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1.
Arch Osteoporos ; 19(1): 13, 2024 02 16.
Article de Anglais | MEDLINE | ID: mdl-38363413

RÉSUMÉ

In this cross-sectional study, we examined the association between Life's Essential 8 (LE8) and bone mineral density (BMD) as well as osteoporosis risk among adults aged 50 and over. The findings of this study revealed that higher LE8 scores were associated with higher BMD and reduced osteoporosis risk. PURPOSE: The objective of the present study was to evaluate the association between Life's Essential 8 (LE8) and bone mineral density (BMD), as well as osteoporosis risk, in adults aged 50 years or over. METHODS: This cross-sectional study recruited individuals who were 50 years old or older from the National Health and Nutrition Examination Survey. LE8 scores were evaluated and calculated according to the scoring algorithm based on the American Heart Association recommendations, which were further categorized into health behaviors (LE8-HB) and health factors (LE8-HF) scores. Furthermore, the present study utilized multivariate linear regression models to examine the correlations between BMD and LE8 scores. In addition, ordinal logistic regression models were employed to determine the associations between the risk of osteoporosis (normal BMD, osteopenia, and osteoporosis) and LE8 scores. RESULTS: The final analysis included a total of 2910 participants, whose mean age was 64.49 ± 9.28 years. LE8 and LE8-HF scores exhibited a negative association with BMD and a positive association with osteoporosis risk in unadjusted models. Nevertheless, after adjustment for covariates, LE8 and LE8-HB scores exhibited a positive association with BMD and a negative association with osteoporosis risk, regardless of age, sex, or menopausal status. CONCLUSIONS: Scoring systems based on multiple lifestyle and behavior factors, similar to LE8, have the potential to become a novel option and be used for osteoporosis risk assessment.


Sujet(s)
Ostéoporose , Adulte , États-Unis/épidémiologie , Humains , Adulte d'âge moyen , Sujet âgé , Enquêtes nutritionnelles , Études transversales , Absorptiométrie photonique , Ostéoporose/complications , Densité osseuse , Facteurs de risque
2.
J Clin Med ; 11(18)2022 Sep 15.
Article de Anglais | MEDLINE | ID: mdl-36143056

RÉSUMÉ

BACKGROUND: Anti-tuberculosis drug concentrations are critical for the treatment of spinal tuberculosis. The distribution pattern of anti-tuberculosis drugs between the blood and the vertebral focus needs to be further explored. METHODS: A total of 31 spinal tuberculosis patients were prospectively included and then divided into a sclerotic group (15 cases) and a non-sclerotic group (16 cases) according to their preoperative CTs. All patients were treated with 2HERZ/6H2R2Z2 chemotherapy for 4 weeks before the operation. During the operation, blood, normal vertebral bone tissue, and vertebral focus tissue were obtained, processed, and sent to the pharmacology laboratory. The concentration values of four anti-tuberculosis drugs in each sample were obtained in a pharmacology laboratory. RESULTS: There was no significant difference in the concentrations of the four anti-tuberculosis drugs in the blood and the normal vertebral bone tissue between the two groups; however, there was a significant difference in the vertebral focus tissue. There existed a linear correlation of four anti-tuberculosis drug concentrations between the blood and the focus in the non-sclerotic bone group. CONCLUSIONS: The existence of sclerotic bone hinders the anti-tuberculosis drug distribution. In the absence of sclerotic bone in the vertebral focus, there exists a linear relationship of the four anti-tuberculosis drug concentrations between the blood and the vertebral focus of spinal tuberculosis patients.

3.
Front Endocrinol (Lausanne) ; 13: 923778, 2022.
Article de Anglais | MEDLINE | ID: mdl-35937792

RÉSUMÉ

Objective: To establish a predictive scoring system for proximal junctional kyphosis (PJK) after posterior internal fixation in elderly patients with chronic osteoporotic vertebral fracture (COVF). Materials and methods: The medical records of 88 patients who were diagnosed with COVF and underwent posterior internal fixation in our hospital from January 2013 to December 2017 were retrospectively analyzed. The included patients were divided into two groups according to whether they suffered PJK after surgery, namely, the PJK group (25 cases) and non-PJK group (63 cases). The following clinical characteristics were recorded and analyzed: age, gender, body mass index (BMI), bone mineral density (BMD), smoking history, fracture segment, proximal junction angle, sagittal vertebral axis, pelvic incidence (PI)-lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), posterior ligamentous complex (PLC) injury, upper instrumented vertebra, lower instrumented vertebra, and the number of fixed segments. The prevalence of these clinical characteristics in the PJK group was evaluated, and the scoring system was established using logistic regression analysis. The performance of the scoring system was also prospectively validated. Results: The predictive scoring system was established based on five clinical characteristics confirmed as significant predictors of PJK, namely, age > 70 years, BMI > 28 kg/m2, BMD < -3.5 SD, preoperative PI-LL > 20°, and PLC injury. PJK showed a significantly higher score than non-PJK (7.80 points vs. 2.83 points, t=9.556, P<0.001), and the optimal cutoff value for the scoring system was 5 points. The sensitivity and specificity of the scoring system for predicting postoperative PJK were 80.00% and 88.89%, respectively, in the derivation set and 75.00% and 80.00% in the validation set. Conclusion: The predictive scoring system was confirmed with satisfactory sensitivity and specificity in predicting PJK after posterior internal fixation in elderly COVF patients. The risk of postoperative PJK in patients with a score of 6-11 is high, while the score of 0-5 is low.


Sujet(s)
Cyphose , Lordose , Malformations de l'appareil locomoteur , Fractures ostéoporotiques , Fractures du rachis , Arthrodèse vertébrale , Sujet âgé , Humains , Cyphose/épidémiologie , Cyphose/étiologie , Cyphose/chirurgie , Lordose/complications , Lordose/chirurgie , Vertèbres lombales/chirurgie , Fractures ostéoporotiques/diagnostic , Fractures ostéoporotiques/chirurgie , Études rétrospectives , Fractures du rachis/étiologie , Fractures du rachis/chirurgie , Arthrodèse vertébrale/effets indésirables , Vertèbres thoraciques/chirurgie
4.
Front Nutr ; 9: 740459, 2022.
Article de Anglais | MEDLINE | ID: mdl-35571899

RÉSUMÉ

Objective: To explore the risk factors of hypoalbuminemia in patients with thoracic and lumbar tuberculosis and develop a scoring scale, according to which the patients with thoracic and lumbar tuberculosis were divided into 2 groups to, respectively calculate the perioperative albumin changes and to find out the preoperative albumin recommended value. Methods: A total of 166 patients with thoracic and lumbar tuberculosis, who underwent spinal focus debridement between January 2012 to May 2020, were identified into 2 groups: with and without postoperative hypoalbuminemia (n = 131 and n = 35, respectively), recording and analyzing clinical characteristics by multivariate analysis to establish a scoring scale. Using this scale, patients with spinal tuberculosis were divided into a high-risk group and a low-risk group, and then, calculated the average decrease of postoperative albumin in both groups. Combined with the diagnostic threshold of hypoalbuminemia, we proposed the preoperative albumin safe values of the patients with thoracic and lumbar tuberculosis. Results: A total of 131 of 166 patients experienced postoperative hypoalbuminemia after spinal focus debridement. Multivariate binary logistic regression analysis identified pulmonary tuberculosis (adjusted odds ratio = 0.270, p = 0.012), pre-operative serum albumin value (adjusted odds ratio = 0.754, p < 0.001), and operation time (adjusted odds ratio = 1.017, p = 0.002) as independent risk factors for the occurrence of postoperative hypoalbuminemia in patients with thoracic and lumbar tuberculosis. According to the OR value, the risk factors are assigned to make the scoring scale, the receiver operating characteristic (ROC) curve indicates that postoperative hypoalbuminemia rises when the score is greater than or equal to 4 points. The scoring scale is tested in the derivation set (166 patients) showed: sensitivity-51.9%, specificity-91.4%, and in the validation set (102 patients) showed: sensitivity-63.6% and specificity-86.1%. The perioperative albumin decreased value is 4.71 ± 2.66 g/L in the low-risk group and 8.99 ± 3.37 g/L in the high-risk group (p < 0.001). Conclusion: Complicated with pulmonary tuberculosis, low preoperative albumin value and long operation time can lead to postoperative hypoalbuminemia in patients with thoracic and lumbar tuberculosis. The scoring scale can effectively assist physicians to evaluate whether patients with thoracic and lumbar tuberculosis develop hypoalbuminemia after surgery. The scale is simple and reliable and has clinical guiding significance. For low-risk patients and high-risk patients, preoperative albumin values should reach 40 and 44 g/L, respectively, to effectively avoid postoperative hypoalbuminemia.

5.
Int Wound J ; 19(7): 1669-1676, 2022 Nov.
Article de Anglais | MEDLINE | ID: mdl-35132769

RÉSUMÉ

The purpose of this study is to find out the risk factors of poor wound healing (PWH) in spinal tuberculosis (STB) patients. A total of 232 STB patients who underwent debridement surgery between January 2012 to June 2020 were included in this retrospective study. The study cohort was divided into two groups according to the presence or absence of PWH. The clinical characteristics of STB patients who developed PWH were evaluated, and risk factors were found using logistic regression analysis. Of the 232 patients, 30 developed PWH. Multivariate binary logistic regression analysis showed that pulmonary tuberculosis, long operation time and low postoperative albumin level were independent risk factors for PWH in STB patients. Receiver operating characteristic curve analysis showed that the optimal cutoff value of PWH in operation time and postoperative albumin are 200 minutes and 30 g/L, respectively. Pulmonary tuberculosis, long operation time and low postoperative albumin level are independent risk factors for PWH following surgery for STB. Curing pulmonary tuberculosis, controlling operation time and supervising postoperative serum albumin may decrease the risk of PWH among STB patients.


Sujet(s)
Tuberculose pulmonaire , Tuberculose vertébrale , Humains , Tuberculose vertébrale/chirurgie , Études rétrospectives , Facteurs de risque , Tuberculose pulmonaire/chirurgie , Études de cohortes , Cicatrisation de plaie , Albumines
6.
BMC Surg ; 22(1): 54, 2022 Feb 13.
Article de Anglais | MEDLINE | ID: mdl-35152902

RÉSUMÉ

OBJECTIVE: To evaluate the clinical efficacy of oblique lateral interbody fusion (OLIF) combined posterior fixation for single-segment lumbar tuberculosis (TB). METHODS: The medical records of spinal TB patients who were admitted to our department from January 2016 to December 2018 were retrospectively reviewed, and those meeting the inclusion criteria were finally included for analysis. The operative time, operative blood loss, hospital stay, visual analogue scale (VAS) score, Oswestry disability index (ODI), Cobb angle of surgical segment, bone graft fusion rate, erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), neurological function (ASIA grade) and complications of the included patients were all recorded and analyzed. RESULTS: Thirty-nine patients with lumbar TB were finally included. The mean operative time, operative blood loss, and hospital stay were 135.8 ± 19.2 min, 239.4 ± 84.7 ml, and 9.5 ± 2.7 days, respectively. The mean follow-up time was 26.3 ± 7.5 months. During the follow-up, both VAS score and ODI were significantly improved at 1 month, 3 months, 6 months, 1 year postoperative, and the last follow-up, compared with preoperative (P < 0.001). Cobb angle was significantly corrected at 1 month postoperatively (P < 0.001), however, from 3 months postoperative to the last follow-up, Cobb angle was getting lost (P < 0.01). Bone graft fusion rate at 3 months, 6 months, 1 year postoperative, and last follow-up were 66.67%, 87.18%, 94.88%, and 100%, respectively. Compared with preoperative, ESR and CRP were both showed significant decrease at 1 and 6 months postoperative, and the last follow-up (P < 0.001). At the last follow-up, all patients had improvement in ASIA grade compared with preoperative (P < 0.001). Six patients were found with postoperative complications, and all were cured after active treatment. CONCLUSIONS: OLIF combined posterior internal fixation is safe and effective in the treatment of single-segment lumbar TB, with satisfactory pain relief, improvement of lumbar and neurological function, and deformity correction.


Sujet(s)
Arthrodèse vertébrale , Tuberculose vertébrale , Ostéosynthèse interne , Humains , Vertèbres lombales/chirurgie , Études rétrospectives , Résultat thérapeutique , Tuberculose vertébrale/chirurgie
7.
Biomed Res Int ; 2022: 4946848, 2022.
Article de Anglais | MEDLINE | ID: mdl-35187165

RÉSUMÉ

BACKGROUND: Many complications occur after surgery in patients with spinal tuberculosis (STB); however, the severity varies in different patients. The complications' severity is evaluated from grades I to V by the Clavien-Dindo classification (CDC), and grade V is the most severe. Most complications are mild, and only severe complications are life threatening, and thus, it is important to identify severe complications in patients with STB. The purpose of this study was to identify the risk factors of postoperative complication severity in patients with STB. METHODS: Between January 2012 and May 2021, a retrospective study included 188 patients that underwent STB debridement surgery. The patients were divided into three groups based on postoperative complication severity. Clinical characteristics measured included age, sex, body mass index (BMI), comorbidities of diabetes mellitus and pulmonary tuberculosis, alcohol use and smoking history, course of disease, preoperative hemoglobin, preoperative serum albumin, preoperative lymphocytes, preoperative erythrocyte sedimentation rate (ESR), preoperative C-reactive protein (CRP), surgical approach, operating time, blood loss during surgery, postoperative hemoglobin, and postoperative serum albumin. The clinical characteristics of patients with STB who developed postoperative complications were evaluated using logistic regression analysis. RESULTS: 188 patients suffered at least one postoperative complication; 77, 91, and 20 patients experienced grade I, II, and III-IV complications, respectively. In the univariate analysis, sex, diabetes mellitus, postoperative hemoglobin, and postoperative albumin are statistically significant. In the multivariable analysis, postoperative albumin (adjusted odds ratio (OR) = 0.861, P < 0.001) was an independent risk factor of the postoperative complication severity in patients with STB. Receiver operating characteristic (ROC) analysis showed that the optimal cutoff values for postoperative albumin were 32 g/L (sensitivity: 0.571, specificity: 0.714, area under the ROC curve: 0.680) and 30 g/L (sensitivity: 0.649, specificity: 0.800, area under the ROC curve: 0.697) for grade II and grade III-IV complications, respectively. CONCLUSIONS: Postoperative albumin is an independent risk factor for postoperative complication severity in patients with STB. The improvement of postoperative albumin levels may reduce the risk of severe complications in patients with STB.


Sujet(s)
Complications postopératoires/sang , Complications postopératoires/classification , Sérumalbumine/analyse , Tuberculose vertébrale/chirurgie , Adulte , Marqueurs biologiques/sang , Débridement , Femelle , Humains , Mâle , Valeur prédictive des tests , Études rétrospectives , Facteurs de risque
8.
Front Pharmacol ; 13: 1108836, 2022.
Article de Anglais | MEDLINE | ID: mdl-36686700

RÉSUMÉ

Ferroptosis is an iron-dependent regulation of cell death driven by lipid peroxidation, which is intracellularly dependent on iron and independent of other metals, and morphologically, biochemically, and genetically distinct from apoptosis, necrosis, and autophagy. Ferroptosis is closely related to physiological and pathological processes, such as development, aging, and immunity, and it plays an important role in a variety of diseases. In many departments, traditional Chinese medicine plays an increasingly important role in their clinical treatment. In recent years, an increasing number of studies have been conducted on the mechanism of ferroptosis in traditional Chinese medicine. However, the role of ferroptosis in the clinical treatment of traditional Chinese medicine requires further exploration. This article mainly introduces the application of ferroptosis in studies of the mechanism of traditional Chinese medicine to help clinicians understand the current status of traditional Chinese medicine therapy for the treatment of ferroptosis-related diseases.

9.
Biomed Res Int ; 2021: 5503022, 2021.
Article de Anglais | MEDLINE | ID: mdl-34873571

RÉSUMÉ

INTRODUCTION: The effect of surgical timing on vertebral refracture rate and mortality remains elusive after percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP), and we aim to assess the impact of surgical timing on vertebral refracture rate and mortality in patients undergoing percutaneous vertebroplasty. METHODS: We did a retrospective cohort study of patients who underwent PKP or PVP because of osteoporotic vertebral compression fracture (OVCF) between April 1, 2014 and March 31, 2016. The primary outcome measure was the incidence of vertebral refracture. Secondary outcomes included the mortality and chronic back pain. RESULTS: The rate of vertebral refracture was significantly lower in early surgical timing group than that in late surgical timing group (HR 2.415, 95% CI 1.318-4.427; P = 0.004). We found that the bone mineral density (BMD) was only the risk factor to increase the vertebral refracture rate after vertebroplasty (P = 0.001). In addition, there was similar mortality between the two groups (15.7% in early surgical timing group versus 10% in late surgical timing group). Male patients (27.3%, 12/44) had higher mortality compared to female patients (10.6%, 20/189), while the mortality was higher in patients with cerebral infarction (25%, 3/12) than those without cerebral infarction (12.1%, 17/140). CONCLUSIONS: Surgical timing significantly affects the vertebral refracture rate after PKP or PVP, which is also influenced by BMD. The mortality after the surgery is not affected by the surgical timing, but gender and cerebral infarction may be the risk factors of mortality.


Sujet(s)
Fractures par compression/chirurgie , Fractures ostéoporotiques/chirurgie , Fractures du rachis/chirurgie , Sujet âgé , Dorsalgie/chirurgie , Ciments osseux/usage thérapeutique , Densité osseuse/physiologie , Femelle , Études de suivi , Humains , Cyphoplastie/méthodes , Mâle , Durée opératoire , Études rétrospectives , Facteurs de risque , Rachis/chirurgie , Résultat thérapeutique
10.
Ann Palliat Med ; 10(9): 9372-9382, 2021 Sep.
Article de Anglais | MEDLINE | ID: mdl-34412495

RÉSUMÉ

BACKGROUND: This investigation established a scoring scale for predicting the incidence of postoperative complications in patients after spinal tuberculosis debridement. METHODS: A total of 232 spinal tuberculosis patients who underwent debridement surgery between January 2012 to May 2020 were included in this retrospective study. The study cohort was divided into 2 groups according to the presence or absence of postoperative complications. The complications were defined as abnormal or impaired body function caused by surgical factors (such as nerve injury and internal fixation looseness) or other factors (such as chemotherapy and bed stay). Clinical characteristics include age, body mass index (BMI), diabetes mellitus, pulmonary tuberculosis, smoking history, preoperative serum albumin, preoperative C-reactive protein (CRP), Cobb angle correction, surgical approach, operation time, etc. operative blood loss was recorded and analyzed. The clinical characteristics of spinal tuberculosis patients who suffered postoperative complications were evaluated, and a scoring scale was established using logistic regression analysis. The performance of this scoring scale was prospectively validated. RESULTS: Out of 232 patients, a total of 188 (81.03%) suffered postoperative complications after surgery. Multivariate binary logistic regression analysis showed that diabetes mellitus [adjusted odds ratio (OR) =1.110, P=0.046], pulmonary tuberculosis (adjusted OR =1.181, P=0.002), low preoperative serum albumin (adjusted OR =0.789, P=0.005), anterior surgical approach (adjusted OR =5.934, P=0.035), and long operation time (adjusted OR =1.019, P<0.01) were independent risk factors of postoperative complications after spinal tuberculosis debridement surgery. The above independent risk factors were assigned to establish a scoring scale for predicting postoperative complications, and receiver operating characteristic (ROC) analysis showed that the optimal cut-off value for the scoring scale was 4 points. The sensitivity and specificity of the scoring scale were 60.8% and 81.8%, respectively, based on the validation set. CONCLUSIONS: Using the scoring scale, spinal tuberculosis patients with a score between 4 to 9 would be considered at high risk of postoperative complications, while patients with a score of 0 to 3 would likely be at low risk of developing postoperative complications.


Sujet(s)
Arthrodèse vertébrale , Tuberculose vertébrale , Études de cohortes , Débridement , Humains , Vertèbres lombales , Complications postopératoires/étiologie , Études rétrospectives , Facteurs de risque , Vertèbres thoraciques , Résultat thérapeutique
11.
Front Surg ; 8: 602513, 2021.
Article de Anglais | MEDLINE | ID: mdl-34055864

RÉSUMÉ

Background: To compare the clinical efficacy of granular bone grafts and transverse process bone grafts for single-segmental thoracic tuberculosis (TB). Methods: The clinical records of 52 patients who were diagnosed with single-segmental thoracic TB and treated by one stage posterior debridement, bone graft fusion, and internal fixation in our department from 2015 to 2018 were retrospectively analyzed. Among them, 25 cases were in the granular bone graft group and 27 cases in the transverse processes bone graft group. Outcomes including the visual analog scale (VAS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neurological function, operative time, operative blood loss, hospital stay, Cobb angle, bone graft fusion time, and postoperative complications were all recorded and analyzed. Results: There were no significant differences in operative time, operative blood loss, and hospital stay between the two groups (P > 0.05). With an average follow-up of 18-33 months, all patients in the two groups showed significant improvement in VAS score, ESR, CRP, and neurological function compared with preoperative measurements (P < 0.05), however, no significant differences were found for the last follow-up (P > 0.05). The two groups showed similar Cobb angle correction (P > 0.05), but the granular bone graft group had a larger Cobb angle loss than the transverse processes bone graft group (P < 0.05). The bone graft fusion time of the granular bone graft group was shorter than that of the transverse processes bone graft group (P < 0.05). No significant difference was found in the postoperative complications rate between the two groups (P > 0.05). Conclusion: Granular bone grafts and transverse process bone grafts may achieve comparable clinical efficacy for single-segmental thoracic TB, but the former method had a shorter bone fusion time.

12.
Dis Markers ; 2021: 5584372, 2021.
Article de Anglais | MEDLINE | ID: mdl-33968282

RÉSUMÉ

PURPOSE: A retrospective imaging study assessing the availability of oblique lumbar interbody fusion at the level of L5-S1 (OLIF51) and to choose ideal surgical corridor in OLIF51 by introducing V-line. METHODS: The axial views through the center of L5-S1 disc were reviewed. We adopt 18 mm as the width of the simulated surgical corridor. The midline of the surgical corridor is at the center of L5-S1 disc. According to the traction distance of the left iliac vein (LCIV) and psoas major (PM), we defined all the subjects as V (+) (traction-difficultly LCIV), V (-) (traction-friendly LCIV), P (+) (traction-difficultly PM), and P (-) (traction-friendly PM). V-line was defined as a straight line dividing equally the simulated surgical corridor. All cases were divided into 2 groups: The V-line (+) group, more than half of the LCIV region, is located in the ventral part of V-line; the V-line (-) group, more than half of the LCIV region, is located in the dorsal part of V-line. Multiple variables regressive analysis was conducted to analyze the independent risk factors of V-line (+). RESULTS: V-line (+) was found in 36 (38.7%) patients and V-line (-) in 57 (61.3%). Incidence of V (+) and P (+) was 35.4% (33/93) and 30.1% (28/93), respectively. 16.1% (15/93) subjects processed V (+) and P (+) at the same time. The independent risk factor of V-line (+) were gender of male (P = 0.034, OR: 12.152) and medial position of LCIV (P < 0.001, OR: 265.085). High iliac crest was a significant independent protective factor (P = 0.001, OR: 0.750). CONCLUSIONS: Most patients were suitable for OLIF51. V-line could assess the injury risk of LCIV. For patients who are V-line (+), mainly among males having the LCIV near the midline or the iliac crest relatively low, a surgical corridor external to the LCIV should be taken into consideration.


Sujet(s)
Vertèbres lombales/imagerie diagnostique , Interventions chirurgicales mini-invasives/méthodes , Arthrodèse vertébrale/méthodes , Tomodensitométrie/méthodes , Adulte , Sujet âgé , Femelle , Humains , Vertèbres lombales/chirurgie , Mâle , Adulte d'âge moyen
13.
J Int Med Res ; 49(1): 300060520982780, 2021 Jan.
Article de Anglais | MEDLINE | ID: mdl-33513047

RÉSUMÉ

OBJECTIVE: This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). METHODS: Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. RESULTS: The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. CONCLUSIONS: Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.


Sujet(s)
Arthrodèse vertébrale , Tuberculose vertébrale , Transplantation osseuse , Ostéosynthèse interne , Humains , Vertèbres lombales/chirurgie , Études rétrospectives , Vertèbres thoraciques , Résultat thérapeutique , Tuberculose vertébrale/traitement médicamenteux , Tuberculose vertébrale/chirurgie
14.
Ann Palliat Med ; 10(2): 1216-1223, 2021 Feb.
Article de Anglais | MEDLINE | ID: mdl-33183031

RÉSUMÉ

BACKGROUND: Postoperative paralytic ileus is not a rare complication after lumbar spinal surgery especially in elderly patients. Chewing is a kind of sham feeding that has been reported to stimulate bowel motility, but so far there was no study showed these positive results may or may not be extrapolated to the spinal surgery population. We sought to determine whether chewing gum facilitates bowel function recovery in elderly patients undergoing lumbar spine surgery. METHODS: Sixty consecutive elderly patients (over 60 years old) with lumbar degenerative diseases undergoing posterior lumbar fusion surgery between September 2017 and April 2019 were respectively included and divided into two groups. The chewing gum group (30 patients) started chewing gum after they were awakened from anesthesia until the first defecation occurred, while the control group (30 patients) chewed nothing. The time to first flatus, first bowel sounds heard and first defecation, the length of hospital stay and postoperative complications were all recorded and analyzed. RESULTS: Compared with control group, the chewing gum group had less time to the first flatus (12.4±2.9 vs. 17.8±2.2 h; P<0.001), first bowel sounds heard (17.3±2.8 vs. 25.0±2.5 h; P<0.001) and first defecation (51.9±5.2 vs. 76.1±3.8 h; P<0.001), but no significant differences were found in the length of hospital stay (11.7±2.1 vs. 11.9±2.5 d; P=0.697) and the postoperative complications (P=0.501). CONCLUSIONS: This study demonstrated that chewing gum can promote bowel function recovery in elderly patients after lumbar spinal surgery.


Sujet(s)
Gomme à mâcher , Iléus , Sujet âgé , Études de cohortes , Humains , Adulte d'âge moyen , Complications postopératoires , Récupération fonctionnelle , Études rétrospectives
15.
Int J Surg ; 83: 39-46, 2020 Nov.
Article de Anglais | MEDLINE | ID: mdl-32927138

RÉSUMÉ

OBJECTIVE: To evaluate the clinical efficacy of oblique lateral interbody fusion combined posterior percutaneous pedicle screw fixation in the treatment of single segment lumbar tuberculosis. METHODS: Patients who underwent surgical treatment for single segment lumbar tuberculosis from 2015 to 2018 in our department were retrospectively included in this study. The included patients were divided into two groups, namely oblique lateral interbody fusion combined percutaneous pedicle screw fixation (OLIF) group and traditional posterior transforaminal or transpedicular approach debridement and pedicle screws fixation (PTA) group, according to the surgical methods. Outcomes including operative time, operative blood loss, hospital stay, visual analogue scale (VAS) score, Oswestry disability index (ODI), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Cobb angle correction and loss, bone fusion time, ASIA grade and complications were all recorded and compared. RESULTS: A total of 60 patients were included in this study, involving 23 patients in the OLIF group and 37 patients in the PTA group. The OLIF group had less operative time, blood loss and shorter hospital stay compared with the PTA group (P < 0.05). Both the two groups achieved significant improvements in ESR, CRP and ASIA grade at the last follow-up (P < 0.05), but no significant differences were found between them (P>0.05). There were no significant differences in Cobb angle correction and loss between the two groups (P > 0.05), but the bone graft fusion time of the OLIF group was significantly shorter than the PTA group (P < 0.05). The two groups achieved similar improvement in VAS score and ODI at 12 months postoperative and the last follow-up, however, OLIF group had a lower VAS score and ODI at 1 month, 3 months and 6 months postoperative (P < 0.05). No significant difference was found in complications between the two groups (P > 0.05) and all patients were cured after active treatment. CONCLUSIONS: Both OLIF and PTA can achieve satisfactory clinical efficacy in the surgical treatment of single segment lumbar TB, but OLIF has the advantages of less surgical trauma, faster postoperative recovery and shorter bone fusion time.


Sujet(s)
Vertèbres lombales/chirurgie , Vis pédiculaires , Arthrodèse vertébrale/méthodes , Tuberculose vertébrale/chirurgie , Adulte , Débridement/méthodes , Femelle , Humains , Mâle , Adulte d'âge moyen , Interventions chirurgicales mini-invasives , Durée opératoire , Études rétrospectives
16.
Medicine (Baltimore) ; 98(21): e15810, 2019 May.
Article de Anglais | MEDLINE | ID: mdl-31124981

RÉSUMÉ

The prevalence of overweight-obesity has increased sharply among undergraduates worldwide. In 2016, approximately 52% of adults were overweight-obese. This cross-sectional study aimed to investigate the prevalence of overweight-obesity and explore in depth the connection between eating habits and overweight-obesity among Chinese undergraduates.The study population included 536 undergraduates recruited in Shijiazhuang, China, in 2017. They were administered questionnaires for assessing demographic and daily lifestyle characteristics, including sex, region, eating speed, number of meals per day, and sweetmeat habit. Anthropometric status was assessed by calculating the body mass index (BMI). The determinants of overweight-obesity were investigated by the Pearson χ test, Spearman rho test, multivariable linear regression, univariate/multivariate logistic regression, and receiver operating characteristic curve analysis.The prevalence of undergraduate overweight-obesity was 13.6%. Sex [male vs female, odds ratio (OR): 1.903; 95% confidence interval (95% CI): 1.147-3.156], region (urban vs rural, OR: 1.953; 95% CI: 1.178-3.240), number of meals per day (3 vs 2, OR: 0.290; 95% CI: 0.137-0.612), and sweetmeat habit (every day vs never, OR: 4.167; 95% CI: 1.090-15.933) were significantly associated with overweight-obesity. Eating very fast was positively associated with overweight-obesity and showed the highest OR (vs very slow/slow, OR: 5.486; 95% CI: 1.622-18.553). However, the results of multivariate logistic regression analysis indicated that only higher eating speed is a significant independent risk factor for overweight/obesity (OR: 17.392; 95% CI, 1.614-187.363; P = .019).Scoremeng = 1.402 × scoresex + 1.269 × scoreregion + 19.004 × scoreeatin speed + 2.546 × scorenumber of meals per day + 1.626 × scoresweetmeat habit and BMI = 0.253 × Scoremeng + 18.592. These 2 formulas can help estimate the weight status of undergraduates and predict whether they will be overweight or obese.


Sujet(s)
Indice de masse corporelle , Régime alimentaire/effets indésirables , Indicateurs d'état de santé , Obésité/étiologie , Surpoids/étiologie , Adolescent , Chine/épidémiologie , Études transversales , Comportement alimentaire , Femelle , Humains , Mode de vie , Modèles linéaires , Mâle , Repas , Analyse multifactorielle , Obésité/épidémiologie , Odds ratio , Surpoids/épidémiologie , Valeur prédictive des tests , Prévalence , Courbe ROC , Facteurs de risque , Population rurale/statistiques et données numériques , Statistique non paramétrique , Étudiants/statistiques et données numériques , Enquêtes et questionnaires , Universités , Population urbaine/statistiques et données numériques , Jeune adulte
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