A Prospective Outcome Study on the Effects of Facet Joint Radiofrequency Denervation on Pain, Analgesic Intake, Disability, Satisfaction, Cost, and Employment

Burnham RS, Holitski S, Dinu I. A prospective outcome study on the effects of facet joint radiofrequency denervation on pain, analgesic intake, disability, satisfaction, cost, and employment.

Objective

To assess the effect of radiofrequency denervation (RFD) on patients with chronic low back pain (LBP) of facet joint origin.

Design

Prospective cohort study.

Setting

Interventional pain management program.

Participants

Consecutive subjects (N=44; 101 facet joints) over 2 years with chronic refractory mechanical LBP of facet origin established by 2 local anesthetic blocks (medial branch ± intra-articular) resulting in more than 50% pain relief.

Intervention

RFD of the symptomatic lumbar facet joints.

Main Outcome Measures

Self-reported pain intensity, frequency, bothersomeness, analgesic intake, satisfaction, disability, back pain-related costs, and employment twice prior to and at 1, 3, 6, 9, and 12 months post-RFD.

Results

Post-RFD, significant improvements in pain, analgesic requirement, satisfaction, disability, and direct costs occurred. They peaked at 3 to 6 months and gradually diminished thereafter. Satisfaction with medical care and living with current symptoms improved similarly. Overall, satisfaction with the RFD procedure was high, and no complications were reported.

Conclusions

RFD provides safe and significant short-term improvement in pain, analgesic requirements, function, satisfaction, and direct costs in patients with chronic LBP of facet origin.     

An updated reference for age-sex-specific birth weight percentiles stratified for ethnicity based on data from all live birth infants between 2005 and 2014 in Alberta,Canada

ObjectiveThis study aims to update the current reference for sex-specific birth weight percentiles by gestational age, overall and for specific ethnic groups, based on data from all singleton live-birth deliveries from 2005 to 2014 in Alberta, Canada.MethodsInfant and maternal information were captured in the Alberta Vital Statistics-Births Database for 473,115 singleton infants born to 311,800 women between January 1, 2005 and December 31, 2014. Within each sex, and each sex-ethnic group, birth weights were modelled by gestational age using generalized additive models and natural cubic splines. Crude and corrected estimates for birth weight percentiles including cut-off values for large for gestational age (LGA) and small for gestational age (SGA) were calculated by sex and sex-ethnic group, and gestational age for singleton live births.ResultsLGA and SGA cut-offs were lower for females than for males for all gestational ages. The SGA and LGA percentiles were greater for both male and female very preterm infants in Alberta compared to previous national references. Ethnicity-specific LGA and SGA cut-offs for term Chinese and preterm and at-term South Asian infants were consistently lower than those for both the general population in Alberta and the previous national reference. South Asian infants had lower birth weights at almost all gestational ages compared with the other groups.ConclusionThe updated birth weight percentiles presented in this study highlight the differences in SGA and LGA cut-offs among infants from South Asian, Chinese, and the general population, which may be important for clinical perinatal care.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00520-9.     

Consumption of Ultra-Processed Foods Is Inversely Associated with Adherence to the Mediterranean Diet: A Cross-Sectional Study

Information on the consumption of ultra-processed foods (UPF) in relation to an adherence to the Mediterranean diet (MD) is limited. Our aim was to assess UPF consumption in a group of Italian adults and to evaluate the relationship with the MD adherence. A total of 670 participants (median age: 30 years) were included in the analysis. The consumption of UPF was assessed through the NOVA Food Frequency Questionnaire (NFFQ). Adherence to the MD was assessed through the Medi-Lite score. The percentage of UPF in the diet was 16.4% corresponding to 299 g of UPF per day. These amounts were significantly (p < 0.05) higher in men than in women and came mainly from ready-to-eat meals or pre-packaged bread, bread alternatives, pizza, frozen potato chips (24.5% of total UPF intake), pre-packaged biscuits and sweets (20.7%), soft drinks (15.8%), and dairy products such as flavored yogurt (12%). As to the MD adherence, a significant inverse association between the Medi-Lite score and the percentage of UPF in the diet (R = −0.35; p < 0.001) was observed. Participants with a low adherence to the MD had a significantly higher contribution of UPF in the diet (22.2%) compared to those with a moderate (16.2%) and high (12.6%) adherence. In terms of individual UPF, the largest difference between low and high MD adherents was observed for pre-packaged biscuits and sweets, soft and energy drinks, sausages and other reconstituted meat products, and pre-packaged bread and bread alternatives. These results suggest that public health strategies are needed to implement more effective actions to promote healthy eating habits in the population.     

Algorithms for adding and subtracting noise levels

Nowadays 7% of Europe's workers suffer from work related hearing difficulties and noise induced hearing loss is among the most commonly reported occupational diseases in the E.U. In this situation the occupational health physician has to evaluate the noise level especially in industrial environment in order to help the patients and the employers to prevent the noise irreversible health damages. This material presents two simple algorithms to be used to calculate the resulting noise level when composing noise sources. Personal contributions.     

Fura-2 imaging of spontaneous and electrically induced oscillations of intracellular free Ca2+ in rat myotubes

Rat myotubes have a resting [Ca²⁺]_i of about 82 nM. Myotubes 3–5 days old (quiescent myotubes) display electrically induced and spontaneous transients in the intracellular concentration of free Ca²⁺ ions ([Ca²⁺]_i) uncoupled to any detectable contraction. By contrast, 1-to 2-day-old myotubes are insensitive to electrical stimuli and, after 6 days in culture, stimulated myotubes always show [Ca²⁺]_i transients and twitch contractions. The spatial distribution of [Ca²⁺]_i variations in quiescent myotubes is heterogeneous, local increases in [Ca²⁺]_i being mainly observed near the periphery of the cell. The small effect of different external Ca²⁺ concentrations and of Cd²⁺ on the amplitude of the [Ca²⁺]_i oscillation indicates that the main source of Ca²⁺ may be the sarcoplasmic reticulum. This conclusion is supported by the close similarity between electrically induced and caffeine-induced [Ca²⁺]_i maps. These findings suggest that, at an early stage of myotube ontogenesis, a part of the excitation/contraction coupling, as membrane ionic channels, voltage sensors and Ca²⁺ release and reuptake mechanisms, is functional but, apparently, still uncoupled to the contractile machinery.This work was supported by the Centre National de la Recherche Scientifique, the Ministère de la Recherche et de la Technologie, the Conseil Régional de l'Aquitaine and the Association Française contre les Myopathies     

Mediterranean,but not lacto-ovo-vegetarian,diet positively influence circulating progenitor cells for cardiovascular prevention: The CARDIVEG study

AimTo evaluate the possible association between dietary habits and progenitor cells using data obtained from a randomized crossover trial using two different diets, lacto-ovo-vegetarian (VD) and Mediterranean (MD), the CARDIVEG study.Methods and resultsEighty clinically healthy subjects with a low-to-moderate cardiovascular risk profile (61 F; 19 M; mean age: 50.7 ± 11.6 years) were randomly assigned to isocaloric VD and MD diets lasting three months each, and then crossed. The two diets showed no effects on endothelial progenitor cells and circulating endothelial cells but opposite effects on circulating progenitor cells. In fact, VD determined significant (p < 0.05) and negative changes on circulating progenitor cells, with an average geometric variation of ?130 cells/10⁶ events for CD34⁺/CD45^–/dim, ?80 cells/10⁶ events for CD133⁺/CD45^–/dim, and ?84 cells/10⁶ events for CD34⁺/CD133⁺/CD45^–/dim while MD determined significant (p < 0.05) and positive changes for CD34⁺/CD45^–/dim levels, with a geometric mean increase of +54 cells/10⁶ events. No significant correlations were observed between changes in progenitor cells and changes in inflammatory parameters during the VD phase. On the other hand, during the MD phase negative correlations between changes of CD34⁺/CD45^–/dim and interleukin-6 (R = ?0.324; p = 0.004) as well as interleukin-8 (R = ?0.228; p = 0.04) and monocyte chemotactic protein-1 (R = ?0.277; p = 0.01), were observed. These correlations remained significant also after adjustment for confounding factors only for CD34⁺/CD45^–/dim and interleukin-6 (β = ?0.282; p = 0.018) and monocyte chemotactic protein-1 (β = ?0.254; p = 0.031).ConclusionsMD, but not VD, reported a significant and positive effect on circulating progenitor cells in a group of subjects at low-to-moderate cardiovascular risk, probably acting through the modulation of inflammatory parameters.