Is there a relationship between low back pain and ligamentum flavum hypertrophy?

OBJECTIVE: A condition known as ligamentum flavum (LF) hypertrophy occurs when the ligamentum flavum (LF) swells as a result of pressures applied to the spine. Among the elderly population, lumbar spinal stenosis is a major cause of pain and disabilities. Numerous studies indicate that lumbar spinal stenosis etiology involves the ligamentum flavum in a major way. This study looks into the relationship between low back pain and ligamentum flavum thickening. PATIENTS AND METHODS: The imaging tests and case histories of all patients with low back pain who had consecutive magnetic resonance imaging exams performed at the Prince Sattam University and King Khalid hospitals in Al Kharj City will serve as the basis for this retrospective observational study. A radiologist utilized the Pfirrmann grading system, which is based on spinal levels starting from the first lumbar to the first sacral vertebrae, to measure the thickness of the ligamentum flavum in all cases who underwent magnetic resonance imaging (MRI). A correlation between age, hypertrophy of LF, and low back pain was investigated. RESULTS: There were 79 participants in the study, ages ranging from 21 to 82, 49 of which were men. The patients' average age was 54 years, and 62% of them were men. We found no appreciable variations in LF thickness according to gender. At the L4-L5 and L5-S1 levels, the left LF was noticeably thicker than the right. Moreover, there was a significant difference (p < 0.05) in the bilateral LF thicknesses at L5-S1 compared to the comparable sides at L4-L5. CONCLUSIONS: By evaluating the thickness of LF on magnetic resonance images, we discovered that it may be closely associated with the etiology of pain processes in the spine.

Infection-Control knowledge, attitude, practice and risk perception of occupational exposure to COVID-19 among dentists: A cross-sectional survey.

Background: COVID-19 is a potentially fatal disease that was announced as a global pandemic at the beginning of the year 2020. Aim: The purpose of our cross-sectional study was to evaluate the infection-control knowledge, attitude, practice, and risk perception of occupational exposure to COVID-19 among multinational dentists. Patients and Methods: A self-designed, 33-item, English questionnaire was created and distributed through social media and digital communication platforms. The questionnaire covered the demographic data, knowledge and perception of the occupational risk of the COVID-19 infections, and compared some infection control measures taken before and after this global pandemic. The results were analyzed, and four scores were used to assess the aforementioned parameters. Results: A total of 300 multinational dentists answered our survey, with the majority being females (59%) and aging from 25 to 44 years old (68%). We found that a statistically significant relationship exists between attitude and nationality, country of practice, medical condition, and the practicing specialty (P < 0.05). In addition, risk perception had a statistically significant correlation with nationality, smoking habits, education level, and specialty (P < 0.05). Furthermore, there was a statistically significant correlation between the practice score and the gender, age, smoking habits, education level, nature of the practice (private or governmental), and academia affiliation (P < 0.05). Conclusions: The study sample had good compliance with the instructions and guidelines of the World Health Organization (WHO) and the Centre for Disease Control (CDC), with most of them improving their infection control precautions after the virus's emergence according to the said guidelines. Furthermore, our participants were fearful of the COVID-19 virus and the fact of being potential transmitters. Despite saying that, the significant majority of them reported being confident in treating COVID-19-positive patients.

Use of plastic adhesive drapes during surgery for preventing surgical site infection.

BACKGROUND: Surgical site infection has been estimated to occur in about 15% of clean surgery and 30% of contaminated surgery. Using plastic adhesive drapes to protect the wound from organisms that may be present on the surrounding skin during surgery is one strategy used to prevent surgical site infection. Results from non-randomised studies have produced conflicting results about the efficacy of this approach but no systematic review has been conducted to date to guide clinical practice. OBJECTIVES: To assess the effect of adhesive drapes used during surgery on surgical site infection, cost, mortality and morbidity. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (last searched 24/4/07), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2,2007), Ovid MEDLINE (1950 to April Week 2, 2007), Ovid EMBASE (1980 to 2007 Week 16), and Ovid CINAHL (1982 to 1980 to April Week 2 2007). SELECTION CRITERIA: Randomised controlled trials comparing any plastic adhesive drape with no adhesive drape, used alone or in combination with woven (material) drapes or disposable (paper) drapes in patients undergoing any type of surgery. DATA COLLECTION AND ANALYSIS: Two authors independently selected and assessed studies for trial quality and both independently extracted data. Study authors were contacted for additional information. MAIN RESULTS: This review includes five studies involving 3,082 participants comparing adhesive drapes with no drape and two studies involving 1,113 participants comparing iodine-impregnated adhesive drapes with no drape. A significantly higher proportion of patients in the adhesive drape group developed a surgical site infection when compared with no drape. (Relative Risk (RR) 1.23, 95% Confidence Intervals (CI) 1.02 to 1.48, p=0.03). Iodine-impregnated adhesive drapes had no effect on the surgical site infection rate (RR 1.03, 95% CI 0.064 to 1.66, p=0.89). Length of hospital stay was similar in adhesive drape and non-adhesive drape groups. AUTHORS' CONCLUSIONS: There was no evidence from the seven trials that plastic adhesive drapes reduces surgical site infection rate and some evidence that they increase infection rates. Further trials may be justified using blinded outcome assessment to examine the effect of adhesive drapes on surgical site infection based on different wound classifications.

Risk factors for red cell transfusion in adults undergoing coronary artery bypass surgery: a systematic review.

BACKGROUND AND OBJECTIVE: Identifying factors that can predict adults at high risk of receiving red blood cell transfusion during coronary artery bypass graft (CABG) surgery may aid in more efficient blood banking practices and may tailor blood conservation strategies for these adult patients. The objective was to identify clinical factors associated with increased red cell transfusion in adults undergoing CABG surgery. METHODS: A systematic review of the MEDLINE and HealthSTAR databases from 1966 to December 2005 was conducted. Citations containing the medical subject heading or textwords 'coronary artery bypass graft', 'CABG' and 'cardiovascular surgery' were combined with the medical subject headings or textwords 'transfusion' and 'blood transfusion'. RESULTS: A total of 2461 abstracts were retrieved. Twenty-one studies met the inclusion/exclusion criteria. Transfusion rates ranged from 7 to 97%. Several variables were identified that were associated with increased red cell transfusion rates including older age, female sex, low haemoglobin concentration or haematocrit value, renal insufficiency and urgent/emergent surgery. The strongest risk factor was the urgency of surgery (urgent or emergent surgery), which was associated with a 4x to 8x increase in transfusion rates compared to elective surgery. Increasing age and female sex increased the likelihood of transfusion by 1x to 3x and 2x, respectively. CONCLUSIONS: Increasing patient age, female sex, lower preoperative haemoglobin levels, as well as the urgency of the CABG surgery were associated with higher transfusion rates. Identifying risk factors for transfusion may allow for targeted use of blood conservation strategies, improved efficiency in blood utilization and informing adults at risk of transfusion.

A high-resolution anthropomorphic voxel-based tomographic phantom for proton therapy of the eye.

Proton therapy is increasingly used in medical treatments for cancer patients due to the sharp dose conformity offered by the characteristic Bragg peak. Proton beam interactions with the eye will be simulated using the MCNPX Monte Carlo code and available nuclear cross-section data to calculate the dose distribution in the eye gel and surrounding organs. A high-resolution eye model will be employed using a 3D geometrical voxel-based anthropomorphic head phantom obtained from the Visible Human Project (female data). Manual segmentation of the eye, carried out by the Medical Physics group at the University of Surrey resulted in 15 identified structures. This work emphasizes the use of a realistic phantom for accurately predicting dose deposition by protons.

Neutron-fluence-to-dose conversion coefficients in an anthropomorphic phantom.

A set of fluence-to-effective-dose conversion coefficients has been calculated for neutrons with energies <20 MeV using a high-resolution anthropomorphic phantom (Zubal model) and the MCNPX code. The calculation used 13 monodirectional monoenergetic neutron beams in the energy range 10(-9) to 20 MeV, under three different source irradiation configurations: anterior-posterior, posterior-anterior and left lateral. Dose calculations were performed for 18 selected organs of the body, for which the International Commission on Radiological Protection and the International Commission on Radiological Units and Measurements have set tissue weighting factors for the determination of the effective dose. Another set of neutron-fluence-to-effective-dose conversion coefficients was also calculated with the proposed modification wR from ICRP Publication 92. From comparison between the dose results calculated and the data reported for the MIRD and VIPMAN models, it can be concluded that, although some discrepancies exist between the Zubal model and the two other models, there is good agreement in the left lateral irradiation geometry.