In the treatment of degenerative lumbar stenosis, facet-sparing laminectomy with instrumented fusion (FSL) was recently almost totally replaced by less invasive, allegedly equally effective surgical ...techniques. We performed a long-term comparison between outcomes after Young laminoplasty (YL) as a representative of the less invasive technique and FSL.
From December 4, 2000, to March 11, 2005, 56 patients with a history of neurogenic claudication and radiologically verified absolute lumbar stenosis were surgically treated. After applying inclusion and exclusion criteria, 44 patients were enrolled.
Using the Oswestry Disability Index scale, significant improvement on 1-year and 8-year follow-up examinations was noticed in the FSL and YL groups. The Oswestry Disability Index was significantly better in the FSL group compared with the YL group at the 8-year follow-up (27.82 ± 1.918 vs. 40.74 ± 2.163).
FSL is a more invasive and more expensive surgical technique than YL. In a short-term and long-term follow-up comparison, FSL is a more successful operative technique, and the difference increases over time in favor of FSL.
The objective of this study is an investigation of the influence of six different plastic packages (polyethylene terephthalate, high-density polyethylene, biodegradable high-density polyethylene, ...low-density polyethylene, polypropylene and polyamide polyethylene) on the migration of phthalate residues in smoked carp, trout and salmon stored at −18 °C for three and six months. Six phthalate residues concentrations were determined using the gas chromatography-mass spectrometry method. Diisobutyl phthalate (DIBP) and dibutyl phthalate (DBP) migrated the most into salmon meat from PAPE packaging after six months of storage, reaching 73.77 μg/kg and 78.45 μg/kg, respectively. The highest concentrations of bis(2-ethylhexyl) phthalate (DEHP) after six months of storage were present in salmon meat packed in polyamide polyethylene (253.56 μg/kg) and the lowest in carp meat packages in polypropylene (157.72 μg/kg). Phthalate residues in all the samples showed higher levels after three and six months of storage compared to the control sample. Among the investigated phthalates, polypropylene was the material with the lowest migration into fish meat. A further amount of DEHP migration in the fish was detected with a higher fat content. We acknowledge that levels of phthalates should be monitored, and research in this field should be continued, especially since there are no legal restrictions regarding the maximum level of phthalates in food.
To report on the outcomes of spinal dural arteriovenous fistulas (sDAVFs) treatment in a single-center retrospective cohort.
Data were retrieved on sDAVF cases treated surgically and endovascularly ...between January 2009 and January 2020. Sociodemographic, clinical, imaging data, and outcomes were analyzed.
Thirty-four patients were identified: 11 female, mean age 64.1 ± 11.5 years; mean time of symptom duration 12 (range 1-149) months. The sDAVF locations were the following: 18 (62.1%) thoracic, 4 (13.8%) lumbar, 4 (13.8%) sacral, and 3 (10%) with multiple location feeders. All patients had a motor deficit and affected walking, and the majority had a sensory deficit, bowel, and bladder dysfunction. Fifteen (44.1%) patients underwent surgical treatment, 7 (20.6%) underwent endovascular treatment, and 12 (35.3%) underwent both (crossover). Radiological myelopathy showed regression in 19 (55.9%) patients. Overall, clinical improvement (decrease in modified Rankin score) following treatment was observed in 14 patients (41.2%), worsening in 1 (2.9%), while other had unchanged status. The proportion of patients with initial treatment failure markedly differed between the before-2014 and after-2014 period. Patients who failed to improve had more extensive myelopathy.
Patients who underwent surgery or endovascular treatment had on average significant clinical recovery, while those who underwent treatment crossover had negligible improvement. The extent of myelopathy seems to be associated with clinical improvement.
We report our experience with 3D customised cranioplasties for large cranial defects. They were made by casting bone cement in custom made moulds at the time of surgery. Between October 2015 and ...January 2018, 29 patients underwent the procedure; 25 underwent elective cranioplasties for large cranial defects and four were bone tumour resection and reconstruction cases. The majority of patients (96.5%) reported a satisfactory aesthetic outcome. No infections related to the surgical procedure were observed in the follow-up period. The method proved to be effective and affordable.
Purpose
To translate, cross-culturally adapt, and validate the Croatian version of the Oswestry Disability Index (ODI).
Methods
The original English-language ODI was cross-culturally adapted into ...Croatian and then evaluated in a group of 114 patients with chronic low back pain (LBP) at the Department of Neurosurgery, Zagreb University School of Medicine. Confirmatory factor analysis (CFA) was conducted with three models: two were theory driven (unidimensional and two dimensional—static and dynamic factors); the other was based on our exploratory factor analysis (EFA). Internal consistency and test–retest reliability were evaluated using Cronbach’s
α
and the intraclass correlation coefficient (ICC), respectively. Construct validity was assessed by evaluating the correlation between the ODI and Visual Analogue Scale (VAS), and between the ODI and 36-item short form survey (SF-36) scores.
Results
The EFA-derived two-dimensional structure explained 82.7% of the total variance and was significantly better than the other models (
P
< 0.001); however, none of the models had acceptable fit. Internal consistency (Cronbach
α
= 0.84) and test–retest reliability (ICC = 0.94) were satisfactory. The ODI was positively correlated with VAS (
r
s
= 0.54,
P
< 0.001) and negatively correlated with all of the SF-36 sections (
r
s
= − 0.35 to − 0.64,
P
< 0.001, all), apart from the role-physical (
r
s
= − 0.02,
P
= 0.767).
Conclusions
The Croatian version of the ODI has acceptable psychometric properties. It appears to be suitable for assessment of LBP and treatment outcomes in Croatian-speaking patients. Overall, there was no evidence to reject the original unidimensional structure in favor of a two-factor solution. As such, the unidimensional structure should continue to be used in future studies.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.
Aim To develop and test a new posterior stabilization system by augmenting the posterior hook-rod system with screws and rods. Methods A biomechanical analysis was performed using the finite element ...method. The anatomical structures were modeled based on computed tomography data. Instrumentation (hooks, rods, and screws) was modeled based on the data obtained by 3D scanning. The discretized model was verified by converging solutions and validated against data from a previously published experiment. A Th12-L1 spinal segment was modeled and modified by removing the body of the L1 vertebra (corpectomy) and the entire L1 vertebra (spondylectomy). The model was additionally modified by incorporating stabilization systems: i) posterior stabilization (transpedicular screws and rods); ii) combined posterior stabilization with sublaminar hooks; and iii) combined anterior (titanium cage) and posterior (sublaminar hooks) stabilization. The rotation angles in each group, and the strains on each part of the three stabilization constructs, were analyzed separately. Results The combined anterior and posterior stabilization system was the stiffest, except in the case of lateral bending, where combined posterior stabilization was superior. Stress analysis showed that the posterior stabilization system was significantly unloaded when augmented with a hook-rod system. A significant strain concentration was calculated in the cranially placed hooks. Conclusion Stiffness analysis showed comparable stiffness between the tested and proposed stabilization construct. Stress analysis showed luxation tendency of the cranially placed hooks, which would most likely lead to system failure.
This study explores the phenomenon of sexting among college students through a qualitative research design. Participants took part in online synchronous focus groups where they were asked twelve ...open-ended questions about their experiences with sexting. Overall, 49 Croatian and Bosnia and Herzegovinian students participated in five focus groups. Participants defined sexting as an exchange of sexually explicit content underpinned by a range of motives. Relational motive was seen as the most prevalent reason for sending ones’ own sexts, while the ‘harm motive’ was identified for posting/sharing sexts of other people without their permission. Young persons expressed positive views toward sending their own sexts, particularly if sexting was voluntary and with a trusted person. Posting and/or sharing someone sextswithout the permission of the person depicted in that material or blackmailing someone with posting and/or sharing their sexts were often perceived negatively. Participants noted a number of advantages related to sexting in terms of increasing relationship satisfaction, but also disadvantages related to the risk of distributing sexts to others, or feelings of guilt associated with distributing other people’s sexts. In conclusion, this study contributes to the extant research on sexting by providing perspectives of young persons from Croatian and Bosnian and Herzegovinian regions.
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