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Spine, Wockhardt Hospital, Mumbai, India
James R. Daniell,Orso L. Osti 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.2
Postsurgical spine syndrome is becoming an increasingly common challenge for clinicians who deal with spinal disorders owing to the expanding indications for spinal surgery and the aging world population. A multidisciplinary approach is most appropriate for patients who are unlikely to benefit from further formal surgical intervention. Anticonvulsant medications are effective in managing neuropathic pain after surgery, whereas opioids are rarely beneficial. Neuromodulation via a surgically implanted dorsal column neurostimulator is gaining popularity owing to its substantial superiority over conventional medical management and/or further surgical intervention. However, considering that prevention is always better than cure, spinal surgeons need to be well aware of the many poor prognostic indicators for spinal surgery, particularly psychosocial overlay.
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Operative Management of Lumbar Degenerative Disc Disease
Yu Chao Lee,Mario Giuseppe Tedesco Zotti,Orso Lorenzo Osti 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.4
Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term.
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Lead Poisoning: Historical Aspects of a Paradigmatic "Occupational and Environmental Disease"
Riva, Michele Augusto,Lafranconi, Alessandra,D'orso, Marco Italo,Cesana, Giancarlo Occupational Safety and Health Research Institute 2012 Safety and health at work Vol.3 No.1
Lead poisoning is one of the earliest identified and most known occupational disease. Its acute effects have been recognized from antiquity when this condition principally afflicted manual workers and slaves, actually scarcely considered by the medicine of that time. The Industrial Revolution caused an epidemic of metal intoxication, urging scientists and physician of that period to study and identify specific symptoms and organ alterations related to chronic lead poisoning. During the 20th century, the acknowledgment of occupational and environmental toxicity of lead fostered public awareness and legislation to protect health. More recently, the identification of sub-clinical effects have greatly modified the concept of lead poisoning and the approaches of medicine towards this condition. Nowadays, lead poisoning is rarely seen in developed countries, but it still represents a major environmental problem in certain areas. Consequently, it may appear as a paradigm of "occupational and environmental disease," and the history of this condition seems to parallel the historical development of modern "Occupational and Environmental Health" as a more complete medical discipline.
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Toshio Nakamae,Kiyotaka Yamada,Yasuyuki Tsuchida,Orso Lorenzo Osti,Nobuo Adachi,Yoshinori Fujimoto 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.5
Study Design: Retrospective case-control study. Purpose: To evaluate the primary outcomes and radiographic results of percutaneous vertebroplasty (PVP) in patients with singlelevel osteoporotic vertebral fracture (OVF) with intravertebral cleft (IVC) to identify the risk factors for cement loosening after PVP. Overview of Literature: PVP is a widely accepted method for managing painful OVF; however, cement loosening occasionally occurs with poor outcomes. Methods: This retrospective study involved 195 patients treated with PVP for single-level OVF with IVC. Six months thereafter, the primary outcomes were evaluated using the Visual Analog Scale (VAS) for back pain and the modified Oswestry Disability Index. Computed tomography was conducted to detect cement loosening. Possible risk factors, such as age, sex, wedging angle, intravertebral instability, Parkinson’s disease, spinous process fracture, ankylosing spinal hyperostosis, split vertebrae, and adjacent intervertebral vacuum, were assessed. Results: Forty-nine patients (25%) experienced cement loosening 6 months after PVP. The mean VAS scores were significantly higher in patients with cement loosening than in those without (50 vs. 26 mm, respectively; p <0.01). Cement loosening was closely associated with intravertebral instability (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40; p =0.015), Parkinson’s disease (OR, 54.31; 95% CI, 4.47–659.53; p =0.002), spinous process fracture (OR, 7.11; 95% CI, 1.65–30.60; p =0.009), and split vertebrae (OR, 11.59; 95% CI, 1.64–82.02; p =0.014). Conclusions: Patients with cement loosening experienced worse back pain than those without cement loosening. The important risk factors that influenced cement loosening after PVP were high intravertebral instability, Parkinson’s disease, spinous process fracture, and split vertebrae.
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Rubieli Carla Frezza Zeferino,Vinicius Aleixo Angonese Piaia,Vinícius Tres Orso,Vítor Machado Pinheiro,Micheli Zanetti,Gustavo Lopes Colpani,Natan Padoin,Cíntia Soares,Márcio Antônio Fiori,Humberto Gr 한국공업화학회 2022 Journal of Industrial and Engineering Chemistry Vol.105 No.-
This work aims to synthesize neryl acetate from the nerol esterification reaction with acetic anhydridethrough heterogeneous catalysis using the ion exchange resin Lewatit GF 101. The reaction was monitoredby gas chromatography and the neryl acetate chemical structure was confirmed by mass spectrometryand nuclear magnetic resonance spectroscopy. The variables effect on the neryl acetate synthesiswas evaluated from an experimental design analysis. The reaction showed the highest combined valuesfor nerol conversion (98.11%) and neryl acetate selectivity (86.10%) at 30 min within optimal experimentalconditions of temperature at 40 C, catalyst content at 7% wt, molar ratio at 1:4 (nerol: acetic anhydride),agitation speed at 250 rpm and nerol content at 3 mmol. The complete nerol conversion wasachieved at 40 min with 82.34% selectivity. The reaction rate was controlled only by the nerol decay,an expected behavior due to the excess of acetic anhydride used. In addition, the value obtained forthe main reaction kinetic constant found by a pseudo-homogeneous model was 6 times greater than thatof the parallel reaction. The catalyst reuse was investigated and after 3 cycles a high conversion (96.68%)and selectivity (83.78%) were observed indicating a low loss of the catalytic activity.
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