Group items tagged

The North American Spine Society and the Society of Interventional Radiology have pointed to flaws in both studies. And earlier studies, published over 15 years, found major benefits to kyphoplasty and a related procedure called vertebroplasty. "We're missing opportunities for patients to receive a safe and effective treatment that can significantly reduce their pain and disability," said Malamis, an interventional radiologist. The procedures are used to treat vertebral compression fractures in patients with osteoporosis and other conditions that result in brittle bones. In a vertebroplasty, an acrylic cement is injected into a fractured vertebra. In a kyphoplasty, a balloon-tipped catheter first is inserted into the fracture. The balloon is inflated to restore the height and shape of the vertebra before the cement is injected. Neva Nelson, 74, of Naperville, Ill., said a kyphoplasty that Malamis performed in October, 2009, has greatly reduced her pain in a vertebra in her lower back that she fractured after falling on ice. Before her kyphoplasty, Nelson had to sit on cushions. Walking, and especially standing, were painful. "I had to do something," she said. "I could not go on like that." Nelson said that since undergoing her kyphoplasty, "I don't have to worry about my back any more." In the controversial studies, patients were randomly assigned to receive a vertebroplasty or a placebo-like "sham" procedure. In the sham procedure, patients received an injection of anesthetic, but no cement. However, patients in severe pain are reluctant to enroll in a trial where there's a 50 percent chance of receiving a sham treatment. In one of the studies, researchers had to screen 1,813 patients to enroll just 131 subjects. In the other study, only 78 of 219 eligible patients were enrolled. This low enrollment rate raises the possibility that the patients who did enroll were not representative. Patients experience the greatest pain during the first three months after a compression fracture. Thereafter, pain gradually subsides. Thus, a vertebroplasty or kyphoplasty provides the greatest benefit when performed within a week or two of the fracture. But the studies enrolled patients up to 12 months after fractures. In addition to reducing pain and disability, a kyphoplasty can reduce the risk of subsequent fractures by improving the angle and height of the spine. The studies evaluated vertebroplasty alone, and did not include the more innovative and very different kyphoplasty procedure. Malamis suggests the medical community wait for the results of additional studies now underway before passing final judgment on vertebroplasty or kyphoplasty. In the mean time, he notes that Medicare still covers the procedures.

Solar-powered drip irrigation enhances food security in the Sudano–Sahel documents a field research project which found that: "solar-powered drip irrigation significantly augments both household income and nutritional intake, particularly during the dry season, and is cost effective compared to alternative technologies" Over the decades, irrigation has been shown to greatly increase agricultural productivity. Drip irrigation is spreading rapidly in Africa, with significant benefits. "Drip irrigation delivers water (and fertilizer) directly to the roots of plants, thereby improving soil moisture conditions; in some studies, this has resulted in yield gains of up to 100%, water savings of up to 40–80%, and associated fertilizer, pesticide, and labor savings over conventional irrigation systems" The solar-powered systems, however, look to offer the potential for even better results. From the study on impacts of PVDI systems it was reported: "The women’s agricultural group members utilizing the PVDI systems became strong net producers in vegetables with extra income earned from sales, significantly increasing their purchases of staples, pulses, and protein during the dry season, and oil during the rainy season. Finally, survey respondents were asked how frequently they were unable to meet their household food needs. Based on the frequency and most recent incident, households were assigned a food insecurity score ranging from zero (no problems during the previous year) to one (perpetually unable to meet food needs). This score changed significantly for project beneficiaries, as they were 17% less likely to feel chronically food-insecure. In short, the PVDI systems had a remarkable effect on both year-round and seasonal food access."