Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective randomized controlled trial

Introduction To evaluate clinical outcomes with PDD as compared with patients who underwent to standard physiotherapy intervention. Material and methods One-hundred-seventy-seven randomly assigned patients with primarily radicular pain associated with a single-level lumbar contained disc herniation were enrolled. Participants received either PDD (89 patients) or conservative physiotherapy care (88 patients). Results Patients in the PDD group had significantly greater reduction in leg pain scores and significantly improved VAS (p<0.001), Oswestry Disability Index (p<0.05), and 36-Item Short Form, than those in the physiotherapy group at 12 months. On subset analysis, patients achieved even better outcomes after PPD who: were younger, had a shorter period of radiculopathy, of male gender, and lower BMI. Patients with subacute pain reported better outcomes than those with chronic pain in the PDD group. Conclusions Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus

Rheology of different hydrocolloids-rice starch blends. Effect of successive heating-cooling cycles

10 pages, 3 figures, 5 tables.-- Available online 25 November 2010.Hydrocolloids are frequently used for modifying starch functionality. In the present study the possible interaction of three different hydrocolloids – guar gum, hydroxypropylmethylcellulose (HPMC) and xanthan gum – with rice starch was explored by determining the pasting, viscoelastic and swelling properties of the rice starch–hydrocolloids mixtures. The impact of successive heating–cooling cycles on the pasting, viscoelasticity and swelling was also determined. Hydrocolloids tested in the range 0.2–0.8% (w/w) significantly modified the pasting, viscoelastic and swelling properties of rice starch–hydrocolloid pastes (8%, w/w) and the extent of the effect was dependent on hydrocolloid concentration. Guar and xanthan gum mixtures with rice starch had the greatest effect on the pasting properties, whereas HPMC mixtures only changed the viscosity during cooling. The starch–hydrocolloids pastes formed weaker gels compared to those of the starch alone. Rheological results suggested the formation of composite network structures with high frequency dependence. Successive multiple-heating cycles allowed the gel to rearrange resulting in altered gel viscoelasticity and release of water soluble compounds that favour phase separation at the highest hydrocolloid level tested.Financial support from University of California-Davis, Ministry of Education and Science, Spanish Research National Council (CSIC) and Spanish Ministerio de Ciencia e Innovación (Project AGL2008-00092/ALI) is gratefully acknowledged. Dr. Rosell thanks the Spanish Ministry of Education and Science for her grant.Peer reviewe

Mittelfristige Ergebnisse mit der Schlittenendoprothese „Endo-Modell“

Zwischen 1995 und 2000 wurden 118 Patienten mit einer Schlittenendoprothese versorgt (51-86 years). 68 Beantworteten einen Fragebogen und wurden klinisch wie auch radiologisch untersucht. 7 Patienten wurden im Untersuchungszeitraum einer Wechseloperation zugeführt.Between 1995 and 2000 a unicompartmental arthroplasty was done in 118 patiens(51–86 years). 68 answered a questionnaire and could be examined clinically and radiologically. 7 patients had undergone a revision surgery for various reasons

Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation A prospective randomized controlled trial

Introduction: To evaluate clinical outcomes with PDD as compared with patients who underwent to standard physiotherapy intervention. Material and methods: One-hundred-seventy-seven randomly assigned patients with primari- ly radicular pain associated with a single-level lumbar contained disc herniation were enrolled. Participants received either PDD (89 patients) or conservative physiotherapy care (88 patients). Results: Patients in the PDD group had significantly greater reduction in leg pain scores and significantly improved VAS ( p < 0.001), Oswestry Disability Index ( p < 0.05), and 36-Item Short Form, than those in the physiotherapy group at 12 months. On subset analysis, patients achieved even better outcomes after PPD who: were younger, had a shorter period of radiculopathy, of male gender, and lower BMI. Patients with subacute pain reported better outcomes than those with chronic pain in the PDD group. Conclusions: Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus

A Statistical Model on Variations in State Gasoline Taxes

State gasoline and diesel fuel taxes are the most important sources of state transportation funding for highway maintenance and repairs. Thirty-six states levy a fixed-rate tax that has been in place for extended periods of time while others impose a variable tax rate. The primary objective of this study is to develop a multivariable econometric model to explain factors associated with variations in state gasoline taxes across 48 states. Three years of panel data, 2008, 2009, and 2010, were used to estimate the model, which controls for economic, climatic, and demographic factors at the state level. Three of the hypothesized variables were statistically significant. All of the hypothesized variables had the expected sign, with the exception of Income Per Capita. Results indicate that as the average temperature in the state declined one degree, the gasoline tax increased by $0.00451 per gallon. As per capita income increased, the gasoline tax decreased by$0.00000310 per gallon. As energy-related carbon dioxide emissions increased, the gas tax increased by $0.000000162 per gallon. The results of this analysis will have significant policy implications for revenue generation, highway maintenance, and transportation infrastructure

Correlation between 3D microstructural and 2D histomorphometric properties of subchondral bone with healthy and degenerative cartilage of the knee joint

Cartilage degeneration of the knee joint is considered to be a largely mechanically driven process. We conducted a microstructural and histomorphometric analysis of subchondral bone samples of intact cartilage and in samples with early and higher- grade arthritic degeneration to compare the different states and correlate the findings with the condition of hyaline cartilage. These findings will enable us to evaluate changes in biomechanical properties of subchondral bone during the evolution of arthritic degeneration, for which bone density alone is an insufficient parameter. From a continuous series of 80 patients undergoing implantation of total knee endoprosthesis 30 osteochondral samples with lesions macroscopically classified as ICRS grade 1b (group A) and 30 samples with ICRS grade 3a or 3b lesions (group B) were taken. The bone samples were assessed by 2D histomorphometry (semiautomatic image analysis system) and 3D microstructural analysis (high-resolution microCT system). The cartilage was examined using the semiquantitative real-time PCR gene expression of collagen type I and II and aggrecan. Both histomorphometry and microstructural and biomechanical analysis of subchondral bone in groups A and B consistently revealed progressive changes of both bone and cartilage compared with healthy controls. The severity of cartilage degeneration as assessed by RT PCR was significantly correlated with BV/TV (Bone Volume Fraction), Tb.Th (Trabecular Thickness) showed a slight increase. Tb.N (Trabecular Number), Tb.Sp (Trabecular separation) SMI (Structure Model Index), Conn.D (Connectivity Density) and DA (Degree of Anisotropy) were inversely correlated. We saw sclerotic transformation and phagocytic reticulum cells. Bone volume fraction decreased with an increasing distance from the cartilage with the differences compared with healthy controls becoming greater in more advanced cartilage damage. The density of subchondral bone alone is considered an unreliable parameter for classifying changes evolving over time. The progressive damage of subchondral bone seen in the present study correlates well with cartilage changes. Trabecular orientation is also impaired, which explains the changes in biomechanical parameters and the inadequate load transfer and excessive loading of cartilage. Besides subchondral bone density, which in turn correlates with cartilage thickness, other parameters such as structure model index and grade of anisotropy best reflect mechanical properties such as Young modulus, compressive strength, tensile stress, and failure energy. However, it remains unclear whether the mechanical interaction of the mineralized subchondral tissues with articular cartilage works vice versa. The possibility of a biochemical signalling from the degenerating cartilage via the synovial fluid and bone- cartilage crosstalks via subchondral pores may indeed explain a certain depth dependency of subchondral bone changes