RESUMEN
We tested artifactual and theory-based accounts of the relationship between schizophrenia liability and suicidality. At baseline, 387 adolescents (12 to 17years) completed measures of schizotypy, hopelessness, and depressed affect. After two years, schizotypal and non-schizotypal subsamples (n=16 and 31, respectively) self-reported passive suicidal ideation, active ideation, and serious ideation and action. Taxonic schizotypy predicted passive ideation (OR=8.15, 95% CI 1.34, 49.60) even when controlling for depressed affect. Hopelessness did not predict suicidality or moderate schizotypy-suicidality relationships. Findings were consistent with the interpersonal theory of suicide and contrary to the artifactual account of the association.
Asunto(s)
Psicología del Esquizofrénico , Trastorno de la Personalidad Esquizotípica/psicología , Ideación Suicida , Adolescente , Afecto , Niño , Depresión , Femenino , Estudios de Seguimiento , Humanos , Masculino , Pronóstico , Estudios Prospectivos , Esquizofrenia/diagnósticoRESUMEN
BACKGROUND: Minimally invasive spinal surgery (MISS) has evolved over the past years due to the combination of microsurgery, minimal access strategies and neuronavigation. Percutaneous or mini-open pedicle screw placement is a challenge, especially for surgeons not experienced in the use of biplanar fluoroscopy or stereotactic imaging techniques. The aim of the study was to compare the precision of pedicle screw fixation for lumbar fusion procedures using Iso-C/stereotactic 3D neuronavigation (3D NAV) vs. standard AP/lateral fluoroscopy (2D NAV). METHODS: Our first 42 patients undergoing MISS for one- or 2-level lumbar or lumbosacral fusion procedures for degenerative lumbar pathology were included in this study. Either 3D NAV (n=29) or standard fluoroscopy (n=13) was used to aid screw placement. Demographics, operative time, blood loss, and screw placement accuracy were evaluated. Screw placement was evaluated postoperatively using lumbar CT scanning. Accuracy of 3D NAV was evaluated by comparing intraoperative planning screenshots to postoperative CT placement of screws. RESULTS: There were no significant differences between groups for mean age, gender or intraoperative blood loss. 90.9% of 3D NAV screws and 73.7% of fluoroscopy screws had no pedicle perforation (p=0.04). Intraoperative navigation screenshots accurately predicted pedicle screw placement in 90.9% of cases. There was a positive correlation between 3D NAV accuracy and better screw grade (rs 0.45, p=0.036). CONCLUSIONS: Utilization of 3D NAV for percutaneous or mini-open lumbar screw placement during the early learning curve for MISS was associated with higher screw accuracy. This study demonstrates that the use of 3D navigation can facilitate the learning curve for MISS.
Asunto(s)
Fluoroscopía/métodos , Vértebras Lumbares/cirugía , Neuronavegación/métodos , Fusión Vertebral/métodos , Tornillos Óseos , Femenino , Humanos , Degeneración del Disco Intervertebral/patología , Degeneración del Disco Intervertebral/cirugía , Vértebras Lumbares/patología , Masculino , Fusión Vertebral/instrumentación , Estenosis Espinal/patología , Estenosis Espinal/cirugía , Espondilolistesis/patología , Espondilolistesis/cirugía , Resultado del TratamientoRESUMEN
Pregnant rats were treated with a single intravenous or oral administration of indium chloride (InCl3) on day 9 of pregnancy and their fetuses were examined for growth and malformation on day 20 of pregnancy. By intravenous administration, fetal weight was significantly decreased and the incidences of fetal mortality and malformation were significantly increased at 0.4 mg In/kg. Fetal malformations of the tail and digits, e.g., kinked tail, brachyury, and oligodactyly, were observed at high incidences. By oral administration, similar tendencies in the fetal effects were observed, but there were no significant differences compared to the control even at 300 mg In/kg. Indium concentrations in the serum of pregnant rats showed low bioavailability of indium by oral administration. It was concluded from these results that indium showed teratogenicity in rats. Oral treatment with indium may be developmentally toxic at 300 mg In/kg, but this is difficult to state with certainty given the limited number of animals that were used in this study.