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  1 / 15137 MEDLINE  
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[PMID]:29505537
[Au] Autor:Chan FK; Hsu CC; Lin HJ; Wang JJ; Su SB; Huang CC; Weng SF
[Ad] Endereço:Department of Emergency Medicine, Kuo General Hospital.
[Ti] Título:Physicians as well as nonphysician health care professionals in Taiwan have higher risk for lumbar herniated intervertebral disc than general population.
[So] Source:Medicine (Baltimore);97(1):e9561, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Physicians in Taiwan have long working hours and are at risk for inappropriate posture when handling patients, which may contribute to lumbar herniated intervertebral disc (L-HIVD). This study was conducted to delineate this issue, which is still unknown. This nationwide population-based cohort study was based on Taiwan National Health Insurance Research Database. We identified 25,428 physicians, 32,316 nonphysician health care professionals (HCPs), and an identical number of age- and sex-matched individuals from the general population. All individuals who had L-HIVD before 2007 were excluded. We compared the L-HIVD risk between physicians and general population, nonphysician HCPs and general population, and physicians and nonphysician HCPs by tracing their medical histories between 2007 and 2011. A comparison among physician specialties was also performed. Physicians and nonphysician HCPs had higher L-HIVD risk than the general population [odds ratio (OR): 1.149; 95% confidence interval (CI): 1.011-1.307 and OR: 1.220; 95% CI: 1.080-1.378, respectively]. Physicians did not have higher L-HIVD risk than nonphysician HCPs [adjusted OR (AOR): 0.912; 95% CI: 0.795-1.046]. Physician specialties of orthopedics and obstetrics and gynecology had a trend of higher L-HIVD risk than other specialties (AOR: 1.538; 95% CI: 0.805-2.939, and AOR: 1.306; 95% CI: 0.967-1.764, respectively). Physicians as well as nonphysician health care professionals in Taiwan have higher L-HIVD risk than the general population, which could be attributed to a probable role of long working hours. This result provides an important reference for the government to promote occupational health in health care professionals; however, further studies are warranted for the underlying mechanisms.
[Mh] Termos MeSH primário: Pessoal Técnico de Saúde/estatística & dados numéricos
Deslocamento do Disco Intervertebral/epidemiologia
Vértebras Lombares
Exposição Ocupacional/efeitos adversos
Médicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Deslocamento do Disco Intervertebral/etiologia
Masculino
Meia-Idade
Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009561


  2 / 15137 MEDLINE  
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[PMID]:29205004
[Au] Autor:Chen F; Cheng YB; Fan LH
[Ad] Endereço:Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai 200063, China.
[Ti] Título:[Analysis of Relationship between Injury and Disease in 17 Cases of Cervical Trauma with Cervical Vertebra Degeneration].
[So] Source:Fa Yi Xue Za Zhi;32(5):350-352, 2016 Oct.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To study the characteristics of the relationship between injury and disease in forensic identification cases of cervical trauma with cervical vertebra degeneration, and to explore the problems about how to identify the participation rates of injury and disease using the clinical information, forensic examination and imaging examination. METHODS: Seventeen forensic identification cases of cervical trauma with cervical vertebra degeneration were collected. The age distributions, injury formations, injury severities and imaging findings of these cases were analyzed and the relationship between injury and disease was evaluated comprehensively. RESULTS: Middle-aged and elderly were common in 17 cases and every case was involved with intervertebral disc herniation. The main reasons of injuries were hyperextension. The degree of injury severity and vertebra degeneration were graded according to the imaging findings. The participation rates of injury and disease were also calculated comprehensively. CONCLUSIONS: The forensic identification cases of cervical trauma with cervical vertebra degeneration should be evaluated with clinical information, forensic examination and imaging finding.
[Mh] Termos MeSH primário: Vértebras Cervicais/lesões
Vértebras Cervicais/patologia
Degeneração do Disco Intervertebral/patologia
Deslocamento do Disco Intervertebral/patologia
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Idoso
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.05.008


  3 / 15137 MEDLINE  
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[PMID]:28460630
[Au] Autor:Moen A; Jacobsen D; Phuyal S; Legfeldt A; Haugen F; Røe C; Gjerstad J
[Ad] Endereço:National Institute of Occupational Health, Pb 8149 Dep., 0033, Oslo, Norway.
[Ti] Título:MicroRNA-223 demonstrated experimentally in exosome-like vesicles is associated with decreased risk of persistent pain after lumbar disc herniation.
[So] Source:J Transl Med;15(1):89, 2017 May 01.
[Is] ISSN:1479-5876
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Previous findings have demonstrated that lumbar radicular pain after disc herniation may be associated with up-regulation of inflammatory mediators. In the present study we examined the possible role of extracellular microRNAs (miRs) in this process. METHODS: Single unit recordings, isolation of exosome-like vesicles, electron microscopy, nanoparticle tracking analysis, western blot analysis and qPCR were used in rats to demonstrate the effect of nucleus pulposus (NP) applied onto the dorsal nerve roots. ELISA and qPCR were used to measure the level of circulating IL-6 and miRs in a 1-year observational study in patients after disc herniation. RESULTS: In the rats, enhanced spinal cord nociceptive responses were displayed after NP applied onto the dorsal nerve roots. An increased release of small non-coding RNAs, including miR-223, miR-760 and miR-145, from NP in exosome-like vesicles was demonstrated. In particular, the NP expression of miR-223, which inhibited the nociceptive spinal signalling, was increased. In the patients, increased extracellular miR-223 was also verified in the acute phase after disc herniation. The increased miR-223 expression was, however, only observed in those who recovered (sex, age and smoking were included as covariates). CONCLUSIONS: Our findings suggest that miR-223, which can be released from the NP after disc herniation, attenuates the neuronal activity in the pain pathways. Dysregulation of miR-223 may predict chronic lumbar radicular pain. Trial registration/ethics REK 2014/1725.
[Mh] Termos MeSH primário: Exossomos/metabolismo
Deslocamento do Disco Intervertebral/complicações
Vértebras Lombares/patologia
MicroRNAs/metabolismo
Dor/etiologia
Dor/genética
[Mh] Termos MeSH secundário: Adulto
Animais
Exossomos/ultraestrutura
Feminino
Seres Humanos
Deslocamento do Disco Intervertebral/patologia
Deslocamento do Disco Intervertebral/fisiopatologia
Vértebras Lombares/fisiopatologia
Masculino
MicroRNAs/genética
Meia-Idade
Ratos Endogâmicos Lew
Recuperação de Função Fisiológica
Fatores de Risco
Regulação para Cima/genética
Escala Visual Analógica
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (MIRN223 microRNA, human); 0 (MIRN223 microRNA, rat); 0 (MicroRNAs)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1186/s12967-017-1194-8


  4 / 15137 MEDLINE  
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[PMID]:29222149
[Au] Autor:Annette W; Posporis C
[Ad] Endereço:Neurology and Neurosurgery Service, Pride Veterinary Centre, Derby, UK.
[Ti] Título:Compressive hydrated nucleus pulposus extrusion: is surgery necessary?
[So] Source:Vet Rec;181(23):622-624, 2017 12.
[Is] ISSN:2042-7670
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Deslocamento do Disco Intervertebral
Núcleo Pulposo
[Mh] Termos MeSH secundário: Animais
Disco Intervertebral
Vértebras Lombares
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171210
[St] Status:MEDLINE
[do] DOI:10.1136/vr.j5683


  5 / 15137 MEDLINE  
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[PMID]:29192043
[Au] Autor:Beltran E
[Ad] Endereço:Department of Clinical Science & Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
[Ti] Título:Acute hydrated non-compressive nucleus pulposus extrusion: what do we know so far?
[So] Source:Vet Rec;181(22):591-593, 2017 12.
[Is] ISSN:2042-7670
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Deslocamento do Disco Intervertebral
Núcleo Pulposo
[Mh] Termos MeSH secundário: Animais
Disco Intervertebral
Degeneração do Disco Intervertebral
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1136/vr.j5494


  6 / 15137 MEDLINE  
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[PMID]:29384882
[Au] Autor:Li X; Chang H; Meng X
[Ad] Endereço:Department of Spine Surgery, The Third Hospital of Hebei Medical University.
[Ti] Título:Tubular microscopes discectomy versus conventional microdiscectomy for treating lumbar disk herniation: Systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);97(5):e9807, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The application of tubular microscopes discectomy (TMD) was supposed to have similar or better results than conventional microdiscectomy (CMD). However, this conclusion had not been verified by sufficient evidence. Therefore, the focus of this meta-analysis was to assess the efficiency, safety, and clinical outcome of these 2 surgical procedures for treating lumbar disk herniation (LDH). METHODS: PubMed, Embase, and Cochrane Collaboration Central databases were searched for studies which compared the results of TMD and CMD for the treatment of LDH up to July 2017. Data analysis was conducted using RevMan 5.3. A standardized electronic form of 17 predefined criteria from the Consort statement was used for the quality assessment. RESULTS: Eight randomized controlled trials (RCT) and 2 retrospective studies were included in this review, including 804 patients. The pooled analysis showed that there was no significant difference in operative time (P = .38), blood loss (P = .14), the length of hospital stay (P = .47), the rate of intraoperative complications (P = .79), postoperative complications (P = .16), dural tear (P = .87), the reoperation (P = .20), the short-term back visual analog scale (VAS) scores (P = .76), the long-term back VAS scores (P = .64), the short-term leg VAS scores (P = .09), the long-term leg VAS scores (P = .35), and the Oswestry disability index (ODI) scores (P = .41). CONCLUSION: The results of this meta-analysis demonstrate that TMD and CMD are both safe and effective surgical procedures which can be recommended for treating LDH. Additionally, the conclusion should be cautiously treated, because it was reached in the context of limited amount of studies and relatively small sample size. Therefore, future studies with good design and more large samples are required to validate this conclusion.
[Mh] Termos MeSH primário: Discotomia
Deslocamento do Disco Intervertebral/cirurgia
Vértebras Lombares
Microcirurgia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009807


  7 / 15137 MEDLINE  
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[PMID]:29297667
[Au] Autor:Byvaltsev VA; Kalinin AA; Okoneshnikova AK; Kerimbaev TT; Belykh EG
[Ti] Título:Facet Fixation Combined with Lumbar Interbody Fusion: Comparative Analysis of Clinical Experience and A New Method of Surgical Treatment of Patients with Lumbar Degenerative Diseases.
[So] Source:Vestn Ross Akad Med Nauk;71(5):375-84, 2016.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Background: For the treatment of patients with degenerative diseases of the lumbar spine the technique of pedicle fixation is widespread, when after open decompression channel structure locking screws are introduced into the vertebral body through the back vertebra legs. We first used a fundamentally new way of fixing the rear using the facet-boards Cage «Facet Wedge¼, when posterior fixation is done by closing the facet joints with minimally invasive, percutaneous method. We have not found data on the clinical efficacy of facet fixation in scientific literature. Aims: To compare the clinical efficacy of facet fixation combined with interbody fusion in the treatment of patients with degenerative lumbar spine disease. Materials and Methods: The study included 145 patients who were divided into 2 groups. The study group with long-term observation included patients (n=100) who underwent a new method for lumbar fixation; the method comprises unilateral or bilateral implantation of titanium Cage «facet Wedge¼ in the joint space facet joint in combination with the anterior, lateral, and transforaminal interbody fusion. Clinical comparison group (n=45) included retrospectively recruited patients who were performed titanium pedicle screw installation after open decompression and interbody fusion posterior lumbar fixation. Dynamic observation and comprehensive evaluation of the treatment clinical results was carried out for 18 months after surgery. Results: Cage facet installation technology is quite simple, universal for the stabilization of the rear of the complex after interbody fusion from the front, side, and rear access; and does not require the intraoperative application of expensive high-tech equipment. Comparative analysis of the main group showed significantly better results in terms of the duration of the operation [CG 125 (90; 140) min, the CCG 205 (160; 220) min; p=0.01], the volume of blood loss [CG 80 (70; 120) ml, CCG 350 (300; 550) ml; p=0.008], activation time [CG 2 (1; 2) days, 4 CCG (3; 5) days; p=0.02], length of hospitalization [CG 9 (10; 11) days, the CCG 13 (12; 15) days; p=0.03], the level of pain on a visual analog scale [CG 3 (2; 4) mm, CCG 15 (12; 18) mm; p=0.001], quality of life (by index Oswestry) [CG 8 (6; 8) points, the CCG 23 (20; 28) points, p=0.003], and labor rehabilitation [CG 3 (2; 6) months, CCG 9 (6; 12) months; p=0.0001]. The number of postoperative complications in group 1 was 13%, in the 2nd ­ 31,1% (p=0,0012). The new method involves fixing the back with considerably less surgical trauma of paravertebral soft tissue that results in early activation of patients, reduction of stay in hospital period, and better functional recovery of patients. Conclusions: The application of facet fixation combined with interbody fusion in the treatment of patients with degenerative diseases of the lumbar spine allows achieving the best clinical outcomes and fewer postoperative complications during the short and long-term follow-up if compared with the traditional method of transpedicular stabilization. The combination of low-impact and reliability facet fixation techniques for posterior stabilization of the operated segment creates favorable conditions for the restoration of a functional condition of patients, full social and physical rehabilitation.
[Mh] Termos MeSH primário: Fixação de Fratura
Degeneração do Disco Intervertebral
Deslocamento do Disco Intervertebral
Vértebras Lombares
Complicações Pós-Operatórias
Fusão Vertebral
Articulação Zigapofisária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Fixação de Fratura/efeitos adversos
Fixação de Fratura/instrumentação
Fixação de Fratura/métodos
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico
Degeneração do Disco Intervertebral/psicologia
Degeneração do Disco Intervertebral/cirurgia
Deslocamento do Disco Intervertebral/diagnóstico
Deslocamento do Disco Intervertebral/psicologia
Deslocamento do Disco Intervertebral/cirurgia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Masculino
Meia-Idade
Parafusos Pediculares
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Qualidade de Vida
Recuperação de Função Fisiológica
Estudos Retrospectivos
Federação Russa
Fusão Vertebral/efeitos adversos
Fusão Vertebral/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.15690/vramn738


  8 / 15137 MEDLINE  
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[PMID]:28466008
[Au] Autor:Xin Z; Liao W; Ao J; Qin J; Chen F; Ye Z; Cai Y
[Ad] Endereço:Department of Spinal Surgery, The First Affiliated Hospital of Zunyi Medical College, Zunyi, China.
[Ti] Título:A Modified Translaminar Osseous Channel-Assisted Percutaneous Endoscopic Lumbar Discectomy for Highly Migrated and Sequestrated Disc Herniations of the Upper Lumbar: Clinical Outcomes, Surgical Indications, and Technical Considerations.
[So] Source:Biomed Res Int;2017:3069575, 2017.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Objective is to describe a safe and effective percutaneous endoscopic approach for removal of highly migrated and sequestrated disc herniations of the upper lumbar spine and to report the results, surgical indications, and technical considerations of the new technique. Eleven patients who had highly migrated and sequestrated disc herniations in the upper lumbar were included in this study. A retrospective study was performed for all patients after translaminar osseous channel-assisted PELD was performed. Radiologic findings were investigated, and pre-and postoperative visual analog scale (VAS) assessments for back and leg pain and Oswestry disability index (ODI) evaluations were performed. Surgical outcomes were evaluated under modified MacNab criteria. All of the patients were followed for more than 1 year. The preoperative and postoperative radiologic findings revealed that the decompression of the herniated nucleus pulposus (HNP) was complete. After surgery, the mean VAS scores for back and leg pain immediately improved from 8.64 (range, 7-10) and 8.00 (range, 6-10) to 2.91 (range, 2-4) and 2.27 (range, 1-3), respectively. The mean preoperative ODI was 65.58 (range, 52.2-86), which decreased to 7.51 (range, 1.8-18) at the 12-month postoperative follow-up. The MacNab scores at the final follow-up included nine excellent, one good, and one fair. The modified translaminar osseous channel-assisted PELD could be a safe and effective option for the treatment of highly migrated and sequestrated disc herniations of the upper lumbar.
[Mh] Termos MeSH primário: Discotomia Percutânea/métodos
Degeneração do Disco Intervertebral/cirurgia
Deslocamento do Disco Intervertebral/cirurgia
Dor/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Descompressão Cirúrgica/métodos
Endoscópios/tendências
Feminino
Seres Humanos
Degeneração do Disco Intervertebral/fisiopatologia
Deslocamento do Disco Intervertebral/patologia
Deslocamento do Disco Intervertebral/fisiopatologia
Vértebras Lombares/fisiopatologia
Vértebras Lombares/cirurgia
Masculino
Meia-Idade
Medição da Dor
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1155/2017/3069575


  9 / 15137 MEDLINE  
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[PMID]:29390461
[Au] Autor:Xiang A; Xu M; Liang Y; Wei J; Liu S
[Ad] Endereço:Shanghai University of Traditional Chinese Medicine, Shanghai, China.
[Ti] Título:Immediate relief of herniated lumbar disc-related sciatica by ankle acupuncture: A study protocol for a randomized controlled clinical trial.
[So] Source:Medicine (Baltimore);96(51):e9191, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Around 90% of sciatica cases are due to a herniated intervertebral disc in the lumbar region. Ankle acupuncture (AA) has been reported to be effective in the treatment of acute nonspecific low back pain. This study aims to evaluate the efficacy of a single session of ankle acupuncture for disc-related sciatica. METHOD: This will be a double-blinded, randomized controlled clinical trial. Patients diagnosed with disc-related sciatica will be randomly divided into 3 parallel groups. The treatment group (n = 30) will receive ankle acupuncture. The 2 control groups will either undergo traditional needle manipulation (n = 30) or sham acupuncture (n = 30) at the same point as the treatment group. The primary outcome will be pain intensity on a visual analog scale (VAS). The secondary outcomes will be paresthesia intensity on a VAS and the Abbreviated Acceptability Rating Profile (AAPR). The success of blinding will be evaluated, and the needle-induced sensation and adverse events will be recorded. All outcomes will be evaluated before, during, and after the treatment. DISCUSSION: This study will determine the immediate effect and specificity of ankle acupuncture for the treatment of disc-related sciatica. We anticipate that ankle acupuncture might be more effective than traditional needle manipulation or sham acupuncture. TRIAL REGISTRATION: ChiCTR-IPR-15007127 (http://www.chictr.org.cn/showprojen.aspx?proj=11989).
[Mh] Termos MeSH primário: Terapia por Acupuntura/métodos
Articulação do Tornozelo
Deslocamento do Disco Intervertebral/complicações
Medição da Dor
Ciática/terapia
[Mh] Termos MeSH secundário: Adulto
Análise de Variância
China
Método Duplo-Cego
Feminino
Seguimentos
Seres Humanos
Deslocamento do Disco Intervertebral/diagnóstico
Dor Lombar/diagnóstico
Dor Lombar/etiologia
Masculino
Meia-Idade
Valores de Referência
Ciática/etiologia
Ciática/fisiopatologia
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009191


  10 / 15137 MEDLINE  
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[PMID]:29390557
[Au] Autor:Lee JA; Ha IH; Choi TY; Choi J; Jun JH; Kang BK; Lee MS
[Ad] Endereço:KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon.
[Ti] Título:Evaluating the clinical application of a leaflet for clinical practice guideline in patients with lumbar herniated intervertebral discs: Randomized controlled trial.
[So] Source:Medicine (Baltimore);96(51):e9406, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aims to demonstrate the effectiveness of using clinical practice guideline (CPG) leaflets as a communication tool between doctors and patients. We evaluated the leaflets as a communication tool in the treatment of lumbar herniated intervertebral discs (HIVDs) in terms of patient and physician satisfaction and ease of treatment. METHODS: This study is a 2-parallel-arm, assessor-blinded, randomized controlled trial at Jaseng Hospital, Seoul, South Korea. We evaluated efficacy through a comparison of satisfaction and clinical outcomes in randomly allocated groups of HIVD lumbar patients visiting Jaseng Hospital of Korean Medicine. We used leaflets on the basis of Korean medicine CPG recommendations as an intervention. The intervention group received treatment and diagnosis using the leaflet, and the control group received the typical intervention, which was provided without the leaflet. RESULTS: The levels of patient satisfaction with and understanding of the doctors' explanation was 92% in the leaflet group and 64% in the nonleaflet group, which showed that, compared with patient satisfaction in the nonleaflet group, patient satisfaction was considerably higher by 28% in the leaflet group. In addition, the level of the reliability with treatment was 92% in the leaflet group and 64% in the control group. However, there were no significant differences in statistical analyses. The level of doctors' satisfaction with communicating with patients using the leaflet was 100% in the leaflet group. Given this satisfaction, the ease of persuasion of treatment was highest (84%) and followed the improvement in the patient's understanding of the treatment (16%) in the leaflet group. In addition, in the nonleaflet user group, almost all doctors thought that having a leaflet would be a more effective treatment. CONCLUSION: Although this study failed to show significant differences between the intervention and control groups, the leaflet, which included CPG information in the treatment of HIVD patients, was an effective communication tool between patients and doctors. However, further studies with larger samples should be conducted to investigate the effectiveness of the communication tool based on the CPG. TRIAL REGISTRATION NUMBER: Clinical Research Information Service: KCT0001762.
[Mh] Termos MeSH primário: Deslocamento do Disco Intervertebral/terapia
Educação de Pacientes como Assunto
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Adulto
Atitude do Pessoal de Saúde
Comunicação
Feminino
Seres Humanos
Deslocamento do Disco Intervertebral/psicologia
Vértebras Lombares
Masculino
Educação de Pacientes como Assunto/métodos
Satisfação do Paciente
Relações Médico-Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009406



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