Population Of Asymptomatic Individuals Research Articles

A Systematic Review of Unilateral Biportal Endoscopic Spinal Surgery versus Uniportal Endoscopic Spinal Surgery in Lumbar Canal Stenosis: Clinical Results and Complications

Abstract Background Lumbar spinal stenosis is an important cause of pain and disability in the aging population. The true prevalence of symptomatic spinal stenosis is unknown because radiographic evidence of the condition does not always lead to clinical symptoms. Boden performed a cross-sectional analysis of MRI findings in a population of asymptomatic individuals and found that 30% to 90% of asymptomatic adults had a major spinal abnormality, including disc herniation, disc degeneration, and spinal stenosis. Objective To compare the clinical outcomes and complications of uniportal endoscopic spine decompression versus unilateral biportal endoscopic spine decompression in management of lumbar spinal stenosis. Methods This study was Randomized control trials, We included 197 patients from 3 studies; 92 in uniportal group and 105 in biportal. We compared VAS score for back pain and leg pain immediate postoperative and after 12 months. Results There was highly statistically significant difference found between the two studied groups regarding operative time (minutes) with p-value <0.003. That there was no statistically significant difference found between the two studied groups regarding complications as dural tears as well as length of hospital stay. Conclusion Our study show that Biportal and uniportal endoscopic spine surgery are both safe and effective technique in treating LSS as well as the new Biportal endoscopic technique proves to be superior method to shorten the operation time as well as learning curve. However, more randomized controlled trials with larger sample sizes are needed to strengthen the demonstration of the current conclusions.

A comparison of centrality measures and their role in controlling the spread in epidemic networks

The ranking of nodes in a network according to their centrality or ``importance'' is a classic problem that has attracted the interest of different scientific communities in the last decades. The COVID-19 pandemic has recently rejuvenated the interest in this problem, as the ranking may be used to decide who should be tested, or vaccinated, first, in a population of asymptomatic individuals. In this paper, we review classic methods for node ranking and compare their performance in a benchmark network that considers the community-based structure of society. The outcome of the ranking procedure is then used to decide which individuals should be tested, and possibly quarantined, first. Finally, we also review the extension of these ranking methods to weighted graphs and explore the importance of weights in a contact network by providing a toy model and comparing node rankings for this case in the context of disease spread.

Guaiac faecal occult blood screening in individuals younger than 50 years of age.

To determine the effectiveness of guaiac faecal occult blood tests (gFOBT) in the early detection of colorectal cancer (CRC) within a population of asymptomatic individuals who attended general periodic examinations, and to suggest the recommended age for this screening tool, the electronic database of the periodic examination institute of Rambam Healthcare Campus for the years 2004-2013 was reviewed. Individuals with positive gFOBT results were interviewed for further workup. Proportions of individuals for whom a polyp or CRC was detected were evaluated according to sex and age. 18 858 individuals were examined during the study period, mean age 48 years. The overall gFOBT uptake was 40.8%. Uptake was significantly higher among men and increased with age. Positive gFOBT was detected in 105 individuals (1.4%). The proportion of positive gFOBT was significantly lower among individuals aged 30-50 years than those older than 50 years of age (1.1 and 1.7%, respectively, P=0.005). No positive gFOBT was detected among individuals younger than 30 years of age. Positive gFOBT was higher in men than in women: 1.8 and 0.9% respectively (P=0.002). CRC was detected in six individuals, including two younger than 50 years of age. Polyps were detected in 15 individuals; of these, four were younger than 50 years of age. In the gFOBT-positive group, proportions of polyps and CRC were the same for subgroups according to age. The findings support consideration of annual gFOBT screening from the age of 40 years.

Thoracic aortic calcium, cardiovascular disease events, and all-cause mortality in asymptomatic individuals with zero coronary calcium: The Multi-Ethnic Study of Atherosclerosis (MESA)

Background and aimsTAC is associated with incident CVD and all-cause mortality. Nevertheless, the independent 10-year prognostic value of TAC in individuals with CAC = 0 beyond traditional risk factors is not well established. Methods3415 MESA participants with baseline CAC = 0 were followed for CHD, CVD events and all-cause mortality. TAC was measured in the ascending and descending aorta in all participants and quantified using Agatston's score. Multivariable Cox proportional hazards regression models were used to study the associations between TAC and incident CHD, CVD events and all-cause mortality. Likelihood ratio tests were used to compare prediction models including traditional risk factors plus TAC versus risk factors alone. Results406 participants (11.9%) had TAC>0 at baseline. Over a median follow-up of 11.3 years, unadjusted event rates per 1000 person-years were higher in TAC>0 than in TAC = 0 participants: CHD 2.18 vs. 2.03; CVD 6.85 vs. 3.42; all-cause mortality 12.84 vs. 4.96. However, in multivariable Cox regression analyses adjusting for CVD risk factors, neither TAC>0, TAC>100 nor log(TAC+1) were independently associated with any of the study outcomes, nor improved their prediction compared to traditional risk factors alone (p value of likelihood ratio tests >0.05). ConclusionsIn a multi-ethnic, modern US population of asymptomatic individuals with CAC = 0 at baseline, the prevalence of TAC>0 was low, and TAC did not improve 10-year estimation of prognosis beyond traditional risk factors. In the presence of CAC = 0, measurement of TAC is unlikely to provide sufficient additional prognostic information to further improve risk assessment.

Prevalence of advanced colorectal neoplasm after kidney transplantation: surveillance based on the results of screening colonoscopy.

The aim of this study was to determine whether the prevalence of advanced colorectal neoplasms increases in kidney transplant recipients and to define the appropriate duration for surveillance colonoscopy after kidney transplantation (TPL). Our study consisted of 248 kidney transplant patients who underwent a colonoscopy at Seoul National University Hospital from 1996 to 2008. For each patient, two or more age- and sex-matched controls were identified from a population of asymptomatic individuals. Twenty (8.1 %) patients had advanced colonic neoplasms, including colorectal cancers (four patients, 1.6 %), after kidney TPL. A case-control study showed that the odds of advanced colonic neoplasms occurring in TPL patients were 2.3 times greater than in the matched subjects. In addition, TPL patients 50 years of age or older had an approximate 5.4-fold higher risk of developing advanced neoplasms than did the matched subjects (OR 5.370; 95 % CI 2.543-11.336; P < 0.001). Age and history of advanced neoplasms were associated with an increased risk of developing advanced neoplasms after TPL. The 5-year cumulative incidence rate of advanced neoplasms was 3.6 % in the 82 patients with normal or non-advanced adenomas detected via screening colonoscopy before TPL. Colonoscopy is recommended for patients before and after kidney TPL, especially for those 50 years of age or older. Colonoscopy surveillance after TPL is warranted strictly according to the baseline risk stratification.

Pharmacological intervention in prediabetes: considering the risks and benefits

The impact of the diabetes epidemic will be staggering in terms of costs to individuals and society. Social educational initiatives are imperative to altering the lifestyle trends that drive the growth of the epidemic. Targeted lifestyle or drug interventions aimed at preventing progression from prediabetes to type 2 diabetes mellitus carry costs and risks that need to be considered in the context of expected benefits, which also need to be carefully defined. In terms of pharmacological intervention as part of a primary prevention programme, the risk/benefit assessment must include the potential for adverse effects in a large population of asymptomatic individuals, a significant proportion of whom would not progress to diabetes in the absence of treatment and in whom impaired glucose regulation may reflect different underlying pathogenetic mechanisms. Improving the balance of risks and benefits in drug interventions will require a greater ability to determine which treatments are likely to safely improve glucose regulation and prevent diabetes and its adverse cardiovascular outcomes in individual patients.