Did you mean: scheuermann s disease
-
Seminars in Musculoskeletal Radiology Oct 2023Scheuermann's disease is a rigid progressive kyphosis occurring in late childhood to adolescence. It is the most common cause of sagittal imbalance and angular...
Scheuermann's disease is a rigid progressive kyphosis occurring in late childhood to adolescence. It is the most common cause of sagittal imbalance and angular progressive kyphosis in adolescents associated with back pain. The exact etiology of the disease is unclear, but it is characterized by defective growth of the end plate that may result from excessive mechanical stress on a weakened end plate during spinal growth. Several other theories have been proposed, and it is thought to be a multifactorial disease occurring as a result of the interplay of multiple factors. The radiographic features consist of anterior vertebral body wedging, irregular end plates, Schmorl's nodes, and intervertebral disk degeneration. The natural history and evolution of this disease is also unknown. Conservative management with physiotherapy, rehabilitation, and bracing is the first line of treatment. Mechanical bracing helps prevent further progression of the kyphotic deformity. Surgery is mostly indicated in patients with failure of conservative management, with neurologic compromise, and for cosmetic reasons.
Topics: Adolescent; Humans; Child; Scheuermann Disease; Spine
PubMed: 37816360
DOI: 10.1055/s-0043-1771334 -
Nature Immunology Oct 2023Millions of people are suffering from Long COVID or post-acute sequelae of COVID-19 (PASC). Several biological factors have emerged as potential drivers of PASC... (Review)
Review
Millions of people are suffering from Long COVID or post-acute sequelae of COVID-19 (PASC). Several biological factors have emerged as potential drivers of PASC pathology. Some individuals with PASC may not fully clear the coronavirus SARS-CoV-2 after acute infection. Instead, replicating virus and/or viral RNA-potentially capable of being translated to produce viral proteins-persist in tissue as a 'reservoir'. This reservoir could modulate host immune responses or release viral proteins into the circulation. Here we review studies that have identified SARS-CoV-2 RNA/protein or immune responses indicative of a SARS-CoV-2 reservoir in PASC samples. Mechanisms by which a SARS-CoV-2 reservoir may contribute to PASC pathology, including coagulation, microbiome and neuroimmune abnormalities, are delineated. We identify research priorities to guide the further study of a SARS-CoV-2 reservoir in PASC, with the goal that clinical trials of antivirals or other therapeutics with potential to clear a SARS-CoV-2 reservoir are accelerated.
Topics: Humans; COVID-19; Post-Acute COVID-19 Syndrome; RNA, Viral; SARS-CoV-2; Antiviral Agents; Disease Progression
PubMed: 37667052
DOI: 10.1038/s41590-023-01601-2 -
Journal of Clinical Neuroscience :... Aug 2023
Topics: Humans; Scheuermann Disease; Spine
PubMed: 37307717
DOI: 10.1016/j.jocn.2023.05.022 -
Journal of the American Heart... Dec 2023Cerebral small vessel disease (cSVD) is a major contributing factor to ischemic stroke and dementia. However, the vascular pathologies of cSVD remain inconclusive. The... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cerebral small vessel disease (cSVD) is a major contributing factor to ischemic stroke and dementia. However, the vascular pathologies of cSVD remain inconclusive. The aim of this systematic review and meta-analysis was to characterize the associations between cSVD and cerebrovascular reactivity (CVR), cerebral autoregulation, and arterial stiffness (AS).
METHODS AND RESULTS
MEDLINE, Web of Science, and Embase were searched from inception to September 2023 for studies reporting CVR, cerebral autoregulation, or AS in relation to radiological markers of cSVD. Data were extracted in predefined tables, reviewed, and meta-analyses performed using inverse-variance random effects models to determine pooled odds ratios (ORs). A total of 1611 studies were identified; 142 were included in the systematic review, of which 60 had data available for meta-analyses. Systematic review revealed that CVR, cerebral autoregulation, and AS were consistently associated with cSVD (80.4%, 78.6%, and 85.4% of studies, respectively). Meta-analysis in 7 studies (536 participants, 32.9% women) revealed a borderline association between impaired CVR and cSVD (OR, 2.26 [95% CI, 0.99-5.14]; =0.05). In 37 studies (27 952 participants, 53.0% women) increased AS, per SD, was associated with cSVD (OR, 1.24 [95% CI, 1.15-1.33]; <0.01). Meta-regression adjusted for comorbidities accounted for one-third of the AS model variance (=29.4%, =0.02). Subgroup analysis of AS studies demonstrated an association with white matter hyperintensities (OR, 1.42 [95% CI, 1.18-1.70]; <0.01).
CONCLUSIONS
The collective findings of the present systematic review and meta-analyses suggest an association between cSVD and impaired CVR and elevated AS. However, longitudinal investigations into vascular stiffness and regulatory function as possible risk factors for cSVD remain warranted.
Topics: Humans; Female; Male; Vascular Stiffness; Cerebral Small Vessel Diseases; Risk Factors; Magnetic Resonance Imaging
PubMed: 37930079
DOI: 10.1161/JAHA.123.032616 -
Viruses Sep 2023The ability of each new SARS-CoV-2 variant to evade host humoral immunity is the focus of intense research. Each variant may also harbor unique replication capabilities...
The ability of each new SARS-CoV-2 variant to evade host humoral immunity is the focus of intense research. Each variant may also harbor unique replication capabilities relevant for disease and transmission. Here, we demonstrate a new approach to assessing viral replication kinetics using real-time cell analysis (RTCA). Virus-induced cell death is measured in real time as changes in electrical impedance through cell monolayers while images are acquired at defined intervals via an onboard microscope and camera. Using this system, we quantified replication kinetics of five clinically important viral variants: WA1/2020 (ancestral), Delta, and Omicron subvariants BA.1, BA.4, and BA.5. Multiple measures proved useful in variant replication comparisons, including the elapsed time to, and the slope at, the maximum rate of cell death. Important findings include significantly weaker replication kinetics of BA.1 by all measures, while BA.5 harbored replication kinetics at or near ancestral levels, suggesting evolution to regain replicative capacity, and both an altered profile of cell killing and enhanced fusogenicity of the Delta variant. Together, these data show that RTCA is a robust method to assess replicative capacity of any given SARS-CoV-2 variant rapidly and quantitatively, which may be useful in assessment of newly emerging variants.
Topics: Humans; SARS-CoV-2; COVID-19; Cell Death; Apoptosis
PubMed: 37766343
DOI: 10.3390/v15091937 -
Is sagittal spinopelvic alignment a cause of low back pain in pediatric spine pathologies? A review.Journal of Children's Orthopaedics Dec 2023Altered spinopelvic morphology is observed in many spine pathologies occurring during growth. The aim of the study is to better understand the sagittal compensatory... (Review)
Review
PURPOSE
Altered spinopelvic morphology is observed in many spine pathologies occurring during growth. The aim of the study is to better understand the sagittal compensatory mechanisms and their possible influence on the occurrence of pain in selected pediatric spine pathologies.
METHODS
A bibliographic search in the PubMed database included articles published between September 1965 and July 2023. The keywords contained in the search were "spondylolysis," "spondylolisthesis," "scoliosis," "kypho," "sagittal," "pediatric," "child," "adolescent," "grow," "development," and "pain."
RESULTS
The largest diversity in sagittal alignment patterns was reported in idiopathic scoliosis, with global flattening of the spine being the most common. Kyphotic deformations occurring during growth are characterized by structural thoracic or thoracolumbar kyphosis compensated by lumbar hyperlordosis and lower pelvic incidence. Whereas in spondylolisthesis, altered morphology of the spinopelvic junction with high values of pelvic incidence is observed. Pain does not seem to be related to sagittal alignment in idiopathic scoliosis. In Scheuermann disease, it is localized at the apex of the deformity and is associated with the curve pattern, whereas in spondylolisthesis, sagittal alignment correlates with pain scores only in high-grade slips.
CONCLUSION
Most of the patients with spine disorders that occurred during growth present a clinically balanced posture in the sagittal plane. It suggests that compensatory mechanisms before achieving skeletal maturity are really significant. A comprehension of sagittal alignment in spine deformities and its relationship to pain is essential for the proper assessment and treatment of these disorders.
PubMed: 38050600
DOI: 10.1177/18632521231215853 -
American Journal of Respiratory Cell... Aug 2023Chronic obstructive pulmonary disease (COPD) is a clinical entity of increasing significance. COPD involves abnormalities of the airways and, in emphysema, parenchymal...
Chronic obstructive pulmonary disease (COPD) is a clinical entity of increasing significance. COPD involves abnormalities of the airways and, in emphysema, parenchymal pulmonary destruction. Cardiovascular disease has emerged as a significant comorbidity to COPD. Heart failure with preserved ejection fraction (HFpEF) appears to be particularly associated with COPD-emphysema. Traditional treatments have shown limited efficacy in improving COPD-associated HFpEF. This lack of therapeutic efficacy highlights the need to identify potential mechanisms that link COPD-emphysema to HFpEF. Therefore, we aimed to study the delayed cardiac physiological impacts in a rat model with acute exacerbated emphysema. Emphysema was induced by four weekly 4 units elastase (ELA) intratracheal pulmonary instillations and exacerbation by one final additional lipolysaccharide (LPS) instillation in male Wistar rats. At 5 weeks after the ELA and LPS exposure, and pulmonary and cardiac measurements were performed. Experimental exacerbated emphysema resulted in decreased pulmonary function and exercise intolerance. Histological analysis revealed parenchymal pulmonary destruction without signs of inflammation or cardiac fibrosis. cardiac functional analysis revealed diastolic dysfunction and tachycardia. analysis revealed a cellular cardiomyopathy with decreased myofilament Ca sensitivity, cross-bridge cycling kinetics, and increased adrenergic PKA (protein kinase A)-dependent phosphorylation of troponin-I. Experimental exacerbated emphysema was associated with exercise intolerance that appeared to be secondary to increased β-adrenergic tone and subsequent cardiac myofilament dysfunction. A β-receptor antagonist treatment (bisoprolol) started 24 hours after ELA-LPS instillation prevented and diastolic dysfunction. These results suggest that novel treatment strategies targeted to the cardiac myofilament may be beneficial to combat exacerbated emphysema-associated HFpEF.
Topics: Male; Rats; Animals; Heart Failure; Lipopolysaccharides; Stroke Volume; Rats, Wistar; Pulmonary Emphysema; Pulmonary Disease, Chronic Obstructive; Emphysema; Cardiomyopathies
PubMed: 37163759
DOI: 10.1165/rcmb.2022-0382OC -
Journal of Children's Orthopaedics Dec 2023Low back pain in childhood was underappreciated for a long time, but recent studies report higher prevalences, up to 70%. Two of the common causes are... (Review)
Review
BACKGROUND
Low back pain in childhood was underappreciated for a long time, but recent studies report higher prevalences, up to 70%. Two of the common causes are spondylolyis/spondylolisthesis and Scheuermann's disease. These disorders are relevant in a way they both cause significant back pain, and may disrupt the sagittal spinal balance.
PURPOSE
To present the current evidence on the diagnosis, natural history and treatment of these disorders with a special focus on sagittal spinal alignment.
METHODS
This study is conducted as a literature review.
RESULTS AND CONCLUSIONS
Spondylolysis and low-grade spondylolisthesis have a benign course and are typically treated conservatively. When pars repair is indicated, pedicle screw-based techniques achieve more than 90% fusion with acceptable complication rates. High-grade spondylolisthesis, however, is frequently progressive. Surgical treatment involves fusion, which can be done in situ or after reduction. Reduction is useful for "unbalanced" patients to acquire sagittal spinopelvic balance, and it is important to distinguish these patients. Despite lowering the risk for pseudoarthrosis, reduction brings a risk for neurologic complications. With re-operation rates as high as 40%, these patients definitely require careful preoperative planning. Scheuermann's disease generally causes back pain in addition to cosmetic discomfort during adolescence. If the kyphosis is lower than 60°, symptoms typically resolve into adulthood with conservative measures only. However, it must be kept in mind that these patients may experience problems with physical performance and have a lower quality of life even when the problem seems to have "resolved". Severe kyphosis and intractable back pain are the most frequently referred surgical indications, and surgery typically involves fusion. Proper utilization of osteotomies and proper selection of the upper and lower fusion levels are of utmost importance to prevent complications in these patients.
PubMed: 38050599
DOI: 10.1177/18632521231215873 -
BMC Medical Genomics Jun 2024Respiratory Syncytial Virus (RSV) disease in young children ranges from mild cold symptoms to severe symptoms that require hospitalization and sometimes result in death....
BACKGROUND
Respiratory Syncytial Virus (RSV) disease in young children ranges from mild cold symptoms to severe symptoms that require hospitalization and sometimes result in death. Studies have shown a statistical association between RSV subtype or phylogenic lineage and RSV disease severity, although these results have been inconsistent. Associations between variation within RSV gene coding regions or residues and RSV disease severity has been largely unexplored.
METHODS
Nasal swabs from children (< 8 months-old) infected with RSV in Rochester, NY between 1977-1998 clinically presenting with either mild or severe disease during their first cold-season were used. Whole-genome RSV sequences were obtained using overlapping PCR and next-generation sequencing. Both whole-genome phylogenetic and non-phylogenetic statistical approaches were performed to associate RSV genotype with disease severity.
RESULTS
The RSVB subtype was statistically associated with disease severity. A significant association between phylogenetic clustering of mild/severe traits and disease severity was also found. GA1 clade sequences were associated with severe disease while GB1 was significantly associated with mild disease. Both G and M2-2 gene variation was significantly associated with disease severity. We identified 16 residues in the G gene and 3 in the M2-2 RSV gene associated with disease severity.
CONCLUSION
These results suggest that phylogenetic lineage and the genetic variability in G or M2-2 genes of RSV may contribute to disease severity in young children undergoing their first infection.
Topics: Humans; Respiratory Syncytial Virus Infections; Phylogeny; Genetic Variation; Severity of Illness Index; Infant; Respiratory Syncytial Virus, Human; Male; Genotype; Female; Genome, Viral
PubMed: 38898440
DOI: 10.1186/s12920-024-01930-7