Evaluation of biomechanical alteration of the spinal intervertebral discs due to the degenerative process

Background: With the progression of aging process, the degenerative process affect all organs throughout the body, including the intervertebral discs. The degeneration of intervertebral discs is the most important etiology for the back pain in human. Hence, having the knowledge of alterations in biomechanics of this structure due to the degeneration is of special importance. Materials and Methods: In this cross sectional study all patients referred to the Spinal Cord Clinic of Bahonar hospital (Kerman, Iran) because of their back pain were participated. The upright anteroposterior and lateral flexion-extension radiographs and MRI of the spine have been ordered for the diagnosis and treatment of the patients with back pain. The sagital translation and rotation and also anterior and posterior disc height in different grades of degenerations was analyzed. Results: The severity of the intervertebral disc degeneration has direct relation to aging. Anterior and posterior disc height was decreased with the progression of the degeneration. Translation and rotation in the sagital plane were decreased along with the progression of the grade of the degeneration and in direct relation to the posterior disc height. Conclusion: The degeneration trend is progressing with the advancement of aging and the disc space is decreasing along with the severity of degeneration, followed by a reduction in the translational and rotational movements of the spinal segments, so the grade 3 degeneration has been assumed to be equivalent to the stabilization phase of the motion segment

Ultrasound-guided minimally invasive autopsy as a tool for rapid post-mortem diagnosis in the 2018 Sao Paulo yellow fever epidemic: Correlation with conventional autopsy.

BackgroundNew strategies for collecting post-mortem tissue are necessary, particularly in areas with emerging infections. Minimally invasive autopsy (MIA) has been proposed as an alternative to conventional autopsy (CA), with promising results. Previous studies using MIA addressed the cause of death in adults and children in developing countries. However, none of these studies was conducted in areas with an undergoing infectious disease epidemic. We have recently experienced an epidemic of yellow fever (YF) in Brazil. Aiming to provide new information on low-cost post-mortem techniques that could be applied in regions at risk for infectious outbreaks, we tested the efficacy of ultrasound-guided MIA (MIA-US) in the diagnosis of patients who died during the epidemic.Methodology/principal findingsIn this observational study, we performed MIA-US in 20 patients with suspected or confirmed YF and compared the results with those obtained in subsequent CAs. Ultrasound-guided biopsies were used for tissue sampling of liver, kidneys, lungs, spleen, and heart. Liver samples from MIA-US and CA were submitted for RT-PCR and immunohistochemistry for detection of YF virus antigen. Of the 20 patients, 17 had YF diagnosis confirmed after autopsy by histopathological and molecular analysis. There was 100% agreement between MIA-US and CA in determining the cause of death (panlobular hepatitis with hepatic failure) and main disease (yellow fever). Further, MIA-US obtained samples with good quality for molecular studies and for the assessment of the systemic involvement of the disease. Main extrahepatic findings were pulmonary hemorrhage, pneumonia, acute tubular necrosis, and glomerulonephritis. One patient was a 24-year-old, 27-week pregnant woman; MIA-US assessed the placenta and provided adequate placental tissue for analysis.ConclusionsMIA-US is a reliable tool for rapid post-mortem diagnosis of yellow fever and can be used as an alternative to conventional autopsy in regions at risk for hemorrhagic fever outbreaks with limited resources to perform complete diagnostic autopsy