bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Sickness Absence in Patients with a New Episode of Low Back Pain in Primary Care
Authors: Melloh M. , Rolli Salathé C. , Käser A. , Elfering A. 
Published: June 2012

Introduction Although there is a call for early risk prediction of sickness absence, specific prognostic factors of low back pain (LBP) related sickness absence have not yet been established in either clinical or research settings. This study examines predictors of sickness absence in patients presenting to a health practitioner with acute/subacute LBP. The aims of our study were twofold: (1) To identify baseline variables that detect patients with a new LBP episode at risk of sickness absence; and (2) To identify prognostic models for sickness absence at different time points after initial presentation. Materials and Methods Prospective cohort study investigating 310 patients presenting to a health practitioner with a new episode of LBP at baseline, 3-, 6-, 12-week, 6-month follow-up, addressing work-related, psychological, and biomedical factors. Multivariate logistic regression analysis was performed to identify baseline predictors of sickness absence at different time points. Results The best prognostic model comprised “job control”, “depression,” and “functional limitation” as predictive baseline factors of sickness absence at 6-week follow-up (sensitivity 43.5; specificity 96.5; overall predictive value 89.0) with “job control” being the best single predictor (OR 0.49; 95% CI, 0.27–0.89). This model explained 46% of variance of sickness absence at 6-week follow-up ( p < 0.001). The second best model included “job control” (OR 0.64; 95% CI, 0.42–0.96) as the only significant predictive baseline factor for sickness absence at 3-week follow-up (sensitivity 45.2; specificity 94.7; overall predictive value 83.9). This model explained 39% of variance of sickness absence ( p < 0.001). Sickness absence at a time point beyond 6 weeks could not be predicted. Conclusion For patients with acute/subacute LBP, the model has the greatest predictive ability for sickness absence at 6 weeks after initial presentation to a health practitioner. The prediction of sickness absence beyond 6 weeks is limited, and health practitioners should re-assess patients at 6 weeks, especially if they have previously been identified as at risk of sickness absence. This would allow timely intervention with measures designed to reduce the likelihood of prolonged sickness absence. Further research is warranted investigating assessment at different time points, to identify the optimal time at which to reassess at risk acute/subacute LBP patients to accurately predict sickness absence. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Who is Likely to Develop Persistent Low Back Pain? a Longitudinal Analysis of Prognostic Occupational Factors
Authors: Melloh M. , Käser A. , Rolli Salathé C. , Elfering A. 
Published: June 2012

Introduction Socioeconomic costs of persistent low back pain (LBP) exceed the costs of acute and subacute LBP by far. This makes the early identification of patients at risk of developing persistent LBP essential. By differentiating risk from protective factors, these factors could be addressed proactively to limit the associated socioeconomic burden. Aim of our study was to identify factors influencing the progression of acute/subacute LBP to the persistent state. Materials and Methods This is a prospective cohort study of patients attending a health practitioner for their first episode of acute/subacute LBP. Patients were assessed at baseline addressing occupational, psychological, biomedical, and demographic/lifestyle factors and followed up over 6 months according to the recommendations from the Multinational Musculoskeletal Inception Cohort Study (MMICS) Statement. Multivariate logistic regression analysis was performed separately for the variables groups of the four different domains, controlling for age, gender, and body mass index. The overall predictive value was calculated for the full regression models of the different domains. Finally, all significant variables from the different domains were combined into a final predictor model. Results The final four-predictor model predicted 51% of variance of persistent LBP and included “resigned attitude towards the job” (OR 1.73; 95% CI, 1.16–2.59), “social support at work” (OR 0.54; 95% CI, 0.32–0.90), “functional limitation” (OR 1.05; 95% CI, 1.01–1.10), and “duration of LBP” (OR 1.04; 95% CI, 1.02–1.06). The accuracy of the model was 83%, with 92% of nonpersistent and 67% of persistent LBP patients correctly identified. Conclusion In this study of patients with acute/subacute LBP, “resigned attitude towards the job” increased the likelihood of persistent LBP at 6 months. Addressing this factor with workplace interventions has the potential to modify the outcome. “Social support at work” was a protective factor meaning that development of persistent LBP was less likely. It can therefore be considered as a resource for prevention of persistent LBP. Findings from this study confirm the requirement for measurement of occupational factors in screening tools for patients at risk of developing persistent LBP. Further research is required to investigate different types of social support at work regarding their prognostic influence on the development of persistent LBP. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Expression and Distribution of Interleukin-17 in Degenerated Human Cervical Intervertebral Disks
Authors: Zhang Y. 
Published: June 2012

Introduction To investigate the expression and distribution of interleukin-17 (IL-17) ingenerate human cervical intervertebral disks tissues and to explore the relationship between IL-l7 and cervical intervertebral disk degeneration. Materials and Methods IL-Iβ,IL-17,tumor necrosis factor (TNF-α), and retinoid-related orphan receptor (RORγt) mRNA levels were respectively measured by real-time quantitative reverse transcription-polymerase chain reaction (QT-PCR) in 30 surgical degenerate cervical intervertebral disk tissues (degeneration group) and 10 nondegenerate control tissues (control group). The level of IL-17 protein and CD4 cell surface antigen were measured by immunohistochemistry staining. Results The mean IL-1β, IL-17, TNF-α, RORγt mRNA levels in degeneration group were significantly higher than that in control group( p < 0.001),and the expression of these factors in nucleus pulposus were significantly higher than that in annulus fibrosus (AF) in degeneration group( p < 0.05). The expression level of IL-17 mRNA was positively correlated with RORγt mRNA level ( r = 0.61, p < 0.001). Immunoreactivity of IL-17 and CD4 cell surface antigen were significantly greater in degenerate disks than in controls ( p < 0.001),and the immunoreactivity in nucleus pulposus was higher than that in AF in degeneration group( p < 0.05). Conclusion The expression level of IL-17 mRNA and IL-17 protein were significantly increased in degenerate human cervical disk tissues than that in autopsy control tissues, and the expression in nucleus pulposus was greater than in AF. These findings suggest involvement of IL-17 in the pathomechanism of intervertebral disk degeneration. Immune inflammation mediated by Th17 lymphocytes may play an important role in the development and progression of human cervical intervertebral disk degeneration. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Is the Morphology and Size of Schmorl's Nodes of the Lumbar Spine Related to Severity of Disk Degeneration?
Authors: Samartzis D. , Mok F. , Karppinen J. , Luk K. , Cheung K. 
Published: June 2012

Introduction We have recently confirmed that the presence of Schmorl's nodes (SN) was highly associated with disk degeneration in a large population-based cohort study in Southern Chinese. Based on our previous proposed classification system of SN, we attempt to further address the association of SN characteristics and the severity of disk degeneration. Materials and Methods Two independent observers assessed sagittal T2-weighted MRIs of the lumbar spine ( n = 2449) for the presence and characteristics of SN, and additional radiologic features. The patterns of SN characteristics were assessed by hierarchical clustering methods. Generalized linear models were used to assess the associations of the shape and size of SN with disk degeneration severity. Results Total 401 subjects with SN (16.4%) were included in the analysis. Hierarchical clustering showed that typical SN were usually smaller in size with shape type I to III (i.e., indented endplate, sharp or rounded shape) whereas atypical SN were larger with shape type IV to V (i.e., rectangular or irregular shape). Total 8.3% of all identified SN ( n = 960) were atypical SN. Multivariate ordinal logistic regression adjusted for gender, age, body mass index, smoking status, presence of disk bulge/extrusion, and high intensity zone showed that atypical SN and typical SN, depending on the lumbar levels, were associated with 5- to 13-fold and 2- to 4-fold higher risk of increased severity of disk degeneration, respectively ( p < 0.05). Conclusion This was the first study to address the relationships of SN morphology to the severity of disk degeneration. The associations of SN morphology with disk degeneration severity might be clinically relevant. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Inhibiting Brain-Derived Neurotrophic Factor (Bdnf) at the Punctured Intervertebral Disk Downregulates Pain-Related Neuropeptide Production in Dorsal Root Ganglia in Rats
Authors: Orita S. , Eguchi Y. , Inoue G. , Yamauchi K. , Ishikawa T. , Miyagi M. , Kamoda H. , Arai G. , Suzuki M. , Sakuma Y. , Oikawa Y. , Kubota G. , Inage K. , Takahashi K. , Ohtori S. 
Published: June 2012

Introduction BDNF-a neurotrophin in dorsal root ganglion (DRG) neurons-is known to be anterogradely transported to the spinal cord and transmits pain signals existing in the central nervous system. A previous study has recently reported its presence in the peripheral sites of degenerative IVDs, although its association with discogenic pain remains unclear. The present study aimed to investigate the association between BDNF and pain-related sensory innervation of multiple-punctured lumbar IVD in rats. Materials and Methods Forty female Sprague-Dawley rats were equally divided into four groups: naïve, sham, and two agent-treated groups (vehicle (saline-treated) and anti-BDNF (anti-BDNF antibody) group). L5-6 IVDs of the agent-treated rats were exposed and injured by repeated punctures. The retrograde neurotracer Fluoro-Gold (FG) and treatment agents were intradiscally applied. In the sham group, FG alone was applied onto uninjured IVD. One week later, L1-3 DRGs were harvested and immunolabeled for the inflammatory pain-related calcitonin gene-related peptide (CGRP), that is, the pain marker. The proportions of FG-labeled CGRP-immunoreactive (-ir) DRG neurons were assessed. BDNF concentration of each L5-6 IVD was measured using enzyme-linked immunosorbent assay (ELISA). Results FG-labeled DRG neurons were almost equally prevalent at each DRG level. The proportions of FG-labeled CGRP-ir DRG neurons in the two agent-treated groups were significantly elevated ( p < 0.05) compared with the naïve and sham groups and were significantly decreased in the anti-BDNF group as compared to the vehicle group ( p < 0.05). BDNF concentrations were elevated maximally in the vehicle group but suppressed in the anti-BDNF group. Conclusion Direct intradiscal application of the anti-BDNF antibody significantly suppressed both CGRP production and the local concentration of BDNF. Our results indicate a possible association between the local production of BDNF and the pathophysiology of discogenic pain. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Chronic Unpredictable Stress Induces Intervertebral Disk Cell Apoptosis and Degeneration
Authors: Reihani Kermani H. , Hobubati H. , Esmaeili Mahani S. , Assadi Shekari M. 
Published: June 2012

Introduction Animal model was used to study the effects of chronic unpredictable stress (CUS) on the intervertebral disk (IVD). Stress is a predictor for low back disability in persons with earlier low back pain (LBP) and LBP is most common in the early stages of IVD degeneration. Stress can increase proinflammatory cytokines. Elevated levels of molecular mediators of inflammation have been described in the pathology of IVD degeneration; however, the effect of chronic stress on the induction of disk degeneration has not yet been clarified. Materials and Methods Cellular events involved in injury-and stress-induced disk degeneration in male Wistar rats were investigated. Disk degeneration and apoptosis was evaluated by microscopic (light and electron) and molecular (immunoblotting and immunohistochemistry) methods. Corticosterone levels were measured by radioimmunoassay as a marker of stress condition. Results The data showed that chronic stress could significantly increase corticosterone levels. Furthermore, biochemical markers of apoptosis (increased Bax to Bcl2 ratio ( p < 0.05) and TUNEL reactivity) were observed in animals that had chronic stress. Electron and light microscopy also showed disk degeneration and apoptotic cells in over experimental group. Conclusion Taken together, the data demonstrated that chronic stress is probably a risk factor for creating IVD degeneration and that programmed cell death is one of the mechanisms of stress-induced disk degeneration, however, the effects of stress and its impact on the escalation of disk degeneration and LBP need to be clarified by further investigations. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Optimizing Oxygenation and Serum Concentration in Ex Vivo Culture of Mouse Nucleus Pulposus Cells Derived from the Notochord
Authors: Nakajima D. , Sakai D. , Tanaka M. , Yokoyama K. , Hiyama A. , Mochida J. 
Published: June 2012

Introduction It has been a long-time argument regarding the origin of NP cells in adult humans. Recent review on lineage studies suggests that all nucleus pulposus cells including chondrocyte-like cells are derived from notochordal precursors and those variations in morphology and size are representative of different stages of maturation, and or, function. To define fate of cells in the IVDs that originate from the notochord, we investigated the IVDs of double-transgenic (TG) mouse encoding Protein-0(P0)-Cre/Floxed-EGFP. Cells originating from the neural crest or notochord express positivity for GFP in this TG mouse. We analyzed the effect of hypoxia and serum concentration in notochordal NP cells. Materials and Methods The double transgenic P0-Cre/Floxed-EGFP mice ( n = 10, 5–7 Wks old) were used. The NP cells were isolated from the coccygeal IVDs of P0-Cre/Floxed-EGFP mouse under microscopy and cultured for 10 days without enzymatic processing. After passage these cells were divided into four groups according to the culture condition, Group A; Hypoxia (2% O2) and 20% FBS, Group B; Hypoxia and 10% FBS, Group C; Normoxia (21% O2) and 20% FBS, Group D; Normoxia and 10% FBS. These cells are cultured for over 7 days. We evaluated cell counts with trypan blue staining, cell cycle, and apoptosis by the flow cytometry on the third, fifth, and the seventh day of culture. Results The cell number in group A after the seventh day of culture showed the obviously largest increase. On the seventh day the cell number in group A showed a 17-fold increase, group B showed a 9-fold increase, group C showed a 2-fold increase, group D showed a 1.8-fold increase. The hypoxia (2% O2) groups showed increased cell proliferation rate than the normoxia (21% O2) groups, and the higher FBS concentration (20%) groups showed increased cell proliferation than the lower FBS (10%) groups. Though it seems that in GFP positive and negative ratio there is a difference between the hypoxia groups and the normoxia groups, it has not said clearly yet. We need to obtain some more number of culture. There were no significant changes in the cell cycle and apoptosis between these groups. Conclusion The condition of a low oxygen density and higher FBS concentration was the optimized condition for the mouse notochordal NP cells. Since notochordal NP cells may be important for NP tissue maintenance and phenotype, our result will be useful in ex vivo investigations and based therapy for disk disease. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared
Human Intervertebral Disk Degeneration is Associated with Increased Chemokine Expression
Authors: Phillips K. L. E. , Chiverton N. , Haddock G. , Bunning R. , Cross A. , Le Maitre C. 
Published: June 2012

Introduction Within the avascular intervertebral disk (IVD) local cells are considered autologous regulators of cellular function. Previously cytokine expression, particularly IL-1 and TNF1,2, has been identified and associated with both homeostatic mechanisms and the pathogenesis of IVD degeneration. To date little is known of chemokine expression within the human IVD and here we investigated the hypothesis that an altered chemokine expression profile is associated with IVD degeneration. Materials and Methods Expression of 11 chemokine and 6 associated receptor genes was investigated using qRT-PCR in human IVD samples from nondegenerate and degenerate study groups. Immunohistochemistry was used to localize protein production of certain chemokines and to relate this to the observable grade of degeneration in human IVD tissue. Results Altered gene expression patterns of chemokines and their receptors were observed between nondegenerate and degenerate groups including; upregulation of CCL3 (Fig. 1A) and downregulation of CX3CL1 in degeneration, and upregulation of receptors CCR1, CXCR1, and CXCR2 in degeneration. Protein expression of IL-16, CCL2, CCL3 (Fig. 1B), CCL4, CCL7, and CXCL8 was localized to nucleus pulposus cells and CCL2, CCL3 (Fig. 1C), and CXCL8 expression was seen to correlate with the observable grade of tissue degeneration. Conclusion This study demonstrates the altered gene expression patterns of certain chemokines and their receptors in human IVD degeneration and the positive correlation between expression of certain chemokines and characteristic signs of IVD degeneration. This suggests chemokines may be involved in the pathogenesis of IVD degeneration. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared Le Maitre et al., (2005) Arthritis Research & Therapy. 7, R732-R745 Le Maitre et al., (2007) Arthritis Research & Therapy. 9, R77
Intervertebral Disk Degeneration in the Growing Spine in Patients with Tuberculosis Kyphosis Exceeding 50 Treated by Reconstruction with a Long-Length Posterior Instrumentation
Authors: Pershin A. A. , Mushkin A. Y. 
Published: June 2012

Introduction The rigid angular kyphoses in the young patients with spinal TB are not only a cosmetic problem, they also lead to cardiovascular, respiratory, and neurological disorders. The correction of the deformity could be reached by combination of the debridement, anterior column reconstruction, the shortening of posterior spine, and extended posterior instrumentation. The zone of instrumentation needs to be longer than the anterior fusion for significant correction and spinal stability. Materials and Methods Total 13 children from 2.5 to 12 years with TB spondylitis of the thoracic and lumbar spine complicated by severe angular kyphosis underwent 1-day combined surgery included anterior debridement followed by cortical bone allografting and posterior osteotomy with correction and instrumentation by laminar or hybrid devises. The anterior reconstruction exceeded three segments in all cases (maximum-replacement of 10 vertebral bodies). For real deformity correction the posterior instrumented zone exceeded the length of anterior reconstruction up to 1 or 3 segments cephalad and caudad. The operations were performed under the SSEP monitoring and additionally with wake-up test-in older cases. Neither neurological nor inflammatory complications were in these patients. The normal or closed to the normal sagittal profile was reached in all cases. Follow-up period ranged from 2 till 13 years. Complete follow-up: 13 cases. All patients have annual X-ray control. There wasn't any signs of anterior pseudo-arthrosis revealed. The condition of subchondral vertebral plates and the height of intact intervertebral disks within the zone of instrumentation and disks adjacent to the instrumented spine were compared. Results Total 11 of 13 operated patients (85%) demonstrated degeneration of initially intact disks within the instrumented spine 2 years after the surgery. The signs included loss of disk height, sclerosis, and deformation of subchondral vertebral plates. Despite nobody had back pain, the main parents' complaint was the limitation of spine range of motion. We've decided to count the early symptoms of disk degeneration, the indication to remove spinal hardware having solid anterior fusion documented. There was no increase of kyphosis, excluding one case of conjunctive deformity above the instrumented spine. Conclusion The intervertebral disks degeneration within the instrumented zone is a typical side effect of prolonged posterior rigid instrumentation in growing spine. After 2 years of surgery, it occurred in a majority of pediatric patients who had been operated due to the thoracic and lumbar spinal TB complicated by kyphosis exceeded 50ø. This degeneration was not accompanied by the pain during the childhood, but it may become symptomatic in adulthood. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared