Magnetic Resonance Imaging Evaluation of Biomechanical Effects of Axial Loading on the Lumbar Spine.

Background: MRI techniques of the lumbar spine have not provided data on the effect of gravity on the spine and on the relationship of anatomic structures during its action. Because conventional MRI examinations of the spine are usually performed in the supine position these are often exacerbated by standing upright and are not evident in the supine position the loading conditions differ from those known to cause symptoms in patients with lumbar instability. Axial loading imaging may improve diagnostics in the clinical management of LBP and lead to appropriate treatment decisions. Objective: The aim of this study is to determine the significance of alMRI in detecting the morphologic changes of the lumbar spine caused by axial loading and to compare it with conventional MRI images of the lumbar spine without loading. Methods: The study was conducted as a prospective, descriptive clinical trial. Imaging was performed with a MRI 1.5 T in the head-first supine position. Imaging was performed in two acts: without load and under load. Loading for alMRI was performed with the DynaWell L-Spine device. The onset of loading was 10 minutes before the start of alMRI. The loading continued throughout the imaging procedure. The height of the IV, AP and LL diameters of IV, IV disk surface area, DSCA and width of the IV foraminas before and under load was measured. Results: After evaluating the changes in the height and size of the lumbar disks, the size of the DSCA, and the narrowing of the intervertebral foramina significant differences were found between the images before and after axial loading. Conclusion: alMRI provides information on morphological changes of all segments of the lumbar spine. This data represents significant information that can lead to more accurate and effective treatment of LBP.

The Proportion and Type of Carbohydrates in the Diets of Children in Early Adolescence.

Background: Carbohydrates are mainly substrates for energy metabolism and can affect satiety, blood glucose levels, insulin secretion, and fat metabolism. Their amount and type in the diet affect metabolic responses. High-carbohydrate diets, particularly high sugar consumption, are considered particularly harmful because of their specific characteristics related to postprandial metabolism, effects on hunger and satiety, and thus on caloric intake and energy balance. The European Food Safety Authority has suggested that the reference intake for carbohydrates should be between 45 and 60% of total energy requirements and less than 10% should be added sugars, especially for children. Objective: Investigate the proportion and type of carbohydrates in the diets of children in early adolescence in two territorially distinct areas, the continental and the Mediterranean. Methods: The study was conducted as part of a longitudinal cohort study. The survey was conducted in elementary schools in two regions: continental and Mediterranean. The School Physical Activity and Nutrition Survey was used for research purposes. Descriptive and inferential statistical tests were applied for data analysis. Results: A total of 1,411 respondents of both sexes aged 12-15 years, 729 boys and 678 girls, participated in the study. The intake of carbohydrates in the total sample is represented in the daily intake of 59%. The proportion of natural sugar in the diet of boys is statistically significantly higher in the continental compared to the Mediterranean region at the age of 12-13 years (p = 0.002), 13-14 years (p = 0.049), and 14-15 years (p = 0.002). Added sugars in total carbohydrate intake are statistically significantly higher in girls in the Mediterranean region compared to the continental region at ages 12-13 years (p = 0.048), 13-14 years (p = 0.001), and 14-15 years (p = 0.001). Conclusion: The high intake of added sugars in children in the Mediterranean region is of concern, although the intake in the continental area is well above current recommendations. Therefore, one of the public health goals is to promote proper nutrition as well as the availability of healthy foods in schools, especially during early adolescence when proper eating habits are adopted.

Intermittent traction therapy in the treatment of chronic low back pain.

Aim To investigate the effect of intermittent traction therapy (ITT) on pain in patients with chronic low back pain (CLBP). Methods A total of 81 patients with CLBP were included: experimental group received ITT (n=40) and control group received conservative physical treatment (n=41) 10 times for two weeks. A visual analogue scale (VAS) was used for measuring low back pain. Results In the experimental group, 26 (out of 40; 65.0%) patients were females, in the control group 20 (out of 41; 48.8%) were females (p=0.141). In a within-group comparison, median of VAS value was significantly decreased in both groups after ITT. A comparison of pre-intervention and post-intervention VAS value showed no statistically significant difference. Females from the experimental group had a significantly greater decrease of VAS compared with females from the control group. Patients in the ITT group with L5/S1 level of hernia had lower estimated marginal mean of VAS scale compared to the control group, as well the patients with left side of leg pain. Conclusion: Intermittent traction therapy is an effective treatment for pain reduction in patients with chronic low back pain.

Effects of early diagnosis of the wrist over-use syndrome on the treatment.

Aim To demonstrate the effects of early diagnosis of overuse syndrome in the wrist on healing, pain intensity and quick recovery to daily work and sport activities. Methods This clinical retrospective study included 60 patients of both sexes aged from 22 to 44 years, with pain in the wrist and clinical signs of creeping tenosynovitis. Patients were divided into two groups: the first group - persons doing sports activity, and the second group - patients who did not deal with sports activities. Results Females in 31 (51.7%) cases compared to males with 29 (48.3%) were slightly more represented in the total sample. Patients with injuries due to sports activities had previously reported to the physician and the diagnosis was set at an average of 3.1±0.9 days after the first symptoms (the range of 2-5 days), compared to the patients of the second group whose diagnosis was set at an average of 4.7±1.1 days after the first symptoms (p<0.05). Conclusion Patients involved in sports activities were more motivated for faster recovery, they had earlier doctor's examination with rapid reduction of subjective symptoms during intensive physical therapy.

T-lymphocyte Subsets as a Prognostic Factor in a Clinical Course of Chickenpox.

OBJECTIVE: To investigate possible prognostic values of CD4+, CD8+ T-lymphocytes, CD4/CD8 ratio to clinical course of chickenpox in immunocompetent hosts. MATERIALS AND METHODS: We performed a prospective study which included 69 immunocompetent patients with chickenpox who were addmited to Clinic for infectious disease, Clinical Center University of Sarajevo, in a 18 month period. All patients were divided into two groups depending on clinical presentation on admission. Patients with mild clinical form were dedicated to "outpatient" group, and patients with moderate, severe or life-threatening clinical forms were dedicated to "hospitalized" group. Also 30 healthy volunteers are included in study as a control group. We analyzed values of CD4+, CD8+ percentage, CD4/CD8 ratio with comparison to clinical course of chickenpox. All specimens were taken in acute phase of illness. RESULTS: Values of CD4+ percentage were significantly declined in a group of hospitalized patients, compared to group of outpatients and control group. Values of CD8+ percentage were higher in a group of hospitalized patients, while CD4/CD8 values were lower in comparison to a group of outpatients and control group. CONCLUSION: We found significant correlation between these parameters and clinical course of chickenpox.