Mental health improvements after elective spine surgery: a Canadian Spine Outcome Research Network (CSORN) study.

BACKGROUND CONTEXT: Spine patients have a higher rate of depression then the general population which may be caused in part by levels of pain and disability from their spinal disease. PURPOSE: Determination whether improvements in health-related quality of life (HRQOL) resulting from successful spine surgery leads to improvements in mental health. STUDY DESIGN/SETTING: The Canadian Spine Outcome Research Network prospective surgical outcome registry. OUTCOME MEASURES: Change between preoperative and postoperative SF12 Mental Component Score (MCS). Secondary outcomes include European Quality of Life (EuroQoL) Healthstate, SF-12 Physical Component Score (PCS), Oswestry Disability Index (ODI), Patient Health Questionaire-9 (PHQ9), and pain scales. METHODS: The Canadian Spine Outcome Research Network registry was queried for all patients receiving surgery for degenerative thoracolumbar spine disease. Exclusion criteria were trauma, tumor, infection, and previous spine surgery. SF12 Mental Component Scores (MCS) were compared between those with and without significant improvement in postoperative disability (ODI) and secondary measures. Multivariate analysis examined factors predictive of MCS improvement. RESULTS: Eighteen hospitals contributed 3222 eligible patients. Worse ODI, EuroQoL, PCS, back pain and leg pain correlated with worse MCS at all time points. Overall, patients had an improvement in MCS that occurred within 3 months of surgery and was still present 24 months after surgery. Patients exceeding Minimally Clinically Important Differences in ODI had the greatest improvements in MCS. Major depression prevalence decreased up to 48% following surgery, depending on spine diagnosis. CONCLUSIONS: Large scale, real world, registry data suggests that successful surgery for degenerative lumbar disease is associated with reduction in the prevalence of major depression regardless of the specific underlaying diagnosis. Worse baseline MCS was associated with worse baseline HRQOL and improved postoperatively with coincident improvement in disability, emphasizing that mental wellness is not a static state but may improve with well-planned spine surgery.

Validation of the serum bactericidal assay for measurement of functional antibodies against group B meningococci associated with vaccine trials.

Provisional licensure of the trial vaccine, MeNZB, required demonstration of immune responses in vaccines, as measured by a validated Serum Bactericidal Assay (SBA). Reported are the investigations undertaken to define test parameters, lower limits of quantitation and measurement of SBA reproducibility. Results helped to formulate the operating procedure for the measurement of serum bactericidal antibodies during six age-group MeNZB vaccine trials. The lower limit of quantitation was determined as a titre of 4. A four-fold rise in antibody (sero-conversion) from a pre-vaccination titre of 2 (<4) required a minimum post-vaccination titre of 8, a more stringent measurement than has been used in other published studies.

The effect of scleral search coil lens wear on the eye.

BACKGROUND/AIM: Scleral search coils are used to measure eye movements. A recent abstract suggests that the coil can affect the eye by decreasing visual acuity, increasing intraocular pressure, and damaging the corneal and conjunctival surface. Such findings, if repeated in all subjects, would cast doubt on the credibility of the search coil as a reliable investigative technique. The aim of this study was to reassess the effect of the scleral search coil on visual function. METHODS: Six volunteer subjects were selected to undergo coil wear and baseline measurements were taken of logMAR visual acuity, non-contact tonometry, keratometry, and slit lamp examination. Four drops of 0.4% benoxinate hydrochloride were instilled before insertion of the lens by an experienced clinician. The lens then remained on the eye for 30 minutes. Measurements of the four ocular health parameters were repeated after 15 and 30 minutes of lens wear. The lens was then removed and the health of the eye reassessed. RESULTS: No obvious pattern of change was found in logMAR visual acuity, keratometry, or intraocular pressure. The lens did produce changes to the conjunctival and corneal surfaces, but this was not considered clinically significant. CONCLUSION: Search coils do not appear to cause any significant effects on visual function. However, thorough prescreening of subjects and post-wear checks should be carried out on all coil wearers to ensure no adverse effects have been caused.

The use of excretory and secretory antigens of the scolex of Taenia ovis for the serodiagnosis of infection in dogs.

The excretory and secretory antigens from the evaginated scoleces of Taenia ovis were collected for 3 days in vitro, and used in an ELISA test to detect antibodies to T. ovis in the serum of dogs. When tested on sequentially collected sera, diagnostic ELISA values could be detected in many dogs 4 wk after infection, and remained for an average of a further 4 wk after worms were removed from dogs with an anthelmintic. Using an ELISA discriminant value that eliminated all false positives from 70 uninfected laboratory dog sera and from 57 uninfected farm dog sera, 54/62 true positives were found in sera from dogs infected with various numbers of T. ovis for various intervals. Sera from dogs infected with T. hydatigena gave 11/15 false positive reactions, whereas sera from 15 dogs infected with Echinococcus granulosus or 7 dogs infected with T. pisiformis were all negative. For T. ovis the test had a high repeatability, was not greatly influenced by the number of worms carried by the dog and higher titres were correlated with long-standing infections. Approximately 1,000 scoleces could be recovered from each experimentally infected sheep. Using the ELISA test with undiluted antigen and serum diluted 1:40, approximately 10 sera could be tested in duplicate with the excretions and secretions from each T. ovis scolex.