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The Journal of the American Academy of... Jul 2019Low back pain resulting from intervertebral disk degeneration is a cause of substantial disability and productivity loss. Over the past few years, growing evidence... (Review)
Review
Low back pain resulting from intervertebral disk degeneration is a cause of substantial disability and productivity loss. Over the past few years, growing evidence exists which suggests that low-grade bacterial infection, particularly infection with Cutibacterium acnes, may be associated with degenerative disk disease in the lumbar spine. Positive cultures are obtained in approximately 30% of intervertebral disk specimens removed at the time of surgery. In addition, one randomized trial has shown that antibiotic therapy for low back pain in patients with disk degeneration can slow the progression of degeneration and improve pain and disability levels. Although these results are encouraging, the link between infection and disk degeneration remains controversial. Investigators have attempted to address the limitations of clinical research by using translational methods and animal models. These methods have shown that seeding of the disk with bacteria can lead to increased local inflammation and an in vivo phenotype that is similar to human disk degeneration. This review seeks to provide an overview of the clinical, translational, and animal model data linking infection to disk degeneration. We review mechanisms for disk degeneration in the setting of infection and explore areas for future investigation.
Topics: Animals; Disease Models, Animal; Gram-Positive Bacterial Infections; Humans; Intervertebral Disc Degeneration; Low Back Pain; Lumbar Vertebrae; Propionibacteriaceae; Severity of Illness Index; Spondylitis
PubMed: 30575599
DOI: 10.5435/JAAOS-D-18-00257 -
Journal of Biological Regulators and... 2020Low Back Pain (LBP) is the most common spine disease and it is the most common cause of absence from work in developed countries. At lumbar level, the natural history of... (Review)
Review
Low Back Pain (LBP) is the most common spine disease and it is the most common cause of absence from work in developed countries. At lumbar level, the natural history of herniated disc is characterized by a disappearance of clinical symptoms in up to 60% with conservative treatment through simple rest for about 6 weeks and reduction of the disk heniation revealed by CT or MR scans within eight to nine months after the onset of back pain. Surgery is considered the treatment of choice for extruded, migrated and free fragment herniated disk associated to clinical symptomatology of cono-cauda syndrome, progressive foot droop and hyperalgic radiculopathy. patients with a small or contained herniated disk, without any benefit from conservative medical treatment, can be candidates for one of minimally invasive percutaneous techniques, whose outcome, though, depends on the characteristics of hernia itself and on the chosen technique. The aim of this paper is to discuss about O2-O3 treatment for symptomatic not extruded herniated disk at lumbar level, highlighting about indication inclusion exclusion criteria and our results.
Topics: Fluoroscopy; Humans; Intervertebral Disc Displacement; Low Back Pain; Lumbar Vertebrae; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 33176413
DOI: No ID Found -
JMIR Medical Informatics May 2021Disk herniation and disk bulge are two common disorders of lumbar intervertebral disks (IVDs) that often result in numbness, pain in the lower limbs, and lower back...
BACKGROUND
Disk herniation and disk bulge are two common disorders of lumbar intervertebral disks (IVDs) that often result in numbness, pain in the lower limbs, and lower back pain. Magnetic resonance (MR) imaging is one of the most efficient techniques for detecting lumbar diseases and is widely used for making clinical diagnoses at hospitals. However, there is a lack of efficient tools for effectively interpreting massive amounts of MR images to meet the requirements of many radiologists.
OBJECTIVE
The aim of this study was to present an automatic system for diagnosing disk bulge and herniation that saves time and can effectively and significantly reduce the workload of radiologists.
METHODS
The diagnosis of lumbar vertebral disorders is highly dependent on medical images. Therefore, we chose the two most common diseases-disk bulge and herniation-as research subjects. This study is mainly about identifying the position of IVDs (lumbar vertebra [L] 1 to L2, L2-L3, L3-L4, L4-L5, and L5 to sacral vertebra [S] 1) by analyzing the geometrical relationship between sagittal and axial images and classifying axial lumbar disk MR images via deep convolutional neural networks.
RESULTS
This system involved 4 steps. In the first step, it automatically located vertebral bodies (including the L1, L2, L3, L4, L5, and S1) in sagittal images by using the faster region-based convolutional neural network, and our fourfold cross-validation showed 100% accuracy. In the second step, it spontaneously identified the corresponding disk in each axial lumbar disk MR image with 100% accuracy. In the third step, the accuracy for automatically locating the intervertebral disk region of interest in axial MR images was 100%. In the fourth step, the 3-class classification (normal disk, disk bulge, and disk herniation) accuracies for the L1-L2, L2-L3, L3-L4, L4-L5, and L5-S1 IVDs were 92.7%, 84.4%, 92.1%, 90.4%, and 84.2%, respectively.
CONCLUSIONS
The automatic diagnosis system was successfully built, and it could classify images of normal disks, disk bulge, and disk herniation. This system provided a web-based test for interpreting lumbar disk MR images that could significantly improve diagnostic efficiency and standardized diagnosis reports. This system can also be used to detect other lumbar abnormalities and cervical spondylosis.
PubMed: 34018488
DOI: 10.2196/14755 -
Journal of Clinical Microbiology Mar 2019In 2019, the Clinical and Laboratory Standards Institute (CLSI) published revisions to the ciprofloxacin and levofloxacin breakpoints. We evaluated the performance of...
In 2019, the Clinical and Laboratory Standards Institute (CLSI) published revisions to the ciprofloxacin and levofloxacin breakpoints. We evaluated the performance of disk diffusion and Etest compared to that of reference broth microdilution by use of the revised breakpoints. Fifty-eight isolates with ciprofloxacin MICs of 0.5 μg/ml or 1.0 μg/ml on initial testing were specifically selected for evaluation. These MICs are susceptible by the 2018 breakpoints and not susceptible by the 2019 breakpoints. For ciprofloxacin disk diffusion, the categorical agreement (CA) was 46.6%, with 0 very major errors (VME), 4 major errors (ME) (21.1%), and 27 minor errors (mE) (46.6%) using the 2019 CLSI disk breakpoints. For levofloxacin, the CA was 72.4%, with 0 VME, 0 ME, and 16 mE (27.6%) using the 2019 CLSI disk breakpoints. Using an error rate-bound evaluation method, levofloxacin but not ciprofloxacin disk diffusion yielded an acceptable minor error rate of <40% for isolates with an MIC plus or minus 1 doubling dilution of the intermediate breakpoint. For Etest compared to the reference broth microdilution, the essential agreement was 100% for both ciprofloxacin and levofloxacin and the CA was 81.0% and 65.5%, respectively. No VME or ME were observed by Etest, and 11 minor errors for ciprofloxacin (19.0%) and 20 (34.5%) for levofloxacin were observed. By the error rate-bound method, the minor error rate for ciprofloxacin was acceptable, but minor error rates for levofloxacin remained outside the acceptance range (i.e., 42.6% for isolates with an MIC within 1 dilution of the breakpoint). In general, the disk diffusion and Etest methods performed well with this challenging collection of isolates, although laboratories must be aware of minor errors, particularly for isolates with results near the breakpoint.
Topics: Anti-Bacterial Agents; Ciprofloxacin; Disk Diffusion Antimicrobial Tests; Drug Resistance, Bacterial; Enterobacteriaceae; Levofloxacin; Microbial Sensitivity Tests
PubMed: 30567744
DOI: 10.1128/JCM.01797-18 -
Micromachines Dec 2023A diamond gel polishing disk with self-sharpening ability is proposed to solve the problem of glazing phenomenon in the gel polishing disks. Aluminum nitride (AlN)...
A diamond gel polishing disk with self-sharpening ability is proposed to solve the problem of glazing phenomenon in the gel polishing disks. Aluminum nitride (AlN) powder with silica sol film coating (A/S powder) is added to the polishing disk, and a specific solution is used to dissolve the A/S powder during polishing, forming a pore structure on the polishing disk. To realize the self-sharpening process, the dissolution property of the A/S powder is analyzed. The effect of A/S powder content on the friction and wear performance and the polishing performance of 4H-SiC wafers are investigated. Results showed that the friction coefficient of the polishing disk with 9 wt% A/S powder content is the most stable. The surface roughness of 2.25 nm can be achieved, and there is no obvious glazing phenomenon on the polishing disk after polishing. The surface roughness of the 4H-SiC wafer is reduced by 38.8% compared with that of the polishing disk with no A/S powder addition after rough polishing, and the 4H-SiC wafer then obtained a damage-free surface with a less than 0.4 nm after fine polishing by chemical mechanical polishing (CMP).
PubMed: 38258175
DOI: 10.3390/mi15010056 -
Cureus Mar 2022Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity and mortality due to the development of antimicrobial resistance...
Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity and mortality due to the development of antimicrobial resistance secondary to irrational use of antibiotics, nonadherence to infection control practices, and increased use of intravascular devices in healthcare systems. Detection of MRSA is critical in clinical microbiology laboratories as it helps identify MRSA carriers and avoid treatment failure in patients. Hence, this study compared various phenotypic methods with the standard genotyping method to determine a method that permits rapid and accurate detection of MRSA. Materials & Methods () was initially identified based on colony morphology, Gram staining, standard biochemical tests, and antibiotic susceptibility using disk diffusion. MRSA was identified based on the detection of the mecA gene by polymerase chain reaction (PCR) and subsequent gel electrophoresis. Disk diffusion using cefoxitin or oxacillin and mannitol salt agar with 6-µg/ml oxacillin were used for phenotypic detection of MRSA. The D test was used to detect inducible clindamycin resistance in isolates. Results Of the 100 isolates analyzed, 37% were identified as MRSA by PCR and the cefoxitin disk diffusion method; however, only 31% were detected by the oxacillin disk diffusion method and 29% by the mannitol salt agar method. The sensitivity of the cefoxitin disk diffusion test, oxacillin disk diffusion, and mannitol salt agar methods was 86.05%, 83.78%, and 70.73%, respectively. Specificity was 100% for all the three phenotypic methods (p < 0.001). Notably, inducible clindamycin resistance was found in 37.2% of the MRSA isolates, indicating potential challenges in treatment. Conclusion Among the three phenotypic methods tested, the cefoxitin disk diffusion method had 100% sensitivity and specificity, which is similar to that of PCR-based MRSA detection. Hence, the cefoxitin disk diffusion method is recommended for use in clinical laboratories, where molecular methods are not available as it is both cost-effective and easy to perform.
PubMed: 35481290
DOI: 10.7759/cureus.23396 -
Orthopedics Jul 2018Consensus is lacking regarding optimal surgical treatment of recurrent lumbar disk herniation. A systematic search of multiple databases was conducted for studies... (Meta-Analysis)
Meta-Analysis Review
Consensus is lacking regarding optimal surgical treatment of recurrent lumbar disk herniation. A systematic search of multiple databases was conducted for studies evaluating outcomes after treatment for recurrent lumbar disk herniation. Treatment options included decompression surgeries and fusion surgeries. Although fusion surgeries eliminated re-recurrence of disk herniation, this coincided with higher incidences of complications and reoperation. Decompression surgeries and fusion surgeries both resulted in improvements in Japanese Orthopaedic Association, Oswestry Disability Index, and visual analog scale back and leg scores postoperatively (P<.05). The complication risk profiles of decompression surgeries and fusion surgeries must be balanced with the risk of disk herniation re-recurrence, as both procedures lead to improvements in functional outcomes. [Orthopedics. 2018; 41(4):e457-e469.].
Topics: Diskectomy; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Pain Measurement; Postoperative Complications; Postoperative Period; Recurrence; Reoperation; Spinal Fusion; Treatment Outcome
PubMed: 29940051
DOI: 10.3928/01477447-20180621-01 -
Oral Surgery, Oral Medicine, Oral... Feb 2018The aim of this study was to assess the relationship between mandibular condylar volume and disk displacement status in adult males and females.
OBJECTIVES
The aim of this study was to assess the relationship between mandibular condylar volume and disk displacement status in adult males and females.
STUDY DESIGN
We evaluated 122 temporomandibular joints in 61 patients using magnetic resonance imaging (MRI) and computed tomography (CT). MRI data were used to assign disk status as normal disk position (NR), disk displacement with reduction (DDR), or disk displacement without reduction (DDNR). CT data were used to calculate total condylar volume and its components, cortical volume, and trabecular volume. The relationships among condylar volume, disk status, and gender were tested with 2-way analysis of variance.
RESULTS
Condylar volumes significantly correlated with disk displacement, tending to decrease as displacement increased. There were significant differences in both total condylar volume and trabecular volume among the DD status (NR > DDR > DDNR), whereas cortical volume was significantly different only between NR/DDR and DDNR (NR/DDR > DDNR). The volume decreases associated with temporomandibular joint DD were found in both males and females, with greater decreases in men than in women as DD progressed.
CONCLUSIONS
Condylar volumes are significantly associated with disk displacement status. Joints with nonreducing disks showed the smallest condylar volumes in both males and females.
Topics: Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Magnetic Resonance Imaging; Male; Mandibular Condyle; Temporomandibular Joint Disorders; Tomography, X-Ray Computed
PubMed: 29233525
DOI: 10.1016/j.oooo.2017.11.001 -
Nature Sep 2018The evolution of the Milky Way disk, which contains most of the stars in the Galaxy, is affected by several phenomena. For example, the bar and the spiral arms of the...
The evolution of the Milky Way disk, which contains most of the stars in the Galaxy, is affected by several phenomena. For example, the bar and the spiral arms of the Milky Way induce radial migration of stars and can trap or scatter stars close to orbital resonances. External perturbations from satellite galaxies can also have a role, causing dynamical heating of the Galaxy, ring-like structures in the disk and correlations between different components of the stellar velocity. These perturbations can also cause 'phase wrapping' signatures in the disk, such as arched velocity structures in the motions of stars in the Galactic plane. Some manifestations of these dynamical processes have already been detected, including kinematic substructure in samples of nearby stars, density asymmetries and velocities across the Galactic disk that differ from the axisymmetric and equilibrium expectations, especially in the vertical direction, and signatures of incomplete phase mixing in the disk. Here we report an analysis of the motions of six million stars in the Milky Way disk. We show that the phase-space distribution contains different substructures with various morphologies, such as snail shells and ridges, when spatial and velocity coordinates are combined. We infer that the disk must have been perturbed between 300 million and 900 million years ago, consistent with estimates of the previous pericentric passage of the Sagittarius dwarf galaxy. Our findings show that the Galactic disk is dynamically young and that modelling it as time-independent and axisymmetric is incorrect.
PubMed: 30232428
DOI: 10.1038/s41586-018-0510-7 -
Indian Journal of Ophthalmology Mar 2023: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the...
BACKGROUND AND PURPOSE
: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the radial peripapillary capillary (RPC) network in congenital optic disk anomalies with optical coherence tomography-angiography (OCTA) can shed light on its pathogenesis. This video describes the OCTA findings of optic nerve head and RPC network using the angio-disk mode in five cases of congenital cavitary optic disk anomalies.
SYNOPSIS
The video presents characteristic RPC network alterations in two eyes of ODP, one eye of optic disk coloboma, and two eyes of noncontractile MGDA.
HIGHLIGHTS
OCTA in ODP and coloboma shows absence of RPC microvascular network and a region of capillary dropout. This finding is in contrast to MGDA, where the microvascular network is dense. OCTA is an effective imaging modality to study vascular plexus and RPC and their alteration in congenital disk anomalies, which could provide information about the structural differences among them.
VIDEO LINK
https://youtu.be/TyZOzpG4X4U.
Topics: Humans; Optic Disk; Coloboma; Eye Abnormalities
PubMed: 36872758
DOI: 10.4103/IJO.IJO_2743_22