919 resultados para lumbar disk hernia


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The aim of the present study was to determine the association between abdominal muscle strength and quality of life among older adults with lumbar osteoarthritis. A blind, cross-sectional study was conducted involving 40 older adults: 20 with lumbar osteoarthritis (12 women and 8 men, mean age of 65.90 ± 4.80 years) and 20 controls (14 women and 6 men, mean age of 67.90 ± 4.60 years). The volunteers were submitted to an abdominal muscle strength test. Quality of life was evaluated using the SF-36 questionnaire. Both abdominal muscle strength and quality of life scores were significantly lower in the group with lumbar osteoarthritis in comparison to the controls (p < 0.05). Moreover, significant and positive associations were found between abdominal muscle strength and the subscales of the SF-36 questionnaire (p < 0.05, 0.421 ≥ rs ≤ 0.694). Based on the present findings, older adults with lumbar osteoarthritis with greater abdominal muscle strength have a better quality of life.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Recently, in [7] we proposed a revisited S-matrix approach to efficiently find the bosonic terms of the open superstring low energy effective lagrangian (OSLEEL). This approach allows to compute the alpha'(N) terms of the OSLEEL using open superstring n-point amplitudes in which n is considerably lower than (N + 2) (which is the order of the required amplitude to obtain those alpha'(N) terms by means of the conventional S-matrix approach). In this work we use our revisited S-matrix approach to examine the structure of the scattering amplitudes, arriving at a closed form for them. This is a RNS derivation of the formula first found by Mafra, Schlotterer and Stieberger [21], using the pure spinor formalism. We have succeeded doing this for the 5, 6 and 7-point amplitudes. In order to achieve these results we have done a careful analysis of the kinematical structure of the amplitudes, finding as a by-product a purely kinematical derivation of the BCJ relations (for N = 4, 5, 6 and 7). Also, following the spirit of the revisited S-matrix approach, we have found the alpha' expansions for these amplitudes up to alpha'(6) order in some cases, by only using the well known open superstring 4-point amplitude, cyclic symmetry and tree level unitarity: we have not needed to compute any numerical series or any integral involving polylogarithms, at any moment. (C) 2014 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).

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Thoracolumbar disk extrusion is the most common cause of extradural compression of the spinal cord in dogs. Myelography is one of the most commonly performed techniques for the diagnosis of this affection. This study aimed to evaluate the applicability and effectiveness of lumbar myelography in the diagnosis of thoracolumbar intervertebral disk extrusion in dogs, as well as its major complications. Twenty dogs were used in this study. Animals were included when neurological examination suggested thoracolumbar spine lesion, myelography was used as a complementary diagnostic method, and diagnosis of disk extrusion was surgically confirmed. The accuracy of the exam to predict location and lateralization of extruded disk material were evaluated, as well as complications associated to the procedure. Lumbar myelography exhibited 95% and 60% accuracy for location and lateralization of the lesion, respectively, with minimal complications.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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BACKGROUND CONTEXT: The relationships between obesity and low back pain (LBP) and lumbar disc degeneration (LDD) remain unclear. It is possible that familial factors, including genetics and early environment, affect these relationships.PURPOSE: To investigate the relationship between obesity-related measures (eg, weight, body mass index [BMI]) and LBP and LDD using twin studies, where the effect of genetics and early environment can be controlled.STUDY DESIGN: A systematic review with meta-analysis.METHODS: MEDLINE, CINAHL, Scopus, Web of Science, and EMBASE databases were searched from the earliest records to August 2014. All cross-sectional and longitudinal observational twin studies identified by the search strategy were considered for inclusion. Two investigators independently assessed the eligibility, conducted the quality assessment, and extracted the data. Metaanalyses (fixed or random effects, as appropriate) were used to pool studies'estimates of association.RESULTS: In total, 11 articles met the inclusion criteria. Five studies were included in the LBP analysis and seven in the LDD analysis. For the LBP analysis, pooling of the five studies showed that the risk of having LBP for individuals with the highest levels of BMI or weight was almost twice that of people with a lower BMI (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.6-2.0; I-2 = 0%). A dose-response relationship was also identified. When genetics and the effects of a shared early environment were adjusted for using a within-pair twin case-control analysis, pooling of three studies showed a reduced but statistically positive association between obesity and prevalence of LBP (OR 1.5; 95% CI 1.1-2.1; I-2 = 0%). However, the association was further diminished and not significant (OR 1.4; 95% CI 0.8-2.3; I-2 = 0%) when pooling included two studies on monozygotic twin pairs only. Seven studies met the inclusion criteria for LDD. When familial factors were not controlled for, body weight was positively associated with LDD in all five cross-sectional studies. Only two cross-sectional studies investigated the relationship between obesity-related measures and LDD accounting for familial factors, and the results were conflicting. One longitudinal study in LBP and three longitudinal studies in LDD found no increase in risk in obese individuals, whether or not familial factors were controlled for.CONCLUSIONS: Findings from this review suggest that genetics and early environment are possible mechanisms underlying the relationship between obesity and LBP; however, a direct causal link between these conditions appears to be weak. Further longitudinal studies using the twin design are needed to better understand the complex mechanisms underlying the associations between obesity, LBP, and LDD.

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Objective: To evaluate the effect of early fetoscopictracheal occlusion (FETO) (22–24 weeks’ gestation) onpulmonary response and neonatal survival in cases ofextremely severe isolated congenital diaphragmatic hernia(CDH). Methods: This was a multicenter study involving fetuseswith extremely severe CDH (lung-to-head ratio < 0.70,liver herniation into the thoracic cavity and no otherdetectable anomalies). Between August 2010 and December 2011, eight fetuses underwent early FETO. Datawere compared with nine fetuses that underwent standard FETO and 10 without fetoscopic procedure fromJanuary 2006 to July 2010. FETO was performed undermaternal epidural anesthesia, supplemented with fetalintramuscular anesthesia. Fetal lung size and vascularitywere evaluated by ultrasound before and every 2 weeksafter FETO. Postnatal therapy was equivalent for bothtreated fetuses and controls. Primary outcome was infantsurvival to 180 days and secondary outcome was fetalpulmonary response. Results: Maternal and fetal demographic characteristicsand obstetric complications were similar in the threegroups (P > 0.05). Infant survival rate was significantlyhigher in the early FETO group (62.5%) comparedwith the standard group (11.1%) and with controls(0%) (P < 0.01). Early FETO resulted in a significantimprovement in fetal lung size and pulmonary vascularitywhen compared with standard FETO (P < 0.01). Conclusions: Early FETO may improve infant survival byfurther increases of lung size and pulmonary vascularityin cases with extremely severe pulmonary hypoplasia inisolated CDH. This study supports formal testing of thehypothesis with a randomized controlled trial.

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An experiment was conducted to examine the luteolytic effectiveness of using low or micro doses of PGF2α when administered at the BAI HUI acupuncture point, which is frequently used to treat ovarian disturbances in veterinary acupuncture. The results indicate that PGF2α given at a very low micro dose of 0.5 mg (one tenth the conventional recommended dose) administered at the BAI HUI acupuncture point located at the sacral lumbar space is equally effective at inducing luteolysis in mid-luteal phase mares as conventional PGF2α i.m. treatment using a tenfold higher dose. Therefore, based on the results of the present study, we suggest that the BAI HUI sacrai lumbar route somehow provides an extremely efficient pathway for the drug to the ovarian level.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Purpose: To compare 2 methods used to determine the disk position based on sagittal magnetic resonance images. Patients and Methods: A cross-sectional study of patients with the signs and symptoms of temporomandibular disorders was conducted. The patients' ages and gender distributions were collected. The disk position diagnosis from the clinical examination was considered the primary outcome. Three observers evaluated the presence of anterior displacement on magnetic resonance images according to 2 criteria: method 1 (12-o'clock position) and method 2 (location of the intermediate zone). To assess the intraobserver variability of the 2 methods, the examiners evaluated the same magnetic resonance images at the beginning of the study (time 1) and 40 days later (time 2). The intraobserver agreement was assessed using the observed agreement and the kappa statistic. McNemar's test was used to assess the differences between each method and the clinical examination findings (P < .05). The accuracy, sensitivity, specificity, and positive and negative predictive values were calculated by comparing the diagnosis from each method with that from the clinical examination (considered the reference standard). Results: The final sample was composed of 20 subjects with a mean age of 33.0 +/- 33.7 years; 3 were men (15%) and 17 were women (85%). A statistically significant difference between the 2 methods was found. Method 1 yielded a greater percentage of anterior displaced disks (52.5%). The agreement between the clinical diagnosis and method 1 was lower (70.0%) than that between the clinical diagnosis and method 2 (87.5%). No statistically significant difference was found between the clinical diagnosis and method 2. Conclusion: The disk position should be judged according to the intermediate zone criterion. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:1534-1539, 2012

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The present report describes an 8-year-old gelding presenting with signs of severe abdominal pain. After performing a thorough physical examination, including rectal palpation and additional diagnostic tests, an exploratory laparotomy was recommended. The jejunum was found herniated through the gastrosplenic ligament, and the stomach was severely distended with gas. Given a poor prognosis, the horse was euthanized on the table. At necropsy, the stomach appeared dilated, with an 180 horizontal gastric torsion, from left (lateral) to right (medial), dividing the organ into dorsal and ventral compartments. We believe that the chronic traction exerted by an incarcerated and distended loop of jejunum, in the dorsal aspect of the gastrosplenic ligament, associated with trauma during episodes of intense rolling, enlarged the rent until it ruptured. Because of this rupture, the lateral dorsal aspect of the stomach became unattached, predisposing it to the torsion. (C) 2012 Elsevier Inc. All rights reserved.

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OBJECTIVE: To estimate the response in lung growth and vascularity after fetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia in the prediction of neonatal survival. METHODS: Between January 2006 and December 2010, fetal lung parameters (observed-to-expected lung-to-head ratio; observed-to-expected lung volume; and contralateral lung vascularization index) were evaluated before fetal tracheal occlusion and were evaluated longitudinally every 2 weeks in 72 fetuses with severe isolated congenital diaphragmatic hernia. Thirty-five fetuses underwent fetal endoscopic tracheal occlusion and 37 cases did not. RESULTS: Survival rate was significantly higher in the fetal endoscopic tracheal occlusion group (54.3%) than in the no fetal endoscopic tracheal occlusion group (5.4%, P<.01). Fetal endoscopic tracheal occlusion resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with fetuses that did not go to the fetal intervention (increase of the observed-to-expected lung-to-head ratio, observed-to-expected total lung volume, and contralateral pulmonary vascularization index 56.2% compared with 0.3%, 37.9% compared with 0.1%, and 98.6% compared with 0.0%, respectively; P<.01). Receiver operating characteristic curves indicated that the observed-to-expected total fetal lung volume was the single best predictor of neonatal survival before fetal endoscopic tracheal occlusion (cutoff 0.23, area under the curve [AUC] 0.88, relative risk 5.3, 95% confidence interval [CI] 1.4-19.7). However, the contralateral lung vascularization index at 4 weeks after fetal endoscopic tracheal occlusion was more accurate in the prediction of neonatal outcome (cutoff 24.0%, AUC 0.98, relative risk 9.9, 95% CI 1.5-66.9) with the combination of observed-to-expected lung volumes and contralateral lung vascularization index at 4 weeks being the best predictor of outcome (AUC 0.98, relative risk 16.6, 95% CI 2.5-112.3). CONCLUSION: Fetal endoscopic tracheal occlusion improves survival rate by increasing the lung size and pulmonary vascularity in fetuses with severe congenital diaphragmatic hernia. The pulmonary response after fetal endoscopic tracheal occlusion can be used to predict neonatal survival. (Obstet Gynecol 2012; 119: 93-101) DOI: 10.1097/AOG.0b013e31823d3aea

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Be stars possess gaseous circumstellar decretion disks, which are well described using standard alpha-disk theory. The Be star 28 CMa recently underwent a long outburst followed by a long period of quiescence, during which the disk dissipated. Here we present the first time-dependent models of the dissipation of a viscous decretion disk. By modeling the rate of decline of the V-band excess, we determine that the viscosity parameter alpha = 1.0 +/- 0.2, corresponding to a mass injection rate (M) over dot = (3.5 +/- 1.3) x 10(-8) M-circle dot yr(-1). Such a large value of a suggests that the origin of the turbulent viscosity is an instability in the disk whose growth is limited by shock dissipation. The mass injection rate is more than an order of magnitude larger than the wind mass-loss rate inferred from UV observations, implying that the mass injection mechanism most likely is not the stellar wind, but some other mechanism.

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BACKGROUND: Alkaline sulfite/anthraquinone (ASA) cooking of Pinus radiata and Pinus caribaea wood chips followed by disk refining was used as a pretreatment for the production of low lignified and high fibrillated pulps. The pulps produced with different delignification degrees and refined at different energy inputs (250, 750 and 1600 Wh) were saccharified with cellulases and fermented to ethanol with Saccharomyces cerevisiae using separated hydrolysis and fermentation (SHF) or semi-simultaneous saccharification and fermentation (SSSF) processes. RESULTS: Delignification of ASA pulps was between 25% and 50%, with low glucans losses. Pulp yield was from 70 to 78% for pulps of P. radiata and 60% for the pulp of P. caribaea. Pulps obtained after refining were evaluated in assays of enzymatic hydrolysis. Glucans-to-glucose conversion varied from 20 to 70%, depending on the degree of delignification and fibrillation of the pulps. The best ASA pulp of P. radiata was used in SHF and SSSF experiments of ethanol production. Such experiments produced maximum ethanol concentration of 20 g L-1, which represented roughly90% of glucose conversion and an estimated amount of 260 L ethanol ton(-1) wood. P. caribaea pulp also presented good performance in the enzymatic hydrolysis and fermentation but, due to the low amount of cellulose present, only 140 L ethanol would be obtained from each ton of wood. CONCLUSION: ASA cooking followed by disk refining was shown to be an efficient pretreatment process, which generated a low lignified and high-fibrillated substrate that allowed the production of ethanol from the softwoods with high conversion yields. (C) 2012 Society of Chemical Industry