34), as well as 6 weeks (n = 38) and a mean of 25 months (SD ± 12) after surgical decompression (n = 36). Correlation analysis was performed to find potential associations of pain relief after injection and after surgery to investigate the predictive value of post-injection pain relief. There was no correlation between immediate pain relief after injection (-32 ± 27 %) and 6 weeks later (-7 ± 19 %), (r = -0.023, p = 0.900). There was an association by tendency between immediate pain relief after injection and post-surgical pain relief at 6 weeks (-82 ± 27 %), (r = 0.28, p = 0.08). Pain relief at follow-up remained high at -70 ± 21 % and was correlated with the immediate pain amelioration effect of the injection (r = 0.37, p = 0.032). Five out of seven patients who reported no pain relief from injection had a pain relief from surgery in excess of 50 %. The amount of immediate radiculopathic pain relief after indirect cervical nerve root injection is associated with the amount of pain relief achieved at long-term follow-up after surgical decompression of single-level cervical radiculopathy

  8. Imaging findings predicting the outcome of cervical facet joint blocks

    International Nuclear Information System (INIS)

    Hechelhammer, Lukas; Pfirrmann, Christian W.A.; Zanetti, Marco; Hodler, Juerg; Schmid, Marius R.; Boos, Norbert

    2007-01-01

    To determine which cross-sectional imaging findings predict the short-term outcome of cervical facet joint blocks (FJB) and to evaluate the effect of combined intra-/periarticular versus periarticular injection on pain. Fifty facet joints in 37 patients were included in the study. Single, unilateral FJBs in 24 patients, and bilateral single level FJBs in 13 patients were performed, respectively. In all patients, pain relief was assessed using a visual analogue scale. All computed tomography (CT) examinations were blindly reviewed by two radiologists. Osteoarthritis was rated using the Kellgren classification. The presence of combined intra-/periarticular vs. sole periarticular injection of contrast was evaluated. Kellgren Grades 0 (n=23), 1 (n=5), 2 (n=3), 3 (n=9), and 4 (n=10) were found. Mean pain relief after injection was 35% (range: 0-100%). 40% of all injections were combined intra-/periarticular. There was neither a statistically significant difference between pain relief and combined intra-/periarticular versus sole periarticular injection (p=0.64) nor the grade of osteoarthritis (p=0.49). Pain relief after cervical FJBs does not correlate with morphologic alterations seen on CT. Periarticular FJBs are not less successful than combined intra-/periarticular FJBs. (orig.)

  9. Short-course palliative radiotherapy for uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won [Dept. of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Nam, Ji Ho; Jeon, Sang Ho [Dept. of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2013-12-15

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  10. Short-course palliative radiotherapy for uterine cervical cancer

    International Nuclear Information System (INIS)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won; Nam, Ji Ho; Jeon, Sang Ho

    2013-01-01

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  11. Extensive vascular remodeling in the spinal cord of pre-symptomatic experimental autoimmune encephalomyelitis mice; increased vessel expression of fibronectin and the α5β1 integrin

    Science.gov (United States)

    Boroujerdi, Amin; Welser-Alves, Jennifer V.; Milner, Richard

    2013-01-01

    Alterations in vascular structure and function are a central component of demyelinating disease. In addition to blood-brain barrier (BBB) breakdown, which occurs early in the course of disease, recent studies have described angiogenic remodeling, both in multiple sclerosis tissue and in the mouse demyelinating model, experimental autoimmune encephalomyelitis (EAE). As the precise timing of vascular remodeling in demyelinating disease has yet to be fully defined, the purpose of the current study was to define the time-course of these events in the MOG35-55 EAE model. Quantification of endothelial cell proliferation and vessel density revealed that a large part of angiogenic remodeling in cervical spinal cord white matter occurs during the pre-symptomatic phase of EAE. At the height of vascular remodeling, blood vessels in the cervical spinal cord showed strong transient upregulation of fibronectin and the α5β1 integrin. In vitro experiments revealed that α5 integrin inhibition reduced brain endothelial cell proliferation under inflammatory conditions. Interestingly, loss of vascular integrity was evident in all vessels during the first 4–7 days post-immunization, but after 14 days, was localized predominantly to venules. Taken together, our data demonstrate that extensive vascular remodeling occurs during the pre-symptomatic phase of EAE and point to a potential role for the fibronectin-α5β1 integrin interaction in promoting vascular remodeling during demyelinating disease. PMID:24056042

  12. Comparison of Cervical Kinematics, Pain, and Functional Disability Between Single- and Two-level Anterior Cervical Discectomy and Fusion.

    Science.gov (United States)

    Chien, Andy; Lai, Dar-Ming; Wang, Shwu-Fen; Hsu, Wei-Li; Cheng, Chih-Hsiu; Wang, Jaw-Lin

    2016-08-01

    A prospective, time series design. The purpose of this study is two-fold: firstly, to investigate the impact of altered cervical alignment and range of motion (ROM) on patients' self-reported outcomes after anterior cervical discectomy and fusion (ACDF), and secondly, to comparatively differentiate the influence of single- and two-level ACDF on the cervical ROM and adjacent segmental kinematics up to 12-month postoperatively. ACDF is one of the most commonly employed surgical interventions to treat degenerative disc disease. However, there are limited in vivo data on the impact of ACDF on the cervical kinematics and its association with patient-reported clinical outcomes. Sixty-two patients (36 males; 55.63 ± 11.6 yrs) undergoing either a single- or consecutive two-level ACDF were recruited. The clinical outcomes were assessed with the Pain Visual Analogue Scale (VAS) and the Neck Disability Index (NDI). Radiological results included cervical lordosis, global C2-C7 ROM, ROM of the Functional Spinal Unit (FSU), and its adjacent segments. The outcome measures were collected preoperatively and then at 3, 6, and 12-month postoperatively. A significant reduction of both VAS and NDI was found for both groups from the preoperative to 3-month period (P < 0.01). Pearson correlation revealed no significant correlation between global ROM with neither VAS (P = 0.667) nor NDI (P = 0.531). A significant reduction of global ROM was identified for the two-level ACDF group at 12 months (P = 0.017) but not for the single-level group. A significant interaction effect was identified for the upper adjacent segment ROM (P = 0.024) but not at the lower adjacent segment. Current study utilized dynamic radiographs to comparatively evaluate the biomechanical impact of single- and two-level ACDF. The results highlighted that the two-level group demonstrated a greater reduction of global ROM coupled with an increased upper adjacent segmental compensatory motions that

  13. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo.

    Science.gov (United States)

    Li, Yongchao; Peng, Baogan

    2015-01-01

    Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients' subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with Barré-Liéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment.

  14. A Multicenter Review of Superior Laryngeal Nerve Injury Following Anterior Cervical Spine Surgery.

    Science.gov (United States)

    Tempel, Zachary J; Smith, Justin S; Shaffrey, Christopher; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel; Kanter, Adam S

    2017-04-01

    A retrospective multicenter case-series study; case report and review of the literature. The anatomy and function of the superior laryngeal nerve (SLN) are well described; however, the consequences of SLN injury remain variable and poorly defined. The prevalence of SLN injury as a consequence of cervical spine surgery is difficult to discern as its clinical manifestations are often inconstant and frequently of a subclinical degree. A multicenter study was performed to better delineate the risk factors, prevalence, and outcomes of SLN injury. A retrospective multicenter case-series study involving 21 high-volume surgical centers from the AO Spine North America Clinical Research Network. Medical records for 17 625 patients who received subaxial cervical spine surgery from 2005 to 2011 were reviewed to identify occurrence of 21 predefined treatment complications. Descriptive statistics were provided for baseline patient characteristics. A retrospective review of the neurosurgical literature on SLN injury was also performed. A total of 8887 patients who underwent anterior cervical spine surgery at the participating institutions were screened, and 1 case of SLN palsy was identified. The prevalence ranged from 0% to 1.25% across all centers. The patient identified underwent a C4 corpectomy. The SLN injury was identified after the patient demonstrated difficulty swallowing postoperatively. He underwent placement of a percutaneous gastrostomy tube and his SLN palsy resolved by 6 weeks. This multicenter study demonstrates that identification of SLN injury occurs very infrequently. Symptomatic SLN injury is an exceedingly rare complication of anterior cervical spine surgery. The SLN is particularly vulnerable when exposing the more rostral levels of the cervical spine. Careful dissection and retraction of the longus coli may decrease the risk of SLN injury during anterior cervical surgery.

  15. Clinical experience using polyetheretherketone (PEEK) intervertebral structural cage for anterior cervical corpectomy and fusion.

    Science.gov (United States)

    Kasliwal, Manish K; O'Toole, John E

    2014-02-01

    Anterior cervical corpectomy and fusion (ACCF) is commonly performed for various pathologies involving the cervical spine. Although polyetheretherketone (PEEK) cages have been widely used following anterior cervical discectomy and fusion (ACDF), clinical literature demonstrating its efficacy following ACCF is sparse. A retrospective review of patients enrolled in a prospective database who underwent single/multi-level ACCF was performed. Fifty-nine patients were identified who underwent corpectomy reconstruction with PEEK cages for symptomatic degenerative, neoplastic, infectious, or traumatic pathologies of the cervical spine. Thirty-five patients having at least 6 months follow-up (FU) were included in the final analysis. The mean age of patients was 51 years (range, 18-81 years) with FU ranging from 6 to 33 months (mean, 6.6 months). None of the patients had dysphagia at last FU. There was no implant failure with fusion occurring in all patients. While 57% of patients (20/35) remained stable with no progression of myelopathy, 43% (15/35) improved one (11 patients) or two (four patients) Nurick grades after surgery. The use of PEEK cages packed with autograft or allograft is safe and effective following anterior cervical corpectomy, demonstrating high fusion rates and good clinical results. This synthetic material obviates the morbidity associated with autograft harvest and possible infectious risks of allograft. The wide array of cage dimensions facilitates ease of use in patients of all sizes and appears safe for use in the typical pathologic conditions encountered in the cervical spine. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. [Total cervical disk replacement--implant-specific approaches: keel implant (Prodisc-C intervertebral disk prosthesis)].

    Science.gov (United States)

    Korge, Andreas; Siepe, Christoph J; Heider, Franziska; Mayer, H Michael

    2010-11-01

    Dynamic intervertebral support of the cervical spine via an anterolateral approach using a modular artificial disk prosthesis with end-plate fixation by central keel fixation. Cervical median or mediolateral disk herniations, symptomatic cervical disk disease (SCDD) with anterior osseous, ligamentous and/or discogenic narrowing of the spinal canal. Cervical fractures, tumors, osteoporosis, arthrogenic neck pain, severe facet degeneration, increased segmental instability, ossification of posterior longitudinal ligament (OPLL), severe osteopenia, acute and chronic systemic, spinal or local infections, systemic and metabolic diseases, known implant allergy, pregnancy, severe adiposity (body mass index > 36 kg/m2), reduced patient compliance, alcohol abuse, drug abuse and dependency. Exposure of the anterior cervical spine using the minimally invasive anterolateral approach. Intervertebral fixation of retainer screws. Intervertebral diskectomy. Segmental distraction with vertebral body retainer and vertebral distractor. Removal of end-plate cartilage. Microscopically assisted decompression of spinal canal. Insertion of trial implant to determine appropriate implant size, height and position. After biplanar image intensifier control, drilling for keel preparation using drill guide and drill bit, keel-cut cleaner to remove bone material from the keel cut, radiologic control of depth of the keel cut using the corresponding position gauge. Implantation of original implant under lateral image intensifier control. Removal of implant inserter. Functional postoperative care and mobilization without external support, brace not used routinely, soft brace possible for 14 days due to postoperative pain syndromes. Implantation of 100 cervical Prodisc-C disk prostheses in 78 patients (average age 48 years) at a single center. Clinical and radiologic follow-up 24 months postoperatively. Significant improvement based on visual analog scale and Neck Disability Index. Radiologic

  17. Intercomparison of methods for the estimation of displacement height and roughness length from single-level eddy covariance data

    Science.gov (United States)

    Graf, Alexander; van de Boer, Anneke; Schüttemeyer, Dirk; Moene, Arnold; Vereecken, Harry

    2013-04-01

    The displacement height d and roughness length z0 are parameters of the logarithmic wind profile and as such these are characteristics of the surface, that are required in a multitude of meteorological modeling applications. Classically, both parameters are estimated from multi-level measurements of wind speed over a terrain sufficiently homogeneous to avoid footprint-induced differences between the levels. As a rule-of thumb, d of a dense, uniform crop or forest canopy is 2/3 to 3/4 of the canopy height h, and z0 about 10% of canopy height in absence of any d. However, the uncertainty of this rule-of-thumb becomes larger if the surface of interest is not "dense and uniform", in which case a site-specific determination is required again. By means of the eddy covariance method, alternative possibilities to determine z0 and d have become available. Various authors report robust results if either several levels of sonic anemometer measurements, or one such level combined with a classic wind profile is used to introduce direct knowledge on the friction velocity into the estimation procedure. At the same time, however, the eddy covariance method to measure various fluxes has superseded the profile method, leaving many current stations without a wind speed profile with enough levels sufficiently far above the canopy to enable the classic estimation of z0 and d. From single-level eddy covariance measurements at one point in time, only one parameter can be estimated, usually z0 while d is assumed to be known. Even so, results tend to scatter considerably. However, it has been pointed out, that the use of multiple points in time providing different stability conditions can enable the estimation of both parameters, if they are assumed constant over the time period regarded. These methods either rely on flux-variance similarity (Weaver 1990 and others following), or on the integrated universal function for momentum (Martano 2000 and others following). In both cases

  18. Symptomatic Raccoon Dogs and Sarcoptic Mange Along an Urban Gradient.

    Science.gov (United States)

    Saito, Masayuki U; Sonoda, Yoichi

    2017-06-01

    We quantitatively evaluated the effects of landscape factors on the distribution of symptomatic raccoon dogs with sarcoptic mange along an urban gradient. We used 246 camera traps (182 traps from April 2005 to December 2006; 64 traps from September 2009 to October 2010) to record the occurrence of asymptomatic and symptomatic raccoon dogs at 21 survey sites along an urban-rural gradient in the Tama Hills area of Tokyo. Each occurrence was explained in terms of the surrounding forest, agricultural, and grassland areas and additional factors (i.e., seasonal variations and survey methods) at various spatial scales using a generalized additive mixed model (GAMM). In our analysis, a 1000-m radius was identified as the important spatial scale for asymptomatic and symptomatic raccoon dog occurrence. The peak of the predicted occurrence probability of asymptomatic raccoon dogs appeared in the intermediate forest landscape as opposed to non-forest and forest landscapes. However, a high occurrence probability of symptomatic raccoon dogs was detected in non-forest and intermediate forest landscapes (i.e., urban and suburban) as opposed to a forest landscape, presumably because of animals occurring at much higher densities in more urbanized areas. Therefore, our results suggest that human-modified landscapes play an important role in the high occurrence of sarcoptic mange in raccoon dogs.

  19. Results of surgical excision of urethral prolapse in symptomatic patients.

    Science.gov (United States)

    Hall, Mary E; Oyesanya, Tola; Cameron, Anne P

    2017-11-01

    Here, we present the clinical presentation and surgical outcomes of women with symptomatic urethral prolapse presenting to our institution over 20 years, and seek to provide treatment recommendations for management of symptomatic urethral prolapse and caruncle. A retrospective review of medical records from female patients who underwent surgery for symptomatic urethral prolapse from June 1995 to August 2015 was performed. Surgical technique consisted of a four-quadrant excisional approach for repair of urethral prolapse. A total of 26 patients were identified with a mean age of 38.8 years (range 3-81). The most common presentations were vaginal bleeding, hematuria, pain, and dysuria. All patients underwent surgical excision of urethral prolapse via a standard approach. Follow-up data was available in 24 patients. Six patients experienced temporary postoperative bleeding, and one patient required placement of a Foley catheter for tamponade. One patient experienced temporary postoperative urinary retention requiring Foley catheter placement. Three patients had visible recurrence of urethral prolapse, for which one later underwent re-excision. Surgical excision of urethral prolapse is a reasonable treatment option in patients who have tried conservative management without relief, as well as in those who present with severe symptoms. Possible complications following excision include postoperative bleeding and recurrence, and patients must be counseled accordingly. In this work, we propose a treatment algorithm for symptomatic urethral prolapse. © 2017 Wiley Periodicals, Inc.

  20. Mammographic profiles of women with symptomatic breast diseases ...

    African Journals Online (AJOL)

    Methods: This was a prospective descriptive analytical study of women with symptomatic breast diseases who had mammography between January 2012 and December 2016 at our health facilities. Data sheet was developed to record the patients' biodata, indication for referral, and mammographic findings. Results: During ...

  1. Symptomatic Tarlov Cysts: Surgical Treatment by Subcutaneous Infusion Port.

    Science.gov (United States)

    Huang, Ying; Zhu, Tong; Lin, Hongyi; Li, Jing; Zeng, Tao; Lin, Jian

    2018-05-01

    The treatment of Tarlov cysts is challenging and difficult. The objective of our study was to describe the security and efficacy of the subcutaneous infusion port for drainage of symptomatic Tarlov cysts. The authors executed a retrospective review of data from 5 symptomatic Tarlov cysts patients who were treated using a subcutaneous infusion port from June 2014 to July 2017. Numerical Rating Scale scores and the Japanese Orthopedic Association scores of back pain were analyzed. Complications and adverse effects on postoperative days 1, 7, 14, and 28 were also analyzed. The mean follow-up was 12.6 months. Five adults (3 females and 2 males) who had been symptomatic received a subcutaneous infusion port. After treatment, all patients experienced pain relief and pain alleviation lasted from 1 day to 3 years without complications and adverse effects. A subcutaneous infusion port is a useful treatment option for symptomatic Tarlov cysts. When the patients' symptoms returned and the cysts repressurized, we quickly and simply drained the cysts by using the infusion port. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Symptomatic HIV infection in infancy - clinical and laboratory ...

    African Journals Online (AJOL)

    in infancy - clinical and laboratory markers of infection. M P Meyer, Z Latief, C Haworlh, 5 Salie,. A van Dyk. Objective. To investigate the usefulness of immunological tests in the diagnosis of HIV infection in young symptomatic children « 15 months of age). Design. Tests were evaluated in HIV-infected (HIV antibody- and ...

  3. Uterine artery embolisation as an effective choice for symptomatic ...

    African Journals Online (AJOL)

    2016-03-31

    Mar 31, 2016 ... Symptomatic uterine leiomyomas can cause pain, heavy bleeding, pressure effects and reduced fertility. ... percent of patients reported being satisfied, 12% partially satisfied and 7% not satisfied. No .... Ten (12.2%) patients reported being partially .... 6-month follow-up, they were referred back to primary.

  4. Aspects of the current treatment modalities for symptomatic gallstones

    NARCIS (Netherlands)

    P.W. Plaisier

    1994-01-01

    textabstractExtracorporeal shock wave lithotripsy (ESWL) of gallbladder stones was clinically introduced in 1985. Before that, cholecystectomy had been the unchallenged standard therapy for symptomatic gallbladder stones for over a century. Expectations with regard to ESWL ran rather high after

  5. Plasmodium falciparum multiplicity correlates with anaemia in symptomatic malaria

    NARCIS (Netherlands)

    Mockenhaupt, Frank P.; Ehrhardt, Stephan; Eggelte, Teunis A.; Markert, Miriam; Anemana, Sylvester; Otchwemah, Rowland; Bienzle, Ulrich

    2003-01-01

    In 366 Ghanaian children with symptomatic Plasmodium falciparum malaria, low haemoglobin levels and severe anaemia were associated with a high multiplicity of infection (MOI) and with distinct merozoite surface protein alleles. High MOI not only reflects premunition but may also contribute to

  6. Prevalence and associations of symptomatic renal papillary necrosis ...

    African Journals Online (AJOL)

    Aim: To assess the prevalence and associations of symptomatic renal papillary necrosis (RPN) in sickle cell anemia patients. Patients and Methods: The case notes of homozygous hemoglobin (Hb) S patients diagnosed with RPN were retrospectively assessed. Diagnosis was based on microscopic hematuria and positive ...

  7. Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

    Science.gov (United States)

    Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

    1992-10-01

    Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

  8. Quiste dermoide cervical

    Directory of Open Access Journals (Sweden)

    Yurian Gbenou Morgan

    Full Text Available Los quistes dermoides presentan una incidencia de 1,6 hasta 6,9 % en la región de cabeza y cuello. Se realiza el siguiente reporte de caso clínico con el objetivo de enfatizar en la importancia de un adecuado manejo diagnóstico preoperatorio, para establecer una acertada planificación quirúrgica en la exéresis de este tipo de lesiones de la región cervicofacial. Se presenta el caso clínico de un paciente masculino, de 13 años de edad, quien hacía 3 años se notaba un crecimiento redondeado en región submentoniana, lo cual le ocasionaba molestias al hablar y ligera afectación de su estética facial. Una vez realizados los estudios complementarios preoperatorios, se decide tratamiento quirúrgico, empleando una cervicotomía medial para la extirpación de la lesión quística, dada la ubicación anatómica por debajo del músculo milohiodeo y su gran dimensión. El diagnóstico histopatológico se corresponde con un quiste epidérmico. Se concluye que resulta imprescindible realizar un exhaustivo examen físico e imagenológico, para lograr resultados satisfactorios en el tratamiento quirúrgico del quiste dermoide cervical.

  9. Outcome of endovascular treatment in symptomatic intracranial vascular stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Dae Chul; Kim, Sang Joon; Lee, Duk Hee; Kim, Won; Choi, Choong Gon; Lee, Jeong Hyun; Kwon, Sun Uck; Kim, Jong Sung [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Hyun Jeong [Daejeon Catholic Hospital, Daejeon (Korea, Republic of)

    2005-03-15

    The outcome evaluation for the revascularization of intracranial vascular stenoses has not been fully described due to the highly technical nature of the procedure. We report here on the early and late clinical outcome of angioplasty and/or stenting of symptomatic severe intracranial vascular stenoses at a single institute. Since 1995, we have treated 35 patients with symptomatic intracranial vascular stenosis (more than 70% stenosis, mean stenosis: 78.6% {+-} 6.2%). Angioplasty (n = 19) was performed for the horizontal segment of the middle cerebral artery (M1) (n = 16) and the basilar artery (BA) (n = 1), the intradural vertebral artery (VA) (n = 1), and the cavernous internal carotid artery (ICA) (n = 1). Stenting (n = 16) was performed for the cavernous or petrous ICAs (n = 9), the intradural VA (n = 3), BA (n = 2), and M1 (n = 2) artery. We assessed the angiographic success (defined as residual stenosis < 50%) rate, the periprocedural complications during the 30-day periprocedural period, the symptomatic recurrence and restenosis during a mean 22-month follow-up (FU) period. The Kaplan-Meier estimate of the cumulative even-free rate of the major cerebrovascular events, i.e. death, stroke or restenosis, was also done. Angiographic success was achieved in 97% of our patients (34/35). There were four procedure-related complications (11%) including a death and a minor stroke. During the mean 22-month FU, the asymptomatic restenosis rate was 9% and the symptomatic restenosis rate was 6% in the target lesion and 9% in all the vascular territories. The Kaplan-Meier estimate was 70.6% (95% confidence interval = 46.5-94.7) after 33 month of FU. In addition to a high angiographic success rate and an acceptable periprocedural complication rate, intracranial angioplasty and/or stenting revealed a relatively low symptomatic recurrence rate. Hemorrhage is a rare, but the physician must aware that potentially fatal periprocedural complications can occur.

  10. Costs Associated with Cervical Cancer Screening

    Centers for Disease Control (CDC) Podcasts

    Dr. Tom Cox, a practicing gynecologist and president of the American Society of Colposcopy and Cervical Pathology, provides a brief introduction to cervical cancer screening guidelines and human papillomavirus (HPV) DNA testing.

  11. NIH Research Leads to Cervical Cancer Vaccine

    Science.gov (United States)

    ... Issues Sexually Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents ... in women, the cause of the majority of cervical cancers. Photo courtesy of Judy Folkenberg, NLM Writer By ...

  12. Preventing Cervical Cancer with HPV Vaccines

    Science.gov (United States)

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  13. CDC Vital Signs: Cervical Cancer is Preventable

    Science.gov (United States)

    ... Digital Press Kit Read the MMWR Science Clips Cervical Cancer is Preventable Language: English (US) Español (Spanish) Recommend ... 000 More than 4,000 women die of cervical cancer each year. 93% As many as 93% of ...

  14. Treatment Options by Stage (Cervical Cancer)

    Science.gov (United States)

    ... cancer is found early. Signs and symptoms of cervical cancer include vaginal bleeding and pelvic pain. These and other signs and symptoms may be caused by cervical cancer or by other conditions . Check with your ...

  15. Reduction of microhemorrhages in the spinal cord of symptomatic ALS mice after intravenous human bone marrow stem cell transplantation accompanies repair of the blood-spinal cord barrier.

    Science.gov (United States)

    Eve, David J; Steiner, George; Mahendrasah, Ajay; Sanberg, Paul R; Kurien, Crupa; Thomson, Avery; Borlongan, Cesar V; Garbuzova-Davis, Svitlana

    2018-02-13

    Blood-spinal cord barrier (BSCB) alterations, including capillary rupture, have been demonstrated in animal models of amyotrophic lateral sclerosis (ALS) and ALS patients. To date, treatment to restore BSCB in ALS is underexplored. Here, we evaluated whether intravenous transplantation of human bone marrow CD34 + (hBM34 + ) cells into symptomatic ALS mice leads to restoration of capillary integrity in the spinal cord as determined by detection of microhemorrhages. Three different doses of hBM34 + cells (5 × 10 4 , 5 × 10 5 or 1 × 10 6 ) or media were intravenously injected into symptomatic G93A SOD1 mice at 13 weeks of age. Microhemorrhages were determined in the cervical and lumbar spinal cords of mice at 4 weeks post-treatment, as revealed by Perls' Prussian blue staining for ferric iron. Numerous microhemorrhages were observed in the gray and white matter of the spinal cords in media-treated mice, with a greater number of capillary ruptures within the ventral horn of both segments. In cell-treated mice, microhemorrhage numbers in the cervical and lumbar spinal cords were inversely related to administered cell doses. In particular, the pervasive microvascular ruptures determined in the spinal cords in late symptomatic ALS mice were significantly decreased by the highest cell dose, suggestive of BSCB repair by grafted hBM34 + cells. The study results provide translational outcomes supporting transplantation of hBM34 + cells at an optimal dose as a potential therapeutic strategy for BSCB repair in ALS patients.

  16. Cervical spondylosis in Nepalese porters.

    Science.gov (United States)

    Bista, P; Roka, Y B

    2008-01-01

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

  17. Does highly symptomatic class membership in the acute phase predict highly symptomatic classification in victims 6 months after traumatic exposure?

    Science.gov (United States)

    Hansen, Maj; Hyland, Philip; Armour, Cherie

    2016-05-01

    Recently studies have indicated the existence of both posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) subtypes but no studies have investigated their mutual association. Although ASD may not be a precursor of PTSD per se, there are potential benefits associated with early identification of victims at risk of developing PTSD subtypes. The present study investigates ASD and PTSD subtypes using latent class analysis (LCA) following bank robbery (N=371). Moreover, we assessed if highly symptomatic ASD and selected risk factors increased the probability of highly symptomatic PTSD. The results of LCA revealed a three class solution for ASD and a two class solution for PTSD. Negative cognitions about self (OR=1.08), neuroticism (OR=1.09) and membership of the 'High symptomatic ASD' class (OR=20.41) significantly increased the probability of 'symptomatic PTSD' class membership. Future studies are needed to investigate the existence of ASD and PTSD subtypes and their mutual relationship. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a

  19. Radical surgery for early stage cervical cancer

    NARCIS (Netherlands)

    Derks, M.

    2017-01-01

    Cervical cancer is one of the most common malignancies in women worldwide. Due to an effective screening programme, in the Netherlands cervical cancer is often detected in early stages of disease. For early stage (International Federation of Gynaecology and Obstetrics (FIGO) stage IB/IIA) cervical

  20. Cervical Cancer is Preventable! PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second Public Service Announcement is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.

  1. Vital Signs-Cervical Cancer is Preventable!

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.

  2. Cervical Cancer—Health Professional Version

    Science.gov (United States)

    The primary risk factor for cervical cancer is human papillomavirus (HPV) infection. Most cases of cervical cancer are preventable by routine screening and by treatment of precancerous lesions. Find evidence-based information on cervical cancer treatment, causes and prevention, screening, research, and statistics.

  3. Grafton and local bone have comparable outcomes to iliac crest bone in instrumented single-level lumbar fusions.

    Science.gov (United States)

    Kang, James; An, Howard; Hilibrand, Alan; Yoon, S Tim; Kavanagh, Eoin; Boden, Scott

    2012-05-20

    Prospective multicenter randomized clinical trail. The goal of our 2-year prospective study was to perform a randomized clinical trial comparing the outcomes of Grafton demineralized bone matrix (DBM) Matrix with local bone with that of iliac crest bone graft (ICBG) in a single-level instrumented posterior lumbar fusion. There has been extensive research and development in identifying a suitable substitute to replace autologous ICBG that is associated with known morbidities. DBMs are a class of commercially available grafting agents that are prepared from allograft bone. Many such products have been commercially available for clinical use; however, their efficacy for spine fusion has been mostly based on anecdotal evidence rather than randomized controlled clinical trials. Forty-six patients were randomly assigned (2:1) to receive Grafton DBM Matrix with local bone (30 patients) or autologous ICBG (16 patients). The mean age was 64 (females [F] = 21, males [M] = 9) in the DBM group and 65 (F = 9, M = 5) in the ICBG group. An independent radiologist evaluated plain radiographs and computed tomographic scans at 6-month, 1-year, and 2-year time points. Clinical outcomes were measured using Oswestry Disability Index (ODI) and Medical Outcomes Study 36-Item Short Form Health Survey. Forty-one patients (DBM = 28 and ICBG = 13) completed the 2-year follow-up. Final fusion rates were 86% (Grafton Matrix) versus 92% (ICBG) (P = 1.0 not significant). The Grafton group showed slightly better improvement in ODI score than the ICBG group at the final 2-year follow-up (Grafton [16.2] and ICBG [22.7]); however, the difference was not statistically significant (P = 0.2346 at 24 mo). Grafton showed consistently higher physical function scores at 24 months; however, differences were not statistically significant (P = 0.0823). Similar improvements in the physical component summary scores were seen in both the Grafton and ICBG groups. There was a statistically significant greater mean

  4. Selective cervical myelography. Pt. 1

    International Nuclear Information System (INIS)

    Mironov, A.M.

    1979-01-01

    The classical ways of subarachnoid puncture - lumbal and suboccipital - require a considerable quantity of air in performing segmental cervical pneumomyelography. An examination technique is described, based on the recently suggested lateral subarachnoid puncture within the interarcus space at C 1 -C 2 level. Emphasis is laid on the possibilities of carrying out various neuro-roentgenological studies through contrast medium introduction in the fashion described, namely: pontocerebellar cistemography and cervical myelography with AMIPAQUE - a water soluble contrast medium. On the basis of literature data and personal experience it is stated that the risk in lateral subarachnoid puncture is by no means higher than in suboccipital puncture. The main advantages of selective cervical myelography effected by contrast medium injection through lateral subarachnoid puncture include the possibility to perform investigation with a minimum amount of air (4-8 cm 3 ) and to study patients with fixed, direct skull fraction after Crutchfield under maximum sparing conditions. (author)

  5. Inhibitory effect of cervical trachea and chest wall vibrations on cough reflex sensitivity and perception of urge-to-cough in healthy male never-smokers

    OpenAIRE

    Kashiwazaki, Naohiro; Ebihara, Satoru; Gui, Peijun; Katayama, Norihiro; Ito, Kumiko; Sato, Ryuhei; Oyama, Chika; Ebihara, Takae; Kohzuki, Masahiro

    2013-01-01

    Background Non-pharmacological options for symptomatic management of cough are desired. Although chest wall mechanical vibration is known to ameliorate cough reflex sensitivity, the effect of mechanical vibrations on perceptions of urge-to-cough has not been studied. Therefore, we investigated the effect of mechanical vibration of cervical trachea, chest wall and femoral muscle on cough reflex sensitivity, perceptions of urge-to-cough as well as dyspnea. Methods Twenty-four healthy male never...

  6. Facetal distraction as treatment for single- and multilevel cervical spondylotic radiculopathy and myelopathy: a preliminary report.

    Science.gov (United States)

    Goel, Atul; Shah, Abhidha

    2011-06-01

    The authors discuss their successful preliminary experience with 36 cases of cervical spondylotic disease by performing facetal distraction using specially designed Goel cervical facet spacers. The clinical and radiological results of treatment are analyzed. The mechanism of action of the proposed spacers and the rationale for their use are evaluated. Between 2006 and February 2010, 36 patients were treated using the proposed technique. Of these patients, 18 had multilevel and 18 had single-level cervical spondylotic radiculopathy and/or myelopathy. The average follow-up period was 17 months with a minimum of 6 months. The Japanese Orthopaedic Association classification system, visual analog scale (neck pain and radiculopathy), and Odom criteria were used to monitor the clinical status of the patient. The patients were prospectively analyzed. The technique of surgery involved wide opening of the facet joints, denuding of articular cartilage, distraction of facets, and forced impaction of Goel cervical facet spacers into the articular cavity. Additionally, the interspinous process ligaments were resected, and corticocancellous bone graft from the iliac crest was placed and was stabilized over the adjoining laminae and facets after adequately preparing the host bone. Eighteen patients underwent single-level, 6 patients underwent 2-level, and 12 patients underwent 3-level treatment. The alterations in the physical architecture of spine and canal dimensions were evaluated before and after the placement of intrafacet joint spacers and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of pain, radiculopathy, and myelopathy. Analysis of radiological features suggested that the distraction of facets with the spacers resulted in an increase in the intervertebral foraminal dimension (mean 2.2 mm), an increase in the height of the intervertebral disc space (range 0.4-1.2 mm), and an increase in the interspinous distance (mean 2

  7. Role of percutaneous nephrostomy in advanced cervical carcinoma with obstructive uropathy: A case series

    Directory of Open Access Journals (Sweden)

    Kamlesh Mishra

    2009-01-01

    Full Text Available Aims and Objective: Over 70% of the cases present in advanced stages of the disease and are associated with poor prognosis and high mortality rates. In many of them, it is difficult to offer definitive treatment as they present in uremia due to associated obstructive uropathy. There are no clear-cut guidelines for performing percutaneous nephrostomy (PCN in patients of advanced cervical cancer. The results are unpredictable in terms of benefits achieved in these cases. Thus, we evaluated our experiences with PCN in the management of cervical cancer patients presenting with obstructive uropathy. Material and Methods: 15 patients of cervical cancer with obstructive uropathy and deranged renal functions were retrospectively evaluated for the role of PCN in their management Results: PCN was done in 15 patients of advanced cervical cancer. The mean age of patients was 44.5 years. Twelve (80% patients presented primarily with advanced cervical carcinoma and obstructive uropathy. Three (20% were already treated. Symptomatic improvement and significant fall of mean serum creatinine value from 7.5 mg% to 0.9 mg% over a period of 1-3 weeks was noted post PCN. Out of 12 patient with primary untreated advanced disease, curative treatment was possible in 3, palliative radiotherapy/chemo-therapy in 7 and only symptomatic treatment in 2 cases, after obstructive uropathy was managed with PCN insertion. Out of 3 already treated patients, 2 were disease free after curative radiotherapy/surgery. PCN was done to prevent permanent kidney damage in them. One patient was defaulter of curative radiotherapy. She had progressive residual disease. Complications like hemorrhage (20%, infection (26%, reinsertion for dislodgment/misplacement (53%, percutaneous leak or perinephric leak (20%, blockage of PCN (33% were noticed. Conclusion: In spite of inherent, albeit manageable complications, PCN is a simple and safe technique. One of the major benefits observed was

  8. Cervical spinal cord injuries in patients with cervical spondylosis.

    Science.gov (United States)

    Regenbogen, V S; Rogers, L F; Atlas, S W; Kim, K S

    1986-02-01

    Eighty-eight patients over age 40 with traumatic cervical spinal cord injuries were clinically and radiographically evaluated, and comparison was made with 35 spinal cord injury patients under age 36. While most older patients sustained obvious bony and/or ligamentous damage commensurate with their neurologic findings, 25 (28%) of the 88 patients had no demonstrable bony abnormalities and 17 (20%) of the 88 patients had only minimal evidence of bony injury. Of particular interest are the patients with severe cord injuries, yet no bony abnormalities, who seem to form a distinct subgroup of the cervical spinal cord injury patient on the basis of radiographic and clinical features. Of these 25 patients, 24 (96%) had severe cervical spondylosis. Fourteen (56%) of the 25 patients were injured in falls, five (36%) of these 14 being of a seemingly trivial nature. Of the 42 patients with minimal or no demonstrable bony abnormalities, 33 (79%) were evaluated with plain tomography and no occult fractures or other significant pathology was demonstrated. Pantopaque myelography in 27 (64%) of the 42 cases revealed no extruded disk or other surgical lesion in any patient. In large measure, these injuries can be attributed to cervical spondylosis, which narrows the canal and makes the cord more susceptible to compression by the bulging ligamenta flava during hyperextension.

  9. Comparison between anterior cervical discectomy with fusion by polyetheretherketone cages and tricortical iliac-crest graft for the treatment of cervical prolapsed intervertebral disc

    Directory of Open Access Journals (Sweden)

    Md. Anowarul Islam

    2016-10-01

    Full Text Available Anterior cervical discectomy and fusion is effective surgical modality in the treatment of cervical prolapsed intervertebral disc, radiculopathy and myelopathy. Aims of our study is to evaluate fusion of cervical spine  by ICG with plating and PEEK cage with bone graft, also assess the donor site morbidity. Thirty patients (male 16; female 14 with mean age 46 ± 9.2 years and were distributed  into two treatment groups (PEEK cage group and ICG group. We assess the patients clinically for myelopathy and functional outcome by Nurick scale and Odom's criteria respectively and  neck and arm pain by Visual Analogue Scale (VAS. Eighteen patients were operated for single level discectomy and fusion by either ICG or PEEK cages and twelve patients for two levels. After surgery follow up was 2 years and better  postoperative score which was assessed by Nurick scale, Odoms criteria and VAS score. Total patients 14(93%were graded excellent in the PEEK cage group compared to 13 patients (86% in the ICG group.  Statistically it was not significant between two groups and p value was <0.35. Difference was significant in VAS score  after 24 months with more reduction of pain in PEEK cage group. Fusion occurred in 13 patients (86% of the PEEK cage group and 14 patient (93% of the ICG group. Result showed more fusion rate in ICG group and less donor site morbidity in PEEK group.  

  10. Imaging of cervical spine injuries of childhood

    Energy Technology Data Exchange (ETDEWEB)

    Khanna, Geetika; El-Khoury, Georges Y. [University of Iowa Hospitals and Clinics, Department of Radiology, 3951 JPP, Iowa, IA (United States)

    2007-06-15

    Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children. (orig.)

  11. Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy.

    Science.gov (United States)

    Schnarr, J; Smaill, F

    2008-10-01

    Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy.

  12. Impaired work performance among women with symptomatic uterine fibroids.

    Science.gov (United States)

    Lerner, Debra; Mirza, Fadi G; Mirza, Fadi; Chang, Hong; Renzulli, Karen; Perch, Katherine; Chelmow, David

    2008-10-01

    To assess the work impact of symptomatic uterine fibroids (UFs). A cohort study compared 58 employed women with symptomatic UFs to 56 healthy controls. Data sources included a self-administered mail questionnaire and medical charts. At-work performance limitations and productivity loss were measured with the Work Limitations Questionnaire. Univariate and multivariate case-control group differences were tested. Based on adjusted mean scores, the UF group had significantly more at-work limitations and productivity loss than controls, while absence rates were similar. The UF group's performance was impaired 18% of the time on average versus 8% for controls (P-values, 0.005-0.040). At-work limitations were explained by depression symptoms, Non-White race/ethnicity, and poorer health-related quality of life. Fibroids and related symptoms impose a burden on the working lives' of women, their employers, and the economy.

  13. Multinuclide digital subtraction imaging in symptomatic prostnetic joints

    International Nuclear Information System (INIS)

    Chafetz, N.; Hattner, R.S.; Ruarke, W.C.; Helms, C.A.; Genant, H.K.; Murray, W.R.

    1985-01-01

    One hundred eleven patients with symptomatic prosthetic joints (86 hips, 23 knees, and two shoulders) were evaluated for prosthetic loosening and infection by combined technetium-99m-MDP/gallium-67 digital subtraction imaging. Clinical correlation was based on the assessment of loosening and bacterial cultures obtained at the time of surgery in 54 patients, joint aspiration cultures obtained in 37 patients, and long-term clinical follow-up for greater than 1.5 years in an additional 15 patients. Results revealed an 80-90% predictive value of a positive test for loosening, and a 95% predictive value of a negative test for infection. However, because of the low sensitivities and specificities observed, this approach to the evaluation of symptomatic prosthetic joints does not seem cost effective

  14. Should symptomatic menopausal women be offered hormone therapy?

    Science.gov (United States)

    Lobo, Rogerio A; Bélisle, Serge; Creasman, William T; Frankel, Nancy R; Goodman, Neil E; Hall, Janet E; Ivey, Susan Lee; Kingsberg, Sheryl; Langer, Robert; Lehman, Rebecca; McArthur, Donna Behler; Montgomery-Rice, Valerie; Notelovitz, Morris; Packin, Gary S; Rebar, Robert W; Rousseau, MaryEllen; Schenken, Robert S; Schneider, Diane L; Sherif, Katherine; Wysocki, Susan

    2006-01-01

    Many physicians remain uncertain about prescribing hormone therapy for symptomatic women at the onset of menopause. The American Society for Reproductive Medicine (ASRM) convened a multidisciplinary group of healthcare providers to discuss the efficacy and risks of hormone therapy for symptomatic women, and to determine whether it would be appropriate to treat women at the onset of menopause who were complaining of menopausal symptoms. Numerous controlled clinical trials consistently demonstrate that hormone therapy, administered via oral, transdermal, or vaginal routes, is the most effective treatment for vasomotor symptoms. Topical vaginal formulations of hormone therapy should be preferred when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy. Data from the Women's Health Initiative indicate that the overall attributable risk of invasive breast cancer in women receiving estrogen plus progestin was 8 more cases per 10,000 women-years. No increased risk for invasive breast cancer was detected for women who never used hormone therapy in the past or for those receiving estrogen only. Hormone therapy is not effective for the treatment of cardiovascular disease and that the risk of cardiovascular disease with hormone therapy is principally in older women who are considerably postmenopause. Healthy symptomatic women should be offered the option of hormone therapy for menopausal symptoms. Symptom relief with hormone therapy for many younger women (at the onset of menopause) with menopausal symptoms outweighs the risks and may provide an overall improvement in quality of life. Hormone therapy should be individualized for symptomatic women. This involves tailoring the regimen and dose to individual needs.

  15. Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

    OpenAIRE

    Ines Mack; Marie-Anne Burckhardt; Marie-Anne Burckhardt; Ulrich Heininger; Friederike Prüfer; Sven Schulzke; Sven Wellmann

    2017-01-01

    Cytomegalovirus (CMV) is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV) transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV) contribute to a much greater proportion of symptomatic cCMV than was previously thou...

  16. [Diagnosis and treatment of symptomatic hydronephrosis in pregnancy].

    Science.gov (United States)

    Simonsen, Jane Angel; Graumann, Ole; Toft, Anja; Henriques, Carsten Ulrik; Walter, Steen

    2015-09-14

    Hydronephrosis in pregnancy is common in the second and third trimester. Only a few cases are symptomatic, caused by a ureteric stone or by the pregnancy itself. The clinical dilemma is when to treat and when not to treat. We propose a multidisciplinary management based on renal ultrasonography to verify hydronephrosis and renography to diagnose obstructive hydronephrosis. Obstruction with a high intra-renal pressure must be treated to avoid kidney dysfunction. Patients with pyonephrosis need immediate treatment.

  17. Plaque Characteristics of Patients with Symptomatic Mild Carotid Artery Stenosis.

    Science.gov (United States)

    Takai, Hiroki; Uemura, Juniti; Yagita, Yoshiki; Ogawa, Yukari; Kinoshita, Keita; Hirai, Satoshi; Ishihara, Manabu; Hara, Keijirou; Toi, Hiroyuki; Matsubara, Shunji; Nishimura, Hirotake; Uno, Masaaki

    2018-03-20

    Carotid revascularization may be considered for severe stenosis, but its use for symptomatic mild stenosis (<50%) with vulnerable plaque or ulcer remains uncertain. The characteristics of patients with symptomatic mild stenosis who underwent revascularization are reviewed. The subjects of this study were 18 patients with symptomatic mild stenosis (<50%) on angiography from among 175 patients who underwent revascularization in our department. The plaques were evaluated by black-blood magnetic resonance imaging (BB-MRI) and ultrasonography (US) and classified into 2 types: type 1 (n = 15), a lesion with an ulcer or mobile plaque or thrombosis on angiography or US; and type 2 (n = 3), a lesion without any of the above. Fourteen patients underwent carotid endarterectomy (CEA), and 4 patients underwent carotid artery stenting. The stenosis on angiography was 27.2% ± 10.7 (5%-41%), and the area carotid artery stenosis rate on US was 69.8 ± 14.5% (44.5%-97%). The stenosis rate of these 2 methods was not at all correlated. In type 1 plaque that underwent CEA, 10 of 11 patients had vulnerable plaque by histopathology, and 1 patient had thrombus on the plaque by operative findings. In type 2 plaque that underwent CEA, all patients had vulnerable plaque by histopathology. During the follow-up period, none of the patients had restenosis or stroke. The findings of US and BB-MRI in patients with symptomatic mild stenosis (<50%) on angiography are important for determining treatment. If BB-MRI or US shows the findings of vulnerable plaque in mild stenosis, surgical treatment may be considered for these patients. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Quality Assurance Standards for Symptomatic Breast Disease Services

    OpenAIRE

    Department of Health (Ireland)

    2007-01-01

    Quality Assurance Standards for Symptomatic Breast Disease Services People in Ireland have a right to expect that medical care be of good quality. They expect that standards of care are consistently high. They expect that access to care is easy, speedy, effective and efficient. Society expects quality of care to measure up to international norms of good practice. Such assurance can be given by auditing the quality of activity. Click here to download PDF 606kb

  19. Symptomatic subserosal gastric lipoma successfully treated with enucleation

    OpenAIRE

    Krasniqi, Avdyl Selmon; Hoxha, Faton Tatil; Bicaj, Besnik Xhafer; Hashani, Shemsedin Isuf; Hasimja, Shpresa Mehmet; Kelmendi, Sadik Mal; Gashi-Luci, Lumturije Hasan

    2008-01-01

    Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptom...

  20. Cervical Vertigo: Historical Reviews and Advances.

    Science.gov (United States)

    Peng, Baogan

    2018-01-01

    Vertigo is one of the most common presentations in adult patients. Among the various causes of vertigo, so-called cervical vertigo is still a controversial entity. Cervical vertigo was first thought to be due to abnormal input from cervical sympathetic nerves based on the work of Barré and Liéou in 1928. Later studies found that cerebral blood flow is not influenced by sympathetic stimulation. Ryan and Cope in 1955 proposed that abnormal sensory information from the damaged joint receptors of upper cervical regions may be related to pathologies of vertigo of cervical origin. Further studies found that cervical vertigo seems to originate from diseased cervical intervertebral discs. Recent research found that the ingrowth of a large number of Ruffini corpuscles into diseased cervical discs may be related to vertigo of cervical origin. Abnormal neck proprioceptive input integrated from the signals of Ruffini corpuscles in diseased cervical discs and muscle spindles in tense neck muscles secondary to neck pain is transmitted to the central nervous system and leads to a sensory mismatch with vestibular and other sensory information, resulting in a subjective feeling of vertigo and unsteadiness. Further studies are needed to illustrate the complex pathophysiologic mechanisms of cervical vertigo and to better understand and manage this perplexing entity. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Cervical cancer: A global health crisis.

    Science.gov (United States)

    Small, William; Bacon, Monica A; Bajaj, Amishi; Chuang, Linus T; Fisher, Brandon J; Harkenrider, Matthew M; Jhingran, Anuja; Kitchener, Henry C; Mileshkin, Linda R; Viswanathan, Akila N; Gaffney, David K

    2017-07-01

    Cervical cancer is the fourth most common malignancy diagnosed in women worldwide. Nearly all cases of cervical cancer result from infection with the human papillomavirus, and the prevention of cervical cancer includes screening and vaccination. Primary treatment options for patients with cervical cancer may include surgery or a concurrent chemoradiotherapy regimen consisting of cisplatin-based chemotherapy with external beam radiotherapy and brachytherapy. Cervical cancer causes more than one quarter of a million deaths per year as a result of grossly deficient treatments in many developing countries. This warrants a concerted global effort to counter the shocking loss of life and suffering that largely goes unreported. This article provides a review of the biology, prevention, and treatment of cervical cancer, and discusses the global cervical cancer crisis and efforts to improve the prevention and treatment of the disease in underdeveloped countries. Cancer 2017;123:2404-12. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. The radiographic observation of the cervical strain

    International Nuclear Information System (INIS)

    Rhee, Chung Sik

    1972-01-01

    A total of 100 cases of cervical disorders were analysed of clinical signs and symptoms. The cervical strain is proved by the loss of normal lordotic curvature of the cervical spinal column on the lateral x-ray film in Ewha University Hospital from January, 1970 to december 1971 with the following results. 1. The 53 cervical strain was diagnosed in radiographic study for its abnormal locations. The hyperextension with abnormal curve is twice more after than hyperflection type. 2. The most frequent location of the cervical strain is demonstrated in the 4-6 th cervical spinal bodies (80%). 3. Most pronounced symptoms of cervical strain are local tenderness (40%), limitation of motion (17%) and radiating pain (15%). 4. The ratio of the sex incidence of male female was 3:2

  3. The radiographic observation of the cervical strain

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Chung Sik [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1972-12-15

    A total of 100 cases of cervical disorders were analysed of clinical signs and symptoms. The cervical strain is proved by the loss of normal lordotic curvature of the cervical spinal column on the lateral x-ray film in Ewha University Hospital from January, 1970 to december 1971 with the following results. 1. The 53 cervical strain was diagnosed in radiographic study for its abnormal locations. The hyperextension with abnormal curve is twice more after than hyperflection type. 2. The most frequent location of the cervical strain is demonstrated in the 4-6 th cervical spinal bodies (80%). 3. Most pronounced symptoms of cervical strain are local tenderness (40%), limitation of motion (17%) and radiating pain (15%). 4. The ratio of the sex incidence of male female was 3:2.

  4. Selective arterial embolization in the management of symptomatic renal angiomyolipomas

    Energy Technology Data Exchange (ETDEWEB)

    Mourikis, Dimitrios; Chatziioannou, Achilles; Antoniou, Aristidis; Kehagias, Dimitrios; Gikas, Dimitrios; Vlahos, Lambros

    1999-12-01

    Current management of renal angiomyolipomas (AMLs) include observation, transcatheter embolization and partial or total nephrectomy. Patients symptoms and size of the lesion are the determinants for the choice of the treatment. In general symptomatic or greater than 8 cm masses require intervention. A retrospective study of five patients presented with symptomatic lesions and treated with selective transcatheter embolization, over a 3 year period was performed in our hospital. A total of eight embolizations were performed, all on an emergency basis due to retroperitoneal bleeding or significant hematuria. Surgical intervention was necessary in one case, due to massive rebleeding on the fourth post-procedural day. Two patients rebled within 6 months and 2 years respectively, and were managed successfully with additional embolization. The remaining two patients are still asymptomatic 26 and 18 months after the successful initial result. Experience with this procedure is reported on with emphasis to the clinical outcome. It is believed that selective arterial embolization should be the standard initial therapy for symptomatic renal AMLs.

  5. Selective arterial embolization in the management of symptomatic renal angiomyolipomas

    International Nuclear Information System (INIS)

    Mourikis, Dimitrios; Chatziioannou, Achilles; Antoniou, Aristidis; Kehagias, Dimitrios; Gikas, Dimitrios; Vlahos, Lambros

    1999-01-01

    Current management of renal angiomyolipomas (AMLs) include observation, transcatheter embolization and partial or total nephrectomy. Patients symptoms and size of the lesion are the determinants for the choice of the treatment. In general symptomatic or greater than 8 cm masses require intervention. A retrospective study of five patients presented with symptomatic lesions and treated with selective transcatheter embolization, over a 3 year period was performed in our hospital. A total of eight embolizations were performed, all on an emergency basis due to retroperitoneal bleeding or significant hematuria. Surgical intervention was necessary in one case, due to massive rebleeding on the fourth post-procedural day. Two patients rebled within 6 months and 2 years respectively, and were managed successfully with additional embolization. The remaining two patients are still asymptomatic 26 and 18 months after the successful initial result. Experience with this procedure is reported on with emphasis to the clinical outcome. It is believed that selective arterial embolization should be the standard initial therapy for symptomatic renal AMLs

  6. Sonographically determined clues to the symptomatic or silent cholelithiasis

    International Nuclear Information System (INIS)

    Saba, S.; Iqbal, Z.

    2007-01-01

    To determine an association between sonographically determined contractility with the symptomatic or silent nature of gallstone. Adult gallstone patients without (group I) and with biliary symptoms (group II) were compared with age and gender-matched controls. Demographic data, body mass index, risk factors, size, number and mobility of gallstone, gallbladder wall thickness (GBWT), volume and Ejection Fraction (EF) were determined on ultrasound before and after a standardized fatty meal (BFM and AFM). Demographic data, risk factors and gallstone characteristics were analyzed by Pearson Chi-square test and the gallbladder characteristics were analyzed by One-way ANOVA and Post Hoc tests by multiple comparisons on SPSS 11 with significance p=0.05. The gallbladder contractility as measured by changes in wall thickness and volume changes BFM and AFM, and ejection fraction was similar in controls and asymptomatic cholelithiasis groups and significantly reduced in symptomatic patients (p<.001). Multiparity (p=0.002), female gender (p=0.018), age less than 50 years (0.05), impacted calculi (p=0.001), multiple calculi (<.001) and calculi 5 mm (p<0.001) were associated with pain. A sluggishly emptying gallbladder was more significantly associated with symptomatic cholelithiasis compared to controls and asymptomatic cholelithiasis state in this series. Consideration of age, gender, impaction of calculi, number and size of calculi is important in causing symptom state and management options. (author)

  7. Genetic and cytokine changes associated with symptomatic stages of CLL.

    Science.gov (United States)

    Agarwal, Amit; Cooke, Lawrence; Riley, Christopher; Qi, Wenqing; Mount, David; Mahadevan, Daruka

    2014-09-01

    The pathogenesis and drug resistance of symptomatic CLL patients involves genetic changes associated with the CLL clone as well as changes within the microenvironment. To further understand these processes, we compared early stage CLL to symptomatic late stage using gene expression and serum cytokine profiling to gain insight of the genetic and microenvironment changes associated with the most severe form of the disease. Patients were classified into low stage (Rai stage 0/I/II) and high stage (Rai stage III/IV). Gene expression profiles were obtained on pretreatment samples using the HG-U133A 2.0 Affymetrix platform. A comparison of low versus high stage CLL revealed a set of 21 genes differentially expressed genes. 15 genes were up regulated in the high stage compared to low stage while 6 genes were down regulated. Analysis of GO molecular function revealed 9 of 21 genes were involved in transcription factor activity. Serum cytokine profiles showed six cytokines to be significantly different in high stage patients. Two chemokines, SDF-1/CXCL12 and uPAR known to be involved in stem cell mobilization and homing were increased in serum of high stage patients. This study has identified therapeutic targets for symptomatic CLL patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. A neural network to predict symptomatic lung injury

    International Nuclear Information System (INIS)

    Munley, M.T.; Lo, J.Y.

    1999-01-01

    A nonlinear neural network that simultaneously uses pre-radiotherapy (RT) biological and physical data was developed to predict symptomatic lung injury. The input data were pre-RT pulmonary function, three-dimensional treatment plan doses and demographics. The output was a single value between 0 (asymptomatic) and 1 (symptomatic) to predict the likelihood that a particular patient would become symptomatic. The network was trained on data from 97 patients for 400 iterations with the goal to minimize the mean-squared error. Statistical analysis was performed on the resulting network to determine the model's accuracy. Results from the neural network were compared with those given by traditional linear discriminate analysis and the dose-volume histogram reduction (DVHR) scheme of Kutcher. Receiver-operator characteristic (ROC) analysis was performed on the resulting network which had Az=0.833±0.04. (Az is the area under the ROC curve.) Linear discriminate multivariate analysis yielded an Az=0.813±0.06. The DVHR method had Az=0.521±0.08. The network was also used to rank the significance of the input variables. Future studies will be conducted to improve network accuracy and to include functional imaging data. (author)

  9. Articulated dental cast analysis of asymptomatic and symptomatic populations

    Science.gov (United States)

    Cordray, Frank E

    2016-01-01

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

  10. Symptomatic isolated middle cerebral artery dissection: High resolution MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Byon, Jung Hee; Kwak, Hyo Sung; Chung, Gyung Ho; Hwang, Seung Bae [Dept. of Radiology, Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2015-11-15

    To perform high-resolution magnetic resonance imaging (HRMRI) and determine clinical features of patients with acute symptomatic middle cerebral artery (MCA) dissection. Thirteen patients with acute symptomatic MCA dissection underwent HRMRI within 3 days after initial clinical onset. They also underwent routine brain MR imaging. HRMRI examinations included time-of-flight MR angiography (MRA), T2-weighted, T1-weighted, proton-density-weighted, and three-dimensional magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequences. Conventional angiography and MRA were used as reference standard to establish the diagnosis of MCA dissection. The angiographic findings and HRMRI findings such as intimal flap, double lumen, and intramural hematoma were analyzed in this study. All patients presented cerebral ischemia (median National Institutes of Health Stroke Scale score = 4, range = 0-18). String sign was seen on MRA in seven patients. However, double lumen was seen in all patients on HRMRI by intimal flap. High signal lesion on MPRAGE sequences around the dissection lumen due to intramural hematoma was seen in three patients. HRMRI can be used to easily detect the wall structure of MCA such as the intimal flap and double lumen in patients with acute symptomatic MCA dissection. MPRAGE can detect hemorrhage in false lumen of MCA dissection.

  11. Factors that influence therapeutic outcomes in symptomatic gastroesophageal reflux disease.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-02-03

    The term "symptomatic gastroesophageal reflux disease" (GERD) refers to those patients who present with the typical GERD symptoms of heartburn and regurgitation, yet do not have endoscopic evidence of esophagitis. The primary goals of managing symptomatic GERD are to control symptoms and improve quality of life. A clinical assessment of the GERD patient can identify important clinical features, such as atypical and extraesophageal symptoms for which acid-suppressive agents tend to be less effective. Performing an endoscopy can further identify the patient as having nonerosive reflux disease, erosive esophagitis, or Barrett\\'s esophagus-diagnoses which can help determine treatment but may not prove predictive of therapeutic response. Determining acid exposure through pH testing can predict therapeutic response, with those revealing an abnormal acid exposure time being more responsive to acid-suppressive therapy. However, the performance of an endoscopy and pH testing on each patient is clearly not practical. Whereas the natural history of symptomatic GERD is still largely undefined, acid-suppressive therapy appears to be the best approach available for both the short-term and long-term management of this disease.

  12. Association of human herpesvirus 6 subtypes with symptomatic apical periodontitis.

    Science.gov (United States)

    Hernádi, Katinka; Csoma, Eszter; Adám, Balázs; Szalmás, Anita; Gyöngyösi, Eszter; Veress, György; Ildikó-Márton; Kónya, József

    2011-09-01

    The occurrence of human herpesvirus (HHV) 6 subtypes A and B in apical periodontitis was determined. The relationship of HHV-6 subtypes to other disease associated herpesviruses, i.e., Epstein-Barr virus (EBV) and human cytomegalovirus, was also investigated. Forty apical periodontitis samples (17 symptomatic and 23 asymptomatic) and 40 healthy pulp control samples were collected. Nested polymerase chain reaction was used to detect HHV-6 DNA. HHV-6 DNA was observed in significantly higher frequencies in apical periodontitis samples than in control samples (20% vs. 2.5%; P = .03). Further classification of apical lesions revealed that subtype B of HHV-6 was significantly associated with large-sized and symptomatic lesions (P apical lesions (77%) harbored ≥1 of the tested herpesviruses: EBV was the most frequent herpesvirus (72.5%) in apical periodontitis, followed by HHV-6 (20%). Our findings suggest that EBV and HHV-6B infections can be associated with symptomatic apical periodontitis. Copyright © 2011 Mosby, Inc. All rights reserved.

  13. Clinical-pathomorphological correlation in patients with symptomatic dystonias

    Directory of Open Access Journals (Sweden)

    Ivanović Nataša

    2002-01-01

    Full Text Available Symptomatic dystonia can be the result of various metabolic, degenerative diseases, the consumption of certain medications or exposure to toxic agents. However, only symptomatic dystonia with focal structural lesion provides a significant "window" for, at least indirect, perception of aetiopa-thogenesis and pathomorphological substratum of idiopathic dystonia. Our study included 57 patients with symptomatic dystonia, which as a base had focal or multifocal lesions, of whom 7 patients had generalized dystonia, 18 hemidystonia, 6 segmental dystonia, 7 torticollis, 6 blepharospasm, 7 hand dystonia, 3 spasmodic dysphonia, and 3 had oromandibular dystonia. Stroke was highly statistically the most frequent cause of structural lesions (33/57 or 58%. Relevant pathomorphological changes were present in 50/57 (88% patients, of whom 25 (50% had lesion in the lenticular nucleus (including individual damage of the putamen and globus pallidus, 12/50 (24% had damage of the thalamus and 6/50 (12% had damage of the brainstem. Generalized dystonia was most frequently associated with bilateral lesion of the putamen, hemidystonia with lesion of contralateral putamen, torticollis with damage of the caudate nucleus, hand dystonia with lesion of the thalamus and blepharospasm with lesion of the upper brainstem.

  14. Neovascularization in Vertebral Artery Atheroma-A Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Based Comparative Study in Patients with Symptomatic and Asymptomatic Carotid Artery Disease.

    Science.gov (United States)

    Usman, Ammara; Yuan, Jianmin; Patterson, Andrew J; Graves, Martin J; Varty, Kevin; Sadat, Umar; Gillard, Jonathan H

    2018-05-24

    Atherosclerosis is a systemic inflammatory disease intertwined with neovascularization. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables the assessment of plaque neovascularization. This study aimed to explore the systemic nature of atherosclerosis by assessing difference in severity of neovascularization as quantified by DCE-MRI of vertebral arteries (VAs) between patients with symptomatic and asymptomatic carotid artery disease. Ten consecutive patients with asymptomatic VA stenosis and concomitant symptomatic carotid artery disease (group 1) and 10 consecutive patients with asymptomatic VA stenosis and concomitant asymptomatic carotid artery disease (group 2) underwent 3-dimensional DCE-MRI of their cervical segment of VAs. A previously validated pharmacokinetic modeling approach was used for DCE-MRI analysis. K trans was calculated in the adventitia and plaque as a measure of neovessel permeability. Both patient groups were comparable for demographics and comorbidities. Mean luminal stenosis was comparable for both groups (54.4% versus 52.27%, P = .32). Group 1 had higher adventitial K trans and plaque K trans (.08 ± .01 min -1 , .07 ± .01 min -1 ) compared with Group 2 (.06 ± .01 min -1 , .06 ± .01 min -1 ) (P = .004 and .03, respectively). Good correlation was present among the two image analysts (intraclass correlation coefficient = .78). Vertebral Artery atheroma of patients with symptomatic carotid artery disease had increased neovessel permeability compared with the patients with asymptomatic carotid artery disease. These findings are consistent with the hypothesis that atherosclerosis is a systemic inflammatory disease. The VA atherosclerosis is likely to have increased severity of neovascularization if another arterial territory is symptomatic in the same patient cohort. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Thiazolidinediones abrogate cervical cancer growth

    Energy Technology Data Exchange (ETDEWEB)

    Wuertz, Beverly R., E-mail: knier003@umn.edu; Darrah, Lindsay, E-mail: ldarrah@obgynmn.com; Wudel, Justin, E-mail: drwudel@drwudel.com; Ondrey, Frank G., E-mail: ondre002@umn.edu

    2017-04-15

    Peroxisome proliferator-activated receptor gamma (PPAR γ) is activated by thiazolidinedione drugs (TZDs) and can promote anti-cancer properties. We used three TZDs (pioglitazone, rosiglitazone, and ciglitazone) to target cervical cancer cell lines and a nude mouse animal model. Each agent increased activation of PPAR γ, as judged by a luciferase reporter gene assay in three HPV-associated cell lines (CaSki, SiHa, and HeLa cells) while decreasing cellular proliferation in a dose-dependent manner. They also promoted Oil Red O accumulation in treated cell lines and upregulated the lipid differentiation marker adipsin. Interestingly, xenograft HeLa tumors in nude mice treated with 100 mg/kg/day pioglitazone exhibited decreased growth compared to control mice or mice treated with standard cervical chemotherapy. In conclusion, TZDs slow tumor cell growth in vitro and in vivo with decreases in cell proliferation and increases in PPAR γ and adipsin. These agents may be interesting treatments or treatment adjuncts for HPV-associated cancers or perhaps even precancerous conditions. - Highlights: • Thiazolidinediones decreases cervical cancer proliferation. • Pioglitazone increases cervical cancer differentiation. • Pioglitazone decreases tumor growth in mice. • Pioglitazone may be a useful treatment adjunct.

  16. Drugs Approved for Cervical Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for cervical cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  17. Tuberculosis of the cervical spine

    African Journals Online (AJOL)

    Tuberculosis of the cervical spine is rare, comprising 3 -. 5% of cases of tuberculosis of the spine. Eight patients with tuberculosis of the cervicaJ spine seen during 1989 -. 1992 were reviewed. They all presented with neck pain. The 4 children presented with a kyphotic deformity. In all the children the disease was extensive, ...

  18. Cervical spine motion: radiographic study

    International Nuclear Information System (INIS)

    Morgan, J.P.; Miyabayashi, T.; Choy, S.

    1986-01-01

    Knowledge of the acceptable range of motion of the cervical spine of the dog is used in the radiographic diagnosis of both developmental and degenerative diseases. A series of radiographs of mature Beagle dogs was used to identify motion within sagittal and transverse planes. Positioning of the dog's head and neck was standardized, using a restraining board, and mimicked those thought to be of value in diagnostic radiology. The range of motion was greatest between C2 and C5. Reports of severe disk degeneration in the cervical spine of the Beagle describe the most severely involved disks to be C4 through C7. Thus, a high range of motion between vertebral segments does not seem to be the cause for the severe degenerative disk disease. Dorsoventral slippage between vertebral segments was seen, but was not accurately measured. Wedging of disks was clearly identified. At the atlantoaxio-occipital region, there was a high degree of motion within the sagittal plane at the atlantoaxial and atlanto-occipital joints; the measurement can be a guideline in the radiographic diagnosis of instability due to developmental anomalies in this region. Lateral motion within the transverse plane was detected at the 2 joints; however, motion was minimal, and the measurements seemed to be less accurate because of rotation of the cervical spine. Height of the vertebral canal was consistently noted to be greater at the caudal orifice, giving some warning to the possibility of overdiagnosis in suspected instances of cervical spondylopathy

  19. Cervical Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  20. Spinal surgery - cervical - series (image)

    Science.gov (United States)

    ... problems include: pain that interferes with daily activities neck pain that extends (radiates) to the shoulder or arm ... done while the patient is deep asleep and pain-free (general anesthesia). For the neck (cervical spine), an incision may be made either in ...

  1. Myelopathy hand in cervical radiculopathy

    International Nuclear Information System (INIS)

    Hosono, Noboru; Mukai, Yoshihiro; Takenaka, Shota; Fuji, Takeshi; Sakaura, Hironobu; Miwa, Toshitada; Makino, Takahiro

    2010-01-01

    The so-called 'myelopathy hand', or characteristic finger paralysis, often recognized in cervical compression myelopathy, has been considered a unique manifestation of cervical myelopathy. We used our original grip and release test, a 15-second test in which finger motion is captured with a digital camera, to investigate whether cervical radiculopathy has the same characteristics as myelopathy hand. Thirty patients with pure radiculopathy, id est (i.e.), who had radiating arm pain and evidence of corresponding nerve root impingement on X-ray images or MRI scans, but did not have spinal cord compression, served as the subjects. In contrast to other radiculopathies, C7 radiculopathy was manifested by a significant reduction in the number of finger motion cycles on the affected side in comparison with the unaffected side, the same as in myelopathy hand. Uncoordinated finger motion was significantly more frequent on the affected side in C6 radiculopathy than on the unaffected side. These findings contradict the conventional notion that myelopathy hand is a unique manifestation of cervical myelopathy, but some radiculopathies manifested the same kinds of finger paralysis observed in myelopathy hand. (author)

  2. Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

    Directory of Open Access Journals (Sweden)

    Ines Mack

    2017-06-01

    Full Text Available Cytomegalovirus (CMV is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV contribute to a much greater proportion of symptomatic cCMV than was previously thought. Here, we describe a case of symptomatic cCMV infection in the newborn of a woman with proven immunity prior to pregnancy. Diagnosis was confirmed by CMV PCR from amniotic fluid and fetal MR imaging. The newborn presented with typical cCMV symptoms including jaundice, hepatosplenomegaly, cholestasis, petechiae, small head circumference, and sensorineural hearing loss, the most common neurologic sequela. CMV was detected in infant blood and urine by PCR, and intravenous ganciclovir was initiated and continued orally for 6 weeks totally. Apart from persisting right-sided deafness, the child exhibited normal neurological development up through the last follow-up at 4.5 years. To date, the most effective strategy to prevent vertical CMV transmission is hygiene counseling for women of childbearing age, which, in our case, and in concordance with recent literature, applies to seronegative, as well as seropositive, women. Once an expecting mother shows seroconversion or signs of an active CMV infection, there are no established procedures to reduce the risk of transmission, or therapeutic options for the fetus with signs of infection. After birth, symptomatic infants can be treated with ganciclovir to inhibit viral replication and improve hearing ability and neurodevelopmental outcome. A comprehensive review of the literature, including our case study, reveals the most current and significant diagnostic and treatment options available. In conclusion, the triad

  3. Value of preoperative cervical discography

    International Nuclear Information System (INIS)

    Kwon, Jong Won; Kim, Sung Hyun; Lee, Joon Woo

    2006-01-01

    The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test

  4. Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study.

    Science.gov (United States)

    Gokaslan, Ziya L; Bydon, Mohamad; De la Garza-Ramos, Rafael; Smith, Zachary A; Hsu, Wellington K; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Mroz, Thomas E; Fehlings, Michael; Arnold, Paul M; Riew, K Daniel

    2017-04-01

    Multicenter retrospective study. To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patients were included if they underwent cervical spine surgery (levels from C2 to C7) between January 1, 2005 and December 31, 2011. Data were analyzed with regard to complication treatment and outcome. Cases were compared to a control group from the AOSpine CSM and CSM-I studies. Three centers reported 19 cases of RLNP from a cohort of 1345 patients. The reported incidence of RLNP ranged from 0.6% to 2.9% between these 3 centers. Fifteen patients (79%) in the RLNP group were approached from the left side. Ten patients (52.6%) required treatment for RLNP-6 required medical therapy (steroids), 1 interventional treatment (injection laryngoplasty), and 3 conservative therapy (speech therapy). When examining outcomes, 73.7% (14/19) of cases resolved completely, 15.8% (3/19) resolved with residual effects, and in 10.5% (2/19) of cases this could not be determined. In this multicenter study examining rare complications following cervical spine surgery, the risk of RLNP after cervical spine surgery ranged from 0.6% to 2.9% between centers. Though rare, it was found that 16% of patients may experience partial resolution with residual effects, and 74% resolve completely.

  5. Hemivertebra of the cervical spine: an uncommon background for neck pain, cervical scoliosis, and torticollis.

    Science.gov (United States)

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Nastoulis, Evangelos; Stavrev, Vladimir

    2017-10-01

    A 15-year-old female patient presented with neck pain accompanied by cervical scoliosis, on the existence of torticollis. Although rare, hemivertebra of the cervical spine is a congenital deformation associated with these three clinical features.

  6. Thyroid storm following anterior cervical spine surgery for tuberculosis of cervical spine

    Directory of Open Access Journals (Sweden)

    Sanjiv Huzurbazar

    2014-01-01

    Full Text Available Objective: The primary objective was to report this rare case and discuss the probable mechanism of thyroid storm following anterior cervical spine surgery for Kochs cervical spine.

  7. Perinatal Outcomes with Tamsulosin Therapy for Symptomatic Urolithiasis.

    Science.gov (United States)

    Bailey, George; Vaughan, Lisa; Rose, Carl; Krambeck, Amy

    2016-01-01

    Medical expulsive therapy represents an effective adjunctive treatment for nonpregnant patients with symptomatic urolithiasis. Tamsulosin is classified by the FDA (Food and Drug Administration) as a category B medication. However, to our knowledge no published data exist for human pregnancy. We explored the safety and efficacy of tamsulosin therapy for symptomatic urolithiasis occurring during pregnancy. We retrospectively identified patients treated with tamsulosin for stone disease during pregnancy at the Mayo Clinic during 2000 to 2014. This medical expulsive therapy cohort was matched 2:1 to pregnant women with symptomatic urolithiasis during pregnancy who did not receive medical expulsive therapy. Groups were compared using linear mixed models for continuous variables and exact conditional logistic regression models for nominal variables to take into account correlation due to matching. A total of 27 patients receiving medical expulsive therapy comprised the study cohort. Median duration of antepartum tamsulosin exposure was 3 days (range 1 to 110), occurring during the first, second and third trimester in 3 (11%), 11 (40.7%) and 18 (67%) patients, respectively. Mean gestational age at delivery was 38.1 weeks (SD 2.4) and 6 (22%) infants were born preterm. All infant birthweights were considered appropriate for gestational age, and no cases of spontaneous abortion, intrauterine demise or neonatal congenital anomalies were encountered. Comparison between the medical expulsive therapy and control groups demonstrated no significant differences in maternal or infant outcomes for any of the examined variables. Tamsulosin medical expulsive therapy does not appear to be associated with adverse maternal or fetal outcomes and may be considered as adjunctive therapy for urolithiasis during pregnancy. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Symptomatic unilateral vocal fold paralysis following cardiothoracic surgery.

    Science.gov (United States)

    Puccinelli, Cassandra; Modzeski, Mara C; Orbelo, Diana; Ekbom, Dale C

    Unilateral vocal fold paralysis (UVFP) is a complication associated with cardiothoracic procedures that presents clinically as dysphonia and/or dysphagia with or without aspiration. The literature lacks both data on recovery of mobility and consensus on best management. Herein, our goals are to 1) Identify cardiothoracic procedures associated with symptomatic UVFP at our institution; 2) Review timing and nature of laryngology diagnosis and management; 3) Report spontaneous recovery rate of vocal fold mobility. Retrospective case series at single tertiary referral center between 2002 and 2015. 141 patients were included who underwent laryngology interventions (micronized acellular dermis injection laryngoplasty and/or type 1 thyroplasty) to treat symptomatic UVFP diagnosed subsequent to cardiothoracic surgery. Pulmonary procedures were most often associated with UVFP (n=50/141; 35.5%). 87.2% had left-sided paralysis (n=123/141). Median time to diagnosis was 42days (x¯=114±348). Over time, UVFP was diagnosed progressively earlier after cardiothoracic surgery. 63.4% of patients (n=95/141) underwent injection laryngoplasty as their initial intervention with median time from diagnosis to injection of 11days (x¯=29.6±54). 41.1% (n=58/141) ultimately underwent type 1 thyroplasty at a median of 232.5days (x¯=367±510.2) after cardiothoracic surgery. 10.2% (n=9/88) of those with adequate follow-up recovered full vocal fold mobility. Many cardiothoracic procedures are associated with symptomatic UVFP, predominantly left-sided. Our data showed poor recovery of vocal fold mobility relative to other studies. Early diagnosis and potential surgical medialization is important in the care of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Predictors of acute symptomatic seizures after intracranial hemorrhage in infants.

    Science.gov (United States)

    Bansal, Seema; Kebede, Tewodros; Dean, Nathan P; Carpenter, Jessica L

    2014-10-01

    To determine the prevalence of acute symptomatic seizures in infants with supratentorial intracranial hemorrhage, to identify potential risk factors, and to determine the effect of acute seizures on long-term morbidity and mortality. Children less than 24 months with intracranial hemorrhage were identified from a neurocritical care database. All patients who received seizure prophylaxis beginning at admission were included in the study. Risk factors studied were gender, etiology, location of hemorrhage, seizure(s) on presentation, and the presence of parenchymal injury. Acute clinical and electrographic seizures were identified from hospital medical records. Subsequent development of late seizures was determined based on clinical information from patients' latest follow-up. Patients with idiopathic neonatal intracranial hemorrhage, premature infants, and those with prior history of seizures were excluded from analysis. Seventy-two infants met inclusion criteria. None. Forty percent of infants had acute symptomatic seizures. The prevalence was similar regardless of whether etiology of hemorrhage was traumatic or nontraumatic. Seizures on presentation and parenchymal injury were independent risk factors of acute seizures (p = 0.001 and p = 0.006, respectively). Younger children and women were also at higher risk (p Acute seizures were not predictive of mortality, but nearly twice as many patients with acute seizures developed late seizures when compared with those without. Electrographic seizures and parenchymal injury were also predictive of development of late seizures (p hemorrhage are at high risk for acute symptomatic seizures. This is regardless of the etiology of hemorrhage. Younger patients, women, patients with parenchymal injury, and patients presenting with seizure are most likely to develop acute seizures. Although the benefits of seizure prophylaxis have not been studied in this specific population, these results suggest that it is an important component

  10. Symptomatic portal vein occlusion: treated by interventional radiological techniques

    International Nuclear Information System (INIS)

    Wang Maoqiang; Gu Xiaofang; Guan Jun; Wang Zhongpu; Liu Fengyong; Wang Zhiqiang

    2004-01-01

    Objective: To evaluate the efficacy and safety of the interventional radiological techniques for management of symptomatic portal vein (PV) occlusion. Methods: Nine patients with PV trunk occlusion were treated using interventional procedures. Four patients presented with abdominal pain, distention, and malabsorption; five presented with portal hypertension and repeated bleeding from esophagogastric varices. The etiologic factors were identified in all 9 patients, including post-transplantation of the liver in 2, hepatocellular carcinoma (HCC) associated with PV tumor thrombus in 3, post abdominal operative state in 1, and PV thrombosis in 3 cases. The portal access was established via a percutaneous transhepatic route in 4, and via a transjugular intrahepatic portosystemic shunt ( TIPS) approach in 5 patients. The interventional procedures included stent placement in 4, balloon angioplasty in 6, and catheter directed pharmacologic and mechanical thrombolysis in 7 patients. Results: The technical success was achieved in all cases. No complications related to the procedure occurred. Portal flow was reestablished in all patients after the procedures. Clinical improvement was seen in 3 patients with symptomatic PV thrombosis, characterized by progressive reduction of abdominal pain, distention, and diarrhea. Follow-up time ranged from 4 to 36 months. One patient with HCC died of multiple organs metastases at 11 months after the treatment . One patient died of intraabdominal sepsis and multiple organs failure 12 days after the procedure even though the antegrade flow was re-established in the main trunk of the PV. Patency of the PV trunk was confirmed by follow-up color Doppler ultrasound scan in the rest 7 patients, without recurrence of variceal bleeding or PV thrombus. Conclusions: Interventional minimally invasive procedures, including balloon angioplasty, stent placement, catheter directed local pharmacologic and mechanical thrombolysis, are safe and effective in

  11. Radiation response of the rat cervical spinal cord after irradiation at different ages: Tolerance, latency and pathology

    International Nuclear Information System (INIS)

    Ruifrok, A.C.C.; Van Der Kogel, A.J.; Stephens, L.C.

    1994-01-01

    Investigation of the age dependent single-dose radiation tolerance, latency to radiation myelopathy, and the histopathological changes after irradiation of the rat cervical spinal cord is presented. Rats were irradiated with graded single doses of 4 MV photons to the cervical spinal cord. When the rats showed definite signs of paresis of the forelegs, they were killed and processed for histological examination. The radiation dose resulting in paresis due to white matter damage in 50% of the animals (ED 50 ) after single dose irradiation was about 21.5 Gy at all ages ≥ 2 weeks. Only the Ed 50 at 1 week was significantly lower. The latency to the development of paresis clearly changed with the age at irradiation, from about 2 weeks after irradiation at 1 week to 6-8 months after irradiation at age ≥ 8 weeks. The white matter damage was similar in all symptomatic animals studied. The most prominent were areas with diffuse demyelination and swollen axons, often with focal necrosis, accompanied by glial reaction. This was observed in all symptomatic animals, irrespective of the age at irradiation. Expression of vascular damage appeared to depend on the age at irradiation. Although the latency to myelopathy is clearly age dependent, single dose tolerance is not age dependent at age ≥ 2 weeks in the rat cervical spinal cord. The white matter damage is similar in all symptomatic animals studied, but the vasculopathies appear to be influenced by the age at irradiation. It is concluded that white matter damage and vascular damage are separate phenomena contributing to the development of radiation myelopathy, expression of which may depend on the radiation dose applied and the age at irradiation. 28 refs., 5 figs., 3 tabs

  12. Cervical spondylosis anatomy: pathophysiology and biomechanics.

    Science.gov (United States)

    Shedid, Daniel; Benzel, Edward C

    2007-01-01

    Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.

  13. Cervical disc arthroplasty: Pros and cons.

    Science.gov (United States)

    Moatz, Bradley; Tortolani, P Justin

    2012-01-01

    Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing.

  14. The Vaccine and Cervical Cancer Screen project 2 (VACCS 2 ...

    African Journals Online (AJOL)

    The Vaccine and Cervical Cancer Screen project 2 (VACCS 2): Linking cervical cancer screening to a two-dose HPV vaccination ... In VACCS 1 the feasibility of linking cervical cancer with HPV vaccination was demonstrated. ... Article Metrics.

  15. Cervical spondylosis and hypertension: a clinical study of 2 cases.

    Science.gov (United States)

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-03-01

    Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis.

  16. Screening for Cervical Cancer: Experience from a University ...

    African Journals Online (AJOL)

    KEY WORDS: Cervical cancer, cervical cytology, north-west Nigeria. Access this article .... involving a larger sample size will give better picture about the prevalent of ... Ridsdale LL. Cervical screening in general practice: Call and recall. J R.

  17. A Study on Knowledge and Screening for Cervical Cancer among ...

    African Journals Online (AJOL)

    A Study on Knowledge and Screening for Cervical Cancer among Women in ... and source of information for awareness of women about cervical cancer in India. ... Results: Majority of the women have poor knowledge about cervical cancer ...

  18. Case report of a symptomatic giant renal oncocytoma.

    LENUS (Irish Health Repository)

    Ahmad, Sarfraz

    2011-01-01

    Renal oncocytomas are benign tumours, often asymptomatic, and picked incidentally on radiological imaging. We present a case report of a symptomatic giant renal oncocytoma in a 61-year old man having lower back\\/right flank pain. A large right renal mass was identified on abdominal CT scan. Radiological features were not sufficient to differentiate this lesion from renal cancer. Right radical nephrectomy was performed. Typical features of oncocytoma, without evidence of malignancy, were seen on histological examination of the specimen. In this report, we discuss literature review of radiological, genetic, and pathological characteristics of renal oncocytoma.

  19. Symptomatic endometriosis of the colon - a case report

    International Nuclear Information System (INIS)

    Leutloff, U.C.; Roeren, T.; Feldmann, K.; Sillem, M.; Rabe, T.; Kauffmann, G.

    1996-01-01

    The intestinal endometriosis in need of treatment is a rare case in the surgical department. Preoperative diagnosis is very difficult and in any case must be based on histologic findings; endoscopy-guided biopsy very frequently yields negative results. Dual-contrast scanning of the colon still is a major examination method, but the findings make it difficult to rule out malignomas. Cyclic, recurrent abdominal complaints reported in the case history strongly indicate the possibility of endometriosis. Typing can be done in general only after surgery. The article reports the clinical and diagnostic parameters of a symptomatic endometriosis of the colon. (orig.) [de

  20. Symptomatic Control in End-of-Life Patients

    Directory of Open Access Journals (Sweden)

    Mariana Alves

    2017-01-01

    Full Text Available End-of-life patients present a variety of symptoms that cause suffering for them and their respective families. Health professionals throughout their university, internship and medical careers are ill-prepared to manage and improve the quality of life of these patients. This article aims to provide basic skills in the symptomatic management of end-of-life patients, focusing in particular on the control of pain, dyspnoea, fatigue, nausea, vomiting and anorexia. It also aims to draw attention to basic concepts of control concerning refractory symptoms and palliative sedation.

  1. Symptomatic Overlap and Therapeutic Opportunities in Primary Headache.

    Science.gov (United States)

    Cady, Roger; Garas, Sandy Yacoub; Patel, Ketu; Peterson, Andrew; Wenzel, Richard

    2015-08-01

    Headache, a nearly universal experience, remains costly, disabling, and often suboptimally managed. The most common presentations in the United States are migraine, tension-type headache (TTH) and "sinus" headache, but their extensive symptomatic overlap suggests that these conditions can be approached as variations in the same underlying pathology and managed accordingly. We use case studies of patients with varying prior diagnoses (none, migraine, TTH, and sinus headache), as well as a 4-question diagnostic screening tool, to illustrate how pharmacists can use this conceptual framework to simplify identification, management, and referral of patients with primary headache conditions of uncertain etiology. © The Author(s) 2014.

  2. Pathogenesis and symptomatics of the acute radiation syndrome

    International Nuclear Information System (INIS)

    Fliedner, T.M.; Haen, M.; Carbonell, F.

    1980-01-01

    The pathogenesis and symptomatics of the acute radiation syndrome are discussed. Diagnosis and therapy would be impossible without detailed knowledge in these fields. The concept of acute radiation syndrome is explained, and a pathophysiological analysis of the various forms of radiation syndrome - haematological, intestinal and affecting the central nervous system is attempted. The developments in the diagnosis and therapy of acute radiation syndrome since its first description - 35 years ago - are reviewed. Today, whole-body doses of 100 rd and more can be treated by radiotherapy. (orig./MG) [de

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

    OpenAIRE

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

    2009-01-01

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

  4. Ipilimumab in Treating Patients With Metastatic or Recurrent Human Papilloma Virus-Related Cervical Cancer

    Science.gov (United States)

    2018-05-23

    Cervical Adenocarcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Human Papillomavirus Infection; Recurrent Cervical Carcinoma; Stage IVA Cervical Cancer AJCC v6 and v7; Stage IVB Cervical Cancer AJCC v6 and v7

  5. Isolated Echinococcosis of cervical region

    Directory of Open Access Journals (Sweden)

    Pratima Khare

    2014-01-01

    Full Text Available Echinococcosis, commonly called as hydatid disease, is a parasitic infestation caused by the larva of the genus Echinococcus in human. Isolated occurrence of Echinococcosis without any evidence of visceral disease is very rare. A thorough search of the literature revealed only 11 cases of isolated cervical Echinococcosis. We report here a very rare case of isolated hydatid cyst in a 45-year-old female patient, who presented with swelling in right cervical region about 5 cm below the angle of mandible with no evidence of the disease elsewhere in the body. The case was diagnosed on fine needle aspiration cytology. The diagnosis was further supported by histopathology. We propose that the treating physician should also consider the differential diagnosis of Echinococcosis in the presence of an asymptomatic soft tissue mass, especially when the patient lives in an endemic area.

  6. Cervical myelopathy: magnetic imaging findings

    International Nuclear Information System (INIS)

    Kholin, A.V.; Makarov, A.Yu.; Gurevich, D.V.

    1996-01-01

    69 patients with clinical signs of cervical myelopathy were examined using magnetic imaging (T1- and T2-suspended tomograms of the sagittal and transverse section using a device with 0.04 T field intensity). Vertebral disk hernias were revealed in 35 patients, compression of the spinal cord with metastases into vertebral body in 2, extramedullary tumor in 11, intramedullary tumor in 9, and syringomyelia in 12 patients. T2-suspended tomograms proved to be more informative due to their higher sensitivity to aqueous content. T1-suspended tomograms help assess the degree of spinal cord compression and the direction of the disk protrusion. Magnetic imaging is an informative method used for objective identification of the cases of myelopathy of cervical localization [ru

  7. Molecular imaging in cervical cancer

    International Nuclear Information System (INIS)

    KHAN, Sairah R.; ROCKALL, Andrea G.; BARWICK, Tara D.

    2016-01-01

    Despite the development of screening and of a vaccine, cervix cancer is a major cause of cancer death in young women worldwide. A third of women treated for the disease will recur, almost inevitably leading to death. Functional imaging has the potential to stratify patients at higher risk of poor response or relapse by improved delineation of disease extent and tumor characteristics. A number of molecular imaging biomarkers have been shown to predict outcome at baseline and/or early during therapy in cervical cancer. In future this could help tailor the treatment plan which could include selection of patients for close follow up, adjuvant therapy or trial entry for novel agents or adaptive clinical trials. The use of molecular imaging techniques, FDG PET/CT and functional MRI, in staging and response assessment of cervical cancer is reviewed.

  8. Preventive vaccines for cervical cancer

    Directory of Open Access Journals (Sweden)

    WHEELER COSETTE M

    1997-01-01

    Full Text Available The potential use of vaccines for the human papillomavirus (HPV in the prevention and treatment of cervical cancer is a possibility in the near future. Close to 20 genotypes of HPV, of the 75 that have been identified, infect the femine genital tract, but four subtypes (16, 18, 31 and 45 have been associated in close to 80% of cervical cancers. this article proposes that in order to design an effective prophylactic vaccine against HPV infection, an adequate immune response should be guaranteed through four goals; a activation of antigens present in the cell; b overcoming the host response and viral genetic variability in the T cell response; c generation of high levels of T and B memory cells; and d persistence of antigens.

  9. Prospective, randomized multicenter study of cervical arthroplasty versus anterior cervical discectomy and fusion: 5-year results with a metal-on-metal artificial disc.

    Science.gov (United States)

    Coric, Domagoj; Guyer, Richard D; Nunley, Pierce D; Musante, David; Carmody, Cameron; Gordon, Charles; Lauryssen, Carl; Boltes, Margaret O; Ohnmeiss, Donna D

    2018-03-01

    OBJECTIVE Seven cervical total disc replacement (TDR) devices have received FDA approval since 2006. These devices represent a heterogeneous assortment of implants made from various biomaterials with different biomechanical properties. The majority of these devices are composed of metallic endplates with a polymer core. In this prospective, randomized multicenter study, the authors evaluate the safety and efficacy of a metal-on-metal (MoM) TDR (Kineflex|C) versus anterior cervical discectomy and fusion (ACDF) in the treatment of single-level spondylosis with radiculopathy through a long-term (5-year) follow-up. METHODS An FDA-regulated investigational device exemption (IDE) pivotal trial was conducted at 21 centers across the United States. Standard validated outcome measures including the Neck Disability Index (NDI) and visual analog scale (VAS) for assessing pain were used. Patients were randomized to undergo TDR using the Kineflex|C cervical artificial disc or anterior cervical fusion using structural allograft and an anterior plate. Patients were evaluated preoperatively and at 6 weeks and 3, 6, 12, 24, 36, 48, and 60 months after surgery. Serum ion analysis was performed on a subset of patients randomized to receive the MoM TDR. RESULTS A total of 269 patients were enrolled and randomly assigned to undergo either TDR (136 patients) or ACDF (133 patients). There were no significant differences between the TDR and ACDF groups in terms of operative time, blood loss, or length of hospital stay. In both groups, the mean NDI scores improved significantly by 6 weeks after surgery and remained significantly improved throughout the 60-month follow-up (both p < 0.01). Similarly, VAS pain scores improved significantly by 6 weeks and remained significantly improved through the 60-month follow-up (both p < 0.01). There were no significant changes in outcomes between the 24- and 60-month follow-ups in either group. Range of motion in the TDR group decreased at 3 months but

  10. Paediatric cervical spine injury but NEXUS negative

    OpenAIRE

    Maxwell, Melanie J; Jardine, Andrew D

    2007-01-01

    Cervical spine injuries in paediatric patients following trauma are extremely rare. The National Emergency X‐Radiography Utilization Study (NEXUS) guidelines are a set of clinical criteria used to guide physicians in identifying trauma patients requiring cervical spine imaging. It is validated for use in children. A case of a child who did not fulfil the NEXUS criteria for imaging but was found to have a cervical spine fracture is reported.

  11. Detecting cervical cancer by quantitative promoter hypermethylation assay on cervical scrapings : A feasibility study

    NARCIS (Netherlands)

    Reesink-Peters, N; Wisman, G.B.A.; Jeronimo, C; Tokumaru, CY; Cohen, Y; Dong, SM; Klip, HG; Buikema, HJ; Suurmeijer, AJH; Hollema, H; Boezen, HM; Sidransky, D; van der Zee, AGJ

    Current morphology-based cervical cancer screening is associated with significant false-positive and false-negative results. Tumor suppressor gene hypermethylation is frequently present in cervical cancer. It is unknown whether a cervical scraping reflects the methylation status of the underlying

  12. Misplaced Cervical Screws Requiring Reoperation.

    Science.gov (United States)

    Peterson, Jeremy C; Arnold, Paul M; Smith, Zachary A; Hsu, Wellington K; Fehlings, Michael G; Hart, Robert A; Hilibrand, Alan S; Nassr, Ahmad; Rahman, Ra'Kerry K; Tannoury, Chadi A; Tannoury, Tony; Mroz, Thomas E; Currier, Bradford L; De Giacomo, Anthony F; Fogelson, Jeremy L; Jobse, Bruce C; Massicotte, Eric M; Riew, K Daniel

    2017-04-01

    A multicenter, retrospective case series. In the past several years, screw fixation of the cervical spine has become commonplace. For the most part, this is a safe, low-risk procedure. While rare, screw backout or misplaced screws can lead to morbidity and increased costs. We report our experiences with this uncommon complication. A multicenter, retrospective case series was undertaken at 23 institutions in the United States. Patients were included who underwent cervical spine surgery from January 1, 2005, to December 31, 2011, and had misplacement of screws requiring reoperation. Institutional review board approval was obtained at all participating institutions, and detailed records were sent to a central data center. A total of 12 903 patients met the inclusion criteria and were analyzed. There were 11 instances of screw backout requiring reoperation, for an incidence of 0.085%. There were 7 posterior procedures. Importantly, there were no changes in the health-related quality-of-life metrics due to this complication. There were no new neurologic deficits; a patient most often presented with pain, and misplacement was diagnosed on plain X-ray or computed tomography scan. The most common location for screw backout was C6 (36%). This study represents the largest series to tabulate the incidence of misplacement of screws following cervical spine surgery, which led to revision procedures. The data suggest this is a rare event, despite the widespread use of cervical fixation. Patients suffering this complication can require revision, but do not usually suffer neurologic sequelae. These patients have increased cost of care. Meticulous technique and thorough knowledge of the relevant anatomy are the best means of preventing this complication.

  13. Os Odontoideum: Rare Cervical Lesion

    Directory of Open Access Journals (Sweden)

    Kristie A Robson

    2011-05-01

    Full Text Available We report the case of a 22-year-old Marine who presented to the emergency department, after a martial arts exercise, with transient weakness and numbness in all extremities. Computed tomography cervical spine radiographs revealed os odontoideum. Lateral flexion–extension radiographs identified atlanto-axillary instability. This abnormality is rare and can be career ending for military members who do not undergo surgical fusion. [West J Emerg Med. 2011;12(4:520–522.

  14. Methods for Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Tatiana Vargas-Revilla

    2014-12-01

    This article is divided in three sections: the first one focuses on the general impact of cervical cancer has hadin CostaRica, these condsection gathers information about different methodologies used around the world to detect this cancer and the third one makes reference to the current development of the screening devise in Mexico that works as a monitoring system and can used by women without external assistance.

  15. A retrospective review comparing two-year patient-reported outcomes, costs, and healthcare resource utilization for TLIF vs. PLF for single-level degenerative spondylolisthesis.

    Science.gov (United States)

    Kim, Elliott; Chotai, Silky; Stonko, David; Wick, Joseph; Sielatycki, Alex; Devin, Clinton J

    2018-03-01

    The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. Patients undergoing TLIF or PLF for single-level spondylolisthesis were included for retrospective analysis. EQ-5D, ODI, SF-12 MCS/PCS, NRS-BP/LP scores were collected at baseline and 24 months after surgery. 90-day post-operative complications, revision surgery rates, and satisfaction scores were also collected. Two-year resource use was multiplied by unit costs based on Medicare payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost was used to assess mean total 2-year cost per QALYs gained after surgery. 62 and 37 patients underwent TLIF and PLF, respectively. Patients in the PLF group were older (p differences were seen in baseline or 24-month PROs between the two groups. There was a significant improvement in all PROs from baseline to 24 months after surgery (p difference in 24-month direct, indirect, and total cost. Overall costs and health care utilization were similar in both the groups. Both TLIF and PLF for single-level degenerative spondylolisthesis provide improvement in disability, pain, quality of life, and general health.

  16. CT-guided percutaneous vertebroplasty for the treatment of metastases in the cervical spine

    International Nuclear Information System (INIS)

    Wang Jianhua; Wang Zhentang; Zuo Changjing; Shao Chenwei; Chen Wei; Lv Taozhen; Dong Aisheng

    2009-01-01

    . (2) CT-guided percutaneous vertebroplasty is very helpful in the management of inoperable patients with symptomatic metastases of cervical spine. The procedure can effectively relieve the pain, stabilize the cervical spine and slow down the deterioration of the patient's condition. (authors)

  17. THE CERVICAL CANCER SCREENING - UNSOLVED PROBLEMS

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available The problem of cervical cancer (CC for many decades continues to be the center of attention leading foreign and domestic oncologists. Malignant cervical tumors occupy the leading position among malignant neoplasms of reproductive system in women, second only to breast cancer, despite having far more effective screening compared with this disease. On predictive expert estimates (taking into account population growth and the expected increase in life expectancy by 2020 in developing countries, the rising incidence and prevalence of cervical cancer is 40%, while in developed countries - 11%. If we do not perform timely interventions for prevention and treatment of cervical cancer, after 2050 cervical cancer every year in the world will become sick 1 million women. In the last decade inRussiathere has been a gradual increase in the incidence of cervical cancer: average annual growth rate of 2.21%, General 25,18%. Cervical cancer is one of nosological forms that meet all the requirements of population-based screening. The current Russian normative documents do not give clear answers to questions concerning the age of onset of cervical cancer screening and the time interval between tests, no clear program organized cytological screening of cervical cancer.

  18. Nanotechnology in the management of cervical cancer.

    Science.gov (United States)

    Chen, Jiezhong; Gu, Wenyi; Yang, Lei; Chen, Chen; Shao, Renfu; Xu, Kewei; Xu, Zhi Ping

    2015-03-01

    Cervical cancer is a major disease with high mortality. All cervical cancers are caused by infection with human papillomaviruses (HPV). Although preventive vaccines for cervical cancer are successful, treatment of cervical cancer is far less satisfactory because of multidrug resistance and side effects. In this review, we summarize the recent application of nanotechnology to the diagnosis and treatment of cervical cancer as well as the development of HPV vaccines. Early detection of cervical cancer enables tumours to be efficiently removed by surgical procedures, leading to increased survival rate. The current method of detecting cervical cancer by Pap smear can only achieve 50% sensitivity, whereas nanotechnology has been used to detect HPVs with greatly improved sensitivity. In cervical cancer treatment, nanotechnology has been used for the delivery of anticancer drugs to increase treatment efficacy and decrease side effects. Nanodelivery of HPV preventive and therapeutic vaccines has also been investigated to increase vaccine efficacy. Overall, these developments suggest that nanoparticle-based vaccine may become the most effective way to prevent and treat cervical cancer, assisted or combined with some other nanotechnology-based therapy. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Modified Laminoplasty for Degenerative Cervical Spondylosis: The ...

    African Journals Online (AJOL)

    2018-04-19

    Apr 19, 2018 ... simple procedure that preserves spine stability and minimizes postoperative spinal deformity. KEYWORDS: Cervical spondylosis, laminoplasty, ligamentous suspension .... the risk of iatrogenic neurological injuries associated.

  20. EXAMINATION RESULTS OF CHILDREN WITH CERVICAL SYNDROME

    Directory of Open Access Journals (Sweden)

    N. H. Bakhteeva

    2010-01-01

    Full Text Available By the example of examination of 80 children aged from 4 to 18 with cervical syndrome it is indicated, that the diagnosed abnormalities of hemodynamics in vertebrobasilar basin in patients of all age groups are connected both with bone and vascular pathology of the cervical part of the spine. The pathology has functional or congenital character. Early detection of discicirculatory vascular injuries in the cervical part of the spine in children with cervical syndrome will allow to define the therapeutic management of patients and to prolong juvenile osteochondrosis clinical behaviour.

  1. Internet-Based Cervical Cancer Screening Program

    National Research Council Canada - National Science Library

    Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A

    2008-01-01

    This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...

  2. Internet-Based Cervical Cytology Screening System

    National Research Council Canada - National Science Library

    Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A

    2007-01-01

    This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...

  3. Internet-Based Cervical Cytology Screening Program

    National Research Council Canada - National Science Library

    Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A

    2006-01-01

    This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...

  4. Uterine artery embolization for the treatment of symptomatic fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ah; Kim, Man Deuk; Kim, Hee Jin; Lee, Mee Hwa; Cho, Jin Ho; Cha, Sun Hee; Yoon, Sang Wook; Ahn, Eun Hee [Bundang CHA General Hospital Pochon CHA University, Sungnam (Korea, Republic of)

    2005-07-15

    The aim of this study was to determine the potential usefulness of uterine artery embolization (UAE) for the management of uterine leiomyoma. Sixty nine patients (mean age; 40.3 years, age range; 31-52 years) who underwent UAE for symptomatic fibroids (with menorrhagia, dysmenorrhoea and bulk-related symptoms) from January 2000 to December 2000 were retrospectively analyzed. The mean follow-up period was 3.5 months (range: 1-8 months). The fibroids ranged in size from 2.0 cm to 13.2 cm with a mean size of 5.8 cm. We performed embolization using polyvinyl alcohol particles (250-710 {mu} m). The improvement of the clinical symptoms was analyzed. Reduction of the uterine and predominant fibroid volumes was assessed using MRI. Symptom improvement for the menorrhagia (87.5%), dysmenorrhoea (83.3%) and the bulk-related symptoms (79.2%) was reported. Complications includes ovarian failure in four patients (5.8% of the total patients, mean age: 43.3 yrs) and infection in three patients (4.3% of the total patients) who underwent conservative management with intravenous antibiotics and analgesics. The volume reduction rate of the uterus and the predominant fibroids after uterine artery embolization were 36.3% and 56.6%, respectively. UAE is a promising new treatment for symptomatic fibroids and may be a valuable alternative to hysterectomy.

  5. Treatment of symptomatic pelvic varices by ovarian vein embolization

    International Nuclear Information System (INIS)

    Capasso, Patrizio; Simons, Christine; Trotteur, Genevieve; Dondelinger, Robert F.; Henroteaux, Denis; Gaspard, Ulysse

    1997-01-01

    Purpose. Pelvic congestion syndrome is a common cause of chronic pelvic pain in women and its association with venous congestion has been described in the literature. We evaluated the potential benefits of lumboovarian vein embolization in the treatment of lower abdominal pain in patients presenting with pelvic varicosities. Methods. Nineteen patients were treated. There were 13 unilateral embolizations, 6 initial bilateral treatments and 5 treated recurrences (a total of 30 procedures). All embolizations were performed with either enbucrilate and/or macrocoils, and there was an average clinical and Doppler duplex follow-up of 15.4 months. Results. The initial technical success rate was 96.7%. There were no immediate or long-term complications. Variable symptomatic relief was observed in 73.7% of cases with complete responses in 57.9%. All 8 patients who had partial or no pain relief complained of dyspareunia. The direct relationship between varices and chronic pelvic pain was difficult to ascertain in a significant number of clinical failures. Conclusion. Transcatheter embolization of lumboovarian varices is a safe technique offering symptomatic relief of pelvic pain in the majority of cases. The presence of dyspareunia seemed to be a poor prognostic factor, indicating that other causes of pelvic pain may coexist with pelvic varicosities

  6. Electrocardiographically and symptomatically silent myocardial ischemia during exercise testing

    International Nuclear Information System (INIS)

    Kurata, Chinori; Tawarahara, Kei; Sakata, Kazuyuki; Taguchi, Takahisa; Fukumoto, Yoshihiro; Kobayashi, Akira; Yamazaki, Noboru; Tanaka, Hiroshi

    1991-01-01

    Certain patients with coronary artery disease (CAD) may have neither ST depression nor chest pain during exercise despite the presence of myocardial ischemia. The frequency and characteristics of such electrocardiographically and symptomatically silent ischemia were studied in 171 patients with both angiographically documented CAD and scintigraphically documented ischemia. Fifty-six (33%) of 171 patients had neither ST depression nor chest pain (Group N), and 115 (67%) had ST depression and/or chest pain (Group P). The two groups were similar with respect to age, gender, the prevalence of prior infarction, and peak systolic blood pressure. Group N patients, however, had a higher mean peak heart rate and rate-pressure product, less severe scintigraphic ischemia, a lower lung thallium-201 uptake, and a smaller number of diseased vessels. Stepwise discriminant analysis showed a history of effort angina, lung thallium-201 uptake, and scintigraphic severity of ischemia to be significant discriminators between Groups N and P. In conclusion, electrocardiographically and symptomatically silent ischemia may be common during exercise in patients with CAD, and less severe ischemia may be one of important determinants. (author)

  7. Microbiology of bile in symptomatic uncomplicated gallstone disease

    International Nuclear Information System (INIS)

    Ahmad, M.; Akhtar, M.R.; Akhtar, M.R.

    2015-01-01

    To determine the microbiology of the bile culture and antimicrobial susceptibility in patients with symptomatic gallstone disease in our setup. Study Design: A descriptive study. Place and Duration of Study: Surgical Department Combined Military Hospital (CMH) Kharian from Oct, 2010 to Jun, 2011. Patients and Methods: A total of 106 patients underwent cholecystectomy due to symptomatic gallstones and their bile was cultured for aerobic and anaerobic bacteria and culture sensitivity was performed. Data was analysed by using statistical package for social sciences (SPSS) version 13. Results: Bile culture was negative in 81 patients (76.4%) and was positive in only 25 patients (23.6%). Escheria Coli was the most common cultured organism in 10 (40%) patients, Klebsiella in 5 (20%) patients, Pseudomonas in 5 (20%) patients, Proteus in 2 (8%) patients, Staphlococcus aureus in 2 (8%) patients and mixed organisms were cultured in 1 patient (4%). Cefoperazone with sulbactum and Amikacin were the most effective prophylactic antibiotics. Conclusion: Bile in majority of patients with symtomatic uncomplicated gallstone disease is sterile. E. coli is the most commonly cultured organism and cefoperazone with sulbactum and amikacin are the most appropriate antibiotics in our setup. (author)

  8. Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

    International Nuclear Information System (INIS)

    Bratby, M.J.; Walker, W.J.

    2009-01-01

    Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

  9. Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

    Energy Technology Data Exchange (ETDEWEB)

    Bratby, M.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom); Walker, W.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom)], E-mail: wjwalker@doctors.org.uk

    2009-04-15

    Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

  10. Gait Analysis of Symptomatic Flatfoot in Children: An Observational Study.

    Science.gov (United States)

    Kim, Ha Yong; Shin, Hyuck Soo; Ko, Jun Hyuck; Cha, Yong Han; Ahn, Jae Hoon; Hwang, Jae Yeon

    2017-09-01

    Flatfoot deformity is a lever arm disease that incurs kinetic inefficiency during gait. The purpose of this study was to measure the degree of kinetic inefficiency by comparing the gait analysis data of a flatfoot group with a normal control group. The patient group consisted of 26 children (21 males and 5 females) with symptomatic flatfoot. They were examined with gait analysis between May 2005 and February 2014. Exclusion criteria were patients with secondary flatfoot caused by neuromuscular disorders, tarsal coalition, vertical talus, or others. Patients' mean age was 9.5 years (range, 7 to 13 years). The gait analysis data of the study group and the normal control group were compared. The mean vertical ground reaction force (GRF) in the push-off phase was 0.99 for the patient group and 1.15 for the control group ( p push-off phase was 0.89 for the patient group and 1.27 for the control group ( p push-off phase was 1.38 for the patient group and 2.52 for the control group ( p push-off phase during gait. Symptomatic flatfeet had a moment inefficiency of 30% and power inefficiency of 45% during gait compared to feet with preserved medial longitudinal arches.

  11. The inconsistent nature of symptomatic pancreatico-jejunostomy anastomotic strictures

    Science.gov (United States)

    Demirjian, Aram N; Kent, Tara S; Callery, Mark P; Vollmer, Charles M

    2010-01-01

    Background Pancreatico-jejunostomy strictures (PJS) after pancreatiocoduodenectomy (PD) are poorly understood. Methods Patients treated for PJS were identified from all PDs (n =357) performed for all indications in our practice (2002 to 2009). Technical aspects of the original operation, as well as the presentation, management and outcomes of the resultant stricture were assessed. Results Seven patients developed a symptomatic PJS for an incidence of 2%. ‘Soft’ glands and small ducts (≤3 mm) were each present in 3/7 of the original anastomoses. Pancreatic fistula occurred in 6/7. The latency period to stricture presentation averaged 41 months. Diagnosis of PJS was confirmed by secretin magnetic resonance cholangio-pancreatography (MRCP). Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was attempted – each unsuccessfully – in four patients. All patients required operative correction of their PJS by takedown/revision of the original pancreatico-jejunal anastomoses (PJA) (n =4) ± a modified Puestow (n =2). One patient's PJS was completely inaccessible due to dense adhesions. Another patient's stricture recurred and was successfully revised with a stricturoplasty. At a mean follow-up of 25 months, all are alive, but only 4/7 are pain free. Conclusion A symptomatic PJS appears to be independent of original pathological, glandular or technical features but pancreatic fistulae may contribute. Secretin MRCP is diagnostically useful, whereas ERCP has been proven to be therapeutically ineffective. Durable resolution of symptoms after surgical revision is unpredictable. PMID:20815857

  12. Acute symptomatic neonatal seizures in preterm neonates: etiologies and treatments.

    Science.gov (United States)

    Pisani, Francesco; Spagnoli, Carlotta

    2017-12-15

    Acute symptomatic neonatal seizures in preterm newborns are a relevant clinical challenge due to the presence of many knowledge gaps. Etiology-wise, acute symptomatic seizures have an age-specific epidemiology, with intraventricular hemorrhage and its complications representing the first cause in extremely and very preterm neonates, whereas other etiologies have similar occurrence rates as in full-term infants. Specific treatment strategies for the premature neonates are not yet available. Studies suggest a similarly low response rate with even more unfavorable prognosis than in full-term infants. Pharmacodynamic and pharmacokinetic changes are likely under way during the preterm period, with the potential to affect both effectiveness and safety of antiepileptic drugs in these patients. However, due to the lack of clear evidence to guide prioritization of second-line drugs, off-label medications are frequently indicated by review papers and flow-charts, and are prescribed in clinical practice. We therefore conclude by exploring potential future lines of research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Symptomatic thoracic spinal cord herniation: case series and technical report.

    Science.gov (United States)

    Hawasli, Ammar H; Ray, Wilson Z; Wright, Neill M

    2014-09-01

    Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on the treatment algorithm and surgical technique, and there are few data on clinical outcomes. In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomatology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially because of multiple sclerosis. Finally, compared with compressive myelopathy in the thoracic spine, surgical treatment of ISCH led to rapid improvement despite a long duration of symptoms. Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair.

  14. Prognostic value of SPECT in newly diagnosed symptomatic west syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Megumi; Suzuki, Yasuhiro; Kato, Tomomi; Futagi, Yasuyuki [Osaka Medical Center and Research Inst. for Maternal and Child Health, Izumi (Japan)

    1999-07-01

    In 19 cases with newly diagnosed symptomatic West syndrome, we assessed interictal regional cerebral blood flow (rCBF) before ACTH therapy with single photon emission computed tomography (SPECT). Based on the SPECT findings, we divided these cases into 3 groups: normal rCBF (Group A, 7 cases), abnormal rCBF corresponding to cerebral lesions on MRI and CT (Group B, 6 cases), and abnormal rCBF in areas different from lesions on MRI and CT (Group C, 6 cases). We compared clinical features, response to initial treatment, and short-term outcome among these 3 groups. No significant differences were found in clinical characteristics (sex, age of onset, prior seizures before onset of spasms, EEG findings). Four cases in Group B (67%) and 5 in Group C (83%) showed complete cessation of spasms after initial treatment (high dose vitamin B{sub 6}{yields}zonisamide{yields}ACTH therapy), while in Group A only 2 patients (29%, p>0.05; compared to Group B or Group C) responded. Although not statistically significant, short-term prognosis (both seizures and development) after a mean follow-up of 2 years and 8 months was also worst in Group A. Our results suggest that normal SPECT findings may be predictive of unfavorable prognosis in infants with symptomatic West syndrome. (author)

  15. Radiation therapy for symptomatic hepatomegaly in myelofibrosis with myeloid metaplasia

    Energy Technology Data Exchange (ETDEWEB)

    Tefferi, A.; Jimenez, T.; Gray, L.A.; Mesa, R.A. [Division of Hematology and Internal Medicine, Rochester, MN (United States); Chen, M.G. [Division of Radiation Oncology, Mayo Clinic and Mayo Foundation, MN (United States)

    2001-07-01

    Objective: To describe the experience with liver irradiation in advanced cases of myelofibrosis with myeloid metaplasia (MMM). Methods: Over a 20-yr period, 14 patients with MMM were treated with a total of 25 courses of liver, abdominal, or abdominal and pelvic irradiation for symptomatic hepatomegaly with (5 patients) or without (9 patients) ascites. All 14 patients had advanced disease and 11 (79%) had previous splenectomy. The median radiation therapy (RT) dose per course was 150 cGy (range 50-1000) administered at a median of six fractions. Four patients received two to six courses. Results. Twelve of the 14 patients (86%) had a transient (median 3 months) subjective response from RT. However, in only 35% of these was there a transient (median 3 months) decrease in palpable liver size. Four of the five patients with ascites experienced a short-term response from RT. Eight of the 13 patients suitable for evaluation (62%) had treatment-associated cytopenia, often in the form of anemia and/or thrombocytopenia. At last follow-up, 10 patients (71%) had died after a median of 7 months (range 0.1-23) and 4 were alive at 3, 20, 33, and 57 months after RT. Conclusions: Low-dose abdominal RT for symptomatic hepatomegaly or ascites associated with advanced-stage MMM is myelosuppressive and provides only temporary and mainly subjective and short-lived relief. (au)

  16. Small C7-T1 lordotic angle and muscle degeneration at C7 level were independent radiological characteristics of patients with cervical imbalance: a propensity score-matched analysis.

    Science.gov (United States)

    Tamai, Koji; Romanu, Joshua; Grisdela, Phillip; Paholpak, Permsak; Zheng, Pengfei; Nakamura, Hiroaki; Buser, Zorica; Wang, Jeffrey C

    2018-01-31

    Cervical sagittal vertical axis (cSVA) of ≥40 mm is recognized as the key factor of poor health-related quality of life, poor surgical outcomes, and correction loss after surgery for cervical deformity. However, little is known about the radiological characteristics of patients with cSVA≥40 mm. The purpose of this study was to identify the radiological characteristics of patients with cervical imbalance. Retrospective analysis of weight-bearing cervical magnetic resonance (MR) images. Consecutive 1,500 MR images of symptomatic patients in weight-bearing position. Cervical sagittal vertical axis, cervical alignment, cervical balance parameters (T1 slope, Co-C2 angle, C2-C7 angle, C7-T1 angle, neck tilt, and thoracic inlet angle), disc degeneration (Pfirmann and Suzuki classification), end plate degeneration (Modic change), spondylolisthesis (antero- and retrolisthesis), anteroposterior (AP) diameter of dural sac, cross-sectional area (CSA), and fat infiltration ratio of the transversospinalis muscles at C4 and C7 levels. Patients were divided into two groups: cSVA≥40 mm and cSVAimbalance (cSVA≥40 mm) and control (imbalance was 2.5% (37 patients). Those patients had a higher incidence of kyphosis, were older, and there were more male patients. In the matched imbalance group, the T1 slope was greater (p=.028), C7-T1 lordotic angle was smaller (pimbalance. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Immediate versus delayed treatment for recently symptomatic carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Vladimir Vasconcelos

    Full Text Available ABSTRACT BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days compared with delayed treatment (after two days for people with recently symptomatic carotid artery stenosis. METHODS: Search methods: We searched the Cochrane Stroke Group Trials Register in January 2016, the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1, MEDLINE (1948 to 26 January 2016, EMBASE (1974 to 26 January 2016, LILACS (1982 to 26 January 2016, and trial registers (from inception to 26 January 2016. We also handsearched conference proceedings and journals, and searched reference lists. There were no language restrictions. We contacted colleagues and pharmaceutical companies to identify further studies and unpublished trials Selection criteria: All completed, truly randomized trials (RCT that compared very early cerebral revascularization (within two days with delayed treatment (after two days for people with recently symptomatic carotid artery stenosis. Data collection and analysis: We independently selected trials for inclusion according to the above criteria, assessed risk of bias for each trial, and performed data extraction. We utilized an intention-to-treat analysis strategy. MAIN RESULTS: We identified one RCT that involved 40 participants, and addressed the timing of surgery for people with recently symptomatic carotid artery stenosis. It compared very early surgery with surgery performed after 14 days of

  18. Risk of recurrence, prognosis, and follow-up for Danish women with cervical cancer in 2005-2013

    DEFF Research Database (Denmark)

    Taarnhøj, Gry Assam; Christensen, Ib Jarle; Lajer, Henrik

    2018-01-01

    BACKGROUND: In developed countries, women attend follow-up after treatment for cervical cancer to detect recurrence. The aim of this study was to describe the Danish population of women with early-stage cervical cancer at risk for recurrence and death due to recurrence. METHODS: Data were extracted...... from 3 nationwide databases to find women diagnosed with stage 1A1 to 1B1 cervical cancer in 2005-2013. Recurrences were determined from data on oncological or surgical treatment more than 3 months after the initial diagnosis and were cross-checked with patient journals. RESULTS: In all, 1523 patients...... were diagnosed with stage 1A1 to 1B1 cervical cancer. Eighty women experienced recurrences: 8 at International Federation of Gynecology and Obstetrics (FIGO) stage 1A1, 0 at FIGO stage 1A2, and 72 at FIGO stage 1B1. The 5-year recurrence rate was 6.4%; 67.5% of the women had symptomatic recurrences...

  19. Pelvic insufficiency fractures in postmenopausal woman with advanced cervical cancer treated by radiotherapy

    International Nuclear Information System (INIS)

    Ogino, Ichiro; Okamoto, Naoyuki; Ono, Yoshimi; Kitamura, Tatsuo; Nakayama, Hiroki

    2003-01-01

    Purpose: To assess the predisposing factors and clinical characteristics of pelvic insufficiency fractures (PIF) in postmenopausal women with pelvic irradiation. Material and methods: A total 335 postmenopausal patients with cervical cancer of the intact uterus treated with radiation therapy between 1983 and 1998 were reviewed. Total external dose was delivered between 45 and 50.4 Gy with parallel opposed anteroposterior portals. Total brachytherapy dose at point A was delivered between 10 and 36 Gy. PIF were diagnosed by bone scintigraphy and confirmed by computed tomography. The cumulative incidence of symptomatic PIF was estimated by actuarial methods. Potential risk factors (age, weight, type II diabetes, delivery, menopause, total external dose, total brachytherapy dose) were assessed. Results: Fifty-seven (17.0%) of 335 patients were diagnosed as having PIF. Forty-seven patients were symptomatic and ten were asymptomatic. Parameters carrying a significant association with PIF were body weight 49 kg or below (P=0.044) in stepwise logistic regression analysis. The cumulative incidence of symptomatic PIF at 5 years was 17.9% calculated by the Kaplan-Meier method. A body weight of 49 kg or below and more than three deliveries were identified as having a significant effect on symptomatic PIF in univariate analysis (P=0.021, P=0.003, log-rank test) and Cox life table regression analysis (P=0.038, P=0.013). Five patients required narcotic agents and eight patients required hospital admission. Conclusions: We should consider reducing the dose contribution to the sacrum and sacroilac joints, without underdosing the tumor, especially in postmenopausal women with many deliveries or low body weight

  20. The effect of 'Candidatus Liberibacter asiaticus' infection on the proteomic profiles and nutritional status of pre-symptomatic and symptomatic grapefruit (Citrus paradisi) plants.

    Science.gov (United States)

    Nwugo, Chika C; Lin, Hong; Duan, Yongping; Civerolo, Edwin L

    2013-04-11

    Huanglongbing (HLB) is a highly destructive citrus disease which threatens citrus production worldwide and 'Candidatus Liberibacter asiaticus' (Las), a non-culturable phloem-limited bacterium, is an associated causal agent of the disease. To better understand the physiological and molecular processes involved in host responses to Las, 2-DE and mass spectrometry analyses, as well as ICP spectroscopy analysis were employed to elucidate the global protein expression profiles and nutrient concentrations in leaves of Las-infected grapefruit plants at pre-symptomatic or symptomatic stages for HLB. This study identified 123 protein spots out of 191 spots that showed significant changes in the leaves of grapefruit plants in response to Las infection and all identified spots matched to 69 unique proteins/peptides. A down-regulation of 56 proteins including those associated with photosynthesis, protein synthesis, and metabolism was correlated with significant reductions in the concentrations of Ca, Mg, Fe, Zn, Mn, and Cu in leaves of grapefruit plants in response to Las infection, particularly in symptomatic plants. Oxygen-evolving enhancer (OEE) proteins, a PSI 9 kDa protein, and a Btf3-like protein were among a small group of proteins that were down-regulated in both pre-symptomatic and symptomatic plants in response to Las infection. Furthermore, a Las-mediated up-regulation of 13 grapefruit proteins was detected, which included Cu/Zn superoxide dismutase, chitinases, lectin-related proteins, miraculin-like proteins, peroxiredoxins and a CAP 160 protein. Interestingly, a Las-mediated up-regulation of granule-bound starch synthase was correlated with an increase in the K concentrations of pre-symptomatic and symptomatic plants. This study constitutes the first attempt to characterize the interrelationships between protein expression and nutritional status of Las-infected pre-symptomatic or symptomatic grapefruit plants and sheds light on the physiological and molecular

  1. Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis.

    Science.gov (United States)

    Fedorchuk, Curtis A; McCoy, Matthew; Lightstone, Douglas F; Bak, David A; Moser, Jacque; Kubricht, Brett; Packer, John; Walton, Dustin; Binongo, Jose

    2016-09-01

    This study investigates the impact of isometric contraction of anterior cervical muscles on cervical lordosis. 29 volunteers were randomly assigned to an anterior head translation (n=15) or anterior head flexion (n=14) group. Resting neutral lateral cervical x-rays were compared to x-rays of sustained isometric contraction of the anterior cervical muscles producing anterior head translation or anterior head flexion. Paired sample t-tests indicate no significant difference between pre and post anterior head translation or anterior head flexion. Analysis of variance suggests that gender and peak force were not associated with change in cervical lordosis. Chamberlain's to atlas plane line angle difference was significantly associated with cervical lordosis difference during anterior head translation (p=0.01). This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis.

  2. Treatments for symptomatic urinary tract infections during pregnancy.

    Science.gov (United States)

    Vazquez, Juan C; Abalos, Edgardo

    2011-01-19

    Urinary tract infections, including pyelonephritis, are serious complications that may lead to significant maternal and neonatal morbidity and mortality. There is a large number of drugs, and combination of them, available to treat urinary tract infections, most of them tested in non-pregnant women. Attempts to define the optimal antibiotic regimen for pregnancy have, therefore, been problematic. The objective of this review was to determine, from the best available evidence from randomised controlled trials, which agent is the most effective for the treatment of symptomatic urinary tract infections during pregnancy in terms of cure rates, recurrent infection, incidence of preterm delivery and premature rupture of membranes, admission to neonatal intensive care unit, need for change of antibiotic, and incidence of prolonged pyrexia. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (November 2009) and reference lists of articles. We considered all trials where the intention was to allocate participants randomly to one of at least two alternative treatments for any symptomatic urinary tract infection. Both review authors assessed trial quality and extracted data. We included 10 studies, recruiting a total of 1125 pregnant women. In most of the comparisons there were no significant differences between the treatments under study with regard to cure rates, recurrent infection, incidence of preterm delivery, admission to neonatal intensive care unit, need for change of antibiotic and incidence of prolonged pyrexia. When cefuroxime and cephradine were compared, there were better cure rates (29/49 versus 41/52) and fewer recurrences (20/49 versus 11/52) in the cefuroxime group. There was only one other statistically significant difference when comparing outpatient versus inpatient treatment. Gestational age at birth was greater in women from the outpatient group (38.86 versus 37.21), while birthweight was on average greater in the inpatient group

  3. Clinical analysis of 34 cases symptomatic epilepsy secondary to cerebrovascular disease

    International Nuclear Information System (INIS)

    Zeng Mingyu; Liu Chunfeng

    2000-01-01

    Objective: To investigate the relation between cerebrovascular disease and symptomatic epilepsy. Method: 786 patients suffered cerebrovascular disease were retrospectively analyzed. Result: The occurrence rate of Secondary to Cerebrovascular Disease symptomatic epilepsy Secondary to Cerebrovascular Disease was 4.3%. Those older than 60 are prone to develop Acrodynia symptomatic epilepsy. Generalized epileptic seizure were often seen. Secondary to Cerebrovascular Disease epilepsy die to cortical lesion are more easily seem than subcortical lesion. Early epilepsy is more than late epilepsy. Conclusion: The cause of symptomatic epilepsy after cerebrovascular disease is not same in different types and course of CVD. Those who developed epilepsy particularly epilepsy continua would have bad prognosis

  4. Pregnancy Outcome in Cervical Incompetence: Comparison of ...

    African Journals Online (AJOL)

    Context: Cervical incompetence is a major cause of recurrent mid-trimester pregnancy loss and preterm deliveries; it contributes significantly to fetal loss and neonatal morbidity and mortality. Despite its wide use, the effectiveness of cervical cerclage in its management remains unsettled. Objective: To evaluate the ...

  5. Role of Lactobacillus in cervical cancer

    Directory of Open Access Journals (Sweden)

    Yang X

    2018-05-01

    Full Text Available Xi Yang,1 Miao Da,2 Wenyuan Zhang,3 Quan Qi,4 Chun Zhang,5 Shuwen Han4 1Department of Intervention and Radiotherapy, Huzhou Central Hospital, 2Medical College of Nursing, Huzhou University, 3Department of Gynaecology, 4Department of Medical Oncology, 5Department of Infectious Diseases, Huzhou Central Hospital, Huzhou, Zhejiang Province, People’s Republic of China Abstract: Cervical cancer is a common malignant cancer among women worldwide. Changes in the vaginal microecological environment lead to multiple gynecological diseases, including cervical cancer. Recent research has shown that Lactobacillus may play an important role in the occurrence and development of cervical cancer. This review explores the role of Lactobacillus in cervical cancer. A total of 29 articles were included after identification and screening. The pertinent literature on Lactobacillus in cervical cancer from two perspectives, including clinical studies and experimental studies, was analyzed. An association network for the mechanism by which Lactobacillus induces cervical cancer was constructed. In addition, we provide direction and insight for further research on the role of Lactobacillus in cervical cancer. Keywords: CIN, cervical cancer, Lactobacillus, microorganism

  6. Odontogenic cervical necrotizing fasciitis, etiological aspects ...

    African Journals Online (AJOL)

    Introduction: Cervical necrotizing fasciitis is a rare but very severe infection that affects the soft‑tissues of the cephalic extremity. Cervical necrotizing fasciitis most frequently occurs secondarily to inflammatory odontogenic disorders and represents the most severe infection of maxillofacial spaces, with a high lethal potential.

  7. Cervical cancer and pregnancy: treatment management

    International Nuclear Information System (INIS)

    Lazar, I.; Toth, R.

    2011-01-01

    Pregnancy and cervical carcinoma occurring concomitantly causes therapeutic and ethical dilemmas. The management for this situation will depend on the gestational age at the time of diagnosis, disease staging, size of the lesion and the patient’s wish to maintain pregnancy and fertility. Review of the literature suggest that pregnancy does not seem to influence the prognosis of cervical cancer. (author)

  8. 21 CFR 884.5250 - Cervical cap.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cervical cap. 884.5250 Section 884.5250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... cap. (a) Identification. A cervical cap is a flexible cuplike receptacle that fits over the cervix to...

  9. The agreement between cervical abnormalities identified by ...

    African Journals Online (AJOL)

    Objectives and design. Human papilloma virus (HPV) is causally associated with cervical cancer. Using the Digene Hybrid Capture2 high-risk HPV test (HC2), we investigated the prevalence of high-risk HPV in cervical specimens, and compared results with those of Papanicolaou (Pap) smears taken concurrently. Subjects ...

  10. Management of Cervical Cytology with HPV Test

    Centers for Disease Control (CDC) Podcasts

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about ASCCP's 2006 Consensus Guidelines on the management of abnormal cervical cytology and histology.

  11. Cervical myositis ossificans traumatica: a rare location

    International Nuclear Information System (INIS)

    Baysal, T.; Sarac, K.; Kutlu, R.; Baysal, O.; Ersoy, Y.; Elmali, N.

    1999-01-01

    An unusual case of myositis ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare. (orig.)

  12. Human papilloma virus infection and cervical dysplasia.

    Science.gov (United States)

    Melinte-Popescu, Alina; Costăchescu, Gh

    2012-01-01

    Pap testing is considered to be the best screening tool for cervical cancer but there is currently great interest in the possible application of human papilloma virus (HPV) testing to supplement Pap screening for cervical cancer. To determine the prevalence of high-risk HPV types in the studied population and to explore the association between high-risk HPV types and cervical dysplasia. Cross-sectional study conducted at the Iasi Cuza Voda Obstetrics-Gynecology Hospital and Suceava County Hospital. 332 women who underwent colposcopy for cervical lesions between 2006 and 2011 were included in this study. The overall prevalence of HPV was 57.23%. HPV prevalence differs significantly in the three age groups up to 50 years. It was highest in patients below the age of 40 and progressively lower with advancing age. The overall prevalence of cervical dysplasia was 56.62%. The prevalence of cervical dysplasia was highest in the age groups up to 40 years. The most important determinant of HPV infection is age. Persistence of HPV appears to be associated with progression to squamous intraepithelial lesion. Dysplasia is often missed in a cervical sample either because of human error in screening and interpretation, or because of suboptimal quality of Pap smear. Incorporation of HPV testing into the present Pap screening program has the potential of making screening for cervical cancer more effective, and a necessary prelude to assessing this is by determining the prevalence of the high-risk types.

  13. Cervical Cancer Screening with HPV Test

    Centers for Disease Control (CDC) Podcasts

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program.

  14. Cervical cancer: current knowledge, perception and associated ...

    African Journals Online (AJOL)

    Background and Objective: Cervical cancer is a major public health problem and one of the leading causes of morbidity and mortality amongst the gynaecological cancers worldwide, especially in developing countries. Cervical cancer continues to persist in Nigeria like other developing countries despite the existence of ...

  15. Operative techniques for cervical radiculopathy and myelopathy.

    LENUS (Irish Health Repository)

    Moran, C

    2012-02-01

    The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970\\'s. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

  16. Sport injuries of the cervical spine

    International Nuclear Information System (INIS)

    Bargon, G.

    1981-01-01

    The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion. (orig.) [de

  17. Inflammatory Bowel Disease and Cervical Neoplasia

    DEFF Research Database (Denmark)

    Rungoe, Christine; Simonsen, Jacob; Riis, Lene

    2015-01-01

    BACKGROUND & AIMS: We examined the risk of cervical neoplasia (dysplasia or cancer) in women with ulcerative colitis (UC) or Crohn's disease (CD). We also calculated the reverse, the risk for diagnosis with cervical neoplasia before development of inflammatory bowel disease (IBD). METHODS: We...... established a national cohort of women diagnosed with UC (n = 18,691) or CD (n = 8717) between 1979 and 2011 and a control cohort of individually matched women from the general population (controls, n = 1,508,334). Incidence rate ratios (IRRs) of screening activity and diagnosis of cervical neoplasia in women...... with IBD were assessed by Cox proportional hazards regression analysis. Odds ratios (ORs) of cervical neoplasia before diagnosis of IBD were calculated by using conditional logistic regression. RESULTS: Women with CD underwent cervical cancer screening as often as women in the general population (IRR, 0...

  18. Sport injuries of the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Bargon, G

    1981-03-01

    The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion.

  19. Cervical cancer incidence in elderly women

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Lönnberg, Stefan; Törnberg, Sven

    2017-01-01

    Aim: In many countries, the age-specific pattern of cervical cancer incidence is currently bipolar with peaks at for instance 45 and 65 years of age. Consequently, a large proportion of cervical cancer cases are presently diagnosed in women above the screening age. The purpose of the study...... was to determine whether this bipolar pattern in age-specific incidence of cervical cancer reflects underlying biology or can be explained by the fact that the data come from birth cohorts with different screening histories. Methods: Combination of historical data on cervical screening and population-based cancer...... incidence data from Denmark 1943–2013, Finland and Norway 1953–2013, and Sweden 1958–2013. Results: Since the implementation of screening, the incidence of cervical cancer has decreased for each successive birth cohort. All birth cohorts showed a unipolar age-specific pattern. In unscreened women in Denmark...

  20. Cervical motion testing: methodology and clinical implications.

    Science.gov (United States)

    Prushansky, Tamara; Dvir, Zeevi

    2008-09-01

    Measurement of cervical motion (CM) is probably the most commonly applied functional outcome measure in assessing the status of patients with cervical pathology. In general terms, CM refers to motion of the head relative to the trunk as well as conjunct motions within the cervical spine. Multiple techniques and instruments have been used for assessing CM. These were associated with a wide variety of parameters relating to accuracy, reproducibility, and validity. Modern measurement systems enable recording, processing, and documentation of CM with a high degree of precision. Cervical motion measures provide substantial information regarding the severity of motion limitation and level of effort in cervically involved patients. They may also be used for following up performance during and after conservative or invasive interventions.

  1. Radiobiological characteristics of cervical cancer

    International Nuclear Information System (INIS)

    Kagabu, Teruo; Kobayashi, Takashi; Nanayama, Kunihiko

    1976-01-01

    In order to observe the radiobiological characteristics of cervical cancer, the author carried out irradiation of 60 Co in 16 cases of cervical cancer. The primary lesion of each case was exposed to radiation of 100 R once a day, 40 times in sequence, totaling 4,000 R. To evaluate this results, the vaginal smears were obtained everyday and examined for changes in cancerous cells caused by the irradiation. The results of our study showed that cervical cancer could be classified into three groups according to the radiosensitivity of its cancerous cells. In the group of low-radiosensitivity (11 cases of 16), the cancerous cells decreased gradually, and enlargement of the nuclei of the cancerous cells was observed from 2,000 R of irradiation, but the majority of the cancerous cells were those of nucleus after the irradiation of 4,000 R. In all of the 5 uterus removed, residual cancer lesion was noted. The radiocuability was unfavourable. In the group of high-radiosensitivity (4 cases of 16), the cancerous cells decreased remarkablly. Enlargement of nucleus was noted from 1,000 R of the irradiation, the cancerous cells of small-sized nucleus appeared with the irradiation of 3,000 R but the cancerous cells almost disappeared with the irradiation of 4,000 R. The radiocuability was favourable. In the group of combination of high-radiosensitivity and low-radiosensitivity portions (one case of 16), the cancerous cells decreased remarkablly until the exposure to the radiation of 2,000 R but thereafter did slowly. In a removed uterus, the cancer lesion was noted, but the prognosis was favourable. The foregoing results suggest that changes in the nuclear diameter of the cancerous cells in vaginal smears during irradiation can tell the radiosensitivity of the cancerous cells. (Kanao, N.)

  2. Symptomatic intraspinal synovial cysts: Opacification and treatment by percutaneous injection

    International Nuclear Information System (INIS)

    Bjorkengren, A.G.; Resnick, D.; Kurz, L.T.; Garfin, S.R.; Sartoris, D.J.

    1986-01-01

    Synovial cysts in an intraspinal location, associated with facet joint osteoarthritis, have been diagnosed using CT. Surgical removal of the cyst, when believed to be the cause of radiculopathy, has resulted in symptomatic relief. The authors have applied a nonoperative treatment method consisting of CT-guided needle placement in the facet joint adjacent to the cyst, followed by injection of contrast material and corticosteroids. Three patients were treated without complications and with complete relief of symptoms in two cases and partial relief in one, although no decrease in the size of the cysts was demonstrated on follow-up CT scans. The preliminary results indicate a possible role for this treatment technique in patients with intraspinal synovial cysts

  3. Symptomatic splenic hamartoma with renal, cutaneous, and hematological abnormalities

    International Nuclear Information System (INIS)

    Kassarjian, A.; Patenaude, Y.G.; Bernard, C.; Bell, L.

    2001-01-01

    Background. There is a rare association between splenic hamartomas and hematological abnormalities with, to our knowledge, only 24 reported cases in the English literature. Patients and methods. We report a case of a splenic hamartoma in a 14-year-old boy associated with membranoproliferative glomerulonephritis, multiple lobular capillary hemangiomas of the skin, hypertension, and anemia. Following imaging with ultrasonography, MRI, and nuclear scans, a hamartoma was suspected, but malignancy could not be excluded. The lesion was removed by partial splenectomy, and pathological examination confirmed the presence of a red pulp splenic hamartoma. Results. The renal, hematological, and dermatological abnormalities resolved following removal of the splenic hamartoma. This is the first reported case of a splenic hamartoma associated with renal, cutaneous, and hematological abnormalities and only the second reported case of a symptomatic splenic hamartoma treated by partial splenectomy. (orig.)

  4. Acromegaly associated with a symptomatic Rathke′s cyst

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2011-01-01

    Full Text Available Our aim is to describe a case of acromegaly that was associated with symptomatic Rathke′s cyst. We describe a young male student without any significant family history who presented with clinical and biochemical features consistent with growth hormone excess, which was confirmed with dynamic testing. He also described a persistent headache predating symptoms of growth hormone excess by 4 years. Magnetic resonance imaging (MRI of the pituitary showed a large sellar mass which was thought to be a somatotroph adenoma. Trans-sphenoidal surgery was performed; however, a colloid lesion was identified by the neurosurgeon that proved to be a Rathke′s cyst. The association of acromegaly with Rathke′s cyst is very rare, with less than 10 cases found to be reported on review of literature. This is the first report from India.

  5. Risk Profile of Symptomatic Lacunar Stroke Versus Nonlobar Intracerebral Hemorrhage.

    Science.gov (United States)

    Morotti, Andrea; Paciaroni, Maurizio; Zini, Andrea; Silvestrelli, Giorgio; Del Zotto, Elisabetta; Caso, Valeria; Dell'Acqua, Maria Luisa; Simone, Anna Maria; Lanari, Alessia; Costa, Paolo; Poli, Loris; De Giuli, Valeria; Gamba, Massimo; Ciccone, Alfonso; Ritelli, Marco; Di Castelnuovo, Augusto; Iacoviello, Licia; Colombi, Marina; Agnelli, Giancarlo; Grassi, Mario; de Gaetano, Giovanni; Padovani, Alessandro; Pezzini, Alessandro

    2016-08-01

    Although lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent acute manifestations of the same pathological process involving cerebral small vessels (small vessel disease), it remains unclear what factors predispose to one phenotype rather than the other at individual level. Consecutive patients with either acute symptomatic LS or dICH were prospectively enrolled as part of a multicenter Italian study. We compared the risk factor profile of the 2 subgroups using multivariable logistic regression. During a time course of 9.5 years, 1931 subjects (1434 LS and 497 dICH; mean age, 71.3±13.3 years; males, 55.5%) qualified for the analysis. Current smoking was associated with LS (odds ratio [OR], 2.17; Prisk factor profile of dICH differs from that associated with LS. This might be used for disease risk stratification at individual level. © 2016 American Heart Association, Inc.

  6. [Effects of midodrine on symptomatic hypotension during hemodialysis].

    Science.gov (United States)

    Cotera, Alejandro; Alvo, Miriam; Sanhueza, María Eugenia; Elgueta, Leticia; Gormaz, Juan Pablo; Ibáñez, Carlos; Cuadra, Cristián

    2002-09-01

    Hypotension occurs in 20% of hemodialysis procedures. To study the effects of midodrine on hypotension during hemodialysis. Ten patients on chronic hemodialysis and with a history of hypotension during the procedure, were studied. They received midodrine 10 mg per os or placebo during 5 dialytic procedures each, in a double blind cross over design. Blood pressure levels prior to dialysis were similar during the midodrine or placebo administration periods. During dialysis, systolic blood pressure fell 19.3 +/- 28 mmHg with midodrine and 23.4 +/- 28 mmHg with placebo. Diastolic blood pressure fell 7.3 +/- 11.5 mmHg with midodrine and 11.1 +/- 12 mmHg with placebo. The reduction in median arterial pressure was also less pronounced with midodrine. Midodrine lessens the fall in arterial pressure during hemodialysis, in patients with symptomatic hypotension.

  7. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    International Nuclear Information System (INIS)

    Rennie, W.J.; Saifuddin, A.

    2005-01-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  8. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, W.J. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences (United Kingdom)

    2005-07-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  9. Extra colonic Findings on CT Colonography in Symptomatic Patients

    International Nuclear Information System (INIS)

    Drahovska, I.; Nigut, F.; Mach, P.; Lazurova, I.; Gombosova, L.

    2011-01-01

    The paper is an analysis of the consequences of the extra colonic findings identified on CT colonography examination of symptomatic patients and the validity of the intravenous application of contrast medium in this examination. The authors enrolled 252 patients, who underwent CT colonogprahy.128 extra colonic findings was identified in 80 patients (31.74%). The average age was 65.62 years (SD = 12.7, min. age was 29, max. age. 85 years). According the clinical significance the extra colonic findings have been divided into three groups – low, moderate and very important extra colonic findings. Low significant findings were 68 (53.12%), moderate 26 (20.31%) and very important extra colonic findings were 34 (26.56%), of which 30 were malignant nature. (author)

  10. Symptomatic splenic hamartoma with renal, cutaneous, and hematological abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, A.; Patenaude, Y.G. [Dept. of Medical Imaging, Montreal Children' s Hospital, PQ (Canada); Bernard, C. [Dept. of Pathology, Montreal Children' s Hospital, PQ (Canada); Bell, L. [Dept. of Nephrology, Montreal Children' s Hospital, PQ (Canada)

    2001-02-01

    Background. There is a rare association between splenic hamartomas and hematological abnormalities with, to our knowledge, only 24 reported cases in the English literature. Patients and methods. We report a case of a splenic hamartoma in a 14-year-old boy associated with membranoproliferative glomerulonephritis, multiple lobular capillary hemangiomas of the skin, hypertension, and anemia. Following imaging with ultrasonography, MRI, and nuclear scans, a hamartoma was suspected, but malignancy could not be excluded. The lesion was removed by partial splenectomy, and pathological examination confirmed the presence of a red pulp splenic hamartoma. Results. The renal, hematological, and dermatological abnormalities resolved following removal of the splenic hamartoma. This is the first reported case of a splenic hamartoma associated with renal, cutaneous, and hematological abnormalities and only the second reported case of a symptomatic splenic hamartoma treated by partial splenectomy. (orig.)

  11. Symptomatic Primary (AL Amyloidosis of the Stomach and Duodenum

    Directory of Open Access Journals (Sweden)

    Reidar Fossmark

    2013-01-01

    Full Text Available Primary (AL amyloidosis of the gastrointestinal tract is relatively rare, and symptomatic amyloidosis of the stomach is even more seldom. We present the case of a patient who was referred to upper endoscopy because of weight loss, nausea, and vomiting. Large areas of intramucosal hemorrhages were seen, and biopsies resulted in profuse bleeding stopped with endoscopic clips. The biopsies showed amyloid depositions and further workup revealed that the patient also had cardiac and neuropathic involvements. The patient started treatment with dexamethasone, melphalan and bortezomib. After treatment was started the nausea and epigastric discomfort improved, and a reduction in the biochemical markers troponin T, NT-proBNP, and M-component was observed. Gastric amyloidosis is rarely seen at upper endoscopy in patients without a previously established diagnosis, but the unusual endoscopic findings and bleeding tendency after biopsy should be kept in mind by gastroenterologists.

  12. Management of symptomatic vertebral haemangioma in a resource challenged environment.

    Science.gov (United States)

    Adeolu, Augustine A; Balogun, James A; Adeleye, Amos O; Adeoye, Peter O; Okolo, Clement A; Ogbole, Godwin I

    2010-07-01

    Vertebral haemangiomas are benign lesions and often asymptomatic. They are more common in the thoracic spine where they may become symptomatic with varying presentations. We present two teenage girls who presented with progressive, nontraumatic paraparesis with no background history of chronic cough or underlying medical illness. The radiologic investigations were suggestive of vertebral haemangiomas of the thoracic spine. They had surgery: transthoracic approach with corpectomy and fusion with iliac crest autograft. The posterior stabilisation in the first patient was with Rush nails and circlage wire and only circlage wire in the second patient. The first patient's post-operative recovery was complicated by graft extrusion necessitating re-opening thoracotomy and graft replacement. They are, however, both ambulant at discharge and have remained so 13 and 15 months post-surgery. We have presented two cases with rewarding outcomes in the face of 'adaptive' instrumentation due to limited resources.

  13. Memory in children with symptomatic temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Catarina A. Guimarães

    2014-03-01

    Full Text Available In children with temporal lobe epilepsy (TLE, memory deficit is not so well understood as it is in adults. The aim of this study was to identify and describe memory deficits in children with symptomatic TLE, and to verify the influence of epilepsy variables on memory. We evaluated 25 children with TLE diagnosed on clinical, EEG and MRI findings. Twenty-five normal children were compared with the patients. All children underwent a neuropsychological assessment to estimate intellectual level, attention, visual perception, handedness, and memory processes (verbal and visual: short-term memory, learning, and delayed recall. The results allowed us to conclude: besides memory deficits, other neuropsychological disturbances may be found in children with TLE such as attention, even in the absence of overall cognitive deficit; the earlier onset of epilepsy, the worse verbal stimuli storage; mesial lesions correlate with impairment in memory storage stage while neocortical temporal lesions correlate with retrieval deficits.

  14. Angiogenesis in hepatocellular carcinoma: correlation of single-level dynamic spiral CT scans in arterial phase and expression of α-smooth muscle actin

    International Nuclear Information System (INIS)

    Liu Yan; Min Pengqiu; Chen Weixia; Zhang Lin

    2005-01-01

    Objective: To investigate the correlation between the single-level dynamic spiral CT scans (SDCT) of hepatocellular carcinoma (HCC) in arterial phase (AP) and the immunohistochemistry expression of α-smooth muscle actin (ASMA). Methods: 33 cases of suspected HCC undergoing spiral CT plain scan of the whole liver, the single-level dynamic scan of the target level of lesion in AP and finally the whole liver scan in portal-venous phase before operations and proved after were included into the study. After the SDCT, a time-density curve (T-DC) was drawn according to the density change of the region of interest (ROI) of the tumor parenchyma with some parameters calculated, and signs of enhancement evaluated. Slices of post-operation specimen underwent hemotoxylin-eosin (HE) and ASMA immunohistochemistry staining. Then the slices were evaluated with emphases on the ASMA-positive neovasculatures in the parenchyma and mesenchyma of carcinomas, and the average count in a low microscopic field (x 100) was recorded (5 low microscopic field were observed and then an average was calculated.). Finally the immunohistochemistry and histologic results were correlated with image findings. Results: According to the PV of the tumor parenchyma, T-DC was divided into type I, II and III in which the criteria were PV>80, 40 HU< PV< 80 HU and PV<40 HU respectively. In the 33 cases, type I, II and III of T-DC were 3, 17 and 13 cases with PV of 103.30, 57.65 and 33.55 HU respectively. In ASMA immunohistochemistry study, ASMA-positive neovasculatures were devided into type A with a thick wall and B with a thin wall. The mean count of neovasculatures of tumor parenchyma in type I, II and III of T-DC were 10, 4.59 and 1 respectively. Statistically, different types of T-DC were significantly correlated with the count of neovasculatures in the parenchyma of carcinomas (r=-0.567, P<0.01). Homogeneous and inhomogeneous enhancement of carcinomas during SDCT in AP were correlated with the

  15. Incidence of Symptomatic Vertebral Fractures in Patients After Percutaneous Vertebroplasty

    International Nuclear Information System (INIS)

    Hierholzer, Johannes; Fuchs, Heiko; Westphalen, Kerstin; Baumann, Clemens; Slotosch, Christine; Schulz, Rudolf

    2008-01-01

    The aim of this study was to evaluate the incidence of secondary symptomatic vertebral compression fractures (VCFs) in patients previously treated by percutaneous vertebroplasty (VTP). Three hundred sixteen patients with 486 treated VCFs were included in the study according to the inclusion criteria. Patients were kept in regular follow-up using a standardized questionairre before, 1 day, 7 days, 6 months, and 1 year after, and, further on, on a yearly basis after VTP. The incidence of secondary symptomatic VCF was calculated, and anatomical distribution with respect to previous fractures characterized. Mean follow-up was 8 months (6-56 months) after VTP. Fifty-two of 316 (16.4 %) patients (45 female, 7 male) returned for treatment of 69 secondary VCFs adjacent to (35/69; 51%) or distant from (34/69; 49%) previously treated levels. Adjacent secondary VCF occurred significantly more often compared to distant secondary VCF. Of the total 69 secondary VCFs, 35 of 69 occurred below and 27 of 69 above pretreated VCFs. Of the 65 sandwich levels generated, in 7 of 65 (11%) secondary VCFs were observed. Secondary VCF below pretreated VCF occurred significantly earlier in time compared to VCF above and compared to sandwich body fractures. No major complication occurred during initial or follow-up intervention. We conclude that secondary VCFs do occur in individuals after VTP but the rate found in our study remains below the level expected from epidemiologic studies. Adjacent fractures occur more often and follow the cluster distribution of VCF as expected from the natural history of the underlying osteoporosis. No increased rate of secondary VCF after VTP was observed in this retrospective analysis. In accordance with the pertinent literature, short-term and also midterm clinical results are encouraging and provide further support for the usefulness and the low complication rate of this procedure as an adjunct to the spectrum of pain management in patients with severe

  16. Zika Virus Shedding in Semen of Symptomatic Infected Men.

    Science.gov (United States)

    Mead, Paul S; Duggal, Nisha K; Hook, Sarah A; Delorey, Mark; Fischer, Marc; Olzenak McGuire, Dana; Becksted, Heidi; Max, Ryan J; Anishchenko, Michael; Schwartz, Amy M; Tzeng, Wen-Pin; Nelson, Christina A; McDonald, Erin M; Brooks, John T; Brault, Aaron C; Hinckley, Alison F

    2018-04-12

    Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that has been linked to adverse birth outcomes. Previous reports have shown that person-to-person transmission can occur by means of sexual contact. We conducted a prospective study involving men with symptomatic ZIKV infection to determine the frequency and duration of ZIKV shedding in semen and urine and to identify risk factors for prolonged shedding in these fluids. Specimens were obtained twice per month for 6 months after illness onset and were tested by real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for ZIKV RNA and by Vero cell culture and plaque assay for infectious ZIKV. A total of 1327 semen samples from 184 men and 1038 urine samples from 183 men were obtained 14 to 304 days after illness onset. ZIKV RNA was detected in the urine of 7 men (4%) and in the semen of 60 (33%), including in semen samples from 22 of 36 men (61%) who were tested within 30 days after illness onset. ZIKV RNA shedding in semen decreased substantially during the 3 months after illness onset but continued for 281 days in 1 man (1%). Factors that were independently associated with prolonged RNA shedding included older age, less frequent ejaculation, and the presence of certain symptoms at the time of initial illness. Infectious ZIKV was isolated from 3 of 78 semen samples with detectable ZIKV RNA, all obtained within 30 days after illness onset and all with at least 7.0 log 10 ZIKV RNA copies per milliliter of semen. ZIKV RNA was commonly present in the semen of men with symptomatic ZIKV infection and persisted in some men for more than 6 months. In contrast, shedding of infectious ZIKV appeared to be much less common and was limited to the first few weeks after illness onset. (Funded by the Centers for Disease Control and Prevention.).

  17. Bleeding Risk Profile in Patients With Symptomatic Peripheral Artery Disease.

    Science.gov (United States)

    Baumann, Frederic; Husmann, Marc; Benenati, James F; Katzen, Barry T; Del Conde, Ian

    2016-06-01

    To assess the bleeding risk profile using the HAS-BLED score in patients with symptomatic peripheral artery disease (PAD). A post hoc analysis was performed using data from a series of 115 consecutive patients (mean age 72.4±11.4 years; 68 men) with symptomatic PAD undergoing endovascular revascularization. The endpoint of the study was to assess bleeding risk using the 9-point HAS-BLED score, which was previously validated in cohorts of patients with and without atrial fibrillation. For the purpose of this study, the low (0-1), intermediate (2), and high-risk (≥3) scores were stratified as low/intermediate risk (HAS-BLED risk (HAS-BLED ≥3). The mean HAS-BLED score was 2.76±1.16; 64 (56%) patients had a HAS-BLED score ≥3.0. Patients with PAD Rutherford category 5/6 ischemia had an even higher mean HAS-BLED score (3.20±1.12). Logistic regression analysis revealed aortoiliac or femoropopliteal segment involvement, chronic kidney disease, as well as Rutherford category 5/6, to be independent risk factors associated with a HAS-BLED score ≥3. Patients with PAD, especially those presenting with Rutherford category 5/6 ischemic symptoms, have high HAS-BLED scores, suggesting increased risk for major bleeding. Prospective clinical validation of the HAS-BLED score in patients with PAD may help with the risk-benefit assessment when prescribing antithrombotic therapy. © The Author(s) 2016.

  18. Outcomes after operative management of symptomatic rib nonunion.

    Science.gov (United States)

    Gauger, Erich M; Hill, Brian W; Lafferty, Paul M; Cole, Peter A

    2015-06-01

    To report the outcomes of rib reconstruction after painful nonunion. Retrospective case series. Level I trauma center. Between November 2007 and May 2013, 10 patients who presented with 16 rib nonunions and disabling pain were treated with reconstruction of their nonunited rib fractures. Rib nonunion reconstruction predominately with iliac crest bone graft and a tension band plate with a locked precontoured plating system for ribs. Demographic data, mechanism of injury, and number of rib nonunions were recorded. Operative procedure, length of follow-up, complications, Short Form Survey 36, and a patient questionnaire were also captured and documented. Eight of the 10 patients sustained their original fractures from a fall. Outcomes were available for the 10 patients at a mean follow-up of up of 18.6 months (range, 3-46 months). All 16 ribs went on to union with a mean time from reconstruction to union of 14.7 weeks (range, 12-24 weeks). At final follow-up, the mean mental and physical component Short Form Survey 36 scores were 54.4 and 43.5, respectively. Eight of the 10 patients were able to return to work and/or previous activities without limitations. Complications included 1 wound infection that resolved after irrigation and debridement with adjunctive antibiotics. One symptomatic implant was removed. Ten patients with 16 symptomatic rib nonunions were reconstructed using autologous bone graft and implant/mesh fixation manifesting in successful union with improved patient function and a low rate of complications. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  19. Acute symptomatic hypocalcemia from immune checkpoint therapy-induced hypoparathyroidism.

    Science.gov (United States)

    Win, Myint Aung; Thein, Kyaw Zin; Qdaisat, Aiham; Yeung, Sai-Ching Jim

    2017-07-01

    Ipilimumab (a monoclonal antibody against CTLA-4) and nivolumab (a humanized antibody against PD-1) target these immune checkpoint pathways and are used for treatment of melanoma and an increasing number of other cancers. However, they may cause immune-related adverse effects (IRAEs). Although many endocrinopathies are known to be IRAEs, primary hypoparathyroidism with severe hypocalcemia has never been reported. This is the first case of hypoparathyroidism as an IRAE presenting to an Emergency Department with acute hypocalcemia. A 73-year-old man with metastatic melanoma presented to the Emergency Department for the chief complaints of imbalance, general muscle weakness, abdominal pain and tingling in extremities. He had wide spread metastasis, and begun immunotherapy with concurrent ipilimumab and nivolumab 1.5months ago. At presentation, he had ataxia, paresthesia in the hands and feet, and abdominal cramping. Magnetic resonance imaging of the brain was unremarkable. He was found to be hypocalcemic with undetectable plasma parathyroid hormone. He was admitted for treatment of symptomatic hypocalcemia and was diagnosed with primary hypoparathyroidism. Shortly afterwards, he had thyrotoxicosis manifesting as tachycardia and anxiety, followed by development of primary hypothyroidism. At 4months after the Emergency Department visit, his parathyroid function and thyroid function had not recovered, and required continued thyroid hormone replacement and calcium and vitamin D treatment for hypocalcemia. Primary hypoparathyroidism caused by ipilimumab and nivolumab may acute manifest with severe symptomatic hypocalcemia. Emergency care providers should be aware of hypoparathyroidism as a new IRAE in this new era of immuno-oncology. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Primary balloon angioplasty for symptomatic, high-grade intracranial stenosis.

    Science.gov (United States)

    Tomycz, Luke; Bansal, Neil K; Lockney, Tim; Strothers, Megan; Connors, John J; Shay, Scott; Singer, Robert J

    2013-01-01

    In light of recent controversy about the safety and efficacy of intracranial stenting, we sought to evaluate our experience with primary balloon angioplasty for symptomatic, high-grade intracranial stenosis. All intracranial angioplasty cases performed at Vanderbilt University Medical Center from 2006 to 2011 were retrospectively reviewed for degree of stenosis pre- and post-procedure. Immediate peri-procedural complications were evaluated as well as one-month and long-term outcomes. A total of 26 patients were included in the study with a mean age of 63.0 years and a mean follow-up of 350.2 days. The average pre-procedure stenosis was 71.2%. The immediate, average post-procedure stenosis was 46.6%, and the average post-procedure stenosis at last angiographic follow-up was 44.5%. Retreatment was required in only 3.8% of patients. The primary end-point of major stroke or death at 30 days was observed in 11.5%, and the overall intra-procedural complication rate was 7.7%. The incidence of stroke or death at last follow-up was 15.4%, which is comparable to the one-year stroke or death rate in the medical arm of the SAMPRISS trial. In this retrospective series, primary balloon angioplasty was found to be effective as a treatment option for symptomatic intracranial stenosis with the risk of stroke or death at 30 days higher than the medical arm of SAMPRIS but lower than the stenting arm. The one-year risk of stroke was comparable to that reported for the one-year outcomes in the SAMPRISS medical arm.

  1. Regional Monitoring of Cervical Cancer.

    Science.gov (United States)

    Crisan-Vida, Mihaela; Lupse, Oana Sorina; Stoicu-Tivadar, Lacramioara; Salvari, Daniela; Catanet, Radu; Bernad, Elena

    2017-01-01

    Cervical cancer is one of the most important causes of death in women in fertile age in Romania. In order to discover high-risk situations in the first stages of the disease it is important to enhance prevention actions, and ICT, respectively cloud computing and Big Data currently support such activities. The national screening program uses an information system that based on data from different medical units gives feedback related to the women healthcare status and provides statistics and reports. In order to ensure the continuity of care it is updated with HL7 CDA support and cloud computing. The current paper presents the solution and several results.

  2. Cervical disc hernia operations through posterior laminoforaminotomy.

    Science.gov (United States)

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  3. Cervical disc hernia operations through posterior laminoforaminotomy

    Directory of Open Access Journals (Sweden)

    Coskun Yolas

    2016-01-01

    Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  4. Prevalence and heritability of symptomatic syringomyelia in Cavalier King Charles Spaniels and long-term outcome in symptomatic and asymptomatic littermates

    DEFF Research Database (Denmark)

    Thøfner, Maria Søndergaard; Stougaard, C. L.; Westrup, Ulrik

    2015-01-01

    (P euthanasia in 20%. Dogs with syringes, which expressed no clinical signs at the age of 6, remained asymptomatic in 14/15 cases (93%). CONCLUSIONS AND CLINICAL IMPORTANCE: The prevalence of symptomatic SM is high...

  5. Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients

    Science.gov (United States)

    Murphy, M.; Connolly, P.; O’Byrne, J.

    2008-01-01

    We analysed the morbidity, mortality and outcome of cervical spine injuries in patients over the age of 65 years. This study was a retrospective review of 107 elderly patients admitted to our tertiary referral spinal injuries unit with cervical spine injuries between 1994 and 2002. The data was acquired by analysis of the national spinal unit database, hospital inpatient enquiry system, chart and radiographic review. Mean age was 74 years (range 66–93 years). The male to female ratio was 2.1:1 (M = 72, F = 35). The mean follow-up was 4.4 years (1–9 years) and mean in-hospital stay was 10 days (2–90 days). The mechanism of injury was a fall in 75 and road traffic accident in the remaining 32 patients. The level involved was atlanto-axial in 44 cases, sub-axial in 52 cases and the remaining 11 had no bony injury. Multilevel involvement occurred in 48 patients. C2 dominated the single level injury and most of them were type II odontoid fractures. Four patients had complete neurology, 27 had incomplete neurology, and the remaining 76 had no neurological deficit. Treatment included cervical orthosis in 67 cases, halo immobilization in 25, posterior stabilization in 12 patients and anterior cervical fusion in three patients. The overall complication rate was 18.6% with an associated in-hospital mortality of 11.2%. The complications included loss of reduction due to halo and Minerva loosening, non-union and delayed union among conservatively treated patients, pin site and wound infection, gastrointestinal bleeding and complication due to associated injuries. Among the 28.9% patients with neurological involvement, 37.7% had significant neurological recovery. Outcome was assessed using a cervical spine outcome questionnaire from Johns Hopkins School of Medicine. Sixty-seven patients (70%) completed the form, 20 patients (19%) were deceased at review and 8 patients (7%) were uncontactable. Functional disability was more marked in the patients with

  6. Overview and Prevention of Cervical Cancer | Ogu | Nigerian Health ...

    African Journals Online (AJOL)

    Background: Cervical cancer though a preventable disease, still has an estimated mortality of 80% from invasive cervical cancer in developing countries. The aim of this paper is to present an overview of cervical cancer and the various modalities available for screening and prevention of cervical cancer. Methodology: ...

  7. Knowledge and attitude towards cervical cancer screening among ...

    African Journals Online (AJOL)

    Background: Cervical cancer is a largely preventable disease. In western countries, the incidence of and mortality associated with cervical cancer has reduced substantially following the introduction of effective cervical screening programmes. This is in contrast to what is obtained in Africa including Nigeria where cervical ...

  8. Sexual life after cervical carcinoma.

    Science.gov (United States)

    Buković, Damir; Strinić, Tomislav; Habek, Mario; Hojsak, Iva; Silovski, Hrvoje; Krhen, Ivo; Maloca, Ivana; Radan, Mirjana

    2003-06-01

    The aim of this study is to determine the differences in sexual life of women with cervical cancer after surgery and radiation therapy. A total of 210 patients treated for cervical cancer at the Department of Obstetrics and Gynecology, School of Medicine, University of Zagreb, Croatia between March 2001 and March 2003 were asked to fill in the questionnaire. Sexual life had worsened in 42.86% of the surgical patients, as had in 25.00% of irradiated patients (p 0.05)). More than 80% of patients didn't notice any changes in their partner's behavior. Almost every third woman felt certain change in her "body image", similar in both groups (p > 0.05). Need for consultations regarding sex life after diagnosis were recognized by 71.43% of patients. In conclusion we can say that considerable amount of attention should be given to psychological and sexual aspects of recovery of patients, because those aspects can significantly influence patients rehabilitation and prognosis.

  9. Photodynamic therapy for cervical lesions

    Directory of Open Access Journals (Sweden)

    E. V. Grebenkina

    2014-01-01

    Full Text Available The experience of treatment for precancer and early cervical cancer by photodynamic therapy in 12 patients with primary diagnosis H-SIL (CIN II–III and cancer in situ is described. Chlo-rine photosensitizer Photolon was given intravenously at a dose of 0.75–1.15 mg/kg body weight. 2.5 h later the treatment with polyposition laser exposure (light dose – 150 J/cm2, light power density – 400–500 mW/cm2 was made. Thirty days later conization of the cervix with endocervical curettage assessing therapeutic response of cervical tumor tissue was per-formed. According to histological data complete response was in 4 patients, minute foci of CIN I were determined in 7 patients, 1 patient had foci of CIN II. 8 of 10 HPV-positive patients had complete eradication of HPV after treatment. There were no serious adverse events after light exposure. Marked therapeutic response, high anti-viral activity and good feasibility allow to consider photodynamic therapy as alternative organ-sparing treatment of early cancer and pre-cancer of cervix. 

  10. Cervical cytology biobanking in Europe.

    Science.gov (United States)

    Arbyn, Marc; Van Veen, Evert-Ben; Andersson, Kristin; Bogers, Johannes; Boulet, Gaëlle; Bergeron, Christine; von Knebel-Doeberitz, Magnus; Dillner, Joakim

    2010-01-01

    A cervical cytology biobank (CCB) is an extension of current cytopathology laboratory practice consisting in the systematic storage of Pap smears or liquid-based cytology samples from women participating in cervical cancer screening with the explicit purpose to facilitate future scientific research and quality audit of preventive services. A CCB should use an internationally agreed uniform cytology terminology, be integrated in a national or regional screening registry, and be linked to other registries (histology, cancer, vaccination). Legal and ethical principles concerning personal integrity and data safety must be respected strictly. Biobank-based studies require approval of ethical review boards. A CCB is an almost inexhaustible resource for fundamental and applied biological research. In particular, it can contribute to answering questions on the natural history of HPV infection and HPV-induced lesions and cancers, screening effectiveness, exploration of new biomarkers, and surveillance of the short- and long-term effects of the introduction of HPV vaccination. To understand the limitations of CCB, more studies are needed on the quality of samples in relation to sample type, storage procedures, and duration of storage.

  11. Functional cervical myelography with iohexol

    International Nuclear Information System (INIS)

    Nakstad, P.; Aaserud, O.; Nyberg-Hansen, R.; Ganes, T.

    1985-01-01

    Thirty patients underwent functional cervical myelography, i.e. radiographs in the lateral view were obtained in extension as well as in flexion of the neck. Sagittal tomography was performed in both positions. Narrowing of the subarachnoid space and increased sagittal diameter of the spinal cord due to shortening were demonstrated in the lateral view in extension. In flexion a widening of the subarachnoid space was seen in almost all. In some cases with advanced narrowing or spinal block in extension, such widening in flexion resulted in better diagnostic images by providing passage of the contrast medium caudally. Although iohexol (Omnipaque, Nyegaard and Co., Oslo) was regularly forced into the posterior cranial fossa by the movements, the frequency of side effects was approximately the same as in our former trials with iohexol in conventional cervical myelography. EEG changes occurred in two patients (7%). A sitting position for 3-4 min after the examination followed by an elevated head end of the bed was probably important for preventing side effects from the contrast medium. Specific questioning revealed twice as many subjective side effects as reported after general questions alone. (orig.)

  12. Qualitative grading of disc degeneration by magnetic resonance in the lumbar and cervical spine: lack of correlation with histology in surgical cases.

    Science.gov (United States)

    Davies, B M; Atkinson, R A; Ludwinski, F; Freemont, A J; Hoyland, J A; Gnanalingham, K K

    2016-08-01

    Clinically, magnetic resonance (MR) imaging is the most effective non-invasive tool for assessing IVD degeneration. Histological examination of the IVD provides a more detailed assessment of the pathological changes at a tissue level. However, very few reports have studied the relationship between these techniques. Identifying a relationship may allow more detailed staging of IVD degeneration, of importance in targeting future regenerative therapies. To investigate the relationship between MR and histological grading of IVD degeneration in the cervical and lumbar spine in patients undergoing discectomy. Lumbar (N = 99) and cervical (N = 106) IVD samples were obtained from adult patients undergoing discectomy surgery for symptomatic IVD herniation and graded to ascertain a histological grade of degeneration. The pre-operative MR images from these patients were graded for the degree of IVD (MR grade) and vertebral end-plate degeneration (Modic Changes, MC). The relationship between histological and MR grades of degeneration were studied. In lumbar and cervical IVD the majority of samples (93%) exhibited moderate levels of degeneration (ie MR grades 3-4) on pre-operative MR scans. Histologically, most specimens displayed moderate to severe grades of degeneration in lumbar (99%) and cervical spine (93%). MR grade was weakly correlated with patient age in lumbar and cervical study groups. MR and histological grades of IVD degeneration did not correlate in lumbar or cervical study groups. MC were more common in the lumbar than cervical spine (e.g. 39 versus 20% grade 2 changes; p < 0.05), but failed to correlate with MR or histological grades for degeneration. In this surgical series, the resected IVD tissue displayed moderate to severe degeneration, but there is no correlation between MR and histological grades using a qualitative classification system. There remains a need for a quantitative, non-invasive, pre-clinical measure of IVD degeneration that

  13. The relationship between electrodiagnosis using spinal cord evoked potential after spinal cord stimulation and MRI evaluation for cervical myelopathy

    International Nuclear Information System (INIS)

    Kato, Tsuyoshi; Shiba, Keiichiro; Ueta, Takayoshi; Ohta, Hideki; Mori, Eiji; Kaji, Kozo; Yuge, Itaru; Kawano, Osamu

    2006-01-01

    We studied the correlation between the site of high intensity spinal cord signals on preoperative sagittal T2 MRIs (T2-high signal) and that of intrdaperative electrophysiological abnormalities for 200 cervical myelopathy cases. We recorded the Sp(E)-SCEPs during posterior cervical laminoplasty operations. In the cases with a T2-high signal at single levels, conduction abnormality matched the site of T2-high signal in 50%, and no conduction abnormalities were detected in 44%. In the cases with a T2-high signal at two levels, conduction abnormality matched the site of T2-high signal in only 11%, and no conduction abnormalities were disclosed in 59%. In the cases with a T2-high signal at three or more levels, conduction abnormalities matched the site of T2-high signal in 8% and no conduction abnormalities were disclosed in 72%. Our study showed a higher correspondence between the MRI finding and conduction abnormalities in the cases with T2-high signal at single levels, although our Sp(E)-SCEP study could not disclose conduction abnormalities in nearly half the cases. False negative findings of Sp(E)-SCEPs may result from the simplified recording technique. (author)

  14. Six psychotropics for pre-symptomatic & early Alzheimer's (MCI, Parkinson's, and Huntington's disease modification

    Directory of Open Access Journals (Sweden)

    Edward C Lauterbach

    2016-01-01

    Full Text Available The quest for neuroprotective drugs to slow the progression of neurodegenerative diseases (NDDs, including Alzheimer's disease (AD, Parkinson's disease (PD, and Huntington's disease (HD, has been largely unrewarding. Preclinical evidence suggests that repurposing quetiapine, lithium, valproate, fluoxetine, donepezil, and memantine for early and pre-symptomatic disease-modification in NDDs may be promising and can spare regulatory barriers. The literature of these psychotropics in early stage and pre-symptomatic AD, PD, and HD is reviewed and propitious findings follow. Mild cognitive impairment (MCI phase of AD: salutary human randomized controlled trial findings for low-dose lithium and, in selected patients, donepezil await replication. Pre-symptomatic AD: human epidemiological data indicate that lithium reduces AD risk. Animal model studies (AMS reveal encouraging results for quetiapine, lithium, donepezil, and memantine. Early PD: valproate AMS findings show promise. Pre-symptomatic PD: lithium and valproate AMS findings are encouraging. Early HD: uncontrolled clinical data indicate non-progression with lithium, fluoxetine, donepezil, and memantine. Pre-symptomatic HD: lithium and valproate are auspicious in AMS. Many other promising findings awaiting replication (valproate in MCI; lithium, valproate, fluoxetine in pre-symptomatic AD; lithium in early PD; lithium, valproate, fluoxetine in pre-symptomatic PD; donepezil in early HD; lithium, fluoxetine, memantine in pre-symptomatic HD are reviewed. Dose- and stage-dependent effects are considered. Suggestions for signal-enhancement in human trials are provided for each NDD stage.

  15. Prolonged Shedding of Human Parechovirus in Feces of Young Children after Symptomatic Infection

    NARCIS (Netherlands)

    Wildenbeest, Joanne G; Benschop, Kimberley S M; Bouma-de Jongh, Saskia; Wolthers, Katja C; Pajkrt, Dasja

    2016-01-01

    After symptomatic human parechovirus (HPeV) infection in infants, the duration of (mostly asymptomatic) shedding in feces was 2-24 weeks (median 58 days). HPeV cycle threshold value could neither differentiate between symptomatic disease and asymptomatic shedding nor between severe and mild disease

  16. Recurrence Risk after a First Remote Symptomatic Unprovoked Seizure in Childhood: A Prospective Study

    Science.gov (United States)

    Ramos-Lizana, J.; Aguirre-Rodriguez, J.; Aguilera-Lopez, P.; Cassinello-Garcia, E.

    2009-01-01

    The aim of this study was to assess recurrence risk after a first remote symptomatic unprovoked seizure in childhood. All consecutive patients younger than 14 years with a first remote symptomatic unprovoked seizure who were seen at our hospital between 1994 and 2006 were included in the study and prospectively followed. Only two patients received…

  17. Elongated Styloid Process and Cervical Spondylosis

    Directory of Open Access Journals (Sweden)

    Zeliha Unlu MD

    2008-01-01

    Full Text Available Background Dysphagia, is a significant sign of many different lesions in upper digestive system especially in proximal esophagus. Tumors, gastroesophageal reflux, achalasia and extrinsic compressions are the most common causes that may lead to dysphagia in geriatric population. Cervical osteophyte induced dysphagia, is one of the uncommon reasons of dysphagia, therefore other causes of dysphagia must be excluded to establish the exact diagnosis. Eagle syndrome is one of the considerable reason which may lead to misdiagnosis in patients with cervical osteophytes. In this case report, we represent four patients who had dysphagia due to anteriorly located cervical osteophytes and evaluate the patients with special reference to Eagle syndrome. Material and methods After a detailed anamnesis and ENT examination, cervical plain radiographs in four projections and Towne radiographs were obtained for every patient. After that, magnetic resonance imaging (MRI of cervical spine and barium swallowing studies were performed to evaluate the presence of esophageal compression. Results Eagle syndrome was excluded due to absence of other symptoms and physical signs, eventhough unilateral or bilateral elongation of styloid processes was found in all of the patients. Conclusion Cervical osteophytes induced dysphagia is a rare clinical entity, diagnosis should be done by a careful examination, intensive radiologic evaluation. Moreover, all the other causes like Eagle syndrome should be excluded during the diagnosis of cervical osteophyte induced dysphagia.

  18. Human Papillomavirus and Vaccination in Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Kung-Liahng Wang

    2007-12-01

    Full Text Available Cervical cancer is not only the most frequently reported cancer among women, but also the most common female genital tract neoplasm in Taiwan. Early detection is effective, because the development, maintenance and progression of precursor lesions (cervical intraepithelial neoplasia [CIN] evolve slowly into invasive cancer, typically over a period of more than 10 years. It is now recognized that human papillomavirus (HPV infection is a necessary cause for over 99% of cervical cancer cases. Advances in the understanding of the causative role of HPV in the etiology of high-grade cervical lesions (CIN 2/3 and cervical cancer have led to the development, evaluation and recommendation of HPV-based technologies for cervical cancer prevention and control. The prevention of HPV infection before the onset of CIN is now possible with recently available prophylactic HPV vaccines, e.g. the quadrivalent Gardasil (Merck & Co., NJ, USA and bivalent Cervarix (GlaxoSmithKline, London, UK. This review article provides an up-to-date summary of recent studies and available information concerning HPV and vaccination in cervical cancer.

  19. EXPRESSION OF HPV 16 AND 18 IN CERVICAL INTRAEPITHELIAL NEOPLASIA

    OpenAIRE

    Kodali Venkataramana; Prasad Usha

    2017-01-01

    BACKGROUND Cervical cancer is by far the most common human papilloma virus related disease. Nearly, all cases of cervical cancer can be attributable to human papilloma virus infection. Infection with the human papilloma virus is the main risk factors for cervical intraepithelial neoplasia and cervical cancer especially the high-risk types. The aim of the study is to study the prevalence of high-risk human papilloma virus 16 and 18 in various grades of cervical intraepithelia...

  20. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Science.gov (United States)

    Magee, David

    2012-01-01

    ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r = 0.82). Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD) and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07). However, clinically important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders. PMID:24422022

  1. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Susan Armijo-Olivo

    2012-09-01

    Full Text Available Objectives: The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods: A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance to determine cervical musculoskeletal impairments. Results: A strong relationship between neck disability and jaw disability was found (r = 0.82. Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD and healthy subjects. However, the difference was too small (3.3º to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07. However, clinically important effect sizes (0.42 - 0.82 were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions: Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders.

  2. Economic burden of cervical cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Sharifa E.W. Puteh

    2008-12-01

    Full Text Available Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An activity based costing for each clinical pathway was done. Results were converted to USD. The cost of managing pre-invasive cervical cancers stage is USD 420,150 (Range: USD 197,158-879,679. Management of invasive cancer (new cases costs USD 51,533,233.44 (Range: USD 32,405,399.69 - USD 129,014,768.40. The cost of managing existing cases is USD 17,005,966.87 (Range: USD 10,693,781.90 - USD  28,901,587.12. The total cost of managing cervical cancers by health care providers in a public setting is around USD 75,888,329.45 (Range: USD 48,083,804.60 - USD 48,083,804.60. The outcome of this study has shown that preventive modalities such as screening have only contributed to 10.3 % of the total management cost of cervical cancer. The major cost contribution (67% came from treatment of invasive cancer especially at more advanced stages of cancer, followed by treatment of existing cases (22% and lastly on pre-invasive disease (0.6%. This study revealed that proportion of preventive modality in this country was still low, and the major cost came from actual treatment cost of cervical cancer. Therefore, heightened public cervical cancer screening in the country is needed. (Med J Indones 2008; 17: 272-80Keywords: cervical cancers, pre invasive disease, HPV vaccination

  3. Radiological evaluation of the cervical spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Bae, W. K.; Koh, B. H.; Hahm, C. K.; Kim, J. J. [School of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1983-03-15

    Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal.

  4. Radiological evaluation of the cervical spinal trauma

    International Nuclear Information System (INIS)

    Bae, W. K.; Koh, B. H.; Hahm, C. K.; Kim, J. J.

    1983-01-01

    Acute injuries of the cervical spine are the most common causes of severe disability following trauma, yet the diagnosis of these injuries are often delayed and the treatment, inadequate. Traumatic injuries of the cervical spine are diagnosed by radiological examinations. And complete evaluations of bony structures and soft tissue changes on conventional radiograms are very important for determining the therapeutic plans and prognoses of the injuries patients. During the period of 5 years from June 1976 to May 1981, the radiological and clinical evaluation had been made on 38 patients suffered from acute cervical spinal injuries which were confirmed by the radiological examinations. The results were as follows. 1. Age distribution of total 38 patients was broad ranging from 19 years to 72 years. 2. The most common cause of injury was traffic accident, next fall down, other accident respectively. 3. Levels of the cervical spinal injuries were as follows: Upper cervical spine in 15.8%, lower cervical spine in 84.2%, and the most common injuries level was C 5. Most of the lower cervical spinal injuries were located in the vertebral body and spinous process. 4. Anatomical sites of the cervical spinal injuries were as follows; vertebral body in 55.5%, spinous process in 23.7%, neural arch in 15.8%, and locked facet in 18.4%, etc. 5. Most of the patients with severe mental changes were injuries in upper cervical spine rather than lower. And most of the patients with quadriplegia or paraplegia were shown marked disruption of spinal canal

  5. Pediatric symptomatic Rathke cleft cyst compared with cystic craniopharyngioma.

    Science.gov (United States)

    Hayashi, Yasuhiko; Kita, Daisuke; Fukui, Issei; Sasagawa, Yasuo; Oishi, Masahiro; Okajima, Michiko; Tachibana, Osamu; Nakada, Mitsutoshi

    2016-09-01

    Symptomatic Rathke cleft cysts (RCCs) are rarely detected in neuroradiological screening and are less commonly found in children than in adults. However, when RCCs are observed in children, it is important to carefully distinguish a RCC from a cystic craniopharyngioma (CP) even if surgically treated or conservatively followed up. We conducted a retrospective review of clinical data from 11 patients with symptomatic RCCs whose ages were under 18 years and compared the data with data from 15 age- and sex-matched patients with cystic CP who were treated at our institute. The mean age of the patients with RCCs was 12.2 years (range, 6-18). There were six males and five females. As initial symptoms, nine patients presented with headache, while two each had impaired visual function, diabetes insipidus, and activity loss. The 14 patients with CP suffered from impaired visual function. Magnetic resonance imaging (MRI) mainly showed hyperintensity on T1-weighted images (WIs) and hypointensity on T2-WI in patients with RCC. However, patients with CP had characteristic hyperintensity on T2-WI. The average maximum diameter of the RCCs was 19.0 mm on average (range, 8-33 mm). The RCCs were thus significantly smaller than CPs (34.9 mm; range, 21-54 mm). The RCCs were usually oval or dumbbell-shaped and regular in appearance, while the larger CPs were lobular and irregular. A preoperative endocrinological evaluation revealed insufficiencies in four axes in five patients with RCC. Postoperative endocrinological status improved in three patients, remained unchanged in three, and worsened in one. The gonadotropin axis was damaged in a majority (nine) of the patients with CP preoperatively. Postoperative evaluation revealed deficits in five axes in 14 patients with CP, which is a significantly different trend than observed in patients with RCC. Eight patients underwent surgical procedures (transsphenoidal surgery (TSS) in four, craniotomy in four). Two of these patients

  6. Immunosuppression and risk of cervical cancer

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Rebolj, Matejka; Garred, Peter

    2013-01-01

    -stage renal disease seem to be at an increased risk of cervical cancer. A higher risk of cervical precancerous lesions was found in patients with some autoimmune diseases; particularly if treated with immunosuppressants. Among behavioral factors weakening the immune system, smoking appeared to strongly...... increase the risk of cervical cancer, while poor diet only moderately increased the risk. It is difficult to determine whether sexually transmitted infections other than human papillomavirus infection are independent risk factors. Identifying those groups of women likely to fail in clearing persistent...

  7. Vital Signs-Cervical Cancer is Preventable!

    Centers for Disease Control (CDC) Podcasts

    2014-11-05

    This podcast is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.  Created: 11/5/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/5/2014.

  8. Cervical Cancer is Preventable! PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-11-05

    This 60 second Public Service Announcement is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.  Created: 11/5/2014 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 11/5/2014.

  9. MR imaging in cervical hyperextension injuries

    International Nuclear Information System (INIS)

    Davis, S.J.; Teresi, L.M.; Bradley, W.G. Jr.; Ziemba, M.R.

    1990-01-01

    This paper reports on cervical hyperextension injuries that are common and often show minimal radiographic abnormalities, even with severe or unstable lesions. MR images and clinical records of 14 patients scanned within 4 months of hyperextension cervical injuries were reviewed. Clinical, radiographic, and MR findings were correlated. Nine patients had acceleration hyperextension whiplash injuries, four with acute cervical disk herniations developing radiculopathy after several weeks. Five patients injured by direct frontal head trauma presented with myelopathy and had MR evidence of cord injury, and four had acute disk herniation

  10. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W

    2015-01-01

    BACKGROUND: The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25-60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our...... 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. CONCLUSION: Despite...

  11. Increasing Cervical Cancer Screening in Underserved Populations.

    Science.gov (United States)

    Dorsainvil, Merlyn A

    The incidence of cervical cancer has declined dramatically due to Papanicolaou smear testing. However, some minority populations continue to suffer with high incidences and/or death rates of cervical cancer, due to lack of screening. This article updates on cervical cancer screening and prevention and discusses cultural impacts on screening. Knowledge deficits disproportionately affect ethnic minority groups and contribute to cancer incidence, whereas lack of healthcare coverage and low socioeconomic status contribute to screening disparities. Although minority women have cultural beliefs and practices that influence screening, recommendation and/or education from a provider often lead to screening.

  12. Significance of T2 Hyperintensity on Magnetic Resonance Imaging After Cervical Cord Injury and Return to Play in Professional Athletes.

    Science.gov (United States)

    Tempel, Zachary J; Bost, Jeffrey W; Norwig, John A; Maroon, Joseph C

    2015-07-01

    Cervical cord magnetic resonance imaging (MRI) T2 hyperintensity is used as evidence of cord trauma in the evaluation and management of athletes in contact sports. The long-term pathophysiologic and prognostic value of this finding is poorly understood, especially in return to play (RTP). To examine the significance of T2 hyperintensity in the cervical spinal cord of professional athletes. Retrospective review of MRI T2 hyperintensity findings between 2007 and 2014 in 5 professional athletes. Pertinent examination and demographics, including mechanism of injury, surgical intervention, radiographs, MRI studies, long-term outcomes, and RTP recommendations were collected. Four National Football League players and 1 professional wrestler had prior traumatic neurapraxia that at the time of initial consultation had resolved. MRIs showed congenitally small cervical canal (1) and multilevel spondylosis/stenosis/disc herniation (4) along with focal cord T2 hyperintensity (5). The signal abnormalities were at C3/C4 (3), C4 mid-vertebral body (1), and C5/C6 (1). Four athletes had single-level anterior cervical discectomy and fusion, and 1 was nonoperative. Serial MRI imaging at 3 months after surgery showed hyperintensity partially resolved (4) and unchanged (1), and at 9-months 3 of the 5 completely resolved. Based on the author's RTP criteria, 4 of 5 were released to return to their sport. Clearance for RTP preceded complete resolution of MRI T2 hyperintensity in 3 of 4 athletes. The 2 athletes that have returned to profession sport have not had any additional episodes of neurapraxia or any cervical spine-related complications. MRI T2 hyperintensity in contact sport athletes who are symptom-free with normal examination and no evidence of spinal instability may not be a contraindication to RTP. Additional observations are needed to confirm this observation.

  13. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    Directory of Open Access Journals (Sweden)

    Salih Gulsen

    2015-03-01

    CONCLUSION: We achieved better cervical lordotic angles at the postoperative period by implanting one-level, two-level, three-level or four-level PEEK cage filled with demineralized bone matrix. Also, the causes of cervical root and or medulla spinalis impingement were different in group1 and 2. While extruded cervical disc impingement was the first pathology in group 1, osteophyte formation was the first pathology in group 2.

  14. Cervical precancerous changes and selected cervical microbial infections, Kiambu County, Kenya, 2014: a cross sectional study.

    Science.gov (United States)

    Kanyina, Evalyne Wambui; Kamau, Lucy; Muturi, Margaret

    2017-09-25

    Cervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions. Population-based cytological screening and early treatment reduces morbidity and mortality associated with the cancer. We determined the occurrence of cervical precancerous changes and cervical microbial infections (Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea and Actinomyces) among women attending Family Health Option Kenya (FHOK) clinic in Thika. This was a hospital based cross sectional study among women attending reproductive health screening clinic from November 2013 to January 2014. Cervical Intraepithelial Neoplasia (CIN) I, II, III, cervical cancer and microbial infection (Actinomyces, Trichomonas vaginalis and Yeast cells) diagnosis was based on Pap smear screening test and High Vaginal Swab wet preparation microscopy. Neisseria gonorrhea was diagnosed through Gram staining. Socio-demographic and reproductive health data was collected using a structured questionnaire administered to the study participants and analyzed using Epi Info version 3.5.1. Of the 244 women screened, 238 (97.5%) presented with cervical inflammation, 80 (32.8%) cervical microbial infections and 12 (4.9%) cervical precancerous changes; 10 (83.3%) with CIN I and 2 (16.7%) CIN II. Of the 80 cervical microbial infections, 62 (77.5%) were yeast cell and 18 (22.5%) T. vaginalis. One thirty four (55%) participants had no history of Pap smear screening of which 84 (62.7%) were 20-40 years. Use of IUCDs (OR: 2.47, 95% CI 1.3-4.6) was associated with cervical inflammation. CIN I was the predominant cervical precancerous change. There is need to scale up cervical screening test to capture all categories of women.

  15. Management of symptomatic thrombocytopenia associated with dengue haemorrhagic fever

    International Nuclear Information System (INIS)

    Jameel, T.; Saleem, I.U.; Mehmood, K.; Tanvir, I.; Saadia, A.

    2010-01-01

    Introduction: Immune - mediated destruction of platelets is thought to be the mechanism of thrombocytopenia seen after the viraemic phase of dengue haemorrhagic fever (DHF). Immuno - suppressants such as steroids, immune globulin and Anti D immune globulin are effective in the treatment of this type of immune thrombocytopenic purpura. Objective: To evaluate the efficacy of oral Prednisolone in the rate of resolution of thrombocytopenia and monitoring of complications in patients recovering from Dengue haemorrhagic fever. Method: A controlled study was carried out on diagnosed cases Dengue haemorrhagic patients presenting with sever thrombocytopenia and symptoms like confluent ecchymosis, epistaxis and purpuric rashes. In study was conducted in Ittefaq hospital (trust) Lahore, during the period of October to December 2008. Treatment group received steroids in two forms i.e. first line therapy prednisolone (1 mg / kg) orally or as second line therapy of initial I/V high dose (prednisolone) in pulse doses i.e. 40 mg / bd for four days and later oral prednisolone as in first line therapy with omeprazole 20 mg / bd in addition to standard treatment. Control group received standard supportive care only. Results: A total of 341 suspected patients were admitted in hospital. Serological diagnosis was confirmed in 166 patients. CBC revealed platelet count . 100 x 109 / l in 106 patients. A group of symptomatic febrile patients have platelet count < 20 x 109 / l was selected for therapeutic intervention. first line therapy (oral prednisolone was stated in 43 patients. In Fourteen patients second line therapy (high dose dexamethasone pulse) therapy was instituted. Seven of them attained complete response whereas two patients achieved partial response. Four patients were shifted to Anti D therapy. Three deaths occurred during our study. Rest of all the patients improved and were discharged in due course of time. Conclusion: This small scale preliminary study shows promising

  16. Distracted cervical spinal fusion for management of caudal cervical spondylomyelopathy in large-breed dogs

    Energy Technology Data Exchange (ETDEWEB)

    Ellison, G. W.; Seim, III, H. B.; Clemmons, R. M.

    1988-08-15

    Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space.

  17. Distracted cervical spinal fusion for management of caudal cervical spondylomyelopathy in large-breed dogs

    International Nuclear Information System (INIS)

    Ellison, G.W.; Seim, H.B. III; Clemmons, R.M.

    1988-01-01

    Using an autogenous bone graft (obtained from the iliac crest), 4-mm cancellous bone screws, and polymethylmethacrylate, a distracted cervical spinal fusion technique was performed on 10 dogs with myelographic evidence of caudal cervical spondylomyelopathy. All dogs had evidence of dynamic soft tissue spinal cord compression, as indicated by flexion, extension, and traction myelographic views. Of the 10 dogs, 4 previously had undergone surgery by use of ventral slot or cervical disk fenestration techniques, and their neurologic status had deteriorated after the original surgery. Preoperative neurologic status of the 10 dogs included nonambulatory tetraparesis (n = 5), severe ataxia with conscious proprioceptive deficits (n = 2), and mild ambulatory ataxia with conscious proprioceptive deficits (n = 3). Five dogs had signs of various degrees of cervical pain. Clinical improvement was observed in 8 of 10 dogs--either improved neurologic status or elimination of cervical pain. Implant loosening developed in 3 dogs; 2 of them were euthanatized because of lack of neurologic improvement. Radiographic evidence of bony cervical fusion was observed during a 9- to 24-week period in 6 of the 8 surviving dogs. The distracted cervical fusion technique appears to be a valid surgical procedure to manage cervical spondylomyelopathy in those dogs in which the lesions are limited to one cervical intervertebral disk space

  18. Cervical tuberculous adenitis: CT manifestations.

    Science.gov (United States)

    Reede, D L; Bergeron, R T

    1985-03-01

    Cervical tuberculous adenitis is being seen with increasing frequency in the United States; in the appropriate clinical setting it should be included in the differential diagnosis of an asymptomatic neck mass. Patients are typically young adults who are recent arrivals from Southeast Asia. A history of tuberculosis is not always elicited nor is the chest radiograph always abnormal. All of these patients have positive purified protein derivative tests unless they are anergic. The CT findings may lead to the diagnosis. Several CT patterns of nodal disease can be seen in tuberculous adenitis; some may mimic benign and neoplastic disease. The presence of a multiloculated or multichambered (conglomerate nodal) mass with central lucency and thick rims of enhancement and minimally effaced fascial planes is highly suggestive of tuberculous adenitis, especially if the patient has a strongly positive tuberculosis skin test.

  19. Cervical tuberculous adenitis: CT manifestations

    International Nuclear Information System (INIS)

    Reede, D.L.; Bergeron, R.T.

    1985-01-01

    Cervical tuberculous adenitis is being seen with increasing frequency in the United States; in the appropriate clinical setting it should be included in the differential diagnosis of an asymptomatic neck mass. Patients are typically young adults who are recent arrivals from Southeast Asia. A history of tuberculosis is not always elicited nor is the chest radiograph always abnormal. All of these patients have positive purified protein derivative tests unless they are anergic. The CT findings may lead to the diagnosis. Several CT patterns of nodal disease can be seen in tuberculous adenitis; some may mimic benign and neoplastic disease. The presence of a multiloculated or multichambered (conglomerate nodal) mass with central lucency and thick rims of enhancement and minimally effaced fascial planes is highly suggestive of tuberculous adenitis, especially if the patient has a strongly positive tuberculosis skin test

  20. Symptomatic Acute-on-Chronic Subdural Hematoma: A Clinicopathological Study.

    Science.gov (United States)

    Castellani, Rudy J; Mojica-Sanchez, Gruschenka; Schwartzbauer, Gary; Hersh, David S

    2017-06-01

    The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion. Given the prevalence of traumatic subdural processes in the forensic setting and the importance of proper assessment of timing, etiology, risk factors, and clinicopathological correlation, we studied 47 patients presenting to the University of Maryland Shock Trauma Center, all of whom underwent craniotomy with resection of the outer membrane due to symptomatic ACSDH. The surgically resected tissue was examined for histopathologic features in all cases. Our findings highlight that ACSDH is a condition precipitated by trauma that affects middle-aged and older adults, is relatively indolent, is unilateral or asymmetric, and has a low in-hospital mortality rate. Pathological analysis demonstrates a substantial outer membrane in all cases with varying degrees of inflammation and organization that cannot be precisely dated as a function of clinical presentation. The extrapolation of adult ACSDH to mixed acute and chronic subdural hemorrhage in the pediatric setting is problematic due to substantial differences in clinical presentation, severity of underlying brain injury, gross and microscopic findings, and outcome.

  1. Symptomatic arrhythmias due to syringomyelia-induced severe autonomic dysfunction.

    Science.gov (United States)

    Riedlbauchová, Lucie; Nedělka, Tomáš; Schlenker, Jakub

    2014-10-01

    Syringomyelia is characterized by cavity formation in the spinal cord, most often at C2-Th9 level. Clinical manifestation reflects extent and localization of the spinal cord injury. 20-year old woman was admitted for recurrent rest-related presyncopes with sudden manifestation. Paroxysms of sinus bradycardia with SA and AV blocks were repeatedly documented during symptoms. There was normal echocardiographic finding, (para) infectious etiology was not proved. Character of the ECG findings raised suspicion on neurogenic cause. Autonomic nervous system testing demonstrated abnormalities reflecting predominant sympathetic dysfunction. Suspicion on incipient myelopathy was subsequently confirmed by MRI, which discovered syringomyelia at Th5 level as the only pathology. A 52-year old man with hypotrophic quadruparesis resulting from perinatal brain injury was sent for 2-years lasting symptoms (sudden palpitation, sweating, muscle tightness, shaking) with progressive worsening. Symptoms occurred in association with sudden increase of sinus rhythm rate and blood pressure that were provoked by minimal physical activity. Presence of significant autonomic dysregulation with baroreflex hyperreactivity in orthostatic test and symptomatic postural orthostatic tachycardia with verticalization-associated hypertension were proved. MRI revealed syringomyelia at C7 and Th7 level affecting sympathetic centers at these levels. Sympathetic fibers dysfunction at C-Th spinal level may cause significant autonomic dysfunction with arrhythmic manifestation.

  2. Morphological findings in dynamic swallowing studies of symptomatic patients

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, Martina; Pokieser, Peter; Schober, Ewald; Schima, Wolfgang; Eisenhuber, Edith; Stadler, Alfred; Memarsadeghi, Mazda; Partik, Bernhard; Lechner, Gerhard [Department of Radiology, University of Vienna (Austria); Ludwig Boltzmann Institute for Radiologic Tumor Diagnosis, Vienna (Austria); Ekberg, Olle [Department of Diagnostic Radiology, Malmoe University Hospital (Sweden)

    2002-05-01

    The aim of this study was to assess the role of videofluoroscopy in the detection of structural abnormalities of the pharynx and esophagus in patients with different symptoms of impaired deglutition. Dynamic radiographic recording of deglutition was performed in 3193 consecutive patients (1578 men, 1615 women; mean age 54 years) suffering from dysphagia, suspicion of aspiration, globus sensation, and non-cardiac chest pain. We assessed different structural lesions from the oral cavity to the esophagus and classified them into eight categories. Their frequency and association with the different clinical symptoms were evaluated. Videofluoroscopy revealed 1040 structural abnormalities in 833 patients (26%) including mass lesions from the oral cavity to hyoid/larynx (n=66), pharyngeal diverticula (n=181), pharyngeal masses (n=78), other pharyngeal narrowings (n=71), webs (n=98), masses (n=39), and other narrowings (n=73) of the upper esophageal sphincter, esophageal diverticula (n=80), esophageal webs, rings and strictures (n=194), and intrinsic and extrinsic esophageal lesions (n=160). There was a considerable variance of findings for different symptoms. In a large proportion of symptomatic patients videofluoroscopy detects morphological abnormalities along pharynx and esophagus often combined with functional disorders. This fact underlines the role of videofluoroscopy as a diagnostic test for function as well as morphology. (orig.)

  3. Morphological findings in dynamic swallowing studies of symptomatic patients

    International Nuclear Information System (INIS)

    Scharitzer, Martina; Pokieser, Peter; Schober, Ewald; Schima, Wolfgang; Eisenhuber, Edith; Stadler, Alfred; Memarsadeghi, Mazda; Partik, Bernhard; Lechner, Gerhard; Ekberg, Olle

    2002-01-01

    The aim of this study was to assess the role of videofluoroscopy in the detection of structural abnormalities of the pharynx and esophagus in patients with different symptoms of impaired deglutition. Dynamic radiographic recording of deglutition was performed in 3193 consecutive patients (1578 men, 1615 women; mean age 54 years) suffering from dysphagia, suspicion of aspiration, globus sensation, and non-cardiac chest pain. We assessed different structural lesions from the oral cavity to the esophagus and classified them into eight categories. Their frequency and association with the different clinical symptoms were evaluated. Videofluoroscopy revealed 1040 structural abnormalities in 833 patients (26%) including mass lesions from the oral cavity to hyoid/larynx (n=66), pharyngeal diverticula (n=181), pharyngeal masses (n=78), other pharyngeal narrowings (n=71), webs (n=98), masses (n=39), and other narrowings (n=73) of the upper esophageal sphincter, esophageal diverticula (n=80), esophageal webs, rings and strictures (n=194), and intrinsic and extrinsic esophageal lesions (n=160). There was a considerable variance of findings for different symptoms. In a large proportion of symptomatic patients videofluoroscopy detects morphological abnormalities along pharynx and esophagus often combined with functional disorders. This fact underlines the role of videofluoroscopy as a diagnostic test for function as well as morphology. (orig.)

  4. Surgical Management of the Adult Symptomatic Retractile Testicle.

    Science.gov (United States)

    Osborn, David James; Martinez, Andy J; Jezior, James R

    2017-02-01

    To assess the efficacy and safety of circumferential cremasteric lysis in the treatment of adult symptomatic retractile testicles. This is a retrospective chart review of all patients who had undergone circumferential cremasteric lysis at a single institution performed by a single surgeon between January 2010 and December 2011. We evaluated the etiology, pre- and postoperative pain intensity, postoperative pain alleviation, and any surgical complications. We used the Wilcoxon signed-rank test to compare pain levels before and at last follow-up after surgery. Eight patients (mean age, 31.5 ± 10.60; range, 22-51 years) underwent circumferential cremasteric lysis. The procedure resulted in a clinically meaningful and statistically significant difference in postoperative pain intensity. The mean pain levels decreased from 5.6 (preoperatively) to 1.5 (at last follow-up) (5.6 vs 1.5, P Wilcoxon signed-rank test). The mean follow-up was 21.63 ± 13.70 months (range, 9-50 months). Four patients (50%) reported complete resolution and four (50%) reported partial resolution of their testicular pain at last follow-up. In this limited retrospective study, we demonstrated that circumferential lysis of the cremasteric muscle through a small subinguinal incision is a safe and effective minimally invasive procedure for physical activity-precipitated painful retractile testicular pain. Published by Elsevier Inc.

  5. Clinicopathological study of asymptomatic gastric cancer and symptomatic gastric cancer

    International Nuclear Information System (INIS)

    Sato, Toshiteru

    2008-01-01

    Gastric cancer can be classified into two categories based on the absence or presence of symptoms at diagnosis. Differences in clinicopathological features and prognoses between asymptomatic gastric cancer (ACG) and symptomatic gastric cancer (SGC) can be used to inform diagnosis strategies and ultimately improve survival rates. All cases of gastric cancer (239 AGC, 323 SGC) diagnosed in our hospital between 1997 and 1999 were used in this study. ACG patients showed significantly higher frequency of males, cases of early cancer, cases found by a mass screening program, cases treated by endoscopic resection, cases treated by curative operation, cases of type 0 macroscopic finding, cases of histologically-differentiated type, and stage I cases. By contrast, SGC patients showed significantly higher numbers of cases treated by chemotherapy alone or best support care, cases of type 2, 3, and 4 macroscopic findings, cases occupying the whole stomach, and cases of stage II, III, IV. Statistically significant differences were also found for the 5-year survival rate (83.3% in AGC, 41.2% in SGC), the incidence of early cancer (90.1% in AGC, 83.7% in SGC), and for advanced cancer (38.7% in AGC, 22.7% in SGC). The higher incidence of advanced cases in SGC than in AGC (40.0% vs. 13.0%), coupled with the low 5-year survival rate of advanced SGC (22.7%), provides strong evidence of the importance of diagnosing gastric cancer during its asymptomatic period. (author)

  6. Motor aphasia after cervical myelography with Metrizamide

    International Nuclear Information System (INIS)

    Boeker, D.K.; Sartor, K.; Winkler, D.; Allgemeines Krankenhaus Altona, Hamburg

    1980-01-01

    Two cases of transient motor aphasia after cervical myelography with Metrizamide are described. A possible mechanism is thought to be prolonged contact of contrast with a brain already damaged by a pre-existing vascular abnormality. (orig.) [de

  7. Hypoglossal Nerve Palsy After Cervical Spine Surgery.

    Science.gov (United States)

    Ames, Christopher P; Clark, Aaron J; Kanter, Adam S; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    Multi-institutional retrospective study. The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies. A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions. No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy (0.01%). This deficit resolved with conservative management. The rate by institution ranged from 0% to 1.28%. Although not directly injured by the surgical procedure, the transient nerve injury might have been related to patient positioning as has been described previously in the literature. Hypoglossal nerve injury during cervical spine surgery is an extremely rare complication. Institutional rates may vary. Care should be taken during posterior cervical surgery to avoid hyperflexion of the neck and endotracheal tube malposition.

  8. Emergency Cervical Cerclage: A Case Series

    Directory of Open Access Journals (Sweden)

    Arzu Doruk

    2011-06-01

    Full Text Available OBJECTIVE: To observe the effect of the emergency cervical cerclage on the duration of pregnancy in the patient with cervical insufficiency METHOD: Thirteen pregnant women between 22-28 th gestational age treated with emergency cerclage were included in the study. Mc Donald technic was perfomed to in all patients. RESULTS: Among the patients,7 women were delivered between 25-32th weeks, and 4 patients were followed beyond the 34th week. CONCLUSION: Ultrasonographic screening to determine cervical insufficiency among the patient in the risk group should be done at 14-20th weeks for the first time. Emergency cerclage can be considered in patient without contractions or chorioamnionitis, if there is any evidence of cervical dilatation at pelvic examination.

  9. Computerized axial tomography in traumatic cervical lesions

    International Nuclear Information System (INIS)

    Koyama, Tsunemaro

    1982-01-01

    Although plain computerized axial tomography cannot routinely demonstrate the spinal cord, it does provide excellent visualization of the bony outline of the spinal canal and vertebral column. So it should be reasonable to use this technique in cases of cervical traumatic disorders. In this paper we presented 10 cases of cervical traumatic lesions; 3 atlanto-axial dislocation, 2 cervical canal stenosis, 3 OPLL, 1 intramedullary hematoma and 1 C 2 -neurinoma. In some patients neurologic deficits were induced by cervical trauma. Bony lesions appeared more adequately deliniated than intraspinal lesions, however, in some cases intramedullary changes could also be demonstrated. The use of metrizamide with high resolution CT-scanner could improve the usefullness of this technique. (author)

  10. Cervical Cancer Screening in Underserved Populations

    Centers for Disease Control (CDC) Podcasts

    Dr. Lisa Flowers, a specialist in human papillovarius (HPV)-related diseases and Director of Colposcopy at Emory University School of Medicine, talks about cervical cancer screening in underinsured or uninsured women.

  11. Cervical myelography with iohexol in horses

    International Nuclear Information System (INIS)

    Fialho, S.A.G.; Graca, D.L.; Silva, A.M. da; Pellegrine, L.C. de; Oliveira, L.S.S. de; Lopes, S.T.D.A.

    1989-01-01

    Five horses, weighing 337 to 400 kg, were used in this research, one of them being used as control. Cervical myelography with iohexol (Omnipaque) was performed on four horses tranquilized with flunitrazepan before induction of anesthesia with sodium thiopental. Anesthesia was maintained with fluothane and oxygen. Cerebrospinal fluid (CSF) was analysed before and after an injection of ioxheol into the subarachnoid space. The animals received 25 to 50 ml of iohexol, after removal of 20 ml cerebrospinal fluid. Radiographies were taken with the horses at lateral recumbency, and the cranial, central and caudal regions of the cervical spine being focalized. No significant changes occurred in the cerebrospinal fluid after injecting the contrast medium. Pathologic changes were not found by gross or microscopic examination of the brain and the cervical spinal cord. Radiographies of good to excellent image quality were obtained. At autopsy, radiographic diagnosis of cervical vertebral instability was confirmed in the animal that had pelvic limb ataxia

  12. Cervical myelography with iohexol in horses

    Energy Technology Data Exchange (ETDEWEB)

    Fialho, S. A.G.; Graca, D. L.; Silva, A.M. da; Pellegrine, L.C. de; Oliveira, L. S.S. de; Lopes, S. T.D.A.

    1989-08-15

    Five horses, weighing 337 to 400 kg, were used in this research, one of them being used as control. Cervical myelography with iohexol (Omnipaque) was performed on four horses tranquilized with flunitrazepan before induction of anesthesia with sodium thiopental. Anesthesia was maintained with fluothane and oxygen. Cerebrospinal fluid (CSF) was analysed before and after an injection of ioxheol into the subarachnoid space. The animals received 25 to 50 ml of iohexol, after removal of 20 ml cerebrospinal fluid. Radiographies were taken with the horses at lateral recumbency, and the cranial, central and caudal regions of the cervical spine being focalized. No significant changes occurred in the cerebrospinal fluid after injecting the contrast medium. Pathologic changes were not found by gross or microscopic examination of the brain and the cervical spinal cord. Radiographies of good to excellent image quality were obtained. At autopsy, radiographic diagnosis of cervical vertebral instability was confirmed in the animal that had pelvic limb ataxia.

  13. Natural History of HPV and Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Dr. Phil Castle, an intramural research scientist at the National Institutes of Health, talks about the natural history of human papillomavirus (HPV) infections, and cervical cancer and other anogenital cancers.

  14. Abnormal cervical cytology requiring colposcopy among women ...

    African Journals Online (AJOL)

    current national screening policy only offers women a free cervical smear at 30, 40 and 50 years ... consistent with the recommendations of working groups in developed ... under the age of 30 years in the Western Cape Province, South Africa.

  15. Detection and prognosis of cervical cancer

    NARCIS (Netherlands)

    Deregowski, Valerie; Van Criekinge, Wim; Dehaspe, Luc; Wisman, G. Bea A.; van der Zee, Ate G. J.; Schuuring, E. M. D.

    2015-01-01

    The present invention relates to methods and kits for identifying, diagnosing, prognosing, and monitoring cervical cancer. These methods include determining the methylation status or the expression levels of particular genes, or a combination thereof.

  16. Trends of cervical cancer in Greenland

    DEFF Research Database (Denmark)

    Sander, Bente B; Rebolj, Matejka; Lynge, Elsebeth

    2014-01-01

    BACKGROUND: Due to its extraordinarily fast economic and social transition, virtually closed borders before 1940 and, moreover, that 85% of the population has the distinctive genetics of the Inuit, Greenland is a very interesting country to study cervical cancer from a historical perspective....... Nevertheless, little has been reported about long-term cancer trends in Greenland. Our aim was to describe and interpret the incidence of cervical cancer from 1950 to 2009. MATERIAL AND METHODS: We systematically searched PubMed for articles reporting the incidence of cervical cancer in Greenland. We...... supplemented this with data for 1980-2009 obtained from the Chief Medical Officer of Greenland. RESULTS: Incidence of cervical cancer was around 10 per 100 000 women (age-standardised, world population, ASW) in the 1950s, 30 per 100 000 in the 1960s, and in the 1980s around 60 per 100 000. From 1985 onwards...

  17. Radiosensitizers in cervical cancer. Cisplatin and beyond

    International Nuclear Information System (INIS)

    Candelaria, Myrna; Garcia-Arias, Alicia; Cetina, Lucely; Dueñas-Gonzalez, Alfonso

    2006-01-01

    Cervical cancer continues to be a significant health burden worldwide. Globally, the majority of cancers are locally advanced at diagnosis; hence, radiation remains the most frequently used therapeutical modality. Currently, the value of adding cisplatin or cisplatin-based chemotherapy to radiation for treatment of locally advanced cervical cancer is strongly supported by randomized studies and meta-analyses. Nevertheless, despite these significant achievements, therapeutic results are far from optimal; thus, novel therapies need to be assayed. A strategy currently being investigated is the use of newer radiosensitizers alone or in combination with platinum compounds. In the present work, we present preclinical information on known and newer cytotoxic agents as radiosensitizers on cervical cancer models, as well as the clinical information emanating from early phase trials that incorporate them to the cervical cancer management. In addition, we present the perspectives on the combined approach of radiation therapy and molecular target-based drugs with proven radiosensitizing capacity

  18. Is dibotermin alfa a cost-effective substitute for autologous iliac crest bone graft in single level lumbar interbody spine fusion?

    Science.gov (United States)

    Svedbom, Axel; Paech, Daniel; Leonard, Catherine; Donnell, David; Song, Fujian; Boszcyk, Bronek; Rothenfluh, Dominique A; Lloyd, Andrew; Borgman, Benny

    2015-11-01

    To evaluate the cost-effectiveness of dibotermin alfa compared with autologous iliac crest bone graft (ICBG) for patients undergoing single level lumbar interbody spinal fusion in a UK hospital setting. An individual patient data (IPD) meta-analysis of six randomized controlled clinical trials and two single arm trials compared dibotermin alfa on an absorbable collagen implantation matrix (ACIM) (n = 456) and ICBG (n = 244) on resource use, re-operation rates, and SF-6D (Short form 6-dimension) health utility (total N = 700). Failure-related second surgery, operating time, post-operative hospital stay, and quality-adjusted life years (QALYs) derived from the IPD meta-analysis were included as inputs in an economic evaluation undertaken to assess the cost-effectiveness of dibotermin alfa/ACIM versus ICBG for patients undergoing single level lumbar interbody spinal fusion. A four year time horizon and the United Kingdom (UK) National Health Service (NHS) and Personal Social Services (PSS) perspective was adopted in the base case, with sensitivity analyses performed to gauge parameter uncertainty. In the base case analysis, patients treated using dibotermin alfa/ACIM (12 mg pack) accrued 0.055 incremental QALYs at an incremental cost of £ 737, compared with patients treated with ICBG. This resulted in an incremental cost-effectiveness ratio (ICER) of £ 13,523, indicating that at a willingness-to-pay threshold of £ 20,000, dibotermin alfa/ACIM is a cost-effective intervention relative to ICBG from the NHS and PSS perspective. In a UK hospital setting, dibotermin alfa/ACIM is a cost-effective substitute for ICBG for patients who require lumbar interbody arthrodesis.

  19. Does restoration of focal lumbar lordosis for single level degenerative spondylolisthesis result in better patient-reported clinical outcomes? A systematic literature review.

    Science.gov (United States)

    Rhee, Chanseok; Visintini, Sarah; Dunning, Cynthia E; Oxner, William M; Glennie, R Andrew

    2017-10-01

    It is controversial whether the surgical restoration of sagittal balance and spinopelvic angulation in a single level lumbar degenerative spondylolisthesis results in clinical improvements. The purpose of this study to systematically review the available literature to determine whether the surgical correction of malalignment in lumbar degenerative spondylolisthesis correlates with improvements in patient-reported clinical outcomes. Literature searches were performed via Ovid Medline, Embase, CENTRAL and Web of Science using search terms "lumbar," "degenerative/spondylolisthesis" and "surgery/surgical/surgeries/fusion". This resulted in 844 articles and after reviewing the abstracts and full-texts, 13 articles were included for summary and final analysis. There were two Level II articles, four Level III articles and five Level IV articles. Most commonly used patient-reported outcome measures (PROMs) were Oswestery disability index (ODI) and visual analogue scale (VAS). Four articles were included for the final statistical analysis. There was no statistically significant difference between the patient groups who achieved successful surgical correction of malalignment and those who did not for either ODI (mean difference -0.94, CI -8.89-7.00) or VAS (mean difference 1.57, CI -3.16-6.30). Two studies assessed the efficacy of manual reduction of lumbar degenerative spondylolisthesis and their clinical outcomes after the operation, and there was no statistically significant improvement. Overall, the restoration of focal lumbar lordosis and restoration of sagittal balance for single-level lumbar degenerative spondylolisthesis does not seem to yield clinical improvements but well-powered studies on this specific topic is lacking in the current literature. Future well-powered studies are needed for a more definitive conclusion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Cervical spine injuries in American football.

    Science.gov (United States)

    Rihn, Jeffrey A; Anderson, David T; Lamb, Kathleen; Deluca, Peter F; Bata, Ahmed; Marchetto, Paul A; Neves, Nuno; Vaccaro, Alexander R

    2009-01-01

    American football is a high-energy contact sport that places players at risk for cervical spine injuries with potential neurological deficits. Advances in tackling and blocking techniques, rules of the game and medical care of the athlete have been made throughout the past few decades to minimize the risk of cervical injury and improve the management of injuries that do occur. Nonetheless, cervical spine injuries remain a serious concern in the game of American football. Injuries have a wide spectrum of severity. The relatively common 'stinger' is a neuropraxia of a cervical nerve root(s) or brachial plexus and represents a reversible peripheral nerve injury. Less common and more serious an injury, cervical cord neuropraxia is the clinical manifestation of neuropraxia of the cervical spinal cord due to hyperextension, hyperflexion or axial loading. Recent data on American football suggest that approximately 0.2 per 100,000 participants at the high school level and 2 per 100,000 participants at the collegiate level are diagnosed with cervical cord neuropraxia. Characterized by temporary pain, paraesthesias and/or motor weakness in more than one extremity, there is a rapid and complete resolution of symptoms and a normal physical examination within 10 minutes to 48 hours after the initial injury. Stenosis of the spinal canal, whether congenital or acquired, is thought to predispose the athlete to cervical cord neuropraxia. Although quite rare, catastrophic neurological injury is a devastating entity referring to permanent neurological injury or death. The mechanism is most often a forced hyperflexion injury, as occurs when 'spear tackling'. The mean incidence of catastrophic neurological injury over the past 30 years has been approximately 0.5 per 100,000 participants at high school level and 1.5 per 100,000 at the collegiate level. This incidence has decreased significantly when compared with the incidence in the early 1970s. This decrease in the incidence of

  1. Nuclear magnetic resonance tomography of the cervical canal

    Energy Technology Data Exchange (ETDEWEB)

    Terwey, B.; Koschorek, F.; Jensen, H.P.

    1985-12-01

    170 patients with suspected lesions of the cervical part of the medulla were examined using nuclear magnetic resonance (NMR) tomography. 27 cases revealed no pathological changes in the regions of the cervical medulla, the cervical canal and of the cervical spine. 143 cases produced pathological findings whose diagnoses determined therapeutical approach. Verified pathological changes comprised anomalies of the cranio-cervical junction like basilar impression and Arnold-Chiari malformation, various types of cavity formation in the cervical medulla (syringomyelia, hydromyelia), demyelinization processes, intramedullary and extramedullary tumours, intervertebral disk degeneration processes, dislocation of intervertebral disks and spondylophytes with spinal stenoses. Sagittal sections in different functional positions allowed to demonstrate the biomechanical effects of extramedullary masses on the cervical medulla. However, proven tumours could not be differentiated successfully using histological methods. Nevertheless, NMR tomography will replace invasive methods like conventional cervical myelography and CT myelography in diagnostic clarification of diseases of the cervical medulla.

  2. Nuclear magnetic resonance tomography of the cervical canal

    International Nuclear Information System (INIS)

    Terwey, B.; Koschorek, F.; Jensen, H.P.

    1985-01-01

    170 patients with suspected lesions of the cervical part of the medulla were examined using nuclear magnetic resonance (NMR) tomography. 27 cases revealed no pathological changes in the regions of the cervical medulla, the cervical canal and of the cervical spine. 143 cases produced pathological findings whose diagnoses determined therapeutical approach. Verified pathological changes comprised anomalies of the cranio-cervical junction like basilar impression and Arnold-Chiari malformation, various types of cavity formation in the cervical medulla (syringomyelia, hydromyelia), demyelinization processes, intramedullary and extramedullary tumours, intervertebral disk degeneration processes, dislocation of intervertebral disks and spondylophytes with spinal stenoses. Sagittal sections in different functional positions allowed to demonstrate the biomechanical effects of extramedullary masses on the cervical medulla. However, proven tumours could not be differentiated successfully using histological methods. Nevertheless, NMR tomography will replace invasive methods like conventional cervical myelography and CT myelography in diagnostic clarification of diseases of the cervical medulla. (orig.) [de

  3. Management of Cervical Cytology with HPV Test

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about ASCCP's 2006 Consensus Guidelines on the management of abnormal cervical cytology and histology.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  4. Brachial Plexopathy After Cervical Spine Surgery

    OpenAIRE

    Than, Khoi D.; Mummaneni, Praveen V.; Smith, Zachary A.; Hsu, Wellington K.; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

    2017-01-01

    Study Design: Retrospective, multicenter case-series study and literature review. Objectives: To determine the prevalence of brachial plexopathy after cervical spine surgery and to review the literature to better understand the etiology and risk factors of brachial plexopathy after cervical spine surgery. Methods: A retrospective case-series study of 12?903 patients at 21 different sites was performed to analyze the prevalence of several different complications, including brachial plexopathy....

  5. Hypoglossal Nerve Palsy After Cervical Spine Surgery

    OpenAIRE

    Ames, Christopher P.; Clark, Aaron J.; Kanter, Adam S.; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

    2017-01-01

    Study Design: Multi-institutional retrospective study. Objective: The goal of the current study is to quantify the incidence of 2 extremely rare complications of cervical spine surgery; hypoglossal and glossopharyngeal nerve palsies. Methods: A total of 8887 patients who underwent cervical spine surgery from 2005 to 2011 were included in the study from 21 institutions. Results: No glossopharyngeal nerve injuries were reported. One hypoglossal nerve injury was reported after a C3-7 laminectomy...

  6. Proteomic alterations in early stage cervical cancer

    OpenAIRE

    Güzel, Coşkun; Govorukhina, Natalia; Wisman, G.B.A.; Stingl, Christoph; Dekker, Lennard; Hollema, Harry; Guryev, Victor; Horvatovich, Peter; van der Zee, Ate; Bischoff, Rainer; Luider, Theo

    2018-01-01

    Laser capture microdissection (LCM) allows the capture of cell types or well-defined structures in tissue. We compared in a semi-quantitative way the proteomes from an equivalent of 8,000 tumor cells from patients with squamous cell cervical cancer (SCC, n = 22) with healthy epithelial and stromal cells obtained from normal cervical tissue (n = 13). Proteins were enzymatically digested into peptides which were measured by high-resolution mass spectrometry and analyzed by “all-or-nothing” anal...

  7. Cervical myositis ossificans traumatica: a rare location

    Energy Technology Data Exchange (ETDEWEB)

    Baysal, T.; Sarac, K.; Kutlu, R. [Dept. of Radiology, Inonu University, Malatya (Turkey); Baysal, O.; Ersoy, Y. [Dept. of Physical Therapy and Rehabilitation, Inonu Univ., Malatya (Turkey); Elmali, N. [Dept. of Orthopedics and Traumatology, Inonu Univ., Malatya (Turkey)

    1999-05-01

    An unusual case of myositis ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare. (orig.) With 4 figs., 16 refs.

  8. Noncarious Cervical Lessions: From Etiology to Therapy

    OpenAIRE

    Marta Krolo; Aleksandra Kovačević

    2015-01-01

    The purpose of this article was to briefly summarize the most important characteristics of non-carious cervical lesions, as well as the etiological factors that lead to their formation. Cervical area represents one of the most sensitive parts of the tooth due to the specific position, as well as the structure and thickness of hard tissue. It is less resistant to various chemical and mechanical stimuli, and as a result the lesions in this area are frequently encountered in everyday practice.

  9. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    OpenAIRE

    Susan Armijo-Olivo; David Magee

    2012-01-01

    ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maxima...

  10. Implications of tyrosine phosphoproteomics in cervical carcinogenesis

    Directory of Open Access Journals (Sweden)

    DeFord James

    2008-01-01

    Full Text Available Abstract Background Worldwide cervical cancer remains a leading cause of mortality from gynecologic malignancies. The link between cervical cancer and persistent infection with HPV has been established. At a molecular level little is known about the transition from the precancerous state to invasive cancer. To elucidate this process, cervical biopsies from human specimens were obtained from precancerous state to stage III disease. Methods Cervical biopsies were obtained from patients with a diagnosis of cervical cancer undergoing definitive surgery or staging operation. Biopsies were obtained from patients with precancerous lesions at the time of their excisional procedure. Control samples were obtained from patients undergoing hysterectomy for benign conditions such as fibroids. Samples were subjected to proteomic profiling using two dimensional gel electrophoresis with subsequent trypsin digestion followed by MALDI-TOF protein identification. Candidate proteins were then further studied using western blotting, immunoprecipitation and immunohistochemistry. Results Annexin A1 and DNA-PKcs were found to be differentially expressed. Phosphorylated annexin A1 was up regulated in diseased states in comparison to control and its level was strongly detected in the serum of cervical cancer patients compared to controls. DNA-PKcs was noted to be hyperphosphorylated and fragmented in cancer when compared to controls. By immunohistochemistry annexin A1 was noted in the vascular environment in cancer and certain precancerous samples. Conclusion This study suggests a probable role for protein tyrosine phosphorylation in cervical carcinogenesis. Annexin A1 and DNA-PK cs may have synergistic effects with HPV infection. Precancerous lesions that may progress to cervical cancer may be differentiated from lesions that will not base on similar immunohistochemical profile to invasive squamous cell carcinoma.

  11. Tophaceous gout in the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Cabot, Jonathan [Royal Adelaide Hospital, Department of Orthopaedic Surgery, Adelaide, South Australia (Australia); Mosel, Leigh; Kong, Andrew; Hayward, Mike [Flinders Medical Centre, Department of Medical Imaging, Bedford Park, South Australia (Australia)

    2005-12-01

    Gout is a common metabolic disorder typically affecting the distal joints of the appendicular skeleton. Involvement of the axial skeleton, particularly the facet joints and posterior column of the cervical spine, is rare. This case report highlights such a presentation in a 76-year old female who presented with cervical spine pain following a fall. Her radiological findings were suggestive of a destructive metastatic process. Histological diagnosis confirmed tophaceous gout. (orig.)

  12. Costs Associated with Cervical Cancer Screening

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Tom Cox, a practicing gynecologist and president of the American Society of Colposcopy and Cervical Pathology, provides a brief introduction to cervical cancer screening guidelines and human papillomavirus (HPV) DNA testing.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  13. Cervical Cancer Screening with HPV Test

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  14. Tophaceous gout in the cervical spine

    International Nuclear Information System (INIS)

    Cabot, Jonathan; Mosel, Leigh; Kong, Andrew; Hayward, Mike

    2005-01-01

    Gout is a common metabolic disorder typically affecting the distal joints of the appendicular skeleton. Involvement of the axial skeleton, particularly the facet joints and posterior column of the cervical spine, is rare. This case report highlights such a presentation in a 76-year old female who presented with cervical spine pain following a fall. Her radiological findings were suggestive of a destructive metastatic process. Histological diagnosis confirmed tophaceous gout. (orig.)

  15. A Symptomatic Displaced Os Odontoideum: A Case Report

    Directory of Open Access Journals (Sweden)

    Farshad Nikouei

    2016-05-01

    Full Text Available Introduction Os odontoideum (OO is a form of odontoid anomaly presented by a separate ossicle with a smooth, sclerotic border not fused with C2 body. The current paper reports a boy with irreducible displaced os odontoideum with severe neurologic deficit after a minor trauma. Case Presentation A 16-year-old boy admitted in the center due to neck pain and torticollis with neurologic deficit. He had a history of multiple minor traumas. Advanced imaging assessment demonstrated displaced os odontoideum with minimal space available for cord (SAC and myelomalacia. After unsuccessful closed reduction a 2-stage operation was planned: first, the anterior transoral release and odontoid resection with subsequent halo-traction and second, the posterior atlanto-axial instrumented fusion with bilateral C1 hook and C2 pedicular screws. Conclusions Congenital anomalies of the odontoid are associated with C1-C2 instability that can be subluxated or dislocated with minor trauma and cause permanent neurologic deficit or even death. When acute cervical spine trauma is imaged, os odontoideum should be distinguished from an acute dens fracture with a multimodality imaging approach including computed tomography (CT, magnetic resonance imaging (MRI and radiography. Here is the report of a rare case with irreducible displaced os odontiodeum treated him with anterior release, odontoid resection and posterior C1-C2 instrumented fusion.

  16. Executive functioning during full and partial remission (positive and negative symptomatic remission) of schizophrenia.

    Science.gov (United States)

    Braw, Yoram; Benozio, Avi; Levkovitz, Yechiel

    2012-12-01

    Despite the upsurge of research regarding cognitive impairment in schizophrenia we still lack adequate understanding of the executive functioning of patients in symptomatic remission. Moreover, the cognitive functioning of patients in partial remission has not been studied previously although they comprise a significant proportion of schizophrenia patients. The current study therefore examined the executive functioning of patients in full symptomatic remission and for the first time assessed two sub-groups of patients in partial remission. Executive functioning of five groups was compared; symptomatic patients, patients in positive symptomatic remission, negative symptomatic remission, full symptomatic remission (SP, PSR, NSR, and FSR; N=101) and healthy controls (N=37). A graded cognitive profile was evident between the groups. SP patients exhibited widespread executive dysfunction while the performance of FSR patients was comparable to that of the healthy controls. Both PSR and NSR patients had working memory deficits, with PSR patients showing additional deficits in cognitive planning. The findings are encouraging, tentatively suggesting intact executive functioning among patients in full symptomatic remission. The graded cognitive profile of the patient groups strengthens earlier findings indicating the significant role of negative symptoms in determining executive dysfunction in schizophrenia. The findings point toward potential targets for therapeutic efforts and emphasize the need for further research of sub-groups of schizophrenia patients in partial remission. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Automated image analysis of uterine cervical images

    Science.gov (United States)

    Li, Wenjing; Gu, Jia; Ferris, Daron; Poirson, Allen

    2007-03-01

    Cervical Cancer is the second most common cancer among women worldwide and the leading cause of cancer mortality of women in developing countries. If detected early and treated adequately, cervical cancer can be virtually prevented. Cervical precursor lesions and invasive cancer exhibit certain morphologic features that can be identified during a visual inspection exam. Digital imaging technologies allow us to assist the physician with a Computer-Aided Diagnosis (CAD) system. In colposcopy, epithelium that turns white after application of acetic acid is called acetowhite epithelium. Acetowhite epithelium is one of the major diagnostic features observed in detecting cancer and pre-cancerous regions. Automatic extraction of acetowhite regions from cervical images has been a challenging task due to specular reflection, various illumination conditions, and most importantly, large intra-patient variation. This paper presents a multi-step acetowhite region detection system to analyze the acetowhite lesions in cervical images automatically. First, the system calibrates the color of the cervical images to be independent of screening devices. Second, the anatomy of the uterine cervix is analyzed in terms of cervix region, external os region, columnar region, and squamous region. Third, the squamous region is further analyzed and subregions based on three levels of acetowhite are identified. The extracted acetowhite regions are accompanied by color scores to indicate the different levels of acetowhite. The system has been evaluated by 40 human subjects' data and demonstrates high correlation with experts' annotations.

  18. Imaging of the cervical articular pillar

    Energy Technology Data Exchange (ETDEWEB)

    Yeomans, E. [Orange Base Hospital, Orange, NSW (Australia)

    1998-12-01

    The cervical articular pillar, due to the complex anatomical structure of the cervical spine, is not well demonstrated in routine plain radiographic views. Dedicated views have been devised to demonstrate the pillar, yet their performance has abated considerably since the inception of Computed Tomography (CT) in the 1970`s. It is the consideration that CT does not image the articular pillar with a 10 per cent accuracy that poses the question: Is there still a need for plain radiography of the cervical articular pillar? This paper studies the anatomy, plain radiography, and incidence of injury to the cervical articular pillar. It discusses (with reference to current and historic literature) the efficacy of current imaging protocols in depicting this injury. It deals with plain radiography, CT, complex tomography, and Magnetic Resonance Imaging (MRI) of the cervical spine to conclude there may still be a position in current imaging protocols for plain radiography of the cervical articular pillar. Copyright (1998) Australian Institute of Radiography 43 refs., 5 figs.

  19. MR imaging of the Achilles tendon: overlap of findings in symptomatic and asymptomatic individuals

    International Nuclear Information System (INIS)

    Haims, A.H.; Schweitzer, M.E.; Patel, R.S.

    2000-01-01

    Objective: To differentiate MR imaging characteristics of symptomatic as compared with asymptomatic Achilles tendons.Design: 1.5 T MR images of 94 feet (88 patients) with ''abnormal'' MR examinations were retrospectively evaluated and clinically correlated. Two masked, independent observers systematically evaluated for intratendon T2 signal, tendon thickness, presence of peritendonitis, retrocalcaneal bursal fluid volume, pre-Achilles edema, bone marrow edema at the Achilles insertion, and tears (interstitial, partial, complete). These findings were correlated with symptoms (onset and duration) and physical examination results (tenderness, palpable defects, increased angle of resting dorsiflexion).Results: Of the 94 ankles, 64 ankles (32 females, 29 males) were clinically symptomatic. No relationship between Achilles tendon disorders and age or gender was identified. Asymptomatic Achilles tendons frequently demonstrated mild increased intratendon signal (21/30), 0.747 cm average tendon thickness, peritendonitis (11/30), pre-Achilles edema (12/30), and 0.104 ml average retrocalcaneal bursal fluid volume. Symptomatic patients had thicker tendons (0.877 cm), greater retrocalcaneal fluid volume (0.278 ml), more frequent tears (23/64), a similar frequency of peritendonitis (22/64) but less frequent pre-Achilles edema (18/64). Sixty-four percent of the Achilles tendon tears were interstitial. Except for two interstitial tears in control patients, the majority of Achilles tears were in symptomatic patients (14/16). Only symptomatic tendons demonstrated partial or complete tendon tears. In addition, calcaneal edema was found almost exclusively in actively symptomatic patients. Thicker tendons were associated more often with chronic symptoms and with tears. When present in symptomatic patients, peritendonitis was usually associated with acute symptoms. The presence of pre-Achilles edema, however, did not distinguish acute from chronic disorders.Conclusion: There is

  20. [Analysis of the results of total cervical disc arthroplasty using a M6-C prosthesis: a multicenter study].

    Science.gov (United States)

    Byval'tsev, V A; Kalinin, A A; Stepanov, I A; Pestryakov, Yu Ya; Shepelev, V V

    Cervical spondylosis and intervertebral disc (IVD) degeneration are the most common cause for compression of the spinal cord and/or its roots. Total IVD arthroplasty, as a modern alternative to surgical treatment of IVD degeneration, is gaining popularity in many neurosurgical clinics around the world. Aim - the study aim was to conduct a multicenter analysis of cervical spine arthroplasty with an IVD prosthesis M6-C ('Spinal Kinetics', USA). The study included 112 patients (77 males and 35 females). All patients underwent single-level discectomy with implantation of the artificial IVD prosthesis M6-C. The follow-up period was up to 36 months. Dynamic assessment of the prosthesis was based on clinical parameters (pain intensity in the cervical spine and upper extremities (visual analog scale - VAS); quality of life (Neck Disability Index - NDI)); and subjective satisfaction with the results of surgical treatment (Macnab scale) and instrumental data (range of motion in the operated spinal motion segment, degree of heterotopic ossification (McAfee-Suchomel classification), and time course of degenerative changes in the adjacent segments).

  1. Stenting for symptomatic vertebral artery stenosis associated with bilateral carotid rate mirabile: The long-term clinical and angiographic outcome

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jang Hyun; Kim, Byung Moon [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    Symptomatic vertebral artery (VA) stenosis associated with bilateral carotid rate mirabile (CRM) has not been reported. We report the long-term clinical and angiographic outcome after stenting for symptomatic VA stenosis in the patient with bilateral CRM. This report is the first case that symptomatic VA stenosis associated with bilateral CRM was treated with stenting.

  2. Stenting for symptomatic vertebral artery stenosis associated with bilateral carotid rate mirabile: The long-term clinical and angiographic outcome

    International Nuclear Information System (INIS)

    Baek, Jang Hyun; Kim, Byung Moon

    2015-01-01

    Symptomatic vertebral artery (VA) stenosis associated with bilateral carotid rate mirabile (CRM) has not been reported. We report the long-term clinical and angiographic outcome after stenting for symptomatic VA stenosis in the patient with bilateral CRM. This report is the first case that symptomatic VA stenosis associated with bilateral CRM was treated with stenting.

  3. Cervical and ocular vestibular evoked potentials in Machado-Joseph disease: Functional involvement of otolith pathways.

    Science.gov (United States)

    Ribeiro, Rodrigo Souza; Pereira, Melissa Marques; Pedroso, José Luiz; Braga-Neto, Pedro; Barsottini, Orlando Graziani Povoas; Manzano, Gilberto Mastrocola

    2015-11-15

    Machado-Joseph disease is defined as an autosomal dominant ataxic disorder caused by degeneration of the cerebellum and its connections and is associated with a broad range of clinical symptoms. The involvement of the vestibular system is responsible for several symptoms and signs observed in the individuals affected by the disease. We measured cervical and ocular vestibular evoked myogenic potentials in a sample of Machado-Joseph disease patients in order to assess functional pathways involved. Bilateral measures of cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP) were obtained from 14 symptomatic patients with genetically proven Machado-Joseph disease and compared with those from a control group of 20 healthy subjects. Thirteen (93%) patients showed at least one abnormal test result; oVEMP and cVEMP responses were absent in 17/28 (61%) and 11/28 (39%) measures, respectively; and prolonged latency of cVEMP was found in 3/28 (11%) measures. Of the 13 patients with abnormal responses, 9/13 (69%) patients showed discordant abnormal responses: four with absent oVEMP and present cVEMP, two with absent cVEMP and present oVEMP, and three showed unilateral prolonged cVEMP latencies. Both otolith-related vestibulocollic and vestibulo-ocular pathways are severely affected in Machado-Joseph disease patients evaluated by VEMPs. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Radiographic measurement of the cervical spine in patients with temporomandibular dysfunction.

    Science.gov (United States)

    de Farias Neto, Jader Pereira; de Santana, Josimari Melo; de Santana-Filho, Valter Joviniano; Quintans-Junior, Lucindo José; de Lima Ferreira, Ana Paula; Bonjardim, Leonardo Rigoldi

    2010-09-01

    To compare the craniocervical angles and distances between temporomandibular dysfunction (TMD) and free TMD subjects. The sample consisted of young adults, of both genders, with age ranging between 18 and 30 years. TMD diagnosis was based on the clinical criteria of the Research Diagnostic Criteria for TMD (RDC/TMD), associated with self-reported symptoms of TMD. For radiological analysis we measured three angles and two distances of craniocervical region. Of the 56 subjects, only 23 completed all stages of research, which were divided into two groups: (1) free TMD group - composed of 11 individuals; (2) TMD group - constituted of 12 subjects. The most common clinical diagnosis of TMD was arthralgia (75.0%) followed by myofascial pain without limited mouth opening (58.4%). Among the self-reported symptoms of TMD, the most frequents were facial (83.4%) and neck (66.6%) pain. Of radiological measurement, only plane atlas angle (APA) (p=0.026) and anterior translation distance (Tz C(2)-C(7)) (p=0.045) showed statistical difference between groups TMD (APA=16.7+/-1.63; Tz C(2)-C(7)=28.7+/-2.58) and free TMD (APA=21.64+/-1.24; Tz C(2)-C(7)=19.82+/-3.29). It could be verified that the symptomatic TMD patients presented a flexion of the first cervical vertebra associated with an anteriorization of the cervical spine (hyperlordosis). Copyright 2010 Elsevier Ltd. All rights reserved.

  5. The natural history and clinical syndromes of degenerative cervical spondylosis.

    LENUS (Irish Health Repository)

    Kelly, John C

    2012-01-01

    Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy.

  6. Assessment of cervical range of motion, cervical core strength and scapular dyskinesia in violin players.

    Science.gov (United States)

    Tawde, Pooja; Dabadghav, Rachana; Bedekar, Nilima; Shyam, Ashok; Sancheti, Parag

    2016-12-01

    Playing the violin can lead to asymmetric postures which can affect the cervical range of motion, cervical core strength and scapular stability. The objective of the study was to assess the cervical range of motion, cervical core strength and scapular dyskinesia in violin players and non-players of the same age group. An inclinometer was used to assess the cervical range of motion, pressure biofeedback was used to assess cervical core strength and scapular dyskinesia was also assessed in 30 professional violin players (18-40 years) compared with 30 age-matched non-players. Analysis was done using an unpaired t test. Significant change was seen with respect to extension (p = 0.051), cervical core strength (p = 0.005), right (Rt) superior angle 0° (p = 0.004), Rt superior angle 45° (p = 0.015) and Rt inferior angle 90° (p = 0.013). This study shows a significant difference in extension range of motion and cervical core strength of violin players. Also, there was scapular dyskinesia seen at 0° and 45° right-side superior angle of the scapula and 90° right-side inferior angle of the scapula.

  7. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  8. Cavum Septi Pellucidi in Symptomatic Former Professional Football Players

    Science.gov (United States)

    Hufschmidt, Jakob; Muehlmann, Marc; Tripodis, Yorghos; Stamm, Julie M.; Pasternak, Ofer; Giwerc, Michelle Y.; Coleman, Michael J.; Baugh, Christine M.; Fritts, Nathan G.; Heinen, Florian; Lin, Alexander; Stern, Robert A.; Shenton, Martha E.

    2016-01-01

    Abstract Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall, p = 0.04) and decreased test scores on a measure of estimate verbal intelligence (Wide Range Achievement Test Fourth Edition Reading Test, p = 0.02). Given the high prevalence of CSP in neuropathologically confirmed CTE in addition to the results of this study, CSP may serve as a potential early in vivo imaging marker to identify those at high risk for CTE. Future research is needed to investigate the pathomechanism underlying the development of CSP after repetitive head impacts, and its potential association with neuropathologically confirmed CTE. PMID:26414478

  9. Gallbladder-associated symptomatic hepatic choristoma: Should you resect?

    Directory of Open Access Journals (Sweden)

    Salah Termos

    Full Text Available Introduction: Hepatic choristomas or ectopic livers are uncommon, and occur due to a failure of embryological liver development. They pose a risk of carcinogenesis, with transformation to hepatocellular carcinoma (HCC being described in the literature (Arakawa et al., 1999. It is often a silent clinical finding that can occur anywhere in the body and is usually diagnosed incidentally during abdominal surgical procedures or autopsies (Eiserth et al., 1940. We present the case of a patient with a symptomatic ectopic liver that was detected preoperatively, and removed laparoscopically with the gallbladder. Presentation of case: A 73-year-old lady was referred to our unit for a gallbladder tumor on ultrasound which was done for biliary colic. Tumor markers were normal. Computed tomography (CT scan showed an enhanced soft tissue lesion measuring about 3 × 1.5 cm interposed between the gallbladder and liver. Laparoscopic exploration revealed a bean-shaped hepatic choristoma attached to the liver on the medial wall of the gallbladder. The lesion was removed by en-bloc resection during laparoscopic cholecystectomy and extracted carefully in an endobag. Histopathological examination confirmed the absence of carcinogenesis. Discussion and conclusion: Hepatic choristomas (HC are a rare entity, usually identified during abdominal surgeries. It had been reported in several studies with different presentations. Awareness of this unexpected finding and familiarity of its potential complications and carcinogenesis will improve care delivery when encountered. Surgical treatment should be considered when the choristoma is not attached to the liver, in light of its potential transformation into HCC. Keywords: Case report, Hepatic choristoma (HC, Hepar succenturiatum, Ectopic liver (EL, Hepatocellular carcinoma (HCC, Gallbladder

  10. Clinical and neurocognitive outcome in symptomatic isovaleric acidemia

    Directory of Open Access Journals (Sweden)

    Grünert Sarah C

    2012-01-01

    Full Text Available Abstract Background Despite its first description over 40 years ago, knowledge of the clinical course of isovaleric acidemia (IVA, a disorder predisposing to severe acidotic episodes during catabolic stress, is still anecdotal. We aimed to investigate the phenotypic presentation and factors determining the neurological and neurocognitive outcomes of patients diagnosed with IVA following clinical manifestation. Methods Retrospective data on 21 children and adults with symptomatic IVA diagnosed from 1976 to 1999 were analyzed for outcome determinants including age at diagnosis and number of catabolic episodes. Sixteen of 21 patients were evaluated cross-sectionally focusing on the neurological and neurocognitive status. Additionally, 155 cases of patients with IVA published in the international literature were reviewed and analyzed for outcome parameters including mortality. Results 57% of study patients (12/21 were diagnosed within the first weeks of life and 43% (9/21 in childhood. An acute metabolic attack was the main cause of diagnostic work-up. 44% of investigated study patients (7/16 showed mild motor dysfunction and only 19% (3/16 had cognitive deficits. No other organ complications were found. The patients' intelligence quotient was not related to the number of catabolic episodes but was inversely related to age at diagnosis. In published cases, mortality was high (33% if associated with neonatal diagnosis, following manifestation at an average age of 7 days. Conclusions Within the group of "classical" organic acidurias, IVA appears to be exceptional considering its milder neuropathologic implications. The potential to avoid neonatal mortality and to improve neurologic and cognitive outcome under early treatment reinforces IVA to be qualified for newborn screening.

  11. Prevalence of Symptomatic Lumbar Spondylolysis in Pediatric Patients.

    Science.gov (United States)

    Nitta, Akihiro; Sakai, Toshinori; Goda, Yuichiro; Takata, Yoichiro; Higashino, Kosaku; Sakamaki, Tadanori; Sairyo, Koichi

    2016-05-01

    Lumbar spondylolysis, a stress fracture of the pars interarticularis, is prevalent in adolescent athletes. Recent advances in diagnostic tools and techniques enable early diagnosis before these fractures progress to complete fractures through the pars. However, because patients often consult family physicians for primary care of low back pain and these physicians may not have access to diagnostic modalities such as magnetic resonance imaging (MRI) and computed tomography, stress fractures can be missed. This study surveyed the prevalence of symptomatic spondylolysis in pediatric patients who consulted an orthopedic clinic for primary care and investigated whether such acute stress fractures may be overlooked without MRI. The prospective study investigated 264 patients who were younger than 19 years and had low back pain. Of the 153 patients (58.0%) with low back pain persisting for longer than 2 weeks, 136 who agreed to undergo MRI were included in the study. This group included 11 elementary school students, 71 junior high school students, and 54 high school students. The overall prevalence of lumbar spondylolysis was 39.7% (54 of 136) and was 9.3% in elementary school students (5 of 11, 45.5%), 59.3% in junior high school students (32 of 71, 45.1%), and 31.5% in high school students (17 of 54, 31.5%). All 54 patients with spondylolysis had a history of athletic activity. Primary care physicians should recognize that approximately 40% of pediatric patients presenting with low back pain persisting for longer than 2 weeks may have spondylolysis and should consider MRI in those with a history of athletic activity. Because the spine is immature in this age group, almost half of affected elementary school and junior high school students may have lumbar spondylolysis. [Orthopedics. 2016; 39(3):e434-e437.]. Copyright 2016, SLACK Incorporated.

  12. Symptomatic and asymptomatic interphalageal osteoarthritis: An ultrasonographic study.

    Science.gov (United States)

    Usón, Jacqueline; Fernández-Espartero, Cruz; Villaverde, Virginia; Condés, Emilia; Godo, Javier; Martínez-Blasco, Maria Jesus; Miguélez, Roberto

    2014-01-01

    To date few studies have examined whether ultrasonography can depict morphologic differences in painful and painless osteoarthritis (OA). This study describes and compares the clinical, radiographic and ultrasonographic findings of patients with both painful and painless proximal interphalgeal (PIP) and/or distal interphalgeal (DIP) OA. Patients with PIP and/or DIP OA (ACR criteria) were prospectively recruited. The clinical rheumatologist chose up to 3 painful joints and up to 3 painless symmetric joints in each patient to define 2 cohorts of OA: symptomatic (SG) and asymptomatic (ASG). A conventional postero-anterior hand x ray was performed and read by one rheumatologist following the OARSI atlas, blinded to clinical and sonographic data. Ultrasound (US) was performed by an experienced rheumatologist, blinded to both clinical and radiographic data in joints previously selected by the clinical rheumatologist. US-pathology was assessed as present or absent as defined in previous reports: osteophytes, joint space narrowing, synovitis, intra-articular power doppler signal, intra-articular bony erosion, and visualization of cartilage. Radiographic and ultrasonographic intrareader reliability test was performed. A total of 50 joints in the SG and ASG were included from 20 right handed women aged 61.85 (46-73) years with PIP and DIP OA diagnosed 6.8 (1-17) years ago. 70% SG joints and ASG were right and left sided respectively. The SG showed significantly more osteophytes, synovitis and non-visualization of joint cartilage. Intrareader radiographic and ultrasonographic agreement was excellent. This study demonstrates that painful PIP and/or DIP OA have more ultrasonographic structural changes and synovitis. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  13. [Helicobacter pylori and gastroduodenal lesions in 547 symptomatic young adults].

    Science.gov (United States)

    Rudelli, A; Vialette, G; Brazier, F; Seurat, P L; Capron, D; Dupas, J L

    1996-01-01

    Helicobacter pylori (H. pylori) is involved in the pathogenesis of gastric inflammatory disorders. Both antral chronic gastritis and H. pylori infection prevalence increase with age. The aim of the study was to assess the prevalence of H. pylori infection in young adults and to study the relationship between endoscopical and histological features and H. pylori infection. The study concerned 547 young patients (age: 18-25 years), undergoing endoscopy for upper gastrointestinal symptoms. The severity and the activity of chronic gastritis was graded by histological examination of antral biopsies. The diagnosis of H. pylori infection was based on histology and culture or urease test. Fifty-three percent of the patients had a normal endoscopy; 44 ulcers were found: 34 duodenal ulcers and 10 gastric ulcers. H. pylori infection was detected in 34% of cases. The prevalence of H. pylori infection was 29.8% in non-ulcer patients, 50% in gastric ulcers and 91% in duodenal ulcers (P < 0.01). Duodenal ulcer, aspect of antral mosaic mucosa and nodular gastritis, were closely related to the presence of H. pylori. There was a significant relationship between H. pylori infection and both the severity (P < 0.01) and the activity (P < 0.01) of the antral chronic gastritis. The prevalence of follicular gastritis was 22% : it was present in 60% of H. pylori positive patients and 2.4% of H. pylori negative patients. H. pylori infection was more frequent in patients from Africa than in Europeans (P < 0.01). There was no significant association between H. pylori infection and different types of diets, settlements (rural vs urban) or symptoms. These results show that in the young population studied, duodenal ulcer, nodular gastritis, antral mosaic mucosa, active chronic gastric and follicular gastritis are closely related to H. pylori infection. They suggest that in the subgroup of non ulcer symptomatic patients, H. pylori prevalence is higher than in the general population.

  14. A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti's Syndrome.

    Science.gov (United States)

    Jancuska, Jeffrey M; Spivak, Jeffrey M; Bendo, John A

    2015-01-01

    Lumbosacral transitional vertebrae (LSTV) are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. This review will focus on the clinical significance of LSTV, disruptions in normal spine biomechanics, imaging techniques, diagnosis, and treatment. A Pubmed search using the specific key words "LSTV," "lumbosacral transitional vertebrae," and "Bertolotti's Syndrome" was performed. The resulting group of manuscripts from our search was evaluated. LSTV are associated with alterations in biomechanics and anatomy of spinal and paraspinal structures, which have important implications on surgical approaches and techniques. LSTV are often inaccurately detected and classified on standard AP radiographs and MRI. The use of whole-spine images as well as geometric relationships between the sacrum and lumbar vertebra increase accuracy. Uncertainty regarding the cause, clinical significance, and treatment of LSTV persists. Some authors suggest an association between LSTV types II and IV and low back pain. Pseudoarticulation between the transverse process and the sacrum creates a "false joint" susceptible to arthritic changes and osteophyte formation potentially leading to nerve root entrapment. The diagnosis of symptomatic LSTV is considered with appropriate patient history, imaging studies, and diagnostic injections. A positive radionuclide study along with a positive effect from a local injection helps distinguish the transitional vertebra as a significant pain source. Surgical resection is reserved for a subgroup of LSTV patients who fail conservative treatment and whose pain is definitively attributed to the anomalous pseudoarticulation. Due to the common finding of low back pain and the wide prevalence of LSTV in the general population, it is essential to differentiate between symptoms originating from an anomalous psuedoarticulation from other potential sources of low back pain. Further studies with larger

  15. Urinary Prothrombin Fragment 1+2 in relation to Development of Non-Symptomatic and Symptomatic Venous Thromboembolic Events following Total Knee Replacement

    DEFF Research Database (Denmark)

    Borris, Lars Carl; Breindahl, Morten; Rud-Lassen, Michael

    2011-01-01

    Prothrombin fragment 1+2 is excreted in urine (uF1+2) as a result of in vivo thrombin generation and can be a marker of coagulation status after an operative procedure. This study compared uF1+2 levels in patients with symptomatic and non-symptomatic venous thromboembolism (VTE) after total knee...... replacement (TKR) and in event-free sex- and age-matched controls. Significantly higher median uF1+2 levels were seen in the VTE patients on days 1, 3, and the day of venography (mostly day 7) after TKR compared with controls. The uF1+2 levels tended to be high in some patients with symptomatic VTE; however...

  16. Symptomatic treatments for amyotrophic lateral sclerosis/motor neuron disease.

    Science.gov (United States)

    Ng, Louisa; Khan, Fary; Young, Carolyn A; Galea, Mary

    2017-01-10

    Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), causes a wide range of symptoms but the evidence base for the effectiveness of the symptomatic treatment therapies is limited. To summarise the evidence from Cochrane Systematic Reviews of all symptomatic treatments for MND. We searched the Cochrane Database of Systematic Reviews (CDSR) on 15 November 2016 for systematic reviews of symptomatic treatments for MND. We assessed the methodological quality of the included reviews using the Assessment of Multiple Systematic Reviews (AMSTAR) tool and the GRADE approach. We followed standard Cochrane study (review) selection and data extraction procedures. We reported findings narratively and in tables. We included nine Cochrane Systematic Reviews of interventions to treat symptoms in people with MND. Three were empty reviews with no included randomised controlled trials (RCTs); however, all three reported on non-RCT evidence and the remaining six included mostly one or two studies. We deemed all of the included reviews of high methodological quality. Drug therapy for painThere is no RCT evidence in a Cochrane Systematic Review exploring the efficacy of drug therapy for pain in MND. Treatment for crampsThere is evidence (13 RCTs, N = 4012) that for the treatment of cramps in MND, compared to placebo:- memantine and tetrahydrocannabinol (THC) are probably ineffective (moderate-quality evidence);- vitamin E may have little or no effect (low-quality evidence); and- the effects of L-threonine, gabapentin, xaliproden, riluzole, and baclofen are uncertain as the evidence is either very low quality or the trial specified the outcome but did not report numerical data.The review reported adverse effects of riluzole, but it is not clear whether other interventions had adverse effects. Treatment for spasticityIt is uncertain whether an endurance-based exercise programme improved spasticity or quality of life, measured at three months after the

  17. tavgM_2d_slv_Nx: MERRA 2D IAU Diagnostic, Single Level Meteorology, Monthly Mean 0.667 x 0.5 degree V5.2.0 (MATMNXSLV) at GES DISC

    Data.gov (United States)

    National Aeronautics and Space Administration — The MATMNXSLV or tavgM_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  18. tavg1_2d_slv_Nx: MERRA 2D IAU Diagnostic, Single Level Meteorology, Time Average 1-hourly 0.667 x 0.5 degree V5.2.0 (MAT1NXSLV) at GES DISC

    Data.gov (United States)

    National Aeronautics and Space Administration — The MAT1NXSLV or tavg1_2d_slv_Nx data product is the MERRA Data Assimilation System 2-Dimensional atmospheric single-level diagnostics that is time averaged...

  19. Squamous cell carcinomas metastatic to cervical lymph nodes from an unknown head and neck mucosal site treated with radiation therapy with palliative intent

    International Nuclear Information System (INIS)

    Erkal, Haldun S.; Mendenhall, William M.; Amdur, Robert J.; Villaret, Douglas B.; Stringer, Scott P.

    2001-01-01

    Minimal information has been published about the results of palliative irradiation for squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site. Forty patients with this diagnosis were treated at the University of Florida with radiation therapy with palliative intent. The nodal response rate was 65% and the symptomatic response rate was 57% at 1 year. The absolute survival rate was 25% at 1 year, as was the cause-specific survival rate. Radiotherapy successfully palliates more than half of those treated. Approximately one fourth are alive 1 year after irradiation

  20. Reliability and validity of CODA motion analysis system for measuring cervical range of motion in patients with cervical spondylosis and anterior cervical fusion.

    Science.gov (United States)

    Gao, Zhongyang; Song, Hui; Ren, Fenggang; Li, Yuhuan; Wang, Dong; He, Xijing

    2017-12-01

    The aim of the present study was to evaluate the reliability of the Cartesian Optoelectronic Dynamic Anthropometer (CODA) motion system in measuring the cervical range of motion (ROM) and verify the construct validity of the CODA motion system. A total of 26 patients with cervical spondylosis and 22 patients with anterior cervical fusion were enrolled and the CODA motion analysis system was used to measure the three-dimensional cervical ROM. Intra- and inter-rater reliability was assessed by interclass correlation coefficients (ICCs), standard error of measurement (SEm), Limits of Agreements (LOA) and minimal detectable change (MDC). Independent samples t-tests were performed to examine the differences of cervical ROM between cervical spondylosis and anterior cervical fusion patients. The results revealed that in the cervical spondylosis group, the reliability was almost perfect (intra-rater reliability: ICC, 0.87-0.95; LOA, -12.86-13.70; SEm, 2.97-4.58; inter-rater reliability: ICC, 0.84-0.95; LOA, -13.09-13.48; SEm, 3.13-4.32). In the anterior cervical fusion group, the reliability was high (intra-rater reliability: ICC, 0.88-0.97; LOA, -10.65-11.08; SEm, 2.10-3.77; inter-rater reliability: ICC, 0.86-0.96; LOA, -10.91-13.66; SEm, 2.20-4.45). The cervical ROM in the cervical spondylosis group was significantly higher than that in the anterior cervical fusion group in all directions except for left rotation. In conclusion, the CODA motion analysis system is highly reliable in measuring cervical ROM and the construct validity was verified, as the system was sufficiently sensitive to distinguish between the cervical spondylosis and anterior cervical fusion groups based on their ROM.