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1.
Health Promot Pract ; : 15248399231221779, 2024 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-38264944

RESUMO

The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) provides nutrition education and support for healthy living in SNAP-qualifying communities. SNAP-Ed supports policy, systems, and environmental (PSE) efforts to make the healthy choice an easier choice. SNAP-Ed implementers have widely adopted healthy eating PSE supports. However, physical activity (PA) PSE strategies are less common, with limited awareness between states of how other SNAP-Ed implementers approach PA-focused PSE work. Physical Activity Policy, Research, and Evaluation Network (PAPREN) Rural Active Living Workgroup project members sought to explore how Extension-based SNAP-Ed implements PA-focused PSE approaches. A sample of Extension-based SNAP-Ed program (n = 8) leaders were purposefully recruited from eligible universities in six of the seven SNAP-Ed regions. An interview guide to systematically collect information about current Extension SNAP-Ed implementation focused on PA PSE strategies was developed iteratively by the PAPREN Rural Active Living Workgroup Extension PA PSE project team. PA PSE Extension SNAP-Ed implementation efforts occurred at the state, county, and community levels and/or within local organizations. PA PSEs included school PA policy change, shared-use agreements, active transportation promotion, park development, walking challenges, and PA-promoting signage. All interviews highlighted the importance of partnerships at local, county, and state levels for PSE efforts. Extension-based SNAP-Ed shows potential to bring community partners together to plan and implement PA-focused PSE approaches. With a focus on SNAP-eligible people and substantial geographic reach, Extension SNAP-Ed is uniquely situated as a public health partner to broadly implement PA PSE changes.

2.
Eur J Nucl Med Mol Imaging ; 51(2): 481-489, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37721580

RESUMO

PURPOSE: Chimeric antigen receptor (CAR) T cells have established themselves as an effective treatment for refractory or relapsed large B cell lymphoma (LBCL). Recently, the sDmax, which corresponds to the distance separating the two farthest lesions standardized by the patient's body surface area, has appeared as a prognostic factor in LBCL. This study aimed to identify [18F]FDG-PET biomarkers associated with prognosis and predictive of adverse events in patients treated with CAR T cells. METHODS: Patients were retrospectively included from two different university hospitals. They were being treated with CAR T cells for LBCL and underwent [18F]FDG-PET just before CAR T cell infusion. Lesions were segmented semi-automatically with a threshold of 41% of the maximal uptake. In addition to clinico-biological features, sDmax, total metabolic tumor volume (TMTV), SUVmax, and uptake intensity of healthy lymphoid organs and liver were collected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The occurrence of adverse events, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), was reported. RESULTS: Fifty-six patients were included. The median follow-up was 9.7 months. Multivariate analysis showed that TMTV (cut-off of 36 mL) was an independent prognostic factor for PFS (p < 0.001) and that sDmax (cut-off of 0.15 m-1) was an independent prognostic factor for OS (p = 0.008). Concerning the occurrence of adverse events, a C-reactive protein level > 35 mg/L (p = 0.006) and a liver SUVmean > 2.5 (p = 0.027) before CAR T cells were associated with grade 2 to 4 CRS and a spleen SUVmean > 1.9 with grade 2 to 4 ICANS. CONCLUSION: TMTV and sDmax had independent prognostic values, respectively, on PFS and OS. Regarding adverse events, the mean liver and spleen uptakes were associated with the occurrence of grade 2 to 4 CRS and ICANS, respectively. Integrating these biomarkers into the clinical workflow could be useful for early adaptation of patients management.


Assuntos
Fluordesoxiglucose F18 , Linfoma Difuso de Grandes Células B , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Estudos Retrospectivos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/terapia , Prognóstico , Biomarcadores , Linfócitos T
3.
Rev Med Interne ; 2023 Nov 23.
Artigo em Francês | MEDLINE | ID: mdl-38000918

RESUMO

INTRODUCTION: PET/CT is regularly used to investigate inflammatory syndrome of unknown origin (IUO), but hypermetabolisms found are not always consistent with the final diagnosis. The objective of the study was to assess the cost attributed to the diagnostic work-up for these false positives. MATERIALS AND METHODS: We conducted an ancillary study on a previous retrospective cohort from the internal medicine department at Amiens university hospital in patients who had a PET/CT scan between October 2004 and April 2017. Patients were included if PET/CT had been prescribed to investigate IUO. Among the 763 PET/CT performed, 144 met the inclusion criteria and a false-positive rate of 17.4% (n=25) was reported. RESULTS: Among these 25 patients, 21 underwent further investigations. The most frequently found hypermetabolic territories were digestive (n=12, mean SUVmax 8 [±4.33]) and osteoarticular (n=11, mean SUVmax 4.33 [±1.15]). The total cost of the 13 prescribed consultations was €390, the total cost of the 40 additional tests was €4,476 (mainly digestive endoscopies and radiological tests) and the total cost of medical transport was €572. The total cost of the 35 days of hospitalization specifically required to investigate these false positives was €22,952. In 23.8% (n=5), these investigations led to the incidental discovery of tumor lesions. CONCLUSION: The economic impact of false-positive PET/CT results does not appear to be negligible and merits a genuine prospective medico-economic study.

4.
J Cancer Res Clin Oncol ; 149(7): 3811-3821, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35994118

RESUMO

PURPOSE: The aim of this project was to provide an overview of the epidemiology of primary salivary gland carcinomas (SGC) in terms of incidence, distribution of clinicopathological features and survival in one of the largest cancer registries in Europe. METHODS: Data were collected from patients with SGC of the major salivary glands registered in the population-based state cancer registry (Landeskrebsregister LKR) in North Rhine-Westphalia (NRW), Germany from 01/01/2009 to 12/31/2018. Age standardization of incidence was performed and relative survival estimates were computed by sex, histological group, age group and T-, N-, and M-stage. RESULTS: A total of 1680 patients were included in this analysis. The most frequent tumor localization was the parotid gland (78%). Adenocarcinoma (not otherwise specified) was the most common tumor entity (18.5%). Most tumors were found in stages T1-T3 (29% T1; 29% T2; 28% T3). The age-standardized incidence rate (ASR) for SGC was 0.65/100,000 and remained stable during the observation period. There was an age-dependent incidence increasing especially from the age 70 years and onwards. The overall 5-year relative survival (RS) for all patients with SGC was 69.2%. RS was 80-95.6% for T1-2 stage tumors, 60.3% for T3, 47.3% for T4 stage, 87.4% for N0 and 51.2% for N1-2, 74.4% for M0 and 44.9% for M1. CONCLUSION: Age-standardized incidence for SGC has been stable for the observed 10-year period. Smaller tumors and those without lymph node or distant metastases had a better RS than more advanced tumors.


Assuntos
Adenocarcinoma , Neoplasias das Glândulas Salivares , Humanos , Idoso , Incidência , Estadiamento de Neoplasias , Glândulas Salivares , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Sistema de Registros , Alemanha/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-36141933

RESUMO

Promotoras de salud (promotoras) have been a valuable part of community research for Latino families, such as in the recruitment or delivery of health promotion programs. However, there has been limited discussion of how to integrate a promotora model into a father-focused program to support nutrition and physical activity within Latino families. This manuscript's purpose is to describe how to engage and collaborate with promotoras in a father-focused, family-centered program for Latino families living in colonias near the U.S.-Mexico border. As part of a longstanding community-academic partnership, the authors outline approaches and lessons learned from collaboration with promotoras during the design (including formative work and training), implementation, and evaluation of a behavioral program-¡Haz Espacio para Papi! (HEPP, Make Room for Daddy!). Promotoras' contributions supported the entire program, from design through evaluation. The team of all-female promotoras created a balance between the needs and preferences of the community and the goals and requirements of the research. While there is considerable time and human capital required for collaboration, the mutual benefits can make this work meaningful to all involved.


Assuntos
Agentes Comunitários de Saúde , Promoção da Saúde , Exercício Físico , Pai , Feminino , Hispânico ou Latino , Humanos , Masculino
6.
Fam Community Health ; 45(2): 115-124, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35125491

RESUMO

Physical activity (PA) is a public health priority due to holistic health benefits; however, many adults do not meet PA guidelines. Few studies have examined Mexican-heritage fathers' social networks, specifically with whom they are physically active. This study examines changes in Mexican-heritage fathers' PA networks after participation in a father-focused, family-centered health program. Families consisting of child (aged 9-11 years), mother, and father were recruited from colonias on the Texas-Mexico border for participation in a 6-week father-focused, family-centered program concentrated on healthy eating and active living. Fathers reported up to 5 people with whom they were active most in the previous month before and after the program as well as how often they were active with the person and what activities they did most often. Multilevel regression models examined changes in networks. Fathers (n = 42; mean age = 39.07 years, SD = 7.45) were significantly more likely to report more frequent PA with others after the program as compared with before. General active play and conditional support were mentioned most frequently. This study provides context to the social networks and PA behaviors of Mexican-heritage fathers and suggests that a father-focused, family-centered health program can increase the PA frequency with social network connections.


Assuntos
Exercício Físico , Pai , Adulto , Criança , Feminino , Promoção da Saúde , Humanos , Masculino , México , Atividade Motora
7.
Neurochirurgie ; 68(1): 94-101, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33989644

RESUMO

PURPOSE: Nocardia farcinica is an opportunistic pathogen causing mainly pneumonia in immunocompromised patients, complicated in almost one-third of the cases by a thick-walled multiloculated cerebral abscess which induces significant morbidity and mortality. This review aims to assess the optimal treatment strategy for N. farcinica cerebral abscess. METHODS: Report of a case. Medline database was used to conduct a systematic review from inception to January 2020 looking for English-language articles focused on N. farcinica cerebral abscess, in accordance with the PRISMA guidelines. RESULTS: The research yielded 54 articles for a total of 58 patients. N. farcinica cerebral abscess displayed three different neuroimaging patterns: a single multiloculated abscess in half of the cases, multiple cerebral abscesses, or a small paraventricular abscess with meningitis. The patients who benefited from surgical excision of the abscess showed a trend towards a lower risk of surgical revision (8% versus 31%, P=0.06) and a lower mortality rate (8% versus 23%, P=0.18) than patients who benefited from needle aspiration. Twenty-two percent of the patients benefited from microbiological documentation from another site with a mortality rate of 23%. CONCLUSION: Urgent multimodal MRI is necessary in face with clinical suspicion of cerebral nocardiosis. In case of single or multiple small cerebral abscesses, microbiological documentation can be obtained with puncture of pseudotumoral visceral lesions. In case of large or symptomatic cerebral abscess, an aggressive surgical excision seems a reliable option and can be preferred over needle aspiration. Long-term antibiotic therapy with cotrimoxazole is necessary thereafter.


Assuntos
Abscesso Encefálico , Nocardiose , Nocardia , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/cirurgia , Humanos , Hospedeiro Imunocomprometido , Nocardiose/diagnóstico , Nocardiose/tratamento farmacológico
8.
Neurochirurgie ; 68(2): 183-187, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34481864

RESUMO

INTRODUCTION: Deformity associating coronal and sagittal malalignment can severely impair quality of life in Parkinson's disease (PD). Realignment using patient-specific rods (PSRs) is useful for achieving alignment goals. METHODS: This was a retrospective single-center analysis of a prospectively maintained database of all PD patients who underwent surgery between January 2013 and January 2017. Clinical evaluation, preoperatively and at 1 year's follow-up, used the Oswestry Disability Index (ODI). Radiological evaluation used systematic preoperative and 1-year postoperative full-spine radiographs. RESULTS: Twelve patients were included: 6 female, 6 male; mean age, 68.4 years. Mean follow-up was 40.8 months [range 12-70]. On average, 14 levels were fused [range 10-18]. Unplanned revision surgery was necessary for 8 patients at a mean 15.625 months after index surgery. Mean preoperative ODI score was 64% preoperatively [range 56-70] versus 52% [range 28-64] at 1 year's follow-up (P=0.004). Lumbar lordosis improved significantly, from -16.7° preoperatively to -41.4° at 1 year (P=0.006). Pelvic tilt was the least effectively corrected parameter, with a mean preoperative value of 31.6° vs. 27.8° at 1 year (P=0.19). Mean preoperative sagittal vertical axis was 149.7mm versus 73.6mm at 1 year (P=0.013). Mean preoperative coronal tilt was 68.2mm versus 22.9mm at 1 year (P=0.007). CONCLUSION: Parkinson's disease is a degenerative disease frequently associated with major spine malalignment. The severity of the postural disorders in these patients needs special precautions to avoid complications.


Assuntos
Doença de Parkinson , Fusão Vertebral , Idoso , Feminino , Seguimentos , Humanos , Masculino , Doença de Parkinson/complicações , Doença de Parkinson/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
9.
J Healthy Eat Act Living ; 2(3): 126-141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-37771477

RESUMO

Low-income communities often have fewer quality community-level physical activity places (PAPs) or resources (e.g., parks, playgrounds). When present, barriers like traffic, distance, and crime often prevent access. Creative solutions and better understanding of current and potential realistic PAPs are necessary for children and families to be active. Streets are rarely considered potential PAPs despite their ubiquity and accessibility. This article describes street segments as potential PAPs in two low-income Mexican-heritage colonias communities along the Texas-Mexico border. Promotora-researchers conducted PAP assessments of all street segments (n=867) in the two communities to describe the availability and quality of their physical activity features (e.g., basketball hoops, bicycles), amenities (e.g., paved driveways, yard space), and incivilities (e.g., vandalism, loose dogs). Streets in these communities did contain features and amenities associated with physical activity promotion. On average, street segments had 6.10 (SD=7.20) physical activity-promoting features, 27.65 (SD=27.30) physical activity-promoting amenities, and both were assessed as good-to-fair quality. Future physical activity programming should consider incorporating streets as potential PAPs to enhance physical activity and active play. Further, evaluating streets as PAPs in this way may provide insight into locations for temporary place-based programs such as Play Streets. Future research should also examine residents' perceptions of their streets as PAPs for safe physical activity and active play, not just as places to walk, and which PAP characteristics matter for safe physical activity and active play to occur on streets.

10.
Artigo em Inglês | MEDLINE | ID: mdl-34639420

RESUMO

Fathers significantly influence family functioning, as coparents and partners, and must be part of family-based approaches to behavioral health interventions or programs. But little is known regarding how to support Latino fathers in health promotion within their family systems, specifically for Latino families living in border communities. Program development was embedded in a larger community-based grant and part of a longstanding academic-community collaboration. An interdisciplinary research team applied theories related to health behavior, family systems, behavior change, and community engagement to develop a father-focused and family-centered behavioral program for Mexican-heritage fathers and children living near the Texas-Mexico border to support changes in nutrition and physical activity at the individual and family levels. Promotoras de salud (trained community health workers) delivered the program through group sessions, check-in calls, and at-home activities. Group session activities were designed to engage family triads and dyads using experiential education related to nutrition and physical activity, like cooking lessons and active play, over a six-week period. Future research can use the program approach and curricula as a roadmap for designing context-specific and culturally-relevant programs for Latino families. Additional research is needed to explore how approaches like this can support families and their health goals.


Assuntos
Exercício Físico , Pai , Criança , Promoção da Saúde , Humanos , Masculino , México , Texas
11.
Neurochirurgie ; 67(6): 556-563, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33989642

RESUMO

OBJECTIVE: The aim of this study was to describe progestin-associated meningiomas' characteristics, outcome and management. MATERIAL AND METHODS: We included 53 patients operated on and/or followed in the department for meningioma with progestin intake longer than one year and with recent drug discontinuation. RESULTS: Cyproterone acetate (CPA), nomegestrol acetate (NomA), and chlormadinone acetate (ChlA) were involved in most cases. Mean duration of progestin drugs intake was 17.5 years. Tumors were multiple in 66% of cases and were located in the anterior and the medial skull base in 71% of cases. Transitional subtype represented 16/25 tumors; 19 meningiomas were WHO grade I and 6 were grade II. The rate of transitional subtype and skull base location was significantly higher compared to matched operated meningioma general population. No difference was observed given WHO classification. But Ki67 proliferation index tends to be lower and 5/6 of the WHO grade II meningiomas were classified as WHO grade II because of brain invasion. Strong progesterone receptors expression was observed in most cases. After progestin discontinuation, a spontaneous visual recovery was observed in 6/10 patients. Under CPA (n=24) and ChlA/NomA (n=11), tumor volume decreased in 71% and 18% of patients, was stabilized in 25% and 64% of patients, and increased in 4% and 18% of patients, respectively. Volume outcome was related to meningioma location. CONCLUSIONS: Outcome at progestins discontinuation is favorable but different comparing CPA versus ChlA-NomA and comparing tumor location. Long-term follow-up is required. In most cases, simple observation is recommended and surgery should be avoided.


Assuntos
Neoplasias Meníngeas , Meningioma , Acetato de Ciproterona , Humanos , Neoplasias Meníngeas/induzido quimicamente , Neoplasias Meníngeas/tratamento farmacológico , Neoplasias Meníngeas/cirurgia , Meningioma/induzido quimicamente , Meningioma/tratamento farmacológico , Meningioma/cirurgia , Progestinas , Base do Crânio
12.
Z Rheumatol ; 80(4): 339-347, 2021 May.
Artigo em Alemão | MEDLINE | ID: mdl-33885947

RESUMO

Infections are a severe complication after an artificial joint replacement. The clinical symptoms are highly variable, particularly in patients with inflammatory rheumatic diseases, which often makes the diagnosis difficult. In addition to clinical and laboratory findings, joint puncture is an essential component of the diagnostics and enables the identification of pathogens. Treatment of periprosthetic infections in patients with rheumatism should be an interdisciplinary cooperation between surgeons, rheumatologists and specialists for infectious diseases. The two essential pillars of treatment are surgical intervention and antibiotics. For acute joint infections an attempt at preservation of the artificial joint can be carried out, whereas for chronic infection situations only replacement of the prosthesis is possible as a curative treatment. In order to reduce the probability of occurrence of a joint infection, modifiable risk factors should be preoperatively identified and specifically treated.


Assuntos
Artrite Infecciosa , Artroplastia de Quadril , Artroplastia de Substituição , Infecções Relacionadas à Prótese , Doenças Reumáticas , Humanos , Próteses e Implantes , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/etiologia , Reoperação , Doenças Reumáticas/diagnóstico
14.
Neurochirurgie ; 67(2): 152-156, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33157123

RESUMO

INTRODUCTION: Complex spinal surgery is known to be at risk of complications. Surgical site infection is a serious complication in spine surgery and its frequency is significantly increased in adult spinal deformity correction. The aim of this study is to identify patients' characteristics and risk factors of surgical site infection (SSI) following an osteotomy. METHODS: This is a single-center retrospective study of patients who underwent an osteotomy between January 2015 and December 2017. Surgical site infection diagnosis was based upon patient's clinical evidence of infection, biologic parameters, microbiological criteria and/or image findings. RESULTS: In total, 102 patients were eligible and 70 were women (68.6%). Mean age was 65 years old (27-83 years) and mean body mass index (BMI) was 26.14kg.m-2 (18.4-44.1). Eleven patients were in the SSI group and 91 in the No-SSI group. The mean Schwab grade was 1.5 (1-4) in the SSI group vs. 1.4 (1-5) in the No-SSI group (P=0.435). The mean operative time was on 201.9 minutes (67-377). Mean length of stay was 20.6 days (10-73) in the SSI group vs. 15 days (5-44) in the No-SSI group (P=0.041). Favorable outcome was found in 10 patients (90.9%) in the SSI group. CONCLUSION: Correction surgery for adult spinal deformity with osteotomies carries a high risk of complications specially SSI. Identification of risk factors, prevention and medical management of SSI should be well assessed.


Assuntos
Procedimentos Neurocirúrgicos/efeitos adversos , Osteotomia/efeitos adversos , Doenças da Coluna Vertebral/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Adulto , Idoso , Antibacterianos/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/tendências , Osteotomia/tendências , Estudos Retrospectivos , Fatores de Risco , Doenças da Coluna Vertebral/diagnóstico , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/prevenção & controle
15.
HNO ; 68(12): 927-934, 2020 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-32929519

RESUMO

INTRODUCTION: Salivary gland carcinomas (SGCs) are rare tumors which represent a challenge for diagnosis and therapy due to their histological diversity and the different disease courses depending on the respective subtype. Little is known about the composition of the tumor microenvironment in SGCs. A more comprehensive understanding of the relevant molecular changes and immunological processes of the tumor and surrounding stroma could help to improve therapeutic efficiency, for example by adjuvant immunomodulation. METHODS: This manuscript highlights recent studies analyzing the composition of the tumor microenvironment in salivary gland carcinomas. RESULTS: The tumor microenvironment displays a significant diversity in the composition of immune cells among different tumor entities. In one third of the SGCs, an expression of cell surface molecule LAG3 on tumor infiltrating lymphocytes could be observed. LAG3-similar to CTLA­4 and PD-1-inhibits cellular proliferation, activation, and homeostasis of antitumor-effective T cells. Especially, prognostically less favorable entities such as salivary duct carcinomas and adenocarcinomas NOS (not otherwise specified) yielded higher expressions. CONCLUSIONS: LAG3 is particularly detectable in aggressive entities and advanced tumors. Hence, LAG3 inhibition poses a potential targeted therapy for advanced and metastatic SGCs.


Assuntos
Carcinoma , Neoplasias das Glândulas Salivares , Biomarcadores Tumorais , Carcinoma/terapia , Humanos , Linfócitos do Interstício Tumoral , Neoplasias das Glândulas Salivares/terapia , Glândulas Salivares , Microambiente Tumoral
16.
Acta Neurochir (Wien) ; 162(10): 2459-2462, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32535796

RESUMO

Ventriculoperitoneal shunt (VPS) is an adequate treatment for congenital hydrocephalus or chronic hydrocephalus in adults. Yet, it is a surgery associated with a significant rate of complications amongst neurosurgical procedures, with frequent shunt obstructions and infections. We report the first-ever case of peritonitis caused by Roseomonas mucosa, shortly after the revision of a VPS ventricular catheter. Hardware removal and proper antibiotic therapy led to the patient's recovery. Roseomonas mucosa is an opportunistic skin pathogen with an antibiotic resistance profile to many beta-lactamines and a tropism for indwelling catheters and post-operative period. Nowadays, it should be taken into account in case of infection of indwelling catheters and for some implantable medical devices.


Assuntos
Methylobacteriaceae/patogenicidade , Peritonite/etiologia , Complicações Pós-Operatórias/etiologia , Infecções Relacionadas à Prótese/etiologia , Derivação Ventriculoperitoneal/efeitos adversos , Adulto , Cateteres de Demora/efeitos adversos , Cateteres de Demora/microbiologia , Humanos , Hidrocefalia/cirurgia , Peritonite/microbiologia , Complicações Pós-Operatórias/microbiologia , Infecções Relacionadas à Prótese/microbiologia
17.
Neurochirurgie ; 66(4): 240-246, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32574614

RESUMO

OBJECT: In recent years, the classical vertebroplasty has tended to be replaced by vertebral augmentation procedures. This article discusses the reliability of vertebral augmentation procedures using balloon kyphoplasty or a spine jack system, with intraoperative CT scan control coupled with the neuronavigation system as a treatment option for cervical and upper thoracic spine lesions. METHODS: In our neurosurgical department, in the past two years, 11 patients underwent either a kyphoplasty or a vertebral augmentation by a Spine Jack via a transpedicular route, under perioperative 3D imaging, for a total of 15 cervical/upper thoracic lesions. For these patients, we evaluated the clinical symptoms before and after surgery, the intraoperative and postoperative complications as well as the radiation exposure and the duration of their hospitalisation. RESULTS: We noted for all of the patients an improvement of the mean Karnofsky index, which improved from 50 to 80, and of the VAS that decreased from a mean of 75 to 15, as they were clearly alleviated after the operation. The radiation was lower for patients that were treated for 2 or more vertebrae, and much lower for the medical staff. The intraoperative complications rate (4 cement leakages for 15 vertebrae, 26%), was low and completely asymptomatic in all cases. The radiological follow-up examinations were satisfactory for all the patients. CONCLUSIONS: Our results suggest that percutaneous transpedicular vertebral augmentation techniques using intraoperative CT scan are a viable treatment for secondary lesions or traumatic compression fractures of the cervical and upper thoracic spine.


Assuntos
Vértebras Cervicais/cirurgia , Neuronavegação/métodos , Procedimentos Neurocirúrgicos/métodos , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/cirurgia , Neoplasias da Coluna Vertebral/complicações , Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas por Compressão/cirurgia , Humanos , Avaliação de Estado de Karnofsky , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Vertebroplastia
18.
J Community Health ; 45(5): 965-972, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32306182

RESUMO

Physical activity (PA) and nutrition behaviors among college students in health-related disciplines are understudied. We used theory of planned behavior (TPB) and role model beliefs (RMB) to predict PA and eating behaviors of college students in health-related programs (nurses, physical education, exercise science, and athletic training). A 26-item survey was administered among the participants. Independent variables included TPB constructs and RMB measured on a 5-point scale. PA was measured by multiplicative scores of students' number of days by the amount of time spent exercising per week. Nutrition behavior was measured using fruits (2½ c-eq/day), vegetables (2½ c-eq/day), dairy (2 c-eq/day), grains (6 oz-eq/day), and proteins (5½ oz-eq/day). Multiple regression analyses were used to predict PA and nutrition behaviors. A total of 271 college health majors (mean age 22.5 ± 4.6 years) participated in the study. The majority (56.8%) of students did not meet the weekly PA guidelines and 43.2% did not meet the recommended dietary guidelines for daily servings of food groups combined. Regression analyses showed that outcome evaluation, behavioral belief, and RMB, were significantly related with student's PA behavior and they accounted for 34%, 8%, and 1% of the variance, respectively (total R2 = 44.7). Outcome evaluation and behavioral beliefs were significantly related with nutritional behavior and they accounted for 13.3%, and 5.3% of the variance respectively (total R2 = 18.6). TPB (outcome evaluation, behavioral belief) and RMB could be used to guide programs in promoting PA and nutrition behavior among college health majors.


Assuntos
Exercício Físico , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Estado Nutricional , Adolescente , Adulto , Feminino , Frutas , Humanos , Masculino , Política Nutricional , Teoria Psicológica , Estudantes , Inquéritos e Questionários , Verduras , Adulto Jovem
19.
J Healthy Eat Act Living ; 1(1): 16-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-37790134

RESUMO

Children are significantly less active during summer months, and rural children may face unique barriers to engaging in physical activity. Play Streets is a low-cost way communities can provide safe play opportunities by activating public spaces. Four low-income rural communities received mini-grants to implement four three-hour Play Streets throughout summer 2017 for a total of 16 Play Streets. System for Observing Play and Recreation in Communities (SOPARC) and iSOPARC were used to assess physical activity. Chi-square tests of homogeneity determined significant differences in the proportion of children observed as active based on sex and target area type. Binomial logistic regression was used to determine if target area characteristics (i.e., type, equipped, supervised, organized) and presence of other active children or adults increased the odds of observing a child as active. In total, 1,750 children were observed across all 16 Play Streets; roughly half of all children (48.6% of boys, 48.7% of girls) were observed as active. There was no significant difference in proportion of children observed as active based on sex of the child (OR = 0.99, 95% CI:0.82-1.20). Significant differences in the proportion of active children were found between target area categories. Boys were significantly more likely to be observed as active in areas which were equipped or organized. All children were significantly more likely to be active if there was another active child present in the same area. These results add to the growing literature surrounding successful implementation of Play Streets in rural settings, social influence, and active play.

20.
Subst Use Misuse ; 55(2): 329-336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31573377

RESUMO

Background: Cannabis and tobacco use are significant public health concerns among young adults, with concurrent (in the same time period) and simultaneous (at the same time so the effects overlap) use of both substances on the rise. Few studies have examined these behaviors among college students. Objective: We examined the prevalence of concurrent and simultaneous cannabis and cigarette (combustible or electronic) use among a sample of college students and characterized the psychosocial predictors of concurrent and simultaneous use compared to using cannabis alone. Methods: Data on past-3 months cannabis and cigarette use were collected on 1352 college students who were past-year cannabis and alcohol users yielding four groups: cannabis-only users (n = 686), concurrent cannabis and cigarette users (CCAC; n = 235), simultaneous cannabis and cigarette users (SCAC; n = 293), and non-recent users of either substance (n = 138). Multinomial logistic regression analyses were utilized to predict group membership. Results: Relative to the cannabis-only group, White, compared to Non-White students, males, compared to females, frequent, compared to infrequent, alcohol users, including those who used alcohol simultaneously with cigarettes, and illicit drug users were more likely to belong to the CCAC or SCAC group. Conclusions: Findings suggest the need for unique intervention efforts to prevent onset or reduce co-use among male and White students as well as illicit drug users and frequent alcohol users.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Cigarros/epidemiologia , Fumar Maconha/epidemiologia , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Universidades/estatística & dados numéricos , Adolescente , Comorbidade , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Prevalência , Estudos Prospectivos , Fatores Sexuais , Estados Unidos/epidemiologia , Adulto Jovem
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