RESUMO
INTRODUCTION: The lateral lumbar interbody fusion arose as a revolutionary approach to treating several spinal pathologies because the techniques were able to promote indirect decompression and lordosis restoration through a minimally invasive approach allowing for reduced blood loss and early recovery for patients. However, it is still not clear how the technique compares to other established approaches for treating spinal degenerative diseases, such as TLIF, PLIF, and PLF. MATERIAL AND METHODS: This is a systematic review and meta-analysis of articles published in the last 10 years comparing lateral approaches to posterior techniques. The authors included articles that compared the LLIF technique to one or more posterior approaches, treating only degenerative pathologies, and containing at least one of the key outcomes of the study. Exclusion articles that were not original and the ones that the authors could not obtain the full text; also articles without the possibility to calculate the standard deviation or mean were excluded. For count variables, the odds ratio was used, and for continuous variables, the standard means difference (SMD) was used, and the choice between random or fixed-effects model was made depending on the presence or not of significant (p < 0.05) heterogeneity in the sample. RESULTS: Twenty-four articles were included in the quantitative review. As for the intra-/perioperative variables, the lateral approaches showed a significant reduction in blood loss (SMD-1.56, p < 0.001) and similar operative time (SMD = - 0.33, p = 0.24). Moreover, the use of the lateral approaches showed a tendency to lead to reduced hospitalization days (SMD = - 0.15, p = 0.09), with significantly reduced odds ratios of complications (0.53, p = 0.01). As for the clinical outcomes, both approaches showed similar improvement both at improvement as for the last follow-up value, either in ODI or in VAS-BP. Finally, when analyzing the changes in segmental lordosis and lumbar lordosis, the lateral technique promoted significantly higher correction in both outcomes (p < 0.05). CONCLUSION: Lateral approaches can promote significant radiological correction and similar clinical improvement while reducing surgical blood loss and postoperative complications.
Assuntos
Lordose , Fusão Vertebral , Humanos , Lordose/cirurgia , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Região Lombossacral/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Although several studies have recently shown that spinous process-splitting laminectomy (SPSL) maintains lumbar spinal stability by preserving posterior ligament components and paraspinal muscles as compared with conventional laminectomy, evidence is scarce on the treatment outcomes of SPSL limited to lumbar degenerative spondylolisthesis. We herein compare the surgical results and global alignment changes for SPSL versus posterolateral lumbar fusion (PLF) without instrumentation for lumbar degenerative spondylolisthesis. METHODS: A total of 110 patients with Grade 1 lumbar degenerative spondylolisthesis who had undergone SPSL (47 patients) or PLF (63 patients) with minimum 1-year follow-up were retrospectively enrolled from a single institutional database. RESULTS: Mean operating time per intervertebral level and intraoperative blood loss per intervertebral level were comparable between the SPSL group and PLF group. Japanese Orthopaedic Association scores, Oswestry disability index, and visual analog scale scores were significantly and comparably improved at 1 year postoperatively in both groups as compared with preoperative levels. The numbers of vertebrae with slip progression to Grade 2 and slip progression of 5% or more at 1 year postoperatively were similar between the groups. In the SPSL group, mean pelvic tilt (PT) was significantly decreased at 1 year postoperatively. In the PLF group, mean lumbar lordosis (LL) was significantly increased, while mean sagittal vertical axis, PT, and pelvic incidence-LL were significantly decreased at 1 year after surgery. CONCLUSIONS: Compared with PLF without instrumentation, SPSL for Grade 1 lumbar degenerative spondylolisthesis displayed comparable results for slip progression and clinical outcomes at 1 year postoperatively.
Assuntos
Lordose , Fusão Vertebral , Espondilolistese , Humanos , Espondilolistese/diagnóstico por imagem , Espondilolistese/cirurgia , Laminectomia , Estudos Retrospectivos , Fusão Vertebral/métodos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Resultado do Tratamento , Lordose/cirurgiaRESUMO
Precision livestock farming (PLF) has spread to various countries worldwide since its inception in 2003, though it has yet to be widely adopted. Additionally, the advent of Industry 4.0 and the Internet of Things (IoT) have enabled a continued advancement and development of PLF. This modern technological approach to animal farming and production encompasses ethical, economic and logistical aspects. The aim of this review is to provide an overview of PLF and Industry 4.0, to identify current applications of this rather novel approach in different farming systems for food producing animals, and to present up to date knowledge on the subject. Current scientific literature regarding the spread and application of PLF and IoT shows how efficient farm animal management systems are destined to become. Everyday farming practices (feeding and production performance) coupled with continuous and real-time monitoring of animal parameters can have significant impacts on welfare and health assessment, which are current themes of public interest. In the context of feeding a rising global population, the agri-food industry and industry 4.0 technologies may represent key features for successful and sustainable development.
Assuntos
Criação de Animais Domésticos , Gado , Animais , Fazendas , IndústriasRESUMO
The distribution of agricultural and livestock products has been limited owing to the recent rapid population growth and the COVID-19 pandemic; this has led to an increase in the demand for food security. The livestock industry is interested in increasing the growth performance of livestock that has resulted in the need for a mechanical ventilation system that can create a comfortable indoor environment. In this study, the applicability of demand-controlled ventilation (DCV) to energy-efficient mechanical ventilation control in a pigsty was analyzed. To this end, an indoor temperature and CO2 concentration prediction model was developed, and the indoor environment and energy consumption behavior based on the application of DCV control were analyzed. As a result, when DCV control was applied, the energy consumption was smaller than that of the existing control method; however, when it was controlled in an hourly time step, the increase in indoor temperature was large, and several sections exceeded the maximum temperature. In addition, when it was controlled in 15-min time steps, the increase in indoor temperature and energy consumption decreased; however, it was not energy efficient on days with high-outdoor temperature and pig heat.
RESUMO
PURPOSE: The aim of this study is to provide a systematic review of the literature about the etiology, clinical and radiological presentation, surgical management, and outcomes of pneumolabyrinth (PNL). METHODS: A systematic review of the literature was performed including studies published up to September 2020 in electronic databases (PubMed/MEDLINE, EMBASE, Cochrane Library, and Scopus). The PRISMA standard was applied to identify English, Italian, or French-language studies mentioning PNL. Full texts lacking information on the etiology were excluded. Data concerning the cause, site of air bubbles/fistula, clinical presentation, treatment, and outcome were collected. A qualitative synthesis of the results was performed. RESULTS: Seventy-eight articles were eventually included; 132 patients were involved in the qualitative synthesis. The most common causes were: stapes surgery (24/132, 18.2%), temporal bone fracture (42/132, 31.8%), head trauma without temporal bone fracture (19/132, 14.4%), penetrating trauma (21/132, 15.9%), and barotrauma (15/132, 11.4%). The site most commonly involved was the vestibule (102/107, 95.3%), followed by cochlea (43/107, 40.2%) and semicircular canals (25/107, 23.4%). CONCLUSION: The etiopathogenesis of PNL can be summarized in traumatic, iatrogenic, or inflammatory/infective. Its management consists in exploratory tympanotomy and sealing the fistula, but also conservative treatments can be attempted. Vestibular symptoms disappear in the majority of cases. Instead, the prognosis of hearing function is widely variable, and complete recovery is less probable. The certainty of evidence is still too low to make it useful for clinical decision-making.
Assuntos
Traumatismos Craniocerebrais , Cirurgia do Estribo , Vestíbulo do Labirinto , Cóclea , Humanos , Canais SemicircularesRESUMO
OBJECTIVE: Bisphosphonates are used to increase bone strength in treating osteopenia and osteoporosis, but their use for increasing lumbar fusion rates has been controversial. The objective of this study was to determine if preoperative treatment with bisphosphonates affects the reoperation rates for nonunions (operative nonunion rates) following lumbar fusions in patients with osteopenia or osteoporosis. METHODS: The authors conducted a cohort study using data from the Kaiser Permanente Spine Registry. Patients (aged ≥ 50 years) with a diagnosis of osteopenia or osteoporosis who underwent primary elective lumbar fusions for degenerative disc disease, deformity, or spondylolisthesis were included in the cohort. Repeated spinal procedures at the index lumbar levels were noted through chart review. Reoperations for symptomatic nonunions (operative nonunions), time to nonunion, and the nonunion spine level(s) were also identified. The crude 2-year cumulative incidence of operative nonunions was calculated as 1 minus the Kaplan-Meier estimator. Cox proportional hazard regression was used to evaluate the association between preoperative bisphosphonate use and operative nonunion after adjustment for covariates. Analysis was stratified by osteopenia and osteoporosis diagnosis. RESULTS: The cohort comprised 1040 primary elective lumbar fusion patients, 408 with osteopenia and 632 with osteoporosis. Ninety-seven (23.8%) patients with osteopenia and 370 (58.5%) patients with osteoporosis were preoperative bisphosphonate users. For the osteopenia group, no operative nonunions were observed in patients with preoperative bisphosphonate, while the crude 2-year incidence was 2.44% (95% CI 0.63-4.22) in the nonuser group. For the osteoporotic group, after adjustment for covariates, no difference was observed in risk for operative nonunions between the preoperative bisphosphonate users and nonusers (HR 0.96, 95% CI 0.20-4.55, p = 0.964). CONCLUSIONS: To the authors' knowledge, this study presents one of the largest series of patients with the diagnosis of osteopenia or osteoporosis in whom the effects of preoperative bisphosphonates on lumbar fusions were evaluated using operative nonunion rates as an outcome measure. The results indicate that preoperative bisphosphonate use had no effect on the operative nonunion rates for patients with osteoporosis. Similar indications were not confirmed in osteopenia patients because of the low nonunion frequency. Further studies are warranted to the determine if preoperative and postoperative timing of bisphosphonate use has any effect on lumbar fusion rates.
Assuntos
Doenças Ósseas Metabólicas/cirurgia , Difosfonatos/administração & dosagem , Vértebras Lombares/cirurgia , Osteoporose/cirurgia , Cuidados Pré-Operatórios/tendências , Sistema de Registros , Fusão Vertebral/tendências , Idoso , Doenças Ósseas Metabólicas/tratamento farmacológico , Doenças Ósseas Metabólicas/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoporose/tratamento farmacológico , Osteoporose/epidemiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Resultado do TratamentoRESUMO
This review deals with the prospects and achievements of individual dairy cow management (IDCM) and the obstacles and difficulties encountered in attempts to successfully apply IDCM into routine dairy management. All aspects of dairy farm management, health, reproduction, nutrition and welfare are discussed in relation to IDCM. In addition, new IDCM R&D goals in these management fields are suggested, with practical steps to achieve them. The development of management technologies is spurred by the availability of off-the-shelf sensors and expanded recording capacity, data storage, and computing capabilities, as well as by demands for sustainable dairy production and improved animal wellbeing at a time of increasing herd size and milk production per cow. Management technologies are sought that would enable the full expression of genetic and physiological potential of each cow in the herd, to achieve the dairy operation's economic goals whilst optimizing the animal's wellbeing. Results and conclusions from the literature, as well as practical experience supported by published and unpublished data are analyzed and discussed. The object of these efforts is to identify knowledge and management routine gaps in the practical dairy operation, in order to point out directions and improvements for successful implementation of IDCM in the dairy cows' health, reproduction, nutrition and wellbeing.
Assuntos
Bovinos/fisiologia , Indústria de Laticínios/métodos , Fenômenos Fisiológicos da Nutrição Animal , Bem-Estar do Animal , Animais , Peso Corporal , Bovinos/genética , Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/prevenção & controle , Indústria de Laticínios/economia , Indústria de Laticínios/instrumentação , Ingestão de Alimentos , Detecção do Estro , Feminino , Nível de Saúde , Lactação/fisiologia , Coxeadura Animal/diagnóstico , Glândulas Mamárias Animais , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/veterinária , Gravidez , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/veterinária , ReproduçãoRESUMO
Our study hypothesis is that the interline registered pH of the cow reticulum can be used as an indicator of health and reproductive status. The main objective of this study was to examine the relationship of pH, using the indicators of the automatic milking system (AMS), with some parameters of cow blood components. The following four main groups were used to classify cow health status: 15-30 d postpartum, 1-34 d after insemination, 35 d after insemination (not pregnant), and 35 d (pregnant). Using the reticulum pH assay, the animals were categorized as pH < 6.22 (5.3% of cows), pH 6.22-6.42 (42.1% of cows), pH 2.6-6.62 (21.1% of cows), and pH > 6.62 (10.5% of cows). Using milking robots, milk yield, fat protein, lactose level, somatic cell count, and electron conductivity were registered. Other parameters assessed included the temperature and pH of the contents of reticulorumens. Assessment of the aforementioned parameters was done using specific smaX-tec boluses. Blood gas parameters were assessed using a blood gas analyzer (EPOC (Siemens Healthcare GmbH, Erlangen, Germany). The study findings indicated that pregnant cows have a higher pH during insemination than that of non-pregnant ones. It was also noted that cows with a low fat/protein ratio, lactose level, and high SCC had low reticulorumen pH. They also had the lowest blood pH. It was also noted that, with the increase of reticulorumen pH, there was an increased level of blood potassium, a high hematocrit, and low sodium and carbon dioxide saturation.
Assuntos
Bovinos/fisiologia , Saúde , Reprodução/fisiologia , Rúmen/fisiologia , Animais , Bovinos/sangue , Condutividade Elétrica , Concentração de Íons de HidrogênioRESUMO
For all homoeothermic living organisms, heart rate (HR) is a core variable to control the metabolic energy production in the body, which is crucial to realize essential bodily functions. Consequently, HR monitoring is becoming increasingly important in research of farm animals, not only for production efficiency, but also for animal welfare. Real-time HR monitoring for humans has become feasible though there are still shortcomings for continuously accurate measuring. This paper is an effort to estimate whether it is realistic to get a continuous HR sensor for livestock that can be used for long term monitoring. The review provides the reported techniques to monitor HR of living organisms by emphasizing their principles, advantages, and drawbacks. Various properties and capabilities of these techniques are compared to check the potential to transfer the mostly adequate sensor technology of humans to livestock in term of application. Based upon this review, we conclude that the photoplethysmographic (PPG) technique seems feasible for implementation in livestock. Therefore, we present the contributions to overcome challenges to evolve to better solutions. Our study indicates that it is realistic today to develop a PPG sensor able to be integrated into an ear tag for mid-sized and larger farm animals for continuously and accurately monitoring their HRs.
Assuntos
Frequência Cardíaca/fisiologia , Gado , Monitorização Fisiológica/métodos , Bem-Estar do Animal , Animais , Eletrocardiografia/métodos , Fotopletismografia/métodosRESUMO
INTRODUCTION: We have conducted a systematic review and meta-analysis that aims to compare outcomes (pain VAS, fusion and adverse event) of PRP and placebo after posterolateral lumbar fusion (PLF) surgery. MATERIALS AND METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies were identified from Medline and Scopus from inception to September 16, 2019 that reported visual analog scale back pain, postoperative complications and fusions of either group. RESULTS: In a total of seven studies, two, two, three studies were RCT, prospective and retrospective studies, respectively. Overall, there were 270 patients (150 in the PRP group and 149 in the placebo group). Three, three, four, three, two, seven and four studies were reported for pain VAS back in 3 months, 6 months, 12 months, 24 months, period of fusion, postoperative fusion and adverse events, respectively. The unstandardized mean difference (UMD) VAS back in 3, 6, 6 and 24 months was - 0.41 (95% CI - 0.87, 0.05) score, - 0.97 (95% CI - 1.68, - 0.27) score, - 0.33 (95% CI - 0.61, - 0.59) score, - 0.19 (95% CI - 1.00, 0.62) scores lower than placebo after posterolateral lumbar fusion (PLF) patients. The UMD period of bone union were - 1.62 (95% CI - 1.85, - 1.39) months faster than placebo after PLF patients. A total of seven and four studies were reported fusion and adverse events between PRP and placebo group. No significant differences were noted for fusion and adverse events with the pooled RR of 1.03 (95% CI 0.48, 1.80) and 0.95 (95% CI 0.14, 6.56). CONCLUSIONS: PRP with autologous bone graft had lower back pain and faster bone union time than bone graft alone. While, there have no difference in fusion rate and adverse events in both groups. Larger, prospective randomized controlled studies are needed to confirm these findings as the current literature is still insufficient. Further research including cost of operation, postoperative function and satisfaction, quality of life and cost-efficacy analysis is required to determine whether the PRP with autologous bone graft is superior to bone graft alone or not. LEVEL OF EVIDENCE: Level II.
Assuntos
Vértebras Lombares/cirurgia , Plasma Rico em Plaquetas , Complicações Pós-Operatórias/prevenção & controle , Fusão Vertebral , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Doenças da Coluna Vertebral/cirurgia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Resultado do TratamentoRESUMO
Fibrodysplasia ossificans progressiva (FOP) is a genetic disease characterized by heterotopic ossification (HO). The disease is caused by a mutation in the activin receptor type 1 (ACVR1) gene that enhances this receptor's responsiveness to Activin-A. Binding of Activin-A to the mutated ACVR1 receptor induces osteogenic differentiation. Whether Activin-A also affects osteoclast formation in FOP is not known. Therefore we investigated its effect on the osteoclastogenesis-inducing potential of periodontal ligament fibroblasts (PLF) from teeth of healthy controls and patients with FOP. We used western blot analysis of phosphorylated SMAD3 (pSMAD3) and quantitative polymerase chain reaction to assess the effect of Activin-A on the PLF. PLF-induced osteoclast formation and gene expression were studied by coculturing control and FOP PLF with CD14-positive osteoclast precursor cells from healthy donors. Osteoclast formation was also assessed in control CD14 cultures stimulated by macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor kappa-B ligand (RANK-L). Although Activin-A increased activation of the pSMAD3 pathway in both control and FOP PLF, it increased ACVR1, FK binding protein 12 (FKBP12), an inhibitor of DNA binding 1 protein (ID-1) expression only in FOP PLF. Activin-A inhibited PLF mediated osteoclast formation albeit only significantly when induced by FOP PLF. In these cocultures, it reduced M-CSF and dendritic cell-specific transmembrane protein (DC-STAMP) expression. Activin-A also inhibited osteoclast formation in M-CSF and RANK-L mediated monocultures of CD14+ cells by inhibiting their proliferation. This study brings new insight on the role of Activin A in osteoclast formation, which may further add to understanding FOP pathophysiology; in addition to the known Activin-A-mediated HO, this study shows that Activin-A may also inhibit osteoclast formation, thereby further promoting HO formation.
Assuntos
Ativinas/farmacologia , Comunicação Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Miosite Ossificante/metabolismo , Osteoclastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Ligamento Periodontal/efeitos dos fármacos , Receptores de Ativinas Tipo I/metabolismo , Adolescente , Adulto , Estudos de Casos e Controles , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Técnicas de Cocultura , Feminino , Fibroblastos/metabolismo , Fibroblastos/patologia , Humanos , Proteína 1 Inibidora de Diferenciação/metabolismo , Receptores de Lipopolissacarídeos/metabolismo , Masculino , Miosite Ossificante/patologia , Osteoclastos/metabolismo , Osteoclastos/patologia , Ligamento Periodontal/metabolismo , Ligamento Periodontal/patologia , Fosforilação , Transdução de Sinais , Proteína Smad3/metabolismo , Proteína 1A de Ligação a Tacrolimo/metabolismo , Adulto JovemRESUMO
OBJECTIVE The health care costs for instrumented spine surgery have increased dramatically in the last few decades. The authors present a novel noninstrumented surgical approach for patients with isthmic spondylolisthesis, with clinical and radiographic results. METHODS Charts of patients who underwent this technique were reviewed. The procedure consisted of nerve root decompression by reconstruction of the intervertebral foramen. This was achieved by removal of the pedicle followed by noninstrumented posterolateral fusion in which autologous bone graft from the right iliac crest was used. Outcomes regarding radicular complaints, bony fusion, progression of the slip, and complications were evaluated using patient history and radiographs obtained at follow-up intervals of 3-18 months after surgery. RESULTS A total of 58 patients with a mean age of 47 years were treated with this method. Partial removal of the pedicle was performed in 93.1% of the cases, whereas in 6.9% of the cases the entire pedicle was removed. The mean duration of surgery was 216.5 ± 54.5 minutes (range 91-340 minutes). The mean (± SD) duration of hospitalization was 10.1 ± 2.9 days (range 5-18 days). After 3 months of follow-up, 86% of the patients reported no leg pain, and this dropped to 81% at last follow-up. Radiographic follow-up showed bony fusion in 87.7% of the patients. At 1 year, 5 patients showed progression of the slip, which in 1 patient prompted a second operation within 1 year. No major complications occurred. CONCLUSIONS Treatment of isthmic spondylolisthesis by reconstruction of the intervertebral neuroforamen and posterolateral fusion in situ is a safe procedure and has comparable results with the existing techniques. Cost-effectiveness research comparing this technique to conventional instrumented fusion techniques is necessary to evaluate the merits for both patients and society.
Assuntos
Descompressão Cirúrgica , Vértebras Lombares/cirurgia , Radiculopatia/cirurgia , Espondilolistese/cirurgia , Adulto , Idoso , Análise Custo-Benefício , Descompressão Cirúrgica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Fusão Vertebral/métodos , Resultado do TratamentoRESUMO
PURPOSE: The use of inter-body device in lumbar fusions has been difficult to validate, only few long-term RCT are available. METHODS: Between 2003 and 2005, 100 patients entered a RCT between transforaminal lumbar inter-body fusion (TLIF) or posterolateral instrumented lumbar fusion (PLF). The patients suffered from LBP due to segmental instability, disc degeneration, former disc herniation, spondylolisthesis Meyerding grade <2. Functional outcome parameters as Dallas pain questionnaire (DPQ), SF-36, low back pain questionnaire (LBRS), Oswestry disability index (ODI) were registered prospectively, and after 5-10 years. RESULTS: Follow-up reached 93 % of available, (94 %, 44 in the PLF's and 92 %, 44 in the TLIF group p = 0.76). Mean follow-up was 8.6 years (5-10 years). Mean age at follow-up was 59 years (34-76 years p = 0.19). Reoperation rate in a long-term perspective was equal among groups 14 %, each p = 0.24. Back pain was 3.8 (mean) (Scale 0-10), TLIF (3.65) PLF (3.97) p = 0.62, leg pain 2.68 (mean) (Scale 0-10) 2.90 (TLIF) and 2.48 (PLF) p = 0.34. No difference in functional outcome between groups p = 0.93. Overall, global satisfaction with the primary intervention at 8.6 year was 76 % (75 % TLIF and 77 % PLF) p = 0.85. CONCLUSION: In a long-term perspective, patients with TLIF's did not experience better outcome scores.
Assuntos
Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Adulto , Idoso , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Satisfação do Paciente , Estudos ProspectivosRESUMO
OBJECT Failed solid bony fusion, or pseudarthrosis, is a well-known complication of lumbar arthrodesis. Recent advances in radiographic technology, biologics, instrumentation, surgical technique, and understanding of the local biology have all aided in the prevention and treatment of pseudarthrosis. Here, the current literature on the diagnosis and management of lumbar pseudarthroses is reviewed. METHODS A systematic literature review was conducted using the MEDLINE and Embase databases in order to search for the current radiographie diagnosis and surgical treatment methods published in the literature (1985 to present). Inclusion criteria included: 1) published in English; 2) level of evidence I-III; 3) diagnosis of degenerative lumbar spine conditions and/or history of lumbar spine fusion surgery; and 4) comparative studies of 2 different surgical techniques or comparative studies of imaging modality versus surgical exploration. RESULTS Seven studies met the inclusion criteria for current radiographie imaging used to diagnose lumbar pseudarthrosis. Plain radiographs and thin-cut CT scans were the most common method for radiographie diagnosis. PET has been shown to be a valid imaging modality for monitoring in vivo active bone formation. Eight studies compared the surgical techniques for managing and preventing failed lumbar fusion. The success rates for the treatment of pseudarthrosis are enhanced with the use of rigid instrumentation. CONCLUSIONS Spinal fusion rates have improved secondary to advances in biologies, instrumentation, surgical techniques, and understanding of local biology. Treatment of lumbar pseudarthrosis includes a variety of surgical options such as replacing loose instrumentation, use of more potent biologies, and interbody fusion techniques. Prevention and recognition are important tenets in the algorithm for the management of spinal pseudarthrosis.
Assuntos
Pseudoartrose/diagnóstico , Pseudoartrose/terapia , Medula Espinal/patologia , Bases de Dados Bibliográficas/estatística & dados numéricos , Humanos , Processamento de Imagem Assistida por Computador , NeuroimagemRESUMO
The integration of digitalization and Artificial Intelligence (AI) has marked the onset of a new era of efficient sheep farming in multiple aspects ranging from the general well-being of sheep to advanced web-based management applications. The resultant improvement in sheep health and consequently better farming yield has already started to benefit both farmers and veterinarians. The predictive analytical models embedded with machine learning (giving sense to machines) has helped better decision-making and has enabled farmers to derive most out of their farms. This is evident in the ability of farmers to remotely monitor livestock health by wearable devices that keep track of animal vital signs and behaviour. Additionally, veterinarians now employ advanced AI-based diagnostics for efficient parasite detection and control. Overall, digitalization and AI have completely transformed traditional farming practices in livestock animals. However, there is a pressing need to optimize digital sheep farming, allowing sheep farmers to appreciate and adopt these innovative systems. To fill this gap, this review aims to provide available digital and AI-based systems designed to aid precision farming of sheep, offering an up-to-date understanding on the subject. Various contemporary techniques, such as sky shepherding, virtual fencing, advanced parasite detection, automated counting and behaviour tracking, anomaly detection, precision nutrition, breeding support, and several mobile-based management applications are currently being utilized in sheep farms and appear to be promising. Although artificial intelligence and machine learning may represent key features in the sustainable development of sheep farming, they present numerous challenges in application.
Assuntos
Criação de Animais Domésticos , Inteligência Artificial , Ovinos , Animais , Humanos , Fazendas , Criação de Animais Domésticos/métodos , Fazendeiros , GadoRESUMO
Precision livestock farming aims to individually and automatically monitor animal activity to ensure their health, well-being, and productivity. Computer vision has emerged as a promising tool for this purpose. However, accurately tracking individuals using imaging remains challenging, especially in group housing where animals may have similar appearances. Close interaction or crowding among animals can lead to the loss or swapping of animal IDs, compromising tracking accuracy. To address this challenge, we implemented a framework combining a tracking-by-detection method with a radio frequency identification (RFID) system. We tested this approach using twelve pigs in a single pen as an illustrative example. Three of the pigs had distinctive natural coat markings, enabling their visual identification within the group. The remaining pigs either shared similar coat color patterns or were entirely white, making them visually indistinguishable from each other. We employed the latest version of the You Only Look Once (YOLOv8) and BoT-SORT algorithms for detection and tracking, respectively. YOLOv8 was fine-tuned with a dataset of 3,600 images to detect and classify different pig classes, achieving a mean average precision of all the classes of 99%. The fine-tuned YOLOv8 model and the tracker BoT-SORT were then applied to a 166.7-min video comprising 100,018 frames. Results showed that pigs with distinguishable coat color markings could be tracked 91% of the time on average. For pigs with similar coat color, the RFID system was used to identify individual animals when they entered the feeding station, and this RFID identification was linked to the image trajectory of each pig, both backward and forward. The two pigs with similar markings could be tracked for an average of 48.6 min, while the seven white pigs could be tracked for an average of 59.1 min. In all cases, the tracking time assigned to each pig matched the ground truth 90% of the time or more. Thus, our proposed framework enabled reliable tracking of group-housed pigs for extended periods, offering a promising alternative to the independent use of image or RFID approaches alone. This approach represents a significant step forward in combining multiple devices for animal identification, tracking, and traceability, particularly when homogeneous animals are kept in groups.
In precision livestock farming, monitoring animal activity is crucial to ensure their health, well-being, and productivity. While digital cameras and computer vision algorithms offer a promising solution for this task, tracking individual animals of similar appearance when housed in groups can be challenging. Close interaction among animals can lead to a loss of individual identity, which affects tracking accuracy. To overcome this problem, we developed a framework that combines camera images with radio frequency identification (RFID) ear tags. This methodology was applied to a pen housing 12 pigs, with an RFID reader located inside the feeder. Among the pigs, three had unique coat markings, enabling them to be tracked most of the time without losing their identity (87% of the time). The remaining pigs could not be visually distinguished from each other, so information from the RFID system was used to recover lost IDs every time pigs entered the feeder. The framework achieves 97% accuracy in tracking, offering a reliable solution for monitoring group-housed pigs.
Assuntos
Algoritmos , Sistemas de Identificação Animal , Abrigo para Animais , Dispositivo de Identificação por Radiofrequência , Animais , Suínos , Sistemas de Identificação Animal/veterinária , Sistemas de Identificação Animal/métodos , Sistemas de Identificação Animal/instrumentação , Criação de Animais Domésticos/métodosRESUMO
Background: Interspinous devices (ISD) constitute a minimally invasive (MI) alternative to open surgery (i.e., laminectomy/decompression with/without fusion (i.e., posterior lumbar interbody fusion (PLIF)/posterolateral instrumented fusion (PLF)) for treating lumbar spinal stenosis (LSS). Biomechanically, static and/or dynamic ISD "offload" pressure on the disc space, increase intervertebral foraminal/disc space heights, reverse/preserve lordosis, limit range of motion (ROM)/stabilize the surgical level, and reduce adjacent segment disease (ASD). Other benefits reported in the literature included; reduced operative time (OR Time), length of hospital stay (LOS), estimated blood loss (EBL), and improved outcomes (i.e., ODI (Oswestry Disability Index), VAS (Visual Analog Scale), and/or SF-36 (Short-Form 36)). Methods: Various studies documented the relative efficacy and outcomes of original (i.e., Wallis), current (i.e., X-STOP, Wallis, DIAM, Aperius PercLID), and new generation (i.e., Coflex, Superion Helifix, In-Space) ISD used to treat LSS vs. open surgery. Results: Although ISD overall resulted in comparable or improved outcomes vs. open surgery, the newer generation ISD provided the greatest reductions in critical cost-saving parameters (i.e., OR time, LOS, and lower reoperation rates of 3.7% for Coflex vs. 11.1% for original/current ISD) vs. original/current ISD and open surgery. Further, the 5-year postoperative study showed the average cost of new generation Coflex ISD/decompressions was $15,182, or $11,681 lower than the average $26,863 amount for PLF. Conclusion: Patients undergoing new generation ISD for LSS exhibited comparable or better outcomes, but greater reductions in OR times, EBL, LOS, ROM, and ASD vs. those receiving original/current ISD or undergoing open surgery.
RESUMO
Perilymph Fistula (PLF), abnormal communication between the fluid-filled space of the inner ear and the air-filled space of the middle ear, is a significant cause of vestibular and auditory symptoms. This is a retrospective study of 22 cases treated with PLF repair surgery, selected based on our surgical indication. We analyzed the characteristics of these 22 cases and evaluated the efficacy of PLF repair surgery in treating vestibular and auditory symptoms. Cases with antecedent events had significantly shorter intervals before surgery. The postoperative recovery from vestibular symptoms following PLF repair surgery was strikingly rapid, with 82% of cases demonstrating marked improvement within a week, even in chronic cases. Despite the notable absence of a control group in the study, the marked improvements in vestibular symptoms and substantial reductions in Dizziness Handicap Inventory (DHI) scores suggest that the observed benefits are attributable to the surgical intervention. Further, timely surgery showed improvements in hearing, with some benefits also seen in late-stage surgeries. Using the perilymph-specific protein Cochlin-tomoprotein (CTP) as a diagnostic biomarker, we could prove that PLF could be responsible for disequilibrium and related auditory disturbances in these patients. A new hypothesis is proposed that the chronic disequilibrium experienced by many PLF patients is due to enhanced mobility of the utricle and not to endolymphatic hydrops. Further research is needed to fully elucidate PLF's symptoms and treatment efficacy using the surgical indication we developed.
RESUMO
More efficient livestock production systems are necessary, considering that only 41% of global meat demand will be met by 2050. Moreover, the COVID-19 pandemic crisis has clearly illustrated the necessity of building sustainable and stable agri-food systems. Precision Livestock Farming (PLF) offers the continuous capacity of agriculture to contribute to overall human and animal welfare by providing sufficient goods and services through the application of technical innovations like digitalization. However, adopting new technologies is a challenging issue for farmers, extension services, agri-business and policymakers. We present a review of operational concepts and technological solutions in the pig and poultry sectors, as reflected in 41 and 16 European projects from the last decade, respectively. The European trend of increasing broiler-meat production, which is soon to outpace pork, stresses the need for more outstanding research efforts in the poultry industry. We further present a review of farmers' attitudes and obstacles to the acceptance of technological solutions in the pig and poultry sectors using examples and lessons learned from recent European projects. Despite the low resonance at the research level, the investigation of farmers' attitudes and concerns regarding the acceptance of technological solutions in the livestock sector should be incorporated into any technological development.
RESUMO
OBJECTIVE: Vertigo is a quite frequent complication after cochlear implantation. Perilymphatic fistula (PLF) is assumed to be one cause of this problem. Cochlin tomoprotein (CTP) is a newly introduced marker for PLF. The present aim was to evaluate the rate of positive CTP testing in cases of newly occurring vertigo after cochlear implantation. MATERIALS AND METHODS: Twelve patients with vertigo after cochlear implantation and a revisional electrode-sealing procedure underwent intraoperative rinsing of their middle ear. The sample was evaluated for CTP with monoclonal antibody testing. Sixteen controls from six CI patients were taken. RESULTS: 4 out of 12 (33%) cases showed positive CTP testing, indicating that a PLF could be evaluated. In all of the positive CTP cases, surgery decreased the vertigo symptoms. A relation between the subjective visual assessment of a fistula and a positive CTP value was not observed. Controls confirmed the value of the testing. DISCUSSION: CTP detection objectively shows that PLF can occur in patients with vertigo after CI.