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Spine Surgery and Related Research 2021Despite being originally developed for the evaluation of lumbar disk degeneration, the Pfirrmann classification has emerged as the most popular classification system for...
INTRODUCTION
Despite being originally developed for the evaluation of lumbar disk degeneration, the Pfirrmann classification has emerged as the most popular classification system for cervical disk degeneration. However, with the Suzuki classification, a new classification system that is specifically tailored for the evaluation of cervical disk disease was introduced. In this study, we aim to evaluate differences in inter- and intraobserver reliability of both classifications in a head-to-head comparison.
METHODS
In total, we have evaluated 120 cervical disks within 40 patients via magnetic resonance imaging according to the Pfirrmann and Suzuki classification. The degree of disk degeneration was evaluated by two independent musculoskeletal radiologists. After 6 months, the classification was reassessed to evaluate the intraobserver reliability. The inter- and intraobserver reliabilities were then calculated using Cohen's kappa.
RESULTS
The inter- and intraobserver reliability provided a significant agreement between all ratings in Pfirrmann as well as the Suzuki classification (p>0.001). The interobserver reliability was determined to be fair in both the Suzuki classification (κ=0.290) and the Pfirrmann classification (κ=0.265). The intraobserver reliability was substantial in the Suzuki classification (κ=0.798), while it was almost perfect in the Pfirrmann classification (κ=0.858).
CONCLUSIONS
Although not designed for the evaluation of cervical disk degeneration, the Pfirrmann classification yielded equal inter- and higher intraobserver reliability. Both classification systems are viable options for the grading of cervical disk degeneration. While the Pfirrmann classification has the advantage of being better established, the Suzuki classification may be clinically superior due to a better representation of cervical disk degeneration and the consideration of disk bulging for the classification of cervical disk degeneration.
PubMed: 34966859
DOI: 10.22603/ssrr.2021-0048 -
The International Journal of Oral &... 2021Previous studies assessing fibroblast interactions with implants have mainly relied on measurements such as cell migration, gene expression, and cell adhesion. For these...
PURPOSE
Previous studies assessing fibroblast interactions with implants have mainly relied on measurements such as cell migration, gene expression, and cell adhesion. For these studies, testing cellular behavior at the implant surface was done by imaging the cell-implant interface using standard microscopy techniques in 2D tissue culture dishes. The true behavior of cells relative to the implant can best be assessed in a more physiologic 3D microenvironment.
MATERIALS AND METHODS
The embedding of the implant disks in 3D collagen gels was standardized with labeled fibroblasts to allow the imaging of fibroblast morphology and behavior when proximal to or binding to the implant disks. This allowed comparison of the behavior of laser-microgrooved and machined implant disk surfaces quantitatively in an in vitro 3D microenvironment.
RESULTS
This in vitro imaging assay revealed for the first time in a 3D microenvironment setting the statistically significant impact laser-microgrooved disk surfaces have on both cell adherence and recruitment of cells in proximity to the disk. It also allowed visualization of membrane protrusivity and cytoskeletal organization in cells adherent to the implant disk.
CONCLUSION
This assay provides a simple and effective way of observing cell behavior on and around the implant disk surface in a more physiologic 3D setting. Within the limits of this study, it revealed that the laser-microgrooved implant surface demonstrates significant superiority in fibroblast recruitment and binding in a 3D microenvironment.
Topics: Animals; Fibroblasts; Mice
PubMed: 34919608
DOI: 10.11607/jomi.9183 -
Journal of Spine Research and Surgery 2023Intervertebral disk degeneration (IDD) is an intricate pathological process contributing to one of the major causes of low back pain. The degradation of the...
Intervertebral disk degeneration (IDD) is an intricate pathological process contributing to one of the major causes of low back pain. The degradation of the extracellular matrix (ECM), inflammation, and apoptosis have all been investigated as critical factors involved in the pathology of degenerative disk disease. Additionally, the presence of aberrant microRNAs (miRNAs), conserved molecules that regulate the amount protein post-transcriptionally, may play a crucial role in the pathogenesis of IDD. Research regarding the dysfunction of miRNAs in IDD has been well researched over the past five years. Here, we provide a critical overview of the current knowledge of miRNAs, emphasizing the processes involved in the degenerative disk pathology.
PubMed: 36777190
DOI: 10.26502/fjsrs0051 -
A Multicenter Study of Patient Acceptability of the IBD Disk Tool and Patient-Reported Disabilities.Digestive Diseases and Sciences Feb 2022IBD, both Crohn's disease and ulcerative colitis, is associated with significant functional disability. Gastrointestinal symptoms alone are not the sole purpose of the...
BACKGROUND
IBD, both Crohn's disease and ulcerative colitis, is associated with significant functional disability. Gastrointestinal symptoms alone are not the sole purpose of the interaction between patients and providers. In order to ascertain patients' disabilities, we utilized the recently developed IBD Disk to help determine their functional concerns and initiate relevant conversation. We aimed to ascertain patient acceptability and their major disabilities.
PATIENTS AND METHODS
In this multicenter study, IBD patients at their outpatient visit were given the paper version of the IBD Disk. Patients were asked to score their level of disability for each item of the IBD Disk. The completed scores were then shared with their healthcare provider to act as a focus of discussion during the consultation. Patients and clinicians were also asked to provide informal qualitative feedback as to the benefits of the IBD Disk and areas for improvement.
RESULTS
A total of 377 (female 60%) patients completed the questionnaires over the study period. Patient acceptability scored on a 0-10 Likert scale was excellent. All patients scored all domains of disability. Sleep, energy, and joint pain were the highest scoring domains of the IBD Disk, scoring higher than digestive symptoms. Clinicians and patients agreed that the IBD Disk allowed for ease of communication about disability symptoms and relevance to their day-to-day functioning.
CONCLUSION
The IBD Disk is a novel easy-to-use tool to assess the functional disability of patients. We next plan to utilize it in the form of an electronic app internationally and in relation to treatment commencement and escalation.
Topics: Abdominal Pain; Adult; Arthralgia; Attitude of Health Personnel; Fatigue; Feasibility Studies; Female; Gastroenterologists; Humans; Inflammatory Bowel Diseases; Male; Middle Aged; Patient Acceptance of Health Care; Patient Reported Outcome Measures; Qualitative Research; Sleep Wake Disorders; Surveys and Questionnaires
PubMed: 33721160
DOI: 10.1007/s10620-021-06893-8 -
European Journal of Clinical... Jun 2021Tigecycline is an alternative antibiotic for managing carbapenem-resistant Gram-negative bacterial infections. However, disk diffusion and automated testing often show... (Comparative Study)
Comparative Study
Performance of VITEK 2, E-test, Kirby-Bauer disk diffusion, and modified Kirby-Bauer disk diffusion compared to reference broth microdilution for testing tigecycline susceptibility of carbapenem-resistant K. pneumoniae and A. baumannii in a multicenter study in China.
Tigecycline is an alternative antibiotic for managing carbapenem-resistant Gram-negative bacterial infections. However, disk diffusion and automated testing often show false-intermediate or false-resistant results in tigecycline susceptibility, misleading clinical antimicrobial therapy. Broth microdilution (BMD) is the reference method for testing tigecycline susceptibility, but it is labor intensive and time consuming to perform in clinical laboratories. Therefore, a simple and accurate method is urgently needed. We evaluated the performance of VITEK 2, E-test, Kirby-Bauer disk diffusion (KB), and modified KB disk diffusion (mKB) versus BMD in testing tigecycline susceptibility of 372 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP) and 346 strains of carbapenem-resistant Acinetobacter baumannii (CRAB). BMD confirmed that 96.8% of CRKP and 91% of CRAB strains were susceptible to tigecycline. E-test, VITEK 2, KB, and mKB yielded categorical agreement of 96.7/59.3%, 69.9/54.3%, 78.5/87.3%, and 96.5%/91% for CRKP/CRAB, respectively. No very major error was found for either CRKP or CRAB by any method. No major error was found for CRKP or CRAB by the mKB method. The mKB method enhanced by R-buffer is simple, accurate, and inexpensive for clinical laboratories to test the susceptibility of CRKP and CRAB isolates to tigecycline.
Topics: Acinetobacter Infections; Acinetobacter baumannii; Anti-Bacterial Agents; Carbapenems; China; Disk Diffusion Antimicrobial Tests; Drug Resistance, Bacterial; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Tigecycline
PubMed: 33411173
DOI: 10.1007/s10096-020-04123-z -
Anaerobe Apr 2023Antimicrobial resistance (AMR) is one of the greatest threats to animal and public health. Clostridioides (prev. Clostridium) difficile is a major burden to healthcare...
INTRODUCTION
Antimicrobial resistance (AMR) is one of the greatest threats to animal and public health. Clostridioides (prev. Clostridium) difficile is a major burden to healthcare and a relevant AMR gene reservoir. Despite the known importance of AMR in C. difficile epidemiology and treatment, antimicrobial susceptibility testing for this pathogen is still based on the determination of the minimal inhibitory concentration (MIC) by the agar dilution method, which is technically demanding and labor-intensive. In this study, the disk diffusion method was used to evaluate the susceptibility of C. difficile to erythromycin, rifampicin, and tetracycline.
MATERIAL AND METHODS
A total of 155 isolates isolated between 2011 and 2022 from humans and animals in Brazil were simultaneously tested using the disk diffusion method and the epsilometer test (Etest) for these three antimicrobials on Brucella blood agar supplemented with vitamin K and hemin.
RESULTS
The results suggest that disk diffusion can be an interesting routine tool to identify erythromycin- and rifampicin-resistant C. difficile isolates (≥20 mm cut-off) and wild type (WT) strains (≥28 mm). However, the disk diffusion protocol tested in this study does not seem suitable for tetracycline because of the common misclassification of resistant strains.
Topics: Humans; Animals; Clostridioides difficile; Erythromycin; Rifampin; Clostridioides; Agar; Anti-Bacterial Agents; Tetracycline; Microbial Sensitivity Tests; Clostridium
PubMed: 36934966
DOI: 10.1016/j.anaerobe.2023.102720 -
Proceedings of the National Academy of... Feb 2020We study the manifestation of the Nernst effect in the Corbino disk subjected to the normal external magnetic field and to the radial temperature gradient. The Corbino...
We study the manifestation of the Nernst effect in the Corbino disk subjected to the normal external magnetic field and to the radial temperature gradient. The Corbino geometry offers a precious opportunity for the direct measurement of the magnetization currents that are masked by kinetic contributions to the Nernst current in the conventional geometry. The magnetization currents, also referred to as the edge currents, are independent on the conductivity of the sample which is why they can be conveniently described within the thermodynamic approach. They can be related to the Landau thermodynamic potential for an infinite system. We demonstrate that the observable manifestation of this, purely thermodynamic, Nernst effect consists in the strong oscillations of the magnetic field measured in the center of the disk as a function of the external field. The oscillations depend on the temperature difference at the edges of the disk. Dirac fermions and 2D electrons with a parabolic spectrum are characterized by oscillations of different phase and frequency. We predict qualitatively different power dependencies of the magnitude of the Nernst signal on the chemical potential for normal and Dirac carriers.
PubMed: 31992642
DOI: 10.1073/pnas.1916567117 -
Helicobacter Aug 2020The aim of this study was to assess the disk diffusion technique against E-test as a routine antibiotic susceptibility testing method for Helicobacter pylori.
BACKGROUND
The aim of this study was to assess the disk diffusion technique against E-test as a routine antibiotic susceptibility testing method for Helicobacter pylori.
MATERIALS AND METHODS
Susceptibilities of 301 H pylori clinical isolates were simultaneously profiled by E-test and disk diffusion method for levofloxacin (5-μg disk), clarithromycin (15-μg disk), metronidazole (5-μg disk), amoxicillin (10-μg disk), and tetracycline (30-μg disk). Furazolidone susceptibility was evaluated using a 100-μg disk only. The correlation between MICs by E-test and inhibition zone diameters by disk diffusion was assessed by linear regression analysis.
RESULTS
Correlation between inhibition zone diameters and MICs was found for levofloxacin (r = -.932), clarithromycin (r = -.894), and to a minor extent metronidazole (r = -.820). Using the linear regression analysis, the inhibition zone diameter breakpoints were calculated to be 29 mm for levofloxacin, 41 mm for clarithromycin, and 15 mm for metronidazole corresponding to the EUCAST-recommended MIC breakpoints. The susceptibility agreement between E-test and disk diffusion for levofloxacin, clarithromycin, and metronidazole was 98.6%, 96.0%, and 96.7%, respectively. The inhibition zone diameters recorded for the amoxicillin, tetracycline, and furazolidone were large (approximately 60 mm in mean), and a poor correlation was found between inhibition zone diameters and MICs for amoxicillin (r = -.594) and tetracycline (r = -.490).
CONCLUSIONS
The disk diffusion can be used as a routine H pylori susceptibility testing method for levofloxacin, clarithromycin, and metronidazole in clinical practice under the described technical conditions. The use of disk diffusion for amoxicillin, tetracycline, and furazolidone susceptibility testing needs to be further studied.
Topics: Anti-Bacterial Agents; Diagnostic Tests, Routine; Disk Diffusion Antimicrobial Tests; Drug Resistance, Bacterial; Helicobacter Infections; Helicobacter pylori; Humans
PubMed: 32453910
DOI: 10.1111/hel.12703 -
Clinical Spine Surgery Nov 2023Cervical disk arthroplasty has been employed with increased frequency over the past 2 decades as a motion-preserving alternative to anterior cervical discectomy and...
Cervical disk arthroplasty has been employed with increased frequency over the past 2 decades as a motion-preserving alternative to anterior cervical discectomy and fusion in select patients with myelopathy or radiculopathy secondary to degenerative disk disease. As indications continue to expand, an understanding of cervical kinematics and materials science is helpful for optimal implant selection. Cervical disk arthroplasty implants can be classified according to the mode of articulation and df , articulation material, and endplate construction. The incorporation of translational and rotational df allows the implant to emulate the dynamic and coupled centers of movement in the cervical spine. Durable and low-friction interfaces at the articulation sustain optimal performance and minimize particulate-induced tissue reactions. Endplate materials must facilitate osseous integration to ensure implant stability after primary fixation. These cardinal considerations underlie the design of the 9 implants currently approved by the FDA and serve as the foundation for further biomimetic research and development.
Topics: Humans; Biomechanical Phenomena; Treatment Outcome; Arthroplasty; Prostheses and Implants; Neck; Diskectomy; Cervical Vertebrae; Spinal Fusion
PubMed: 37735758
DOI: 10.1097/BSD.0000000000001523 -
European Spine Journal : Official... Nov 2022Discoblock is effective in relieving discogenic low back pain, but it can also cause intervertebral disk degeneration (IDD). The effect of species, concentration and...
PURPOSE
Discoblock is effective in relieving discogenic low back pain, but it can also cause intervertebral disk degeneration (IDD). The effect of species, concentration and volume of local anesthetics on IDD with discoblock have not been reported. The purpose was to study the effect of species, concentration and volume of local anesthetics on IDD in rats undergoing discoblock.
METHODS
The effects of local anesthetics on nucleus pulposus cell (NPC) viability in vitro were studied. NPCs were exposed to lidocaine, bupivacaine and ropivacaine at different concentrations. NPC viability was measured. The least cytotoxic local anesthetic was used in vivo. The concentration and volume of local anesthetics on IDD in rat with discoblocks were tested in vivo. Detection indicators included X-ray, MRI, water content of the disk and histological changes.
RESULTS
The toxicity of local anesthetics to NPCs was dose and time dependent, and the cytotoxicity of different local anesthetics was different. Among the three local anesthetics, ropivacaine was the least toxic to NPCs. The effect of ropivacaine concentration on IDD was not significant, as detected by X-ray, MRI, disk water content and histology (P < 0.05). The volume of ropivacaine has a significant effect on IDD, as supported by X-ray, MRI, disk water content and histology (P < 0.05). Acupuncture itself significantly increased IDD, as detected by MRI, disk water content and histology (P < 0.05).
CONCLUSION
Ropivacaine should be selected for its low cytotoxicity. A lower volume and slow injection speed should be used to reduce IDD during discoblock.
Topics: Rats; Animals; Anesthetics, Local; Intervertebral Disc Degeneration; Ropivacaine; Intervertebral Disc; Water
PubMed: 36152221
DOI: 10.1007/s00586-022-07398-2