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Biomedical subjects

H Thiel

Publications and source records attributed to H Thiel.

77 records · Page 5Linked to original sources
PubMedDate not supplied

Lumbar motion trends and correlation with low back pain. Part I. A roentgenological evaluation of coupled lumbar motion in lateral bending.

OBJECTIVE: A radiographic study was undertaken to describe the relationship between coupled lumbar motion in lateral bending and the presence of low back pain symptomatology, evaluate trends of coupled motion and determine if these trends were attributable to chance confluence of independent motions. DESIGN: Survey. SETTING: Chiropractic college student health center and private chiropractic clinic. PARTICIPANTS: 249 subjects: 114 with low back pain, 29 asymptomatic with no history and 106 asymptomatic with history. Of these, 194 were freshman volunteers and 55 were new private clinic low back pain patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Lumbar segmental coupled motion categories according to the scheme of Cassidy and Grice, as well as a modified scheme. RESULTS: Statistical analysis demonstrated no significant relationship (p = .01) between coupled lumbar motion and low back pain. When viewed intersegmentally, approximately half of all lumbar motion was type II; symmetric motion was rare and attributable to chance confluence of individual segmental motion. CONCLUSIONS: This study suggests that back pain is not an indication for the routine use of lateral bending films for the identification of abnormal coupled motion. Furthermore, each segmental categorization appears to be independent of contralateral categorization as well as motion at all other segmental levels. It is also suggested that type II motion cannot be ruled out as a normal variant. Finally, the ubiquity of coupled motion asymmetry suggests that symmetry must be reevaluated as a criterion for normal spinal function.

Adolescent↗
PubMedDate not supplied

[Problems of occupationally induced respiratory allergies as exemplified by bakers' asthma].

In the Federal Republic of Germany (FRG) approximately every fourth case of occupational lung disease, registered with application for compensation at the "Gewerbliche Berufsgenossenschaften", in 1984 was suspected to be caused by allergic airway obstruction. Respiratory allergies may arise if two prerequisites exist firstly exposure to sensitizing agents in the work environment and secondly individual disposition to allergic reactions. The large range of sensitizing agents includes organic and inorganic substances derived from animals, plants, fungi, metals or chemicals. Most of them are responsible for Type-I IgE-mediated allergic reactions. Three different patterns of respiratory responses can be found following simulated occupational exposure: immediate, late (non-immediate), and the dual-type of asthmatic reaction, whereby the non-immediate asthmatic response must be strictly differentiated from the genuine Type-III hypersensitivity. Today, bakers' asthma is the most frequent and most costly occupational allergy in the FRG, contributing more than 50% of all registered and more than 75% of all compensated cases. Therefore, flour allergies can be used as a classic model of an occupational allergic disease in order to discuss epidemiological, social and clinical problems, such as prevalence, socioeconomic impact, as well as prevention, early diagnosis and therapeutic measures. Despite many well-known clinical and epidemiological data, respiratory allergies display a lot of unresolved questions calling for further research.

Allergens↗
PubMedDate not supplied

The validity of the extension-rotation test as a clinical screening procedure before neck manipulation: a secondary analysis.

OBJECTIVE: To determine the validity of the neck extension-rotation test as a clinical screening procedure to detect decreased vertebrobasilar blood flow that might be associated with dizziness. DESIGN: Secondary analysis of a clinical screening test. METHODS: Twelve subjects with dizziness reproduced by the extension-rotation test and 30 healthy control subjects had Doppler ultrasonography examination of their vertebral arteries with the neck extended and rotated. Vascular impedance to blood flow was measured and the presence of signs and symptoms of vertebrobasilar ischemia was recorded. RESULTS: Cut-off points for validity estimates were derived through the percentile and Gaussian methods using impedance to blood flow as the standard. The sensitivity of the extension-rotation test for increased impedance to blood flow was 0%, regardless of the selected cut-off point. The specificity rates for the left vertebral artery were 71% and 67% for the percentile and Gaussian methods, respectively. The extension-rotation test was more specific on the right side, with a rate varying from 90% with the percentile method to 86% with the Gaussian technique. The positive predictive value of the test was 0% and its negative predictive value ranged from 63% to 97%. CONCLUSION: We were unable to demonstrate that the extension-rotation test is a valid clinical screening procedure to detect decreased blood flow in the vertebral artery. The value of this test for screening patients at risk of stroke after cervical manipulation is questionable.

Adult↗