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Biomedical subjects

A Tsur

Publications and source records attributed to A Tsur.

15 recordsLinked to original sources
PubMed2002

Exhausting fatigue influences F-wave and peripheral conduction velocity, following lumbar radiculopathy.

PURPOSE: The purpose of the study was to determine whether mechanical nerve root compression could indirectly contribute to early muscle fatigue because of impaired activation. METHOD: The patients' two legs and the control group's dominant leg were subjected to exhausting foot dorsiflexion against 2 kg weight. Electrophysiological parameters were measured under three conditions: before, upon completion of, and five minutes after the exhausting effort (i.e. causing unbearable fatigue). The study was performed in a warm room (24 degrees C), in the EMG laboratory of a rehabilitation centre using standard equipment. Eighteen patients participated in the study (12 males and six females, mean age 47.8 +/- 12.0 years). They suffered from lumbar radiculopathy and unilateral complaints at the L4, L5 innervation territory. There were 22 matched controls (18 males and 4 females, mean age 44.4 +/- 9.9 years) that were healthy subjects. The patients' two legs and the dominant leg of the control participants were tested. The peroneal nerve was stimulated supra-maximally, behind the fibular head. Recording the activity of the anterior tibial muscle served to calculate F-wave latency, the conduction velocity of the nerve and muscle complex (NMCV), the compound muscle action potential (CMAP) amplitude and the exhaustion time. RESULTS: Following the exhausting fatigue, the symptomatic, asymptomatic, and control legs exhibited a significant decrease in NMCV and reduced CMAP amplitude (p < 0.05). In each condition (rest, effort, recovery), the patients' two leg types exhibited similar NMCV (symptomatic vs asymptomatic), yet each of these two types was significantly slower than the controls' NMCV. A significant prolongation of F-wave latency after an exhausting effort was found in the symptomatic legs. CONCLUSIONS: Our results suggest that a continuous exhausting effort impairs F-wave latency and NMCV, presumably by decreasing the proportion of fast conducting nerve fibres. Peroneal nerve root compression can contribute to early fatigue of the respective muscles.

Case-Control Studies↗
PubMed2001

Arthrodesis with the Ilizarov device after failed knee arthroplasty.

Thirteen patients with failed total knee arthroplasty (TKA) due to infection (12 patients) or aseptic loosening (1 patient) underwent arthrodesis using the Ilizarov external fixator. Solid fusion was achieved in all patients with an average healing time of 27.6 weeks. Patients spent an average 18.8 weeks in the fixator followed by an average 8.8 weeks in a plaster cylinder cast. Five patients had a pin tract infection and one a superficial wound infection. One patient had 15 degrees recurvatum after surgery that was gradually corrected by adding a hinge system to the fixator. Average shortening of the affected limb was 3.7 cm (range: 1-6 cm). The Ilizarov fixator for knee arthrodesis after failed TKA produced favorable results and should be considered for use by surgeons familiar with the technique.

Aged↗
PubMed2001

[Diagnosis and therapy in acute stroke: a rehabilitation center viewpoint].

The extent of the diagnostic work-up of patients with acute stroke was evaluated in 101 patients admitted for rehabilitation during a 4-month period in 1997. This included specific blood tests and neuro- and cardiac imaging, and compared the extent of work-up in a community hospital versus a rehabilitation center. Comparisons were also made with similar investigations 10 and 20 years earlier. Results demonstrated that the trend to admit younger stroke patients (< 50 years) to neurological (as opposed to medical) departments observed between 1977-1987 persisted in 1997. The use of CT scan increased dramatically from 1977 to 1987 (19% vs 78%), and in 1997 was actually 100%. The use of carotid duplex and echocardiography increased steadily during the 3 decades reaching 26% and 28% respectively. Tests for thrombophilia were seldom done. However, in neurological departments it was done in about 50% of the younger stroke patients. In neurology departments carotid duplex was done 2 to 3 times more often than in medical departments. During rehabilitation imaging tests were done once or more in almost half the patients. The results and those of additional blood tests, have led to modification of antithrombotic treatment in 14% of the younger group and 4% of the older group. We have clearly shown that while stroke work-up has become more comprehensive in recent years, there is still much to do in this field. Stroke units or teams in our general hospitals will increase stroke awareness, improve work-up and hasten definitive treatment.

Acute Disease↗
PubMed2000

Brachial biceps tendon injuries in young female high-level tennis players.

AIM: To evaluate brachial biceps tendon lesions in four young female tennis players who complained about anterior shoulder pain on their dominant side. METHODS: Medical and sport's activity history, palpation of the painful zone, Ghilchrist (palm-up) test, and brachial biceps contraction against resistance were performed. RESULTS: The two girls who suffered from mild tenderness in the bicipital groove and over the anterior aspect of the upper arm and the shoulder joint, had tendinitis of the long biceps head. The two girls who suffered from severe tenderness just under the groove, had a partial tear in the long head of the biceps. Ghilchrist test was positive in all girls. CONCLUSION: Tennis players can have shoulder pain without clear history of trauma. Pain occurred probably as a result of technical errors or use of inadequate equipment.

Adolescent↗
PubMed1997

[Suprascapular nerve entrapment in a basketball player].

A basketball player was shown to have a suprascapular nerve lesion without any history of shoulder girdle trauma. This acute neuropathy, never previously described in basketball players, is a result of repeated micro-trauma, due to nerve traction over the coracoid notch during violent movement ("dunking" most probably). Clinically, he was unable to abduct his arm and had some difficulty in external rotation. He developed atrophy in both the supra- and the infraspinatus muscles. Nerve conduction latency to the supraspinatus muscle was 8.0 ms, and to the infraspinatus, 8.5 ms. The compound muscle action potential registered in the supraspinatus was 1.224 mV, and in the infraspinatus, 1.237 mV. After 3 weeks of inactivity, recovery was spontaneous and practically complete.

Adult↗
PubMed1996

Pre-clinical Cushing's syndrome: an unexpected frequent cause of poor glycaemic control in obese diabetic patients.

OBJECTIVE: Autonomous cortisol secretion without clinical stigmata of Cushing's syndrome (CS) has been recently recognized and termed pre-clinical or sub-clinical CS. The common assumption is that CS is an extremely rare cause of uncontrolled diabetes; however, the prevalence of this entity has not been studied. We assessed the prevalence of pre-clinical CS among obese patients with uncontrolled diabetes. PATIENTS AND DESIGN: (1) In a retrospective analysis, the medical records of 63 patients with endogenous CS were reviewed. (2) In a cross-sectional study, 90 obese patients (BMI > 25 kg/m2) followed in a University Hospital and the local Health Fund endocrine and diabetes clinics, with poorly controlled diabetes (glycosylated haemoglobin > 9%), underwent an overnight 1 mg dexamethasone suppression. In patients with non-suppressible cortisol levels (> 140 nmol/l), Liddle's 2 and 8 mg dexamethasone suppression tests and imaging studies were performed. MEASUREMENTS: The prevalence of poorly controlled diabetes, the major presenting symptom of CS, was assessed in the retrospective analysis. The prevalence of "true' CS and the false positive rate in the overnight dexamethasone suppression test were calculated. The endocrine evaluation of the patients with pre-clinical CS and the effects of surgical cure on glycaemic control are described. RESULTS: In the retrospective analysis, 11 (17.5%) had diabetes and 2 (3.2%) lacked the classic physical characteristics of the syndrome. In the cross-sectional study, 4 patients failed to suppress plasma cortisol (< 140 nmol/l). In one patient the diagnosis of CS was not confirmed by a standard Liddle's test and was therefore considered false positive. In the other 3, the diagnosis of CS was confirmed (prevalence of 3.3%, 95% confidence interval 1-9%). In all other patients the overnight cortisol suppression test was normal (cortisol level 47.3 +/- 2.5 nmol/l (mean +/- SEM)). After surgical treatment of CS, glycaemic control was markedly improved in all 5 patients (2 from retrospective and 3 from cross-sectional studies). CONCLUSIONS: The prevalence of pre-clinical Cushing's syndrome in obese patients with poorly controlled diabetes appears to be considerably higher than previously believed. The overnight dexamethasone suppression test proved to be a simple, sensitive and highly specific screening test for Cushing's syndrome despite the presence of obesity and hyperglycaemia.

Adult↗
PubMed1996

Cervical spine movements in hemiparetic patients.

Cervical spine movements in 38 severe hemiparetic patients were measured, at least 6 months after the breakout of the first and unique cerebral vascular accident. The purpose was to investigate if there was any difference in maximal head rotation and lateral bending movements between the plegic and the sound side. The measurements were taken by a spherical compass attached to a cubic protractor with a small mobile ball inside, both fixed to the patient's head. All the tests were done several months after the end of the rehabilitation process and compared to those obtained in 29 orthopaedic patients without hemiparesis (control group). The results obtained demonstrate that the cervical spine movements in hemiparetic patients are minimally limited and manifested only in lateral bending towards the sound side (p = 0.042). The difference was more significant after 1 year or more of hemiparesis (p = 0.013). In the control group the differences in the external rotation angle and lateral bending angle between the right and left sides were not significant.

Cerebrovascular Disorders↗
PubMed1996

Relationship between muscular tone, movement and periarticular new bone formation in postcoma-unaware (PC-U) patients.

Forty-eight post-traumatic brain-injured patients in postcoma-unawareness (PC-U) state, are included in this study. All recovered consciousness at least 1 month after the accident. The muscular tone and movement of all limbs was examined. At least two X-rays of the big joints were taken. Periarticular new bone formation appeared in 26 patients. This heterotopic ossification occurs in severely injured patients, primarily in proximal joints of the upper and lower extremities. Their aetiology in brain injury is unknown. Risk factors include prolonged coma, tone and movements in the involved extremity, and associated fractures. We found that the appearance of periarticular new bone formation had a close correlation with pathological movement (paresis or plegia), a borderline correlation with hypertonus, and no correlation with hypotonus or with associated fractures.

Arthrography↗
PubMed1995

[Javelin elbow].

Explore the source record for details and available documents.

Humans↗
PubMed1992

Falciparum malaria-induced hypoglycaemia in a diabetic patient.

We report a patient with diabetes mellitus who suffered severe falciparum malaria complicated by profound and persistent hypoglycaemia. The hypoglycaemia evolved before therapy with quinine was begun and resolved with eradication of the parasitaemia. The patient reverted to her baseline hyperglycaemia despite continuation of quinine. This case illustrates the critical role of falciparum malaria in the pathogenesis of malaria-associated hypoglycaemia, rather than quinine-mediated mechanisms. Anticipation of hypoglycaemia in falciparum malaria and its vigorous treatment may improve the poor prognosis associated with this complication.

Blood Glucose↗
PubMed1992

[Influence of muscle tone and force on ossification in postcomatose patients].

68 post-traumatic brain-injured patients in postcomatose unawareness (PCU) states were admitted during 1982-1987. 32 of them also suffered from fractures of the long bones and pelvis (total of 51 limbs). The muscle tone and force of all limbs were examined and x-rays of the large joints and of the fractures were taken periodically. Periarticular new-bone formation appeared in 32 patients. Normal callus developed in 41 fractured limbs and hypertrophic callus in 18. We found that pathological muscular tone (hypertonus and hypotonus) and pathologically decreased muscle force (paresis and plegia) were closely correlated with the appearance of periarticular new-bone formation. The extent of callus formation was not correlated with muscle tone and force.

Biomechanical Phenomena↗