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Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Spinal disease, especially in the elderly, should be differentiated from neoplasm, as radiotherapy or anti-cancer chemotherapy may cause a therapeutic disaster. Differentiation may be made by needle aspiration or biopsy - this is particularly important when other stigmata or neoplasm are not present, as tuberculosis may still be the cause - even in the 1990's! Both untreated spinal and chronic renal disease (e.g. an untreated tuberculous 'autonephrectomy') may lead to spread of infection, including miliary disease, later in life.
Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Extramedullary (includes extradural and intradural): Degenerative spine disease.Epidural collection (hematoma, abscess).Neoplastic (metastatic vs. primary).
Multiple Myeloma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
There is a complete lack of adequate randomized trials as to the optimal management of spinal disease including bracing, vertebral augmentation (vertebroplasty and kyphoplasty), and radiotherapy. The issue is further complicated as the nature of the spinal disease (anatomical site, number of vertebrae involved, and degree of collapse/deformity, for example) is important in treatment decisions.
Metastatic intradural extramedullary spinal cord tumor from ovarian cancer: A case report with a literature review
Published in The Journal of Spinal Cord Medicine, 2022
Yuki Tajima, Masahito Takahashi, Takuya Kawai, Makoto Higashi, Hideto Sano, Shoichi Ichimura, Hiroaki Kobayashi
In general, nonsurgical management of metastatic spine disease is recommended when tumor involvement has not resulted in spinal instability, neurologic deficits, or pain nonresponsive to medical management.18 Radiation therapy would be the most appropriate management given the indications above.19 In this case, the preoperative differential diagnoses were Schwannoma, neurofibroma, or metastatic tumor. The possibility of a metastatic tumor was all but unthinkable because there were only two reports of metastatic intradural extramedullary spinal cord tumor from ovarian cancer in the literature. The main purpose of this resection was to eliminate intractable pain. The second purpose was to diagnose enhancing, intradural, and extramedullary lesions. CSF cytology may show evidence of malignant cells.10 However, CSF cytology is not always positive in patients with intradural extramedullary spinal metastases.20 CSF cytology was positive in only two of ten patients with intradural extramedullary spinal metastases.9 Therefore, if CSF cytology is negative, histological examination of the resection specimen might be needed to achieve a definitive diagnosis.
New Horizons of Knowledge in Intervertebral Disc Disease
Published in Journal of Investigative Surgery, 2021
Silvia Ravalli, Giuseppe Musumeci
Intervertebral disc disease (IVDD) refers to degenerative processes of the spine resulting in reduced shock-absorbing ability, which may ultimately lead to disc herniation and spinal cord compression. Back pain is associated with this condition, representing the clinical feature mostly frequently referred by the patients. The etiology, as for many musculoskeletal diseases, should be sought in environmental and genetic factors. These latter involve genes which are responsible for Collagen type IX and I, Aggrecan, Vitamin D receptor, while non-hereditary factors include primarily mechanical injuries, excessive loads and uneven weight distribution, as well as aging, obesity, chronic inflammation, and work-related risk factors like long sitting sessions, e.g. while driving, or non-ergonomics office equipment [1]. It is estimated that more than 200 million cases of lumbar degenerative spine disease occur, each year, worldwide, significantly contributing as a major cause of disability and socio-economic burden [2].
Patterns of buprenorphine/naloxone prescribing: an analysis of claims data from Massachusetts
Published in The American Journal of Drug and Alcohol Abuse, 2020
Richard Paulsen, Alicia Sasser Modestino, Md Mahmudul Hasan, Md. Noor-E-Alam, Leonard D. Young, Gary J. Young
Third, we examined the likelihood that patients being treated for pain received buprenorphine/naloxone rather than oxycodone. To be able to make appropriate comparisons, we confined the sample to patients who (1) had at least one claim in each year during the study period for either buprenorphine/naloxone or oxycodone, and (2) had a medical claim in the three months prior to their prescription for a pain-related condition that fell into one of three broadly-defined categories: 1) spinal disease, 2) general set of pain symptoms including fever, headache and cough, and 3) joint disease. These three broad categories of conditions represent the three-digit ICD-9 codes that are specified in the Appendix. We selected oxycodone as a comparison group for buprenorphine/naloxone because during the study period it was the most commonly prescribed opioid in Massachusetts and the only other opioid for which there was considerable growth in prescription claims. Of the prescriptions in our study sample for oxycodone or buprenorphine/naloxone, over 65% were preceded in the prior three months by a medical claim that included spinal disease, general pain symptoms, or joint disease. The next three most common classes of medical claims preceding oxycodone claims were unrelated to pain.