Osteoporosis can lead to spinal fractures that are traditionally treated with bed rest, braces, and pain medications. However, this risks further bone loss and weakness. The document discusses operative treatments for osteoporotic spinal fractures including spinal fixation and minimally invasive techniques like vertebroplasty and kyphoplasty. It outlines challenges posed by osteoporosis like early and late hardware failure. Methods to improve screw fixation in weak bone are described, such as cement augmentation, screw design modifications, and technique adjustments. Vertebroplasty and kyphoplasty provide pain relief but kyphoplasty can restore lost height while vertebroplasty risks cement leakage. Operative fixation and minimally invasive treatments can successfully
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Pain from acute vertebral fracture appears to be due in part to instability (non-union or slow union at the fracture site), while more than 1/3 of patients become chronically painful.
Traditional treatment for patients with painful VCFs includes bed rest, narcotic analgesics and bracing, resulting in increased pain because of acceleration bone loss and muscle weakness.
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Pain from acute vertebral fracture appears to be due in part to instability (non-union or slow union at the fracture site), while more than 1/3 of patients become chronically painful.
Traditional treatment for patients with painful VCFs includes bed rest, narcotic analgesics and bracing, resulting in increased pain because of acceleration bone loss and muscle weakness.
Diffuse idiopathic skeletal hyperostosis (DISH) is a common skeletal process of uncertain etiology found in 12 to 18% of Indian populations above 50 years. The primary manifestations of DISH are calcification and ossification of the spinal ligaments, as well as entheseal ossification within extraspinal sites
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...drashraf369
femoral head fractures are very complex fractures that need immediate and prompt surgical intervention.conventional surgical appproaches to hip may lead to short and long term complications.dr mohamed ashraf ,dr rahul thampi et al are presenting their experience with gantz safe surgical dislocation approach to surgical management of femoral head fractures
Vertebro/kyfoplastiek: bewezen effectief of (nog) niet bewezen effectief, presentatie van Mw. Dr. C.A.H. Klazen op 23/24 november 2012 voor de Stichting IWO.
Diffuse idiopathic skeletal hyperostosis (DISH) is a common skeletal process of uncertain etiology found in 12 to 18% of Indian populations above 50 years. The primary manifestations of DISH are calcification and ossification of the spinal ligaments, as well as entheseal ossification within extraspinal sites
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...drashraf369
femoral head fractures are very complex fractures that need immediate and prompt surgical intervention.conventional surgical appproaches to hip may lead to short and long term complications.dr mohamed ashraf ,dr rahul thampi et al are presenting their experience with gantz safe surgical dislocation approach to surgical management of femoral head fractures
Vertebro/kyfoplastiek: bewezen effectief of (nog) niet bewezen effectief, presentatie van Mw. Dr. C.A.H. Klazen op 23/24 november 2012 voor de Stichting IWO.
Vertebroplasty and Kyphoplasty are performed using general anesthesia, however, this largely depends on the doctor and the needs, circumstances and preferences of the patient.
How do we diagnose osteoporosis and making a treatment decission using BMD as a diagnostic tool. It also covers how do we assess clinical risk factors to make an intervention and to minimize fracture
Vertebroplasty is an effective, minimally invasive spine procedure where acrylic bone cement is injected into a painful pathologically compressed vertebral body.
Osteoporosis is a systemic disease, which results in :
progressive bone mineral loss
concurrent changes in bony architecture
leaving the spinal column vulnerable to compression fractures, usually after minimal or no trauma.
The role of Cement Augmentation in the Prevention of Spinal Insufficiency Fra...Winston Rennie
The Role of Cement Augmentation in the Prevention of Spinal Insufficiency Fractures. Spinal Vertebral fractures and percutaneous cement augmentation, vertebroplasty and kyphoplasty. The arguments for a role in preventing new spinal fractures and those against it. The flaws in experimental biomechanical studies and the importance of clinical spinal stability. Biplanar bipedicular percutaneous imaging approaches and formal trainig schemes to be established to train new practitioners with a biomechanically based cement placement.
Cervical Hybrid Arthroplasty by Pablo Pazmino MDPablo Pazmino
This video explains Cervical Arthroplasty in combination with a fusion. When people have more than one cervical disc which has degenerated or which has sustained a traumatic rupture they may need a procedure to address both levels. These herniations may begin to affect the surrounding nerves and/or spinal cord. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Cervical Herniations/ Radiculopathy at multiple levels feel free to look us up online www.beverlyspine.com or call toll free 1-8SPINECAL-1
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. • OsteoporosisOsteoporosis is a systemic disease,is a systemic disease,
which results in :which results in :
• progressive bone mineral lossprogressive bone mineral loss
• concurrent changes in bony architectureconcurrent changes in bony architecture
• leaving the spinal column vulnerable toleaving the spinal column vulnerable to
compression fractures, usually after minimal orcompression fractures, usually after minimal or
no trauma.no trauma.
Riggs:Riggs: N Engl J Med 1986N Engl J Med 1986
Normal Bone Osteoporotic Bone
3. • VCFsVCFs contribute to:contribute to:
• a fivefold increased risk ofa fivefold increased risk of
further fracturefurther fracture by virtue ofby virtue of
force transmission to weakforce transmission to weak
vertebrae, above or below,vertebrae, above or below,
• while these have been shownwhile these have been shown
to be associated with up to ato be associated with up to a
25%25% age-adjusted increaseage-adjusted increase inin
mortality.mortality.
HeaneyHeaney: Bone 1992: Bone 1992
KadoKado: Arch Intern Med 1999: Arch Intern Med 1999
4. Traditional treatmentTraditional treatment for patients withfor patients with
painful VCFs includes :painful VCFs includes :
• bed restbed rest
• narcotic analgesicsnarcotic analgesics
• bracingbracing
resulting in increased pain because of:resulting in increased pain because of:
• acceleration bone lossacceleration bone loss
• and muscle weakness.and muscle weakness.
UthoffUthoff: JBJS 1978: JBJS 1978
ConvertinoConvertino: Med Sci Exerc 1997: Med Sci Exerc 1997
23. • the pullout strength,
• cutout torque,
and
• maximum insertional
torque
for pedicle screws
have been shown
to correlate with
bone mineral density
and are
significantly decreased
in osteoporotic
vertebrae.
Halvorson TL, Spine 1994
Okuyama K, Spine 1993
Considerations for Instrumentation of the Osteoporotic Spine
24.
25. Using multiple points
of fixation, such as
segmental
pedicle screws
• the load applied to
individual screws is
reduced and
• the stiffness of the
overall construct is
increased.
26. A similar principle
applies
to hooks
or wires,
although these
implants generally
require longer
constructs than
pedicle screws
to provide
adequate fixation
Hu SS, Spine 1997
Hart R, et al, Spine 2006
27. In the presence of
osteoporosis
the strength of bone
anchors may not allow
• strong compression
• distraction
or
• vertebral rotation
forces
to be applied.
Glassman SD, et al, Instr Course Lect 2003
Hu SS, Spine 1997;
Hettwer WH, et al, Advances in Osteoporotic Fracture
Management 2004
29. Injectable cements
of several types
have been shown
to substantially
increase
the pullout strength
of screw fixation in
osteoporotic bone.
Glassman SD, et al, . Instr Course Lect 2003
Soshi S, et al, Spine 1991
Zindrick MR, et al, Clin Orthop Relat Res 1986
Taniwaki Y, et al, J.Orthop Sc 2003
30. However,
• cement extravasation
can potentially injure
surrounding structures,
and
• permanent cements
such as
polymethylmethacrylate
represent a potential
locus for late infection.
Glassman SD, Instr Course Lect 2003
Soshi S, et al, Spine 1991
32. • Conical screws,
which better approximate
pedicle morphometry,
have been shown
to increase pullout
resistance in osteoporotic
bone.
• It should be noted,
however, that
conical screws lose
a significant portion
of their strength
when backed out
by even a half turn,
which may limit
their ability to
accommodate rod contour
by backing out the screw.
Ono A, Brown MD, et al, J. Spinal Disord 2001
Kwok AW, et al, Spine 1996
33. • Expandable screws
offer additional
improvement
in pullout strength
in severely osteoporotic
bone.
• Clinical series using these
devices, which include 21
patients with osteoporosis,
demonstrated radiographic
evidence of fusion
in 86% of patients.
• One concern with such
implants is that increasing
screw diameter could
fracture the pedicle placing
the adjacent nerve root at
risk Islam NC, et al, Spine 2001
Kostuik JP, et al, Instr Course Lect 2003
Brantley AG, et al, Spine 1994
34. • In patients with
osteoporosis
o undertapping
or
o avoiding tapping
of the pilot hole
altogether
before screw insertion
does help improve
screw fixation
especially in the
lumbar spine
Havolosn TL, et al, Spine, 1994
Carmouche JJ, et al, J. Neur.
Spine, 1998
35. Screw orientation
also should be optimized in
patients with osteoporosis.
Screw
triangulation via a
medial orientation
• takes advantage of the bone
mass between the
converging screws for
fixation,
• rather than only that bone
lying between threads of a
single screw, and
• has been shown to improve
pullout strength in
osteoporotic, bone.
Ono A, et al J.spinal Disord 2001
Rulad CM, et al, Spine 1991
36. Similarly,
screws oriented
o caudal
or
o parallel relative to the
vertebral end plate,
as opposed
to
o a cranial orientation,
avoid increased
bending moments at
the screw hub in normal
vertebrae,
and
use of this technique is
also prudent in
osteoporotic bone.
McKinley TO, et al, Spine 1999
Youssef JA, et al, Spine 1999
37. • HA – coated screws
have been shown to
increase pullout forces
presumably by increasing
both
o the contact surface area
as well as
o the frictional coefficient at
the bone implant interface
• The mechanical behavior
of these implants
over time
as resorption
of the HA coating occurs
has not been studied,
however.Hasegawa T, et al , Spine, 2005
57. Osteoporotic spinal fracturesOsteoporotic spinal fractures
can be treatedcan be treated
successfully by internal fixationsuccessfully by internal fixation
or by M.I.T.or by M.I.T.
64. Balloon Kyphoplasty
disadvantages
• The risk of fracture in the adjacent levels is
enhanced in the balloon kyphoplasty
• Increased operative time and radiation
exposure