The many facets of occupational asthma.
Adult; Humans; Male; Middle Aged; Disability Evaluation; Asthma/*diagnosis/etiology/rehabilitation; Occupational Diseases/*diagnosis/etiology/rehabilitation
Occupational asthma is an all-encompassing term that describes asthma derived from, worsened by, or encountered in an occupational setting. The diagnosis can be elusive and is easily confused with other disorders. Nevertheless, clarity of the diagnosis is essential for legal purposes. To best serve the patient, it is important to be familiar with the legal distinctions as well as proper medical management techniques.
Demeter S L
Cleveland Clinic journal of medicine
1991
1991-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3949/ccjm.58.2.137" target="_blank" rel="noreferrer noopener">10.3949/ccjm.58.2.137</a>
A novel method for treatment of lumbar spinal stenosis in high-risk surgical candidates: pilot study experience with percutaneous remodeling of ligamentum flavum and lamina.
Adult; Female; Humans; Male; Middle Aged; Aged; Pilot Projects; Follow-Up Studies; Risk Factors; Prospective Studies; Pain Measurement; Equipment Design; Comorbidity; Disability Evaluation; Conscious Sedation; Fluoroscopy; Ligamentum Flavum/*surgery; Lumbar Vertebrae/*surgery; Minimally Invasive Surgical Procedures/*instrumentation; Postoperative Complications/diagnosis/*prevention & control; Spinal Stenosis/*surgery; Anesthesia; Human; Pilot Studies; Middle Age; 80 and over; Local; Ligaments; Decompression; Surgical/*instrumentation; 80 and Over; Spinal Stenosis – Surgery; Postoperative Complications – Diagnosis; Articular – Surgery; Lumbar Vertebrae – Surgery; Minimally Invasive Procedures – Equipment and Supplies; Postoperative Complications – Prevention and Control; Surgical – Equipment and Supplies
OBJECT: treatment of lumbar spinal stenosis (LSS) in chronically ill or debilitated patients is challenging. The percutaneous remodeling of ligamentum flavum and lamina (PRLL) technique is a novel method for decompression of the hypertrophic ligamentum flavum component of LSS that is performed using a fluoroscopically guided percutaneous approach, local anesthesia, and minimal sedation. METHODS: fourteen patients deemed to be at high risk for complications related to open spine surgery and general anesthesia were treated using the PRLL technique. Prospectively collected visual analog scale (VAS) and Oswestry Disability Index (ODI) data were analyzed at the most recent follow-up. The average follow-up duration was 23.5 weeks. RESULTS: a statistically significant improvement in VAS scores was observed, with a reduction in pain of 53% compared with preoperative levels. In contrast, the ODI scores failed to improve. CONCLUSIONS: this pilot series points to a potential new therapeutic option for LSS in high-risk surgical patients.
Chopko Bohdan Wolodymyr
Journal of neurosurgery. Spine
2011
2011-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3171/2010.9.SPINE091012" target="_blank" rel="noreferrer noopener">10.3171/2010.9.SPINE091012</a>
The effect of race on outcomes of surgical or nonsurgical treatment of patients in the Spine Patient Outcomes Research Trial (SPORT).
Adult; African Americans/statistics & numerical data; Aged; Chi-Square Distribution; Disability Evaluation; European Continental Ancestry Group/statistics & numerical data; Female; Humans; Male; Middle Aged; Outcome Assessment (Health Care)/*statistics & numerical data; Randomized Controlled Trials as Topic; Recovery of Function; Retrospective Studies; Spinal Diseases/*ethnology/*surgery/therapy; Spine/pathology/physiopathology/*surgery; Surveys and Questionnaires
STUDY DESIGN: Retrospective review of the data collected prospectively through the Spine Patient Outcomes Research Trial (SPORT). OBJECTIVE: To determine the effect that race or ethnicity had on outcomes after spine surgery in the 3 arms of SPORT. SUMMARY OF BACKGROUND DATA: There is a dearth of research regarding the effect of race or ethnicity on outcome after treatment of spinal disorders. METHODS: All participants from the 3 arms of the SPORT were evaluated in an as-treated analysis, with patients categorized as white, black, or other. Baseline and operative characteristics of the groups were compared using the chi test and analysis of variance. Differences in the changes between baseline and
Schoenfeld Andrew J; Lurie Jon D; Zhao Wenyan; Bono Christopher M
Spine
2012
2012-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/BRS.0b013e318251cc78" target="_blank" rel="noreferrer noopener">10.1097/BRS.0b013e318251cc78</a>
Long-term results of percutaneous lumbar decompression for LSS: two-year outcomes.
80 and over; 80 and Over; Aged; Cohort Studies; Decompression; Disability Evaluation; Female; Human; Humans; Intermittent Claudication – Complications; Intermittent Claudication – Surgery; Intermittent Claudication/complications/surgery; Lumbar Vertebrae; Male; Middle Age; Middle Aged; Prospective Studies; Questionnaires; Spinal Stenosis – Complications; Spinal Stenosis – Surgery; Spinal Stenosis/complications/*surgery; Surgical – Methods; Surgical/*methods; Surveys and Questionnaires; Time Factors; Treatment Outcome; Treatment Outcomes; Visual Analog Scale; Visual Analog Scaling
OBJECTIVE: The aim of this report was to evaluate the long-term effectiveness and safety of mild lumbar decompression for the treatment of neurogenic claudication associated with lumbar spinal stenosis. This technique uses a percutaneous dorsal approach to remove small portions of ligament and lamina, thereby restoring space and decompressing the spinal canal. MATERIALS AND METHODS: Two-year data are reported for 45 patients treated with mild decompression at 11 US sites. Outcome measures included the Visual Analog Scale (VAS), Oswestry Disability Index, and Zurich Claudication Questionnaire. Safety was monitored throughout the procedural and follow-up period for all patients. Interim data are included for these patients at 1 week, 6 months, and 1-year follow-up. RESULTS: Seventy-one percent of patients reported improvement in VAS at the end of the reporting period. At 2 years, patients demonstrated a statistically significant reduction of pain as measured by VAS, and improvement in physical function and mobility was significant as measured by Zurich Claudication Questionnaire and Oswestry Disability Index. Tukey honestly significant different test found significant improvement in all outcome measures from baseline to each follow-up interval. Further, major improvement occurred by 1-week follow-up and showed no difference between each subsequent follow-up, signifying considerable stability and durability of the initial result over time. No major device or intraprocedural adverse events were reported. DISCUSSION: In this report of 2-year follow-up on 45 patients treated with mild percutaneous lumbar decompression, patients experienced statistically significant pain relief and improved functionality.
Chopko Bohdan W
The Clinical journal of pain
2013
2013-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/AJP.0b013e31827fb803" target="_blank" rel="noreferrer noopener">10.1097/AJP.0b013e31827fb803</a>