198,434 research outputs found
Aquello que ocurre entre los ojos, la mano y el papel: Entrevista de M. Laura Lattanzi y Paz López a la artista y escritora Leticia Obeid
No full textInterview of M. Laura Lattanzi and Paz López to the artist and writer Leticia ObeidEntrevista de M. Laura Lattanzi y Paz López a la artista y escritora Leticia Obei
Aquello que ocurre entre los ojos, la mano y el papel : Entrevista de M. Laura Lattanzi y Paz López a la artista y escritora Leticia Obeid
No full textInterview of M. Laura Lattanzi and Paz López to the artist and writer Leticia ObeidEntrevista de M. Laura Lattanzi y Paz López a la artista y escritora Leticia Obei
Nilpotent matrices and the minus partial order
No full text[EN] In this paper, {1}-inverses of a nilpotent matrix as well as matrices above a given nilpotent matrix under the minus partial order are characterized.This paper was partially supported by Universidad Nacional de La Pampa, Facultad de Ingenieria (Grant Resol. No 155/14). The third author was partially supported by Ministerio de Economia y Competitividad of Spain (Grant number DGI MTM2013-43678-P and Grant Red de Excelencia MTM2015-68805-REDT).Gareis, MI.; Lattanzi, M.; Thome, N. (2017). Nilpotent matrices and the minus partial order. Quaestiones Mathematicae. 40(4):519-525. https://doi.org/10.2989/16073606.2017.1300612S51952540
Can the WIMP annihilation boost factor be boosted by the Sommerfeld enhancement?
No full textWe demonstrate that the Sommerfeld correction to cold dark matter (CDM) annihilations can be appreciable if even a small component of the dark matter is extremely cold. Subhalo substructure provides such a possibility given that the smallest clumps are relatively cold and contain even colder substructure due to incomplete phase space mixing. Leptonic channels can be enhanced for plausible models and the solar neighborhood boost required to account for PAMELA/ATIC data is plausibly obtained, especially in the case of a few TeV mass neutralino for which the Sommerfeld-corrected boost is found to be similar to 10(4)-10(5). Saturation of the Sommerfeld effect is shown to occur below beta similar to 10(-4), thereby making this result largely independent on the presence of substructures below similar to 10(5)M. We find that the associated diffuse gamma-ray signal from annihilations would exceed EGRET constraints unless the channels annihilating to heavy quarks or to gauge bosons are suppressed. The lepton channel gamma rays are potentially detectable by the FERMI satellite, not from the inner galaxy where substructures are tidally disrupted, but rather as a quasi-isotropic background from the outer halo, unless the outer substructures are much less concentrated than the inner substructures and/or the CDM density profile out to the virial radius steepens significantly
Foreign Trade System and Law
No full textThis chapter provides a concise description of Italy's foreign trade system and law, intended for Chinese commercial actors interested in trade relations with European countries under the Belt and Road initiative. As a matter of fact, Italy, as a Member State of the European Union, is subject to the EU's exclusive competence in matters of Common Commercial Policy, and forms part of the EU's Customs Union. Accordingly, this chapter is essentially focused on the distinctive features of the EU's Customs Union and Common Commercial Policy, drawing light, insofar as relevant given the direct applicability of most EU acts in the field concerned, on national implementation issues. As noted in the introductory footnote, although this chapter is the result of mutual exchange of views among the co-authors, Fabrizio Marongiu Buonaiuti is mainly responsibile for the drafting of Sections 2.1 to 2.3 and Sections 2.5 to 2.11, while Pamela Lattanzi for the drafting of Sections 2.4 and 2.13, and Alessio Bartolacelli for the drafting of Section 2.12
Analysis of risk factors and postoperative predictors for recurrent lumbar disc herniation
No full textOriginal Article
Analysis of risk factors and postoperative predictors for recurrent lumbar disc herniation
M. Dobran, Davide Nasi, R. Paracino, M. Gladi, M. Della Costanza, A. Marini, S. Lattanzi, M. Iacoangeli
Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy.
E-mail: M. Dobran - [email protected]; *Davide Nasi - [email protected]; R. Paracino - [email protected]; M. Gladi - [email protected]; M. Della Costanza - [email protected]; A. Marini - [email protected]; S. Lattanzi - [email protected];
M. Iacoangeli - [email protected]
ABSTRACT
Background: This study identified risk factors and postoperative indicators for recurrent lumbar disc herniations (rLDH) following microdiscectomy.
Methods: We retrospectively reviewed the 1-year recurrence rate for LDH in 209 consecutive patients undergoing microdiscectomy (2013–2018).
Results: Utilizing a multivariate analysis, higher body mass index (BMI) and postsurgery Oswestry disability index (ODI) were significantly associated with an increased risk of rLDH.
Conclusions: Elevated postsurgery ODI and higher BMI were significantly associated with increased risk of rLDH.
Keywords: Discectomy, lumbar disc herniation, lumbar microdiscectomy, recurrent disc herniation
*Corresponding author:
Davide Nasi,
Department of Neurosurgery, Università Politecnica delle Marche - Ospedali Riuniti, Via Conca #71, Ancona - 60020, Italy.
[email protected]
Received : 13 January 19
Accepted : 18 January 19
Published : 26 March 19
DOI
10.25259/SNI-22-2019
Quick Response Code:
INTRODUCTION
Lumbar disc herniation (LDH) is the most common reason for performing lumbar spine surgery. Today, many are managed utilizing a microdiscectomy approach. Nevertheless, these procedures correlate with a recurrence rate at 1 year that ranges from 1% to 21%.[1,3,5] Here, we looked at potential risk factors that may contribute to recurrent LDH (rLDH) following microdiscectomy.
MATERIALS AND METHODS
We retrospectively reviewed consecutive patients who underwent standard lumbar spinal microdiscectomy for disc herniation (LDH) (2013–2018). The follow-up evaluations were performed at 1, 6, and 12 months postoperatively. Recurrence of disc herniation was defined as disc herniation at the same level and side of the previous microdiscectomy after a 3-month postoperative pain-free
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Surgical Neurology International
Editor-in-Chief: Nancy E. Epstein, MD, NYU Winthrop Hospital, Mineola, NY, USA.
SNI: Spine Editor
Nancy E. Epstein, MD
NYU Winthrop Hospital, Mineola, NY, USAOpen Access
Dobran, et al.: Predictors for recurrent lumbar disc herniation
Surgical Neurology International • 2019 • 10(36) | 2
period. Variables contributing to rLDH included age, sex,
weight/body mass index (BMI), smoking status, postoperative
(6 months) Oswestry disability index (ODI), and the level of the
disc herniation. Radiological examination included magnetic
resonance imaging before and after surgery.
Statistical analysis
Analyses include Student’s t-test, Mann–Whitney U-test or
Chi-squared test, logistic regression, and multivariate analysis.
Results were considered significant for P < 0.05 (two-sided). Data
analysis was performed using STATA/IC 13.1 statistical package
(StataCorp LP, Texas, USA).
RESULTS
There were 209 patients included in this study; 20 of 209 (9.6%)
had rLDH at 1 postoperative year. Utilizing a multivariate
analysis, older age, higher BMI, and postsurgery ODI
were significantly associated with increased risk of rLDH
[Tables 1 and 2].
DISCUSSION
Microdiscectomy is a relatively straightforward procedure
but is associated with a complication rate of up to 15–18%.[1-6]
rLDH is the most frequent complication, occurring from 5% to
15% of the time.[6] rLDH is defined as a disc hernia at the same
level of a previous microdiscectomy in patient with a pain-free
interval of at least 3 months long after surgery.[1-6] In patients
treated with microdiscectomy, it is important to avoid a second
surgery due to the attendant increased risks/complications
associated with repeated decompression versus decompression/
fusion.[5,6] In our study, BMI was an independent predictor
of recurrence both at unadjusted logistic regression analysis
(P = 0.004) and adjusted analysis (P = 0.024). In our series,
postoperative 6-month ODI score value correlated with
rLDH. Furthermore, in this study, older age was a predictor of
recurrence.[1-6]
CONCLUSIONS
To summarize, patients with rLDH were older and had higher
BMI and postsurgery ODI score after a pain-free 3-month
interval.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
1. Ambrossi GL, McGirt MJ, Sciubba DM, Witham TF, Wolinsky JP,
Gokaslan ZL, et al. Recurrent lumbar disc herniation after singlelevel
lumbar discectomy: Incidence and health care cost analysis.
Neurosurgery 2009;65:574-8.
2. Dobran M, Brancorsini D, Costanza MD, Liverotti V, Mancini F,
Nasi D, et al. Epidural scarring after lumbar disc surgery: Equivalent
scarring with/without free autologous fat grafts. Surg Neurol Int
2017;8:169.
3. Dobran M, Marini A, Gladi M, Nasi D, Colasanti R, Benigni R, et al.
Deep spinal infection in instrumented spinal surgery: Diagnostic
factors and therapy. G Chir 2017;38:124-9.
Table 1: Characteristics of patients according to 1‐year outcome; relapse: n=20 (9.6%).
Variable Full cohort (n=209) No relapse (n=189) Relapse (n=20) P
Age (years) 44.6 (11.8) 43.9 (11.7) 50.4 (12.0) 0.021a
Male sex 125 (59.8) 115 (60.9) 10 (50.0) 0.347b
BMI (kg/m2) 27 (24–20) 27 (24–28) 29 (27.5–30.5) 0.005c
Smoking 144 (68.9) 129 (68.3) 15 (75.0) 0.535b
VAS 2.6 (1.5) 2.5 (1.5) 3.2 (1.7) 0.076a
ODI 15 (10–20) 15 (5–20) 20 (15–22) 0.002c
Disc hernia level ‐ ‐ 3 (8.6) 0.973b
L3–L4 35 (16.8) 32 (91.4) 10 (9.6) ‐
L4–L5 104 (49.8) 94 (90.4) 7 (10.0) ‐
L5–S1 70 (33.5) 63 (90.0) ‐ ‐
Data are mean (SD) or median (IQR) for continuous variables and n (%) for categorical variables. aTwo‐sample t‐test. bChi‐squared test. cMann–Whitney U‐test.
ODI: Oswestry disability index; VAS: Visual analog scale, BMI: Body mass index, SD: Standard deviation
Table 2: Prediction of 1‐year LDH.
Independent
variable
Unadjusted Adjusted*
OR (95% CI) P OR (95% CI) P
Age 1.05 (1.01–1.09) 0.023 1.04 (1.00–1.09) 0.060
Sex 0.64 (0.26–1.62) 0.350 0.50 (0.18–1.38) 0.178
BMI 1.28 (1.08–1.51) 0.004 1.23 (1.03–1.46) 0.022
Smoking 1.40 (0.48–4.02) 0.537 0.98 (0.30–3.13) 0.968
ODI 1.10 (1.03–1.17) 0.005 1.09 (1.02–1.18) 0.017
Disc hernia level 1.08 (0.55–2.12) 0.824 0.88 (0.41–1.88) 0.740
ORs for every 1 year and 1‐point BMI or ODI increases are obtained with
logistic regression analysis. BMI: Body mass index; CI: Confidence interval;
ODI: Oswestry disability index; OR: Odds ratio, LDH: Lumbar disc herniation
Dobran, et al.: Predictors for recurrent lumbar disc herniation
Surgical Neurology International • 2019 • 10(36) | 3
4. Dobran M, Marini A, Nasi D, Gladi M, Liverotti V, Costanza MD,
et al. Risk factors of surgical site infections in instrumented spine
surgery. Surg Neurol Int 2017;8:212.
5. Huang W, Han Z, Liu J, Yu L, Yu X. Risk factors for recurrent lumbar
disc herniation: A systematic review and meta-analysis. Medicine
(Baltimore) 2016;95:e2378.
6. Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases
the risk of recurrent herniated nucleus pulposus after lumbar
microdiscectomy. Spine J 2010;10:575-80.
How to cite this article: Dobran M, Nasi D, Paracino R, Gladi M, Costanza MD,
Marini A, et al. Analysis of risk factors and postoperative predictors for recurrent
lumbar disc herniation. Surg Neurol Int 2019:10:36
A separable solution for the oscillatory structure of plasma in accretion disks
No full textIn this paper we provide a new analysis of the system of partial differential equations describing the radial and vertical equilibria of the plasma in accretion disks. In particular, we show that the partial differential system can be separated once a definite oscillatory (or hyperbolic) form for the radial dependence of the relevant physical quantities is assumed. The system is thus reduced to an ordinary differential system in the vertical dimensionless coordinate. The resulting equations can be integrated analytically in the limit of small magnetic pressure. We complete our analysis with a direct numerical integration of the more general case. The main result is that a ring-like density profile (i.e., radial oscillations in the mass density) can appear even in the limit of small magnetic pressure. Copyright (C) EPLA, 201
Reader response: Neuroimaging findings in midlife and risk of late-life dementia over 20 years of follow-up
No full textReader response: Atrial cardiopathy in patients with embolic strokes of unknown source and other stroke etiologies
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