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1.
Acta Neurochir (Wien) ; 163(3): 853-861, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33404879

RESUMEN

BACKGROUND: There is debate regarding criteria to select patients for lumbar fusion surgery who have chronic low back pain (CLBP) and corresponding degenerative changes, but without nerve root compression or neurogenic claudication. The aim of this study was to compare patterns in current practice. METHOD: A total of 143 printed questionnaires containing 51 questions were distributed at the German Spine Societies' (DWG) annual congress, 6-8 December 2018. RESULTS: We received 127 (89%) surveys (64 orthopedic surgeons and 63 neurosurgeons). Excluding the 22% who do not perform lumbar fusion for CLBP, 41.4% reported performing 1-10 lumbar fusion procedures for patients with CLBP per year, 20.2% reported 11-20, 10.1% reported 21-30 and 17.2% reported performing more than 50. A total of 44.9% of surgeons reported treating patients for at least 6-12 months conservatively before considering surgery; 65.6% considered postoperative pain reduction of 50-70% a treatment success; 32.6% of respondents believe that <50% of patients showed good outcomes after fusion in CLBP and only 15.5% believed that 70% or more showed good outcomes. Orthopedic surgeons perform more lumbar fusion surgeries than neurosurgeons (p = 0.05), fuse more lumbar segments than neurosurgeons (p = 0.02) and are more likely to suggest that their patients with CLBP cease smoking preoperatively (p = 0.02). CONCLUSIONS: Despite discouraging evidence in the literature, the majority of respondents still perform fusion surgery in patients with CLBP. The use of preoperative diagnostics and tests vary widely among spine surgeons.


Asunto(s)
Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/cirugía , Vértebras Lumbares/cirugía , Guías de Práctica Clínica como Asunto , Fusión Vertebral/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neurocirujanos , Cirujanos Ortopédicos , Encuestas y Cuestionarios , Resultado del Tratamiento
2.
Asian Spine J ; 15(2): 234-243, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32703924

RESUMEN

STUDY DESIGN: This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. PURPOSE: This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. OVERVIEW OF LITERATURE: Implant-associated infection occurs in 0.7%-20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. METHODS: Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. RESULTS: Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22-89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4-13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12-60 months). Three patients (6.5%) were lost to follow-up. CONCLUSIONS: Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists.

3.
Acta Neurochir (Wien) ; 162(1): 109-119, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31781995

RESUMEN

BACKGROUND: Prognostic scores have been proposed to guide the treatment of patients with metastatic spine disease (MSD), but their accuracy and usefulness are controversial. The aim of this study was to evaluate seven such prognostic scoring systems. The following prognostic scores were compared: Tomita, Van der Linden (VDL), Bauer modified (BM), Oswestry Spinal Risk Index (OSRI), Tokuhashi original (T90), Tokuhashi revised (TR05), and modified Tokuhashi revised (TR17). METHODS: We retrospectively reviewed all our patients who underwent surgery for spinal metastases, February 2008-January 2015. We classified all 223 patients into the predicted survival-time categories of each of the 7 scoring systems and then tallied how often this was correct vis-à-vis the actual survival time. Accuracy was also assessed using receiver operating characteristic (ROC) analysis at 1, 3, and 12 months. RESULTS: The median (95% CI) survival of the 223 patients was 13.6 (7.9-19.3) months. A groupwise ROC analysis showed sufficient accuracy for 3-month survival only for TR17 (area under the curve [AUC] 0.71) and for 1-year survival for T90 (AUC 0.73), TR05 (AUC 0.76), TR17 (AUC 0.76), Tomita (AUC 0.77), and OSRI (AUC 0.71). A pointwise ROC score analysis showed poor prognostic ability for short-term survival (1 and 3 months) with sufficient accuracy for T90 (AUC 0.71), TR05 (AUC 0.71), TR17 (AUC 0.71), and the Tomita score (AUC 0.77) for 1-year survival. CONCLUSION: The TR17 was the only prognostic system with acceptable performance here. More sophisticated assessment tools are required to keep up with present and future changes in tumor diagnostics and treatment.


Asunto(s)
Neoplasias Epidurales/patología , Índice de Severidad de la Enfermedad , Adulto , Anciano , Neoplasias Epidurales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Pronóstico
4.
Technol Health Care ; 28(3): 303-314, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31594268

RESUMEN

BACKGROUND: Spinal metastases are being diagnosed more frequently because of increasing life expectancies and advances in the diagnosis and therapy of primary tumours. OBJECTIVE: This aim of this study was to assess the quality of life (QoL) and functional outcomes after surgical intervention for spinal metastases in a large cohort. METHODS: A single-centre, prospective, observational study was conducted from June 2016 to February 2018. Patients treated surgically for spinal metastasis were included. Primary endpoints were the Core Outcome Measure Index (COMI), Oswestry Disability Index (ODI), and QoL questionnaire (EuroQoL-5D) scores recorded preoperatively, 6 weeks postoperatively, and 3, 6, and 12 months postoperatively. RESULTS: Ninety-two patients (mean age, 62.7 ± 12.8 years) were included. The most frequent neoplasms were multiple myeloma (n= 18; 19.6%), lung cancer (n= 16; 17.4%), prostate cancer (n= 14; 15.2%), and breast cancer (n= 11; 12.0%). During the observation period, 44.6% of patients died. The COMI score improved significantly from preoperatively (mean, 7.1; 95% CI, 6.6-7.6) to 3 months (mean, 5.5; 95% CI, 4.8-6.2; p= 0.01) and 12 months (mean, 4.6; 95% CI, 3.7-5.5; p= 0.001) postoperatively. The ODI showed a significant improvement from preoperatively (mean, 52.9; 95% CI, 48.5-57.4) to 6 weeks (mean, 43.4; 95% CI, 37.1-49.6; p= 0.03), 3 months (mean, 37.0; 95% CI, 31.0-42.9) 6 months mean, 40.5; 95% CI, 34.2-46.8; p= 0.01), and 12 months (mean, 31.9; 95% CI, 24.8-39.1; p= 0.005) postoperatively. Improvements in the COMI at 6 weeks (p= 0.05), and 6 months (p= 0.05) postoperatively were not statistically significant. QoL improved from preoperatively to 6 weeks (mean, 0.48; 95% CI, 0.38-0.59; p= 0.002), 3 months (mean, 0.50; 95% CI, 0.38-0.61; p= 0.009), and 12 months (mean, 0.61; 95% CI, 0.51-0.71; p= 0.001) postoperatively. After 6 months, the difference was not significant (p= 0.08). CONCLUSION: Short-term and long-term improvements in functional outcomes and QoL were observed after surgical treatment of spinal metastases. Surgery is a good option for patients with an estimated life expectancy of more than 3 months.


Asunto(s)
Vértebras Lumbares/cirugía , Calidad de Vida , Neoplasias de la Columna Vertebral/secundario , Neoplasias de la Columna Vertebral/cirugía , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Evaluación de la Discapacidad , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Rendimiento Físico Funcional , Complicaciones Posoperatorias/epidemiología , Estudios Prospectivos , Factores Sexuales
5.
J Sports Med Phys Fitness ; 59(3): 476-480, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30264971

RESUMEN

BACKGROUND: Equestrian vaulting is a sport, particularly popular among children and adolescents, in which gymnastic and dance routines are performed on horseback. Current data regarding injuries and thus, the risks of this sport, is meager and based only on retrospective studies. METHODS: In the current prospective study, 233 active members of a vaulting club were questioned monthly from November 2014 until October 2015. In addition to general information (training, competitions), the questionnaire collected the number of competitions, the competitive class, the discipline (single, team, Pas-de-Deux), and injuries (type, localization, treatment). RESULTS: There were 102 documented events resulting in 125 injuries, yielding an average 31.64 days of training lost. Each vaulter suffered an average 0.44 injuries per year. Frequency of injury was 2.15 injuries per 1000 training hours. Injuries occurred most often to the lower and upper extremities. Most common were bruises and muscle injuries. Injury risk increased with increasing age, number of falls from the horse, increasing competitive level, number of tournament entries and events (P=0.006), and previous injuries (P=0.010). CONCLUSIONS: Our study found that vaulting has a low risk of injury comparable to non-contact sports. The best focus for injury prevention strategies is on older vaulters at higher competitive levels performing more complex routines.


Asunto(s)
Traumatismos en Atletas/epidemiología , Caballos , Accidentes por Caídas/estadística & datos numéricos , Adolescente , Adulto , Animales , Traumatismos en Atletas/prevención & control , Niño , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
6.
GMS J Med Educ ; 35(3): Doc36, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30186946

RESUMEN

Background: Clinical training concepts of medical students differ in the various European countries. The goal of this paper is to study the differences at the beginning of medical practice in specific clinical skills on an international level. Methods: The data were collected by a publically accessible online questionnaire online from February to June 2010. The participants in the study were recruited through the official letter sent by deaneries and student organisations. Two thousand nine hundred and seven medical students participated in the online survey. From study years 1 to 6, 2406 valid data records (67.3 percent female; 32.7 percent male) from four different European countries were sent. The skills in the questionnaire included patient consultation and anamnesis, physical examination, auscultation, gypsum and bandage dressing, suture techniques, venepuncture, and laying of indwelling catheters. Results: One thousand six hundred and twenty-nine data records of medical students in their training years 3 to 6 were assessed. The average age of the students was 24.7 years. On a scale from 1 to 10, the average satisfaction of the students with their medical faculty was 6.47 (±2.07); the assessment of the preparation for the clinical activities was 4.72 (±2.13). By comparison, British students indicated most satisfaction with their training (6.70±1.85). With respect to the clinical skills, the students interviewed felt safest in patient consultation and anamnesis (7.63±2.13) followed by blood sampling (7.46±2.29). The topics of surgical suturing techniques (4.40±2.81) and the gypsum and bandaging techniques (2.63±2.23) were taught worst subjectively. Discussion: The training of medical students in basic clinical skills is an essential part of the studies. This study was able to demonstrate that the subjective trust of medical students in their personal skills positively correlated with the satisfaction with their own university. The results pointed out that future curricula of universities could profit from an increased focus on clinical skills.


Asunto(s)
Competencia Clínica , Estudiantes de Medicina , Adulto , Austria , Autoevaluación Diagnóstica , Educación de Pregrado en Medicina , Europa (Continente) , Femenino , Alemania , Humanos , Masculino , Proyectos Piloto , Suiza , Reino Unido , Adulto Joven
7.
BMC Musculoskelet Disord ; 19(1): 199, 2018 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-30016956

RESUMEN

BACKGROUND: The purpose of this study was to assess the radiological and clinical outcome parameters following lumbar hybrid dynamic instrumentation with the focus on the adjacent segment degeneration (ASD) and adjacent segment disease (ASDi). METHODS: In this prospective trial all patients presenting with degenerative changes to the lumbar spine have been included. Precondition was a stable adjacent level with/without degenerative alteration. The elected patients underwent a standardised fusion procedure with hybrid instrumentation (DTO™, Zimmer Spine Inc., Denver, USA). Patients' demographics have been documented and the follow-up visits were conducted after 6 weeks, and then stepwise after 6 up to 48 months. Each follow-up visit included assessment of quality of life and pain using specific questionnaires (COMI, SF-36, ODI) and the radiological evaluation with focus on the adjacent level alterations. RESULTS: At a mean follow up of 24 months an incidence of ASD with 10.91% and for ASDi with 18.18% has been observed. In 9% a conversion to standardised fusion was needed. There was a high rate of mechanical complication: (1) screw loosening (52.73%), (2) pedicle screw breakage (10.91%), and (3) rod breakage (3.64%) after a follow up of a maximum of 60 months. There were no significant difference of COMI, ODI and SF-36(v2) in comparison to all groups but all 55 patients showed a clinical improvement over the time. CONCLUSION: The dynamic hybrid DTO™ device is comparable to the long-term results after standardised fusion procedure, while a high rate of mechanical complication decreased the initial benefit. TRIAL REGISTRATION: This trial was registered at the ClinicalTrials Register ( #NCT03404232 , 2018/01/18, registered retrospectively).


Asunto(s)
Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Tornillos Pediculares/tendencias , Fusión Vertebral/tendencias , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Encuestas Epidemiológicas/tendencias , Humanos , Masculino , Persona de Mediana Edad , Tornillos Pediculares/efectos adversos , Estudios Prospectivos , Radiografía/tendencias , Fusión Vertebral/efectos adversos , Resultado del Tratamiento
8.
World Neurosurg ; 117: e228-e237, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29906580

RESUMEN

OBJECTIVE: The purpose of this study was to assess the radiologic and clinical outcomes after lumbar fusion intervention and to compare the established posterior lumbar interbody fusion (PLIF) technique and dynamic hybrid instrumentation (topping off). METHODS: In this prospective randomized trial, all patients who presented with degenerative changes to the lumbar spine (L2-S1) were included and randomized in 2 groups: patients who underwent the 360°-fusion procedure in PLIF (group 1: control group) and those patients who underwent fusion surgery with additional hybrid instrumentation (Dynesys-Transition-Optima [Zimmer Spine Inc., Denver, Colorado, USA]) cranial to the rigid fixed segment (group 2: intervention group). Patients' demographics were documented and follow-up visits were conducted after 6 weeks and then stepwise after 6 up to 36 months. Each follow-up visit included assessment of quality of life and pain using specific questionnaires (Core Outcome Measurements Index, Short-Form 36, and Oswestry Disability Index) as well as radiologic evaluation with the focus on the adjacent level alteration. RESULTS: Fifteen patients per group met the inclusion criteria, and after 36 months, the loss to follow-up was 20%. At the maximum follow-up time, the overall risk for adjacent segment degeneration was substantial (i.e., 24.14%), independent of the surgical procedure. Material failure was observed in 17.24%. Although no significant difference was observed between both groups, all patients presented with postoperative improvement regarding the clinical scores. CONCLUSIONS: The present study cannot support the safety of dynamic hybrid devices in those cases if the reduction of adjacent segment degeneration is the main target, especially regarding the reported implant failure rates and the similar clinical outcomes between the both groups.


Asunto(s)
Vértebras Lumbares/cirugía , Fusión Vertebral/instrumentación , Estenosis Espinal/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/cirugía , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/etiología , Estudios Prospectivos , Prótesis e Implantes , Calidad de Vida , Radiografía , Estenosis Espinal/diagnóstico por imagen , Resultado del Tratamiento
9.
World Neurosurg ; 116: e983-e995, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29857208

RESUMEN

BACKGROUND: Although an abundance of literature about the treatment of chronic subdural hematoma is available, it provides little evidence to clarify which treatment is most successful. OBJECTIVE: The aim of this study was to examine and compare current clinical standards between several hospitals. METHODS: Chairmen of all neurosurgical units in Austria, Germany, and Switzerland, as listed on the national neurosurgical societies' websites, were invited to participate with a personal token to access a web-based survey. A total of 159 invitations were sent and up to 5 reminder e-mails. RESULTS: Eighty-four invitees (53%) completed the survey. The most common surgical intervention was a single burr hole in 52 (65%) of the responding neurosurgical units, double burr holes were performed as primary procedure in 16 centers (20%), a small osteoplastic craniotomy in 4 (5%), and a twist drill craniostomy in 8 (10%). Seventy-two (90%) would place a drain in estimated 75%-100% of cases or whenever possible/safe. Sixty-five used subdural-external drains, and 7 used subgaleal-external drains. Seventeen applied suction to the drains. Thirty-six (49%) agreed with the statement that watchful waiting was an option for the treatment of chronic subdural hematomas and 19 (23.4%) disagreed. Eighteen (23%) would consider corticosteroids and 34 (45%) tranexamic acid as part of their armamentarium for the treatment of subdural hematomas. CONCLUSIONS: The results of this survey reflect the current evidence available in literature. Although the benefits of using of a drain are widely recognized, no consensus regarding the type of drain and surgical approach to the hematoma was reached.


Asunto(s)
Hematoma Subdural Crónico/cirugía , Procedimientos Neuroquirúrgicos/métodos , Procedimientos Neuroquirúrgicos/normas , Resultado del Tratamiento , Austria/epidemiología , Femenino , Alemania/epidemiología , Encuestas Epidemiológicas , Hospitales , Humanos , Masculino , Procedimientos Neuroquirúrgicos/clasificación , Recurrencia , Estadísticas no Paramétricas , Suiza/epidemiología
10.
Acta Neurochir (Wien) ; 160(4): 863-871, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29411117

RESUMEN

BACKGROUND: Our aim was to examine the specific dimensions of cervical pedicles in a large Caucasian cohort on high dissolving CT scans. METHODS: A retrospective analysis of 100 cervical spine CT scans with a maximum slice thickness of 1 mm in axial, sagittal, and coronal reconstructions was performed. The pedicle axial length (PAL), inner and outer pedicle diameter (IPD/OPD), pedicle sagittal and transverse angle (PSA/PTA), pedicle height (PH), pedicle width (PW), and the cortical thickness (COT) at different margins were measured by two independent observers. A total of 1000 cervical pedicles (C3-C7) of 52 male (age 58 ± 17.47 years, height 177.97 ± 8.17 cm) and 48 female patients (age 57 ± 19.07 years, height 165.50 ± 7.44) were measured. RESULTS: Cortical thickness at the medial limitation of the pedicle was 1.77 ± 0.43 and 0.90 ± 0.36 mm at the lateral limitation (p < 0.001). The mean PAL ranged from 30.5 mm at C4 level to 35.3 mm at C6 level. PW and PAL were smaller in the female than in the male patients. The smallest values for PW were at C3 with 29.17% of males and 52.88% of females < 4.5 mm. The percentage of patients with PW < 4.5 mm decreased caudally with less than 10% of pedicles below C4 in male participants and below C6 in female participants. Mean PTA ranged from 34.6° to 48.02° peaking at C4 and C5 levels. No gender-specific difference was found for PTA and PSA (p ≥ 0.13). IPD and OPD were larger in males (p < 0.001), and body height correlated significantly with IPW (p ≤ 0.019) and OPW (p ≤ 0.003). The interrater reliability was very good for PW, PH, and IPD (0.84-0.86), good for OPD, PTA, and PSA (0.64-0.79), and moderate for PAL (0.54) and cortical thickness (0.44). CONCLUSIONS: Peculiarities of pedicle dimension of this central European cohort are comparable to morphometric studies in other ethnicities. Preoperative planning before cervical pedicle screw insertion on fine-cut CT scans demonstrates good interrater reliability for all important dimensions and angulations. More than half of female patients and almost a third of male patients had a PW of less than 4.5 mm at C3 level. Even though this percentage decreases caudally, pedicle screws might not be safe to insert in a noteworthy percentage of patients.


Asunto(s)
Vértebras Cervicales/diagnóstico por imagen , Tornillos Pediculares/efectos adversos , Complicaciones Posoperatorias/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Vértebras Cervicales/cirugía , Pruebas Diagnósticas de Rutina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Factores Sexuales , Tomografía Computarizada por Rayos X/normas
11.
Case Rep Orthop ; 2017: 7191476, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29109886

RESUMEN

INTRODUCTION: Radiofrequency-targeted vertebral augmentation (RF-TVA) is a recognized treatment for painful compression fractures. RF-TVA in a patient with multiple compression fractures due to type I osteogenesis imperfecta (OI) has not been previously reported. CASE PRESENTATION: A 54-year-old patient with type I OI is presented with a segmental thoracic hyperkyphosis and 7 recent vertebral compression fractures. Because of persistent severe thoracolumbar back pain despite conservative therapy, RF-TVA was indicated. Nocturnal back pain was almost completely relieved at all postoperative time points evaluated. However, overall pain relief dropped only slightly from 7 to 5 on the numerical rating scale (NRS) at the 6-week follow-up, and there was only a small decrease in the Oswestry Disability Index (ODI) from 72% to 63%. An MRI at the 3-month follow-up revealed hyperintensity at levels T11 and T12, indicating slight recollapsing. At the 6-month follow-up, the ODI improved to 55%, although overall pain had worsened to 6 on the NRS. Pain at rest remained at a very low level. CONCLUSION: Despite the remaining lumbago, RF-TVA may be a good option for patients with OI who have multiple fractures. However, fractures at multiple levels and segmental thoracic hyperkyphosis may increase the risk for recollapsing and ongoing pain.

12.
World Neurosurg ; 108: 513-518, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28919560

RESUMEN

BACKGROUND: Parkinson disease (PD) is a major risk factor during spine surgery, and its frequency is increasing as the population ages. The study aim was to examine the influence of PD specifically on lumbar decompression surgery. METHODS: A retrospective review was performed of all patients with PD who underwent elective lumbar decompression surgery at 2 university hospital departments between December 2003 and July 2016. For each patient, 2 controls without PD were selected randomly among those who were matched for sex and age and had a similar year of surgery (±3) and comorbidity profile. The main outcomes were complications and reoperation rate. RESULTS: The mean follow up was 1.2 ± 1.6 years in the PD group (n = 36) and 1.4 ± 2.1 years in the control group (n = 72). The overall complication rate was 47.2% in the PD group and 19.4% in the control group (P < 0.01). The reoperation rate was 27.8% in the PD group and 9.7% in the control group (P = 0.02). CONCLUSIONS: There is a significantly greater rate of perioperative complications in patients with PD undergoing elective decompression surgery. Although the difference in major complication rates was minimal, minor complications were more frequent in patients with PD.


Asunto(s)
Descompresión Quirúrgica , Vértebras Lumbares/cirugía , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/epidemiología , Estenosis Espinal/epidemiología , Estenosis Espinal/cirugía , Anciano , Estudios de Casos y Controles , Comorbilidad , Procedimientos Quirúrgicos Electivos , Femenino , Estudios de Seguimiento , Humanos , Complicaciones Intraoperatorias/epidemiología , Tiempo de Internación , Modelos Logísticos , Masculino , Complicaciones Posoperatorias/epidemiología , Reoperación , Estudios Retrospectivos
13.
Dtsch Med Wochenschr ; 140(18): e176-85, 2015 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-26360955

RESUMEN

BACKGROUND: The aim was to examine potential differences in various aspects of life as well as study satisfaction amongst medical students of three German speaking countries. METHOD: Data was collected between February and June 2010 using an online survey with the open source survey tool Limesurvey (Version 1.85 RC3). RESULTS: 1179 medical students in year 4-6 completed the online questionnaire (798 in Germany (Ger), 265 in Austria (A) and 116 in Switzerland (CH)). Mean age was similar (25.0-25.3) for the countries (p = 0.14). Respondents from Austria were significantly more often (17.4 %) smoking than Swiss (12.1 %) or German (10 %) medical students (p = 0.002). The average number of hours spent studying per week and desired weekly work hours varied significantly between countries. The average desired working week post-graduation was 42 hours. The perceived ability to work as junior doctor post-graduation was below 5 on a visual analogue scale of 1-10. CONCLUSION: Results of consumption, work life balance and activity were similar to statistics of the population of each country. With regard to the desired work time after graduation this is in clear contrast to the reality as a doctor. Improvement of medical courses can be achieved with better preparation for the internship.


Asunto(s)
Estilo de Vida , Satisfacción Personal , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Adulto , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Fumar , Deportes , Carga de Trabajo
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