Wczesne i odległe wyniki leczenia pojedynczych złamań osteoporotycznych za pomocą wertebroplastyki

Background and purpose Percutaneous vertebroplasty (PVP) is a minimally invasive vertebral augmentation procedure for the treatment of recent, osteoporotic vertebral compression fractures. The aim of the study was to determine the early and late outcomes of PVP for osteoporotic vertebral compression fractures. Material and methods We prospectively assessed outcomes of PVP in 200 patients with single, osteoporotic vertebral compression fracture. Follow-up assessment was made 12 hours after surgery as well as after 7 days, 30 days, 3 months, 6 months, and 1 year after surgery. A subgroup of 80 patients was evaluated also 2 years after PVP. A 100-mm visual analogue scale of pain was used for outcome measurement. Results Twelve hours after PVP, very significant relief of pain was obtained in 85% of patients; on the 7th and 30th day a very good result of treatment was noted in 96%. The same result was noted in 92% of patients at the 6th month, and in 90% of patients at the 12th month. Among the 80 patients followed for 2 years, 3 patients reported recurrence of pain and were subsequently diagnosed with new osteoporotic fractures. Conclusions Percutaneous vertebroplasty is a minimally invasive method of treatment for fresh osteoporotic fractures, which provides a significant and sizeable reduction of pain in the short as well as long term after surgery. Complete relief of pain was noted 12 hours after PVP in 94% of patients, and was noted in 90% two years after treatment. Despite some literature data suggesting no beneficial effect of PVP, it can be concluded that PVP is the most effective and the safest method for fresh vertebral compression fracture treatment.Wstęp i cel pracy Wertebroplastyka jest szeroko stosowaną, minimalnie inwazyjną metodą leczenia świeżych kompresyjnych złamań osteoporotycznych trzonów kręgów. Celem pracy była ocena wczesnych i odległych wyników leczenia świeżych złamań osteoporotycznych trzonów kręgów za pomocą przezskórnej wertebroplastyki. Materiał i metody Prospektywnej analizie poddano 200 pacjentów leczonych za pomocą wertebroplastyki z powodu pojedynczego, osteoporotycznego złamania trzonu kręgu. Stan pacjentów oceniano 12 godz. po zabiegu, po upływie 7 dni, miesiąca, 3 miesięcy, 6 miesięcy i 12 miesięcy, a 80 pacjentów oceniono także po upływie 24 miesięcy. Wynik był oceniany przy użyciu 100-milimetrowej wzrokowej analogowej skali oceny bólu. Wyniki Po 12 godz. po zabiegu ustąpienie dolegliwości lub istotną poprawę zanotowano u 85% pacjentów, w 7. i 30. dniu bardzo dobre wyniki stwierdzono u 96% pacjentów. Po 6 miesiącach bardzo dobry wynik utrzymywał się u 92%, a po 12 miesiącach – u 90% leczonych. Spośród 80 pacjentów obserwowanych po 2 latach nawrót dolegliwości bólowych wystąpił tylko u 3 pacjentów, u których doszło do złamania kolejnego trzonu kręgu. Wnioski Wertebroplastyka jest minimalnie inwazyjną metodą leczenia świeżych złamań osteoporotycznych, pozwalającą na uzyskanie bardzo dobrych wyników leczenia, zarówno wczesnych, jak i późnych. Całkowite ustąpienie dolegliwości obserwowano już po 12 godz. u 94% chorych, taki wynik utrzymywał się przez kolejne dwa lata u 90% leczonych. Mimo pojedynczych doniesień o nieskuteczności tej metody wydaje się, że w świeżych złamaniach osteoporotycznych wertebroplastyka jest najskuteczniejszą i najbezpieczniejszą metodą leczenia dolegliwości bólowych, będących wynikiem złamań trzonów kręgów

Administracja, zarządzanie i handel zagraniczny w warunkach integracji. Materiały konferencyjne - zarządzanie

Ze wstępu: "Partnerstwo jest rodzajem związku między władzami lokalnymi a innymi organizacjami; strony zachowują wolność działania, ale zgadzają się współpracować dla osiągnięcia wspólnych celów. Istnieje szeroka gama efektywnego wykorzystania partnerstwa przy rozwiązywaniu zagadnień zrównoważonego rozwoju, takich jak odnowa wewnętrzna obszarów miast, przekształcanie i rewitalizacja śródmieść, ochrona terenów turystycznych, dynamizacja mieszkalnictwa itp."(...

Vertebroplasty (PVP) is effective in the treatment of painful vertebral hemangiomas

Purpose: We assessed the results of percutaneous vertebroplasty treatment of painful vertebral hemangiomas in 110 patients, with a three years follow-up.Patients and methods: 110 patients with painful vertebral hemangiomas were treated by percutaneous vertebroplasty. The patients were diagnosed by MRI and observed for 3 years after surgery. Visual Analog Scale was used to assess the level of pain.  Results: Pain significantly diminished in all patients, 90% were free of pain for three years after augmentation. In 10% some pain appeared after 1 year, but less intensive than before surgery. 3 years after vertebroplasty 90% of patients were free of pain. No complications of PVP were observed. In 3 patients extravertebral leakage was noted with no clinical symptoms.Conclusions: PVP is highly effective in the treatment of painful vertebral hemangiomas. The method is safe, produce minimal complications and eliminates, or highly reduces pain for a long time period

Selected Medical and Social Problems of The Elderly

Time definition of this process is very difficult, because the life situation of an individual human being significantly changes its course. In the evaluation of the aging process of the elderly in addition to calendar age, which to a small extent determines the spiritual and physical human efficiency, the biological age and mental state together with the social situation should also be taken into account. The age of sixty five has conventionally been adopted as the lower limit of old age. In the group of people crossing that limit there is a substantial difference in the condition and needs, which to a lesser extent depend on chronological age and to greater extent on other factors. Older people during this period of their lives experience numerous medical and social problems (major geriatric problems, loneliness, ageism)

Satisfaction with the lives of elderly nursing homes residents

Introduction. Ageing of societies is a process apparent in nearly all countries worldwide. Many families will not be able to provide care services for the elderly, the burden of care will fall mainly on public and private institutions. This puts employees of nursing homes in front of numerous challenges in order to provide seniors with improvement of their life satisfaction

Keyhole surgery of pineal area tumors - personal experience in 22 patients

Pineal area tumors are challenging for surgery due to their location. However, the removal of the lesion is critical for further treatment and survival of the patient

Chronic subdural hematoma (CSH) is still an important clinical problem. Analysis of 700 consecutive patients

Chronic subdural hematoma (CSH) is still an important neurosurgical problem and the number of patients increases despite the progress in early diagnosis of cerebral lesions

Factors affecting decision concerning influenza vaccination among students of medical faculties

Influenza is one of the most common cyclic respiratory diseases in humans. Methods of prevention are multidirectional, but the most effective and most efficacious way to prevent influenza and its complications is through preventive vaccination. This work aims to determine different factors affecting the decision concerning influenza vaccine. The percentage of people vaccinated against the flu was evaluated, as well as their knowledge of post-influenza complications, etc. among full-time students and bridging studies of nursing and physiotherapy (full-time and part-time) at the University of Technology and Life Sciences in Radom, and students of medicine and pharmacy at the Medical University of Łódź. The research tool was the authors' questionnaire with 18 questions. The surveys conducted, consisting of multiple choice questions, were anonymous. In total, the survey involved 470 students. Overall, the number of people who were vaccinated against influenza in the 2012/13 epidemic season numbered 15 respondents, representing 5.84% of the total group of respondents. For the group of nursing students it was 6%, for physiotherapy students 5%, for students of medicine and pharmacy 14%. The percentage of respondents who said they would get vaccinated if the vaccinaton was free of charge was also low. Increasing the percentage of people vaccinated against influenza (immunization coverage) is a very important measure in preventing influenza epidemics. Therefore, it is necessary to identify the reasons why people are reluctant to be vaccinated against influenza, particularly among students who will work in the future in the health care services sector

Associations of diabetic retinopathy with retinal neurodegeneration on the background of diabetes mellitus. Overview of recent medical studies with an assessment of the impact on healthcare systems

Diabetes Mellitus (DM) is one of the biggest healthcare and financial problems worldwide. The disease is strongly associated with microvascular and macrovascular complications, causing co-existing diseases like Diabetic Retinopathy, Diabetic Neuropathy and Diabetic Nephropathy. Annual healthcare expenditures for diabetes treatment and complications prevention cost 727 billion USD in year 2017