The value of a pantaloon cast test in surgical decision making for chronic low back pain patients: a systematic review of the literature supplemented with a prospective cohort study

The results of lumbar fusion in chronic low back pain (LBP) patients vary considerably, and there is a need for proper patient selection. Lumbosacral orthoses have been widely used to predict outcome, however, with little scientific support. The aim of the present study was to determine the value of a pantaloon cast test in selecting chronic LBP patients for lumbar fusion or conservative management. First, a systematic review of the literature was carried out in which two independent reviewers identified studies in Medline, Cochrane and Current Contents databases. Three papers met the selection criteria. In the only study with a control group, a significantly better outcome after fusion compared to conservative treatment was found in patients who reported significant pain relief while in a cast (i.e. a positive cast test). The results of lumbar fusion, however, were not significantly different for patients with a positive and those with a negative cast test. In addition to the review, a clinical cohort study of 257 LBP patients, who had been allocated to either lumbar fusion or conservative management by a temporary external transpedicular fixation trial, was performed. Prior to allocation, all had undergone a pantaloon cast test. Patients with no history of prior spine surgery and with a positive pantaloon cast test had a better outcome after lumbar fusion than those treated conservatively (P = 0.002, χ ² test). In patients with previous spine operations the outcomes were poor and the test was of no value. From the literature and the present patient cohort, it was concluded that only in chronic LBP patients without prior spine surgery, a pantaloon cast test with substantial pain relief suggests a favorable outcome of lumbar fusion compared to conservative management. The test has no value in patients who have had previous spine surgery.     

Evidence for frequent divergence impairment in French dyslexic children: deficit of convergence relaxation or of divergence per se?

Aim There is a controversy as to whether dyslexic children present visuo-motor disabilities such as vergence and accommodative problems assessed with orthoptic tests. The purpose of this study is to re-examine this issue in a large population of children. Methods Extensive orthoptic evaluation was made in 57 dyslexic and 46 non-dyslexic (“normal”) age-matched children. Convergence and divergence capacities were evaluated at two distances (30 cm and 400 cm). Results Binocular vision measured with stereo-acuity tests was normal in dyslexics. In contrast, the near point of convergence was significantly more remote in dyslexics; most importantly, divergence at both far and near distance was significantly more reduced in dyslexics (median value 4 pD and 10 pD, respectively, at far and near) than in “normals” (median value 6 pD and 12 pD, at far and near). Conclusion The existence of the divergence deficit at far distance indicates the presence of deficit of divergence per se, independently from convergence and accommodation relaxation. This result is novel and corroborated by physiological studies indicating distinct control of convergence and divergence, both at the cortical and subcortical premotor level. We conclude that vergence deficits are frequently present in dyslexics, and that dyslexics should be re-educated; training should address distinctively convergence and divergence subsystems.     

Discrimination of idiopathic pain syndromes from neurogenic pain syndromes and healthy volunteers by means of clinical rating,personality traits,monoamine metabolites in CSF,serum cortisol,platelet MAO and urinary melatonin

Summary The aim of the present study was to investigate the discriminative power of a series of variables (including determination of depressive symptomatology by means of a visual analogue scale, determination of personality traits by means of the Karolinska Scales of Personality, determination of monoamine metabolites in CSF, platelet MAO activities, serum cortisol before and after dexamethasone suppression and urinary melatonin) in differentiating (a) chronic pain patients from healthy subjects, and (b) patients with idiopathic pain syndromes from patients with neurogenic pain syndromes. Separately each of the measures gave a significant but often low contribution to the discrimination, while a combination of several measures gave a complete discrimination both between healthy subjects and patients with chronic pain syndromes and between patients with idiopathic and neurogenic pain syndromes, respectively.Supported in part by grants from the Swedish Medical Research Council (grants no. 3371, 4145 and 5740) and by a grant from Stiftelsen Söderström-Königska Sjukhemmet     

Is the Evaluation of the Global Quality of Life Determined by Emotional Status?

The present study investigated relationships between global QOL perceptions and well-being dimensions. Especially our goal was to evaluate the impact of generally recognised four broad dimensions of QOL (physical, functional, social and emotional well-being) on global QOL perceptions, additionally person's satisfaction with life achievements and economical situation were measured as well as social demographic variables. The subjects were a representative sample of Finns (n = 4613, from 25 to 65 years) of the FINRISK-97 study. Correlation coefficients and models of hierarchical regression indicated that physical, functional and social well-being as well as sociodemographic factors and satisfaction with life achievements are important factors of global QOL perceptions both among males and females. However percentages of variances explained with these measures were only moderately high, ranging from 1 to 10%. After measures of emotional well-being were entered into the models of hierarchical analyses of regression, variances explained grew dramatically over 20%. The results of the study indicated that global QOL judgements are likely to be based on current emotional state.     

Flavocoxid is as effective as naproxen for managing the signs and symptoms of osteoarthritis of the knee in humans: a short-term randomized,double-blind pilot study

Flavocoxid (Limbrel), a proprietary mixture of flavonoid molecules (baicalin and catechin), was tested against a traditional nonsteroidal anti-inflammatory drug, naproxen, for the management of the signs and symptoms of moderate osteoarthritis (OA) in humans. Discomfort and global disease activity were used as the primary end points, and safety assessments were also taken for both treatments as a secondary endpoint. In this double-blind study, 103 subjects were randomly assigned to receive either flavocoxid [500 mg twice daily (BID)] or naproxen (500 mg BID) in a 1-month onset of action trial. Outcome measures included the short Western Ontario and McMaster University Osteoarthritis Index, subject Visual Analogue Scale for discomfort and global response, and investigator Visual Analogue Scale for global response and fecal occult blood. Both flavocoxid and naproxen showed significant reduction in the signs and symptoms of knee OA (P ≤ .001). There were no statistically detectable differences between the flavocoxid and naproxen groups with respect to any of the outcome variables. Similarly, there were no statistically detectable differences between the groups with respect to any adverse event, although there was a trend toward a higher incidence of edema and nonspecific musculoskeletal discomfort in the naproxen group. In this short-term pilot study, flavocoxid was as effective as naproxen in controlling the signs and symptoms of OA of the knee and would present a safe and effective option for those individuals on traditional nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors. A low incidence of adverse events was reported for both groups.     

英语阅读障碍儿童词汇命名加工特征的研究

目的研究英语阅读障碍儿童操作英语词汇的相关能力 ,探索英语阅读障碍的表现特点与矫治的手段。方法英语真、假词命名实验 ,观察 3 4名阅读障碍儿童和 3 4名对照组儿童的实验结果。结果 ( 1)障碍组右视野在真、假词的命名时间上与对照组存在显著差异 ;( 2 )障碍组在真词和假词上的命名错误率均大于正常组 ,假词命名的错误率大幅增加。 ( 3 )障碍组右视野的真词命名时间明显长于左视野 ,假词命名的错误率也明显大于左视野。结论英语阅读障碍的儿童显示出了操作英语语音能力的欠缺以及左测大脑半球活动水平不足的倾向。     

弱视儿童不同部位记录视觉诱发电位比较

目的对弱视儿童不同部位所记录的视觉诱发电位（ＶＥＰ）进行比较研究。方法分析５２只弱视眼常规视觉刺激时于Ｏ１、Ｏ２、Ｏｚ三点记录的ＶＥＰ，并以６６只健康眼的ＶＥＰ作比较。结果弱视眼三个点ＶＥＰ的异常率：Ｏｚ一个点２３％，Ｏ１、Ｏ２两点为７５％，Ｏｚ、Ｏ１和Ｏ２三个点为８１％。与正常眼比较，弱视眼此三点ＶＥＰ的潜伏期均显著延长，Ｏｚ点波幅显著降低，Ｏ１、Ｏ２点波幅则无显著差异。弱视眼的ＶＥＰＯ１和Ｏ２点潜伏期较其Ｏｚ点显著延长，波幅亦显著降低。结论对ＶＥＰ的评价，必须考虑到有无弱视和记录部位这两个因素。     

Differences in the temporal dynamics of the visual ON and OFF pathways

The temporal structure of spike trains recorded from optic fibers and single units of the lateral geniculate nucleus (LGN) and primary visual cortex of the cat was studied with a novel method of inter-spike interval analysis. ON type relay cells of the LGN exhibited a multimodal interval distribution preferring a distinct interval (fundamental interval) and its multiples during the sustained light response, whereas most OFF cells showed a broad, unimodal distribution. The general pattern of the interval distribution was relatively independent of stimulus size and contrast and the degree of light adaptation. Simultaneously recorded S-potentials originating from the retinal input generally produced only a single peak at the fundamental interval length. Therefore, the multimodal interval distribution of LGN cells seems to be a result of intra-geniculate inhibition. Cortical cells also showed a weak tendency to fire with spike intervals similar to LGN cells. Therefore, the regular firing pattern observed at peripheral stages of the visual pathway can persist at higher levels and might promote the occurrence of oscillatory activity.     

一次阿扑吗啡注射对大鼠视觉辨别学习和工作记忆的影响

目的探讨多巴胺受体激动剂 -阿扑吗啡对大鼠视觉辨别学习和工作记忆的影响。方法利用旋转T迷宫装置 ,通过食物强化 ,分别训练大鼠正常和逆反的视觉辨别学习任务。动物达到规定的标准次数后 ,腹腔注射 2mg/kg体重的阿扑吗啡 ,3 0分钟后观察药物对工作记忆的影响。 结果对于正常学习 ,阿扑吗啡注射组动物的正确次数与生理盐水对照组相比无显著性差异 ,且两组动物继续进行逆反学习训练 ,达到学习标准所需的总次数亦无显著性差异 ;对于逆反学习 ,阿扑吗啡注射组动物的正确次数较对照组显著降低。结论单独一次阿扑吗啡注射可能干扰大鼠逆反学习的工作记忆 ,但不影响正常学习的工作记忆和逆反学习的过程。     

032 百里香与报春花根固定组方对急性支气管炎病人的疗效和耐受性

Visual Basic作为一门可视化的高级编程语言，已经在各高等院校作为计算机基础教育的一门主干课程，随着多媒体技术、校园网建设和互联网技术的发展，原来滞后的教学方法势必影响高校计算机基础教学的效果。本文针对医学院校的计算机基础教育，着重探讨在新的历史时期Visual Basic的教学方法。