CT-guided lumbar facet cyst rupture and corticosteroid injection: technique, approach, and procedural and clinical success rates.

PURPOSE: To evaluate success rates of computed tomography (CT)-guided lumbar facet synovial cyst (LFC) rupture. MATERIALS AND METHODS: We retrospectively reviewed all LFC ruptures performed by a single musculoskeletal radiologist with > 10 years of experience, using posterior facet approach and/or direct puncture by ipsilateral/contralateral interlaminar, or transforaminal approach. All patients also received a corticosteroid injection. Rupture rates were calculated, and clinical success rate was determined through medical record review. Pre-procedure magnetic resonance imaging (MRI) images and CT procedure images were also reviewed for LFC and facet joint imaging features that may predict rupture. RESULTS: There were 37 patients, 17 (46%) female and 20 (54%) male, ages 62 ± 12 (range 39-87) years. Thirty-four (92%) of LFC were successfully ruptured, 17 (50%) by facet approach and 17 (50%) by direct cyst puncture. At least one direct puncture approach was possible in 35 (95%) patients. No MRI or CT LFC or facet joint features predicted cyst rupture. Thirty-one (91%) of patients reported immediate pain relief, and 19 (53%) did not have further intervention for LFC-related pain. Sixteen (84%) of these patients remained pain-free for an average follow-up time period of 28 months. Fourteen (39%) of patients required surgical intervention. There were no complications. CONCLUSION: Our systematic approach to CT-guided LFC rupture is safe and has high technical and clinical success rates similar to prior studies. Since there are no definitive imaging features that determine rupture success, this procedure can almost always be attempted as a first-line treatment for LFC.

Aromatherapy for Procedural Anxiety in Pain Management and Interventional Spine Procedures: A Randomized Trial.

OBJECTIVE: The aim of this study was to evaluate a nonsedating agent, lavender aromatherapy, to reduce anxiety before interventional spinal procedures. DESIGN: In this prospective, single-blind study performed at a tertiary care center for an academic institution, 144 patients undergoing spinal procedures (epidural steroid injection, medial branch block, or radiofrequency ablation) were randomized into two groups of 72 patients. The experimental group was exposed to a tablet formulation of lavender aromatherapy, while the control group was exposed to tablets devoid of any scent. The exposure duration for each group was 5 mins. The primary outcome measurement was patients' anxiety state before the spinal procedure using the six-item State-Trait Anxiety Inventory. Secondary outcomes quantified the rate of vasovagal events and aborted procedures because of patient intolerance. RESULTS: Compared with the control group, the posttreatment anxiety score of those exposed to lavender aromatherapy revealed a statistically significant difference as measured by the six-item State-Trait Anxiety Inventory (12.15 ± 2.67 and 10.67 ± 2.81, P < 0.05). Within group, the experimental group's anxiety level decreased from 12.26 ± 2.75 to 10.67 ± 2.81 (P < 0.05). There were two vasovagal episodes and one aborted procedure in the control group, whereas there was one vasovagal episode and no aborted procedures in the aromatherapy group. CONCLUSIONS: Lavender-based aromatherapy is effective in reducing preprocedural anxiety before interventional spine procedures for pain management.

Supra-acetabular Pelvic External Fixator, Percutaneous With Fluoroscopic Guidance.

Unstable pelvic fractures are associated with high-energy trauma and can lead to increased morbidity and mortality if not managed properly in the acute setting. Early recognition and intervention is crucial for optimal patient outcomes. This article, in addition to the video footage, outlines a safe and effective method for stabilizing unstable pelvic fractures by applying a supra-acetabular pelvic external fixator using fluoroscopic guidance.

Percutaneous Sacroiliac Screw Technique.

Remembering that preoperative planning, surgical indications, and fracture reduction are paramount for this procedure, presented here is our technique for performing percutaneous sacroiliac screws, both transiliac-transsacral and sacral style. A combination of video, still pictures, and fluoroscopy images will guide the viewer through the process we routinely use highlighting specific details. Patient positioning and intraoperative fluoroscopy imaging are critical to a successful procedure. Although inlet and outlet films remain important, we find the procedure best started on the lateral sacral view to reduce the need for start site, trajectory, and imaging position changes during the case. A cannulated pig sticker (drill guide) used with long drill tip guide wires provide improved manual control to both finding a good start site and directing the trajectory. For patient safety, sacral anatomy and safe zones are discussed as well. Using these technical points will help make this a successful procedure.

The effects of single-sex versus coeducational schools on adolescent peer victimization and perpetration.

Bullying is a growing public health concern for South Korean adolescents. In our quantitative investigation, we analyze the frequency with which Korean adolescents in single-sex versus coeducational schools are targets of or engage in three peer aggressive behaviors (verbal, relational (social exclusion), and physical (including theft)). We use two nationally representative datasets, the 2011 Trends in International Mathematics and Science Study (TIMSS) and the 2005 Korea Education Longitudinal Study (KELS), and rely on propensity score matching (PSM). For adolescent girls, we find that being in all-girls schools mitigates both their exposure to and engagement in peer victimization. For adolescent boys, we find that boys in all-boys schools have significantly higher odds of experiencing more frequent verbal and physical attacks versus their counterparts in coeducational schools. Our findings strongly suggest that interventions to mitigate peer victimization and aggression in Korea should consider the gendered schooling contexts in which they are implemented.

Does Prison-Based Adult Basic Education Improve Postrelease Outcomes for Male Prisoners in Florida?

The authors use administrative data from Florida to determine the extent to which prison-based adult basic education (ABE) improves inmate's postrelease labor market outcomes, such as earnings and employment. Using two nonexperimental comparison groups, the authors find evidence that ABE participation is associated with higher postrelease earnings and employment rates, especially for minorities. The authors find that the relationship is the largest for ABE participants who had uninterrupted ABE instruction and for those who received other education services. However, the results do not find any positive effects of ABE participation on reducing recidivism.

Recuperación funcional y laboral de los amputados del Hospital Universitario de Los Andes Mérida Venezuela / Functional and laboural rehabilitation of the amputees at the University Hospital of The Andes Mérida Venezuela

Se estudiaron 446 amputados en la Unidad de Medicina Física y rehabilitación del Instituto Autónomo Hospital Universitario de los Andes, Mérida Venezuela, en un lapso de 25 años. Se clasificaron en : Grupo 1 con 224 amputados (50,23 por ciento) cuando no existía el laboratorio de prótesis (1973-1985) y Grupo 2 con 222 amputados (49,77 por ciento), cuando ya funcionaba ese laboratorio (1986-1997). Edad promedio 48 años (rango 10 meses a 89 años). De las 361 amputaciones de las extremidades inferiores, las etiologías más frecuentes correspondieron a diabetes mellitus y accidentes de tránsito. Prevalecieron los varones. Las edades más efectadas fueron de 40 a 79 años. El nivel de amputación más frecuente fue "por encima de la rodilla". De las 85 amputaciones de las extremidades superiores, las dos primeras causas fueron accidentes laborales y caseros, dominaron en los varones, en edades de 9-39 años y el nivel más frecuente fue manos-dedos. Se encontró el 54.70 por ciento de complicaciones locales del muñon. Las dos primeras causas fueron: infecciones de la herida operatoria y muñón dolorosa. Comparando el número de amputados que reingresaron a sus labores después de seis meses de seguimiento hubo diferencias significativas, (P<0.001) siendo mayor el grupo 2 (P<0.001). En los amputados protetizados y evaluados a los 12 meses de seguimiento, se observa que en el grupo 2, 79 (69,20 por ciento) pacientes usaron en forma útil, situándose en los tres primeros grados de la escala Rusk, "capacidad autónoma", por tanto, la puesta en marcha el Laboratorio de prótesis y ortesis de la Facultad de Medicina y IAHULA, ha sido fundamental para el equipamiento protésico, recuperación funcional y laboral.

Culminación del embarazo en pacientes con conización previa San Cristóbal-Estado Táchira-Venezuela / Pregnancy after uterine cervical conization in patients: San Cristóbal-State Tachira-Venezuela

Estudio restrocpectivo de 17 historias con diagnóstico de embarazo pos-conización cervical uterina en elHospital Patriciano Peñuela Ruíz, desde marzo 1985 amarzo 1995. La distribución por edad es 41,18 por ciento en pacientes de 31 a 35 años. El 58,82 por ciento tiene procedencia urbana. La ocupación más frecuente es oficios del hogar. El 88,24 por ciento corresponde a multiparas. NIC III es la principal causa de conización y el 65,72 por ciento no acudió a controles sucesivos. El 57,06 por ciento de los embarazos ocurrieron en los 12 meses siguientes al cono y 59,9 por ciento culminó entre las 37 y 41 semanas de gestación con 76,57 por ciento en cesárea segmentaria