The aim of this study is to understand the magnitude of the pedicle's diameters for the use of pedicle screw fixation in spinal instrumentation. Pedicle dimensions from T1 to L5 were measured in 16 whole human cadaver spines (eight women and eight men). The mean age at the time of death was 67.2 (range: 59-84 years). The external transverse, the external sagittal, and the internal transverse diameter pedicle widths were measured with electronic calipers both on the right and left pedicles. The widest external transverse diameter was at the L5 level with a mean of 13.61 mm (range: 10.29-16.20 mm). The narrowest external transverse pedicle diameter was at the T5 level with a mean of 5.09 mm (range: 4.10-6.88 mm). The widest external sagittal pedicle diameter was at the T11 level with a mean of 17.02 mm (range: 14.84-19.57 mm), while the narrowest one was at T1 level with a mean of 8.90 mm (range: 7.18-11.37 mm). The maximum internal transverse pedicle diameter was at the L5 level with a mean 8.95 mm (range: 7.10-11.21 mm), while the minimum was at the T5 level with a mean 3.90 mm (range: 3.10-4.82 mm). Statistical significant greater pedicle dimensions were found in males at multiple levels. Pedicle dimensions at the levels from T3 to T8 need preoperative evaluation with computed tomography before the insertion of pedicle screws with diameter more than 5 mm. Pedicles at T12 to L5 levels may accommodate screws of 7 mm diameter.
Diagnosis of hyperparathyroid bone disease and adynamic bone is difficult on the basis of iPTH and BGP, especially when bone aluminium deposition is prevalent. However, using these bone markers, preferably in combination, the exclusion of these lesions is feasible.
BackgroundWe conducted a systematic review to investigate avian influenza outbreaks and to explore their distribution, upon avian influenza subtype, country, avian species and other relating details as no comprehensive epidemiological analysis of global avian influenza outbreaks from 2010 to 2016 exists.MethodsData was collated from four databases (Scopus, Web of Science Core Correlation, PubMed and SpringerLink electronic journal) and a global electronic reporting system (ProMED mail), using PRISMA and ORION systematic approaches. One hundred seventy three avian influenza virus outbreaks were identified and included in this review, alongside 198 ProMED mail reports.ResultsOur research identified that the majority of the reported outbreaks occurred in 2016 (22.2%). These outbreaks were located in China (13.6%) and referred to commercial poultry farms (56.1%). The most common subtype reported in these outbreaks was H5N1 (38.2%), while almost 82.5% of the subtypes were highly pathogenic avian influenza viruses. There were differences noticed between ProMED mail and the scientific literature screened.ConclusionsAvian influenza virus has been proved to be able to contaminate all types of avian species, including commercial poultry farms, wild birds, backyard domestic animals, live poultry, game birds and mixed poultry. The study focused on wet markets, slaughterhouses, wild habitats, zoos and natural parks, in both developed and developing countries. The impact of avian influenza virus seems disproportionate and could potentially burden the already existing disparities in the public health domain. Therefore, a collaboration between all the involved health sectors is considered to be more than necessary.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0691-z) contains supplementary material, which is available to authorized users.
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