Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty

Interbody fusion is the gold standard surgery to treat lumbar disc degeneration disease but can be a high-risk procedure in elderly and polymorbid patients. Percutaneous Cement Discoplasty (PCD) is a minimally invasive technique developed to treat advanced stage of disc degeneration exhibiting a vacuum phenomenon. A patient-specificstand-alone spacer is created by filling the disc with polymethylmethacrylate cement, allowing to recover the disc height and improve the patient’s conditions. As it has recently been introduced in the lumbar spine, this review aims to present a transversal state-of-the-art of the surgery from its clinical practice and outcome to biomechanical and engineering topics. The literature was searched across multiple databases using predefined keywords over no limited period of time. Papers about vertebroplasty were excluded. Among 466 identified papers, the relevant ones included twelve clinical papers reporting the variations of the surgical technique, follow-up and complications, four papers reporting biomechanical ex vivo and numerical tests, and four letters related to published clinical papers. Papers presenting the operative practice are reported, as well as follow-ups up to four years. The papers found, consistently reported that PCD significantly improved the clinical status of the patients and maintained it after two years. Spine alignment was impacted by PCD: the sacral slope was significantly reduced, and disc height increased. The foramen opening correlated to the volume of injected cement. Substitutes to the acrylic cement exhibited better osteointegration and mechanical properties closer to bone tissue. Finally, limitations and risks of the surgery are discussed as well as potential improvements such as the development of new filling materials with better mechanical properties and biological integration or the investigation of the inner disc

A bifactor structural model of the Hungarian Pain Catastrophizing Scale and latent classes of a clinical sample

Pain catastrophizing is an exaggerated cognitive-affective response to actual or anticipated pain, usually measured by the Pain Catastrophizing Scale (PCS). Our study aimed to test the bifactor measurement model of the Hungarian PCS and to identify a catastrophizing risk group with a clinically meaningful cut-off score. The data of 404 chronic spine-related (neck, back and low-back) pain patients (mean age: 58.61 (SD = 14.34)) were used in our cross-sectional study. Besides pain-related and demographic data, pain catastrophizing and depressive symptoms were measured with questionnaires. Confirmatory factor analyses confirmed that the bifactor model outperformed the other tested measurement models, and the general catastrophizing factor was responsible for 81.5% of the explained variance. Using latent class analysis, we found that even moderately elevated pain catastrophizing score was related to more depressive symptoms and higher perceived pain intensity, and 22 score could be used as a cut-off score. Our results support the concept of global pain catastrophizing and the validity of the Hungarian PCS. Further studies are needed to evaluate the bifactor structure of this scale and the predictive value of the proposed cut-off score

Assessment of foraminal decompression following discoplasty using a combination of ex vivo testing and numerical tools

: Percutaneous Cement Discoplasty (PCD) is a minimally invasive surgical technique to treat degenerated intervertebral discs. When the disc is severely degenerated, the vacuum observed in place of the nucleus pulposus can be filled with bone cement to restore the disc height, open the foramen space, and relieve pain. This study aimed to evaluate the foramen geometry change due to PCD, in the loaded spine. Cadaveric spines (n = 25) were tested in flexion and extension while Digital Image Correlation (DIC) measured displacements and deformations. Tests were performed on simulated pre-operative condition (nucleotomy) and after PCD. Registering DIC images and the 3D specimen geometry from CT scans, a 3D model of the specimens aligned in the experimental pose was obtained for nucleotomy and PCD. Foramen space volume was geometrically measured for both conditions. The volume of cement injected was measured to explore correlation with the change of foramen space. PCD induced a significant overall foraminal decompression in both flexion (foramen space increased by 835 ± 1289 mm3, p = 0.001) and extension (1205 ± 1106 mm3, p < 0.001), confirming that the expected improvements of PCD show also during spine motion. Furthermore, in extension when the foramen is the most challenged, the impact of PCD on the foramen correlated with the injected cement volume

Resenha - GUIMARÃES, VALERIA LIMA. O turismo levado a sério: discursos e relações de poder no Brasil e na Argentina (1933-1946). 333f. Tese (Doutorado em História Comparada) - Instituto de História, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 2012.

O texto resenha a tese de doutorado de Valéria Guimarães no campo da história do turismo. Apresenta as reflexões da autora que se dedica a estudar discursos e práticas turísticas produzidos no Brasil e na Argentina, entre os anos de 1933 e 1946, quando os dois países passaram pela experiência de governos autoritários. As principais contribuições da pesquisa foram identificadas, especialmente a crítica a uma história do turismo linear, descritiva, amparada em relações de causa-efeito, consolidada em cronologias e pautada por mitos fundadores. Outra contribuição que se destaca é a refutação de duas ideias: a de que a II Guerra Mundial paralisou por completo os fluxos turísticos mundiais e a de que a primeira expressão de política de turismo no Brasil foi a criação da Comissão Brasileira de Turismo (Combratur). As potencialidades tanto do método da história comparada quanto dos periódicos como fontes documentais nas pesquisas sobre história do turismo foram igualmente analisadas

As cidades mineiras do barroco nos cinejornais da Agência Nacional

O presente artigo examina três cinejornais produzidos pela Agência Nacional e analisa imagens e narração na tentativa de compreender os discursos produzidos sobre o patrimônio histórico do país, considerado um dos elementos fundamentais das práticas turísticas. A investigação utiliza-se do método indiciário e da análise fílmica, propostos por Carlo Ginzburg (1989) e por Francis Vanoye e Anne Goliot-Lété (2012), respectivamente, e de conceitos desenvolvidos por Stuart Hall (2006). A originalidade do trabalho proposto recai na utilização de filme documentário na pesquisa em turismo e na interlocução com os campos de conhecimento da História, Cinema e Sociologia. O principal resultado alcançado foi a verificação da possibilidade de entrelaçamento das noções de identidade nacional e identidade turística

A utilização de línguas estrangeiras por travestis brasileiras como estratégia de marketing no turismo sexual na cidade do Rio de Janeiro

O texto analisa, sob a ótica do conceito de “comodificação do consumidor”, de Zygmunt Bauman, a utilização de línguas estrangeiras como ferramenta de marketing na prestação de serviços sexuais por travestis brasileiras, na busca pela atração de turistas internacionais na cidade do Rio de Janeiro, através do exame de anúncios em sítios de internet. A partir de uma revisão bibliográfica temática e contextual, o trabalho conecta as complexas modificações corporais, sociais e psicológicas engendradas pelas travestis, em seu processo de autoconstrução, com a ideia baumaniana de transformação do ser humano (enquanto consumidor) em mercadoria. Conclui-se, ao final do artigo, que o caso das travestis corporifica tal transformação e que o uso de línguas estrangeiras em seus anúncios é um exemplo marcante da necessidade de autopromoção proposta por Bauman em seus escritos

El derecho al ocio y a la ciudad: la experiencia de un proyecto de turismo social en Brasil

An extension project has provided tourist experiences for students/staff of Fluminense Federal University who have some limitations. This article is the result of an investigation of how the tours influenced the daily life of the people who participated. It is an exploratory qualitative study based on semi-structured interviews with the tourists who visited some tourist spots. The relevance of the study is its demonstration that access to touristic leisure can bring physical, psychic and emotional benefits, such as different perception of places visited previously, change of habits, and possibility of experiencing contemplative moments to escape from everyday problems. The results show that access to the different tourist attractions and cultural facilities brought different contributions and perspectives. Subjects to the stress of the academic routine, the practice of touristic leisure helps them to ameliorate emotional/physical exhaustion and the sense of belonging, in relation to the university and the places visited.Un proyecto de extensión ha proporcionado experiencias turísticas para estudiantes/empleados universitarios de la Universidad Federal Fluminense que tienen algunas limitaciones. Este artículo es el resultado de una investigación sobre cómo los recorridos ofrecidos por el proyecto influyeron en la vida cotidiana de las personas que participaron. Esta es una investigación cualitativa exploratoria, basada en entrevistas semiestructuradas con turistas que visitaron algunos lugares turísticos. La relevancia del estu- dio es demostrar que el acceso al ocio turístico puede traer beneficios físicos, psicológicos y emocionales, así como diferentes percepciones de lugares visitados anteriormente, cambios en los hábitos y la posibilidad de experimentar momentos contemplativos para escapar de los problemas cotidianos. Los resultados muestran que el acceso a las diferentes atracciones turísticas e instalaciones culturales de los lugares visitados aportó diferentes contribuciones y perspectivas para estas personas. Sujeto al estrés de la rutina académica, la práctica del ocio turístico les ayuda a mejorar el agotamiento emocional / físico y el sentimiento de pertenen- cia, en relación con la universidad y los espacios visitados