Search PubMed⌕ Search

Biomedical subjects

J J Nicholas

Publications and source records attributed to J J Nicholas.

At least 55 records · Page 3Linked to original sources
PubMed1986

Spinal pain made worse by recumbency: a clue to spinal cord tumors.

In the absence of physical findings, pain in the low back, cervical or thoracic spine, or the extremities presents a diagnostic problem. On occasion the pain is present or made worse only when the patient lies down. We have attended four patients with underlying extradural tumors of the spinal canal. A 75-year-old woman with chronic back pain was treated for multiple myeloma with intravenous dexamethasone and 400 rads of x-ray irradiation to the lumbar spine and experienced marked pain relief in 24 hours. A 76-year-old woman with neck pain had complete pain relief after a vascular, calcified meningioma was removed surgically from under the 2nd and 3rd cervical nerve roots. A 38-year-old male with constant pain in the lumbar area and right leg and foot experienced marked relief from pain after a neurolemmoma of the cauda equina was surgically removed. A 57-year-old woman with knee pain became pain free 24 hours after radiation therapy to an enlarged nodular cauda equina. These four cases illustrate a diagnostic clue rarely mentioned in the literature.

Adult↗
PubMed1985

Rehabilitative rheumatology content in current rehabilitation medicine training programs.

The Council on Rehabilitative Rheumatology of the American Rheumatism Association, through the Education Subcommittee, surveyed directors of 69 approved rehabilitation medicine residency training programs to assess the nature of training in rehabilitative-rheumatology and whether the directors believed this training to be adequate. Sixty-one directors responded, with 84% of the respondents reporting a rheumatology department in their hospitals and 43% reporting a formal rotation for their residents in rheumatology. Fifty-nine (97%) reported their residents received lectures in rheumatology. Fifty-five (90%) reported lectures given by a physiatrist in the rehabilitative management of rheumatic diseases. Only 21 (34%) reported a physiatrist-attended rheumatology outpatient clinic. Fifty-one (82%) desired a closer liaison with the rheumatology department. Thirty-seven (61%) indicated their residents received adequate training on the diagnosis of rheumatic diseases, and 46 (75%) adequate training in rehabilitative management, while 59 (97%) desired a concise handbook which emphasizes the rehabilitative management of rheumatic diseases. A previous survey of 100 arthritis fellowship programs approved by the American Medical Association brought 81 responses, of which only 43% considered that their Fellows had adequate training in rehabilitative rheumatology. Physiatrists attended clinics 21% of the time and patient care rounds 19%. Ninety-four percent desired a syllabus. Both surveys indicated limited interaction between the two specialties and leads us to conclude that a rehabilitative-rheumatology handbook would be desirable, closer liaison of rehabilitation faculty with rheumatology faculty is needed to respond to individual training needs, more active participation by a physiatrist in patient care conferences may be necessary for adequate education in rehabilitative-rheumatology.

Education, Medical, Graduate↗
PubMed1984

Malignant myositis ossificans: occult gastric carcinoma presenting as an acute rheumatic disorder.

A patient developed ossifying skeletal muscle metastases from a primary gastric mucin-producing adenocarcinoma. The unusual nature of skeletal muscle metastases and the inflammatory-like syndrome associated with heterotopic ossification is reviewed. It is suggested that this case of 'neoplasm-induced post-traumatic myositis ossificans' may be caused by the interaction of local haemorrhage and thrombosis, mucin-producing tumour implants, and the presence of large quantities of gamma-carboxyglutamic acid, an amino acid associated with the calcification of bone matrix formation.

1-Carboxyglutamic Acid↗
PubMed1983

Bone-forming gastric metastases in muscle-computed tomographic demonstration.

Bone-forming metastases to soft tissues and muscle are a rare entity. An unusual case of heterotopic ossification occurring within metastases to muscle arising from a primary gastric adenocarcinoma is reported. No bone was found in the primary gastric malignancy. There is one prior report of ossification in muscle occurring in metastases from gastric malignancy, but no previous computed tomographic demonstration of this. The mechanism of osseous metaplasia is discussed, but its precise morphogenesis remains obscure.

Adenocarcinoma↗
PubMed1982

Splinting in rheumatoid arthritis: I. Factors affecting patient compliance.

Fifty-four patients with rheumatoid arthritis were fitted with either unilateral or bilateral hand and wrist splints. Of 36 patients available for evaluation, 29 (greater than 80%) reported wearing their splints more frequently for activities requiring greater strength than dexterity. Patients also reported pain relief from wearing their splints, but did not report donning them for this purpose. We feel that a vigorous educational effort should be promoted to encourage patients to wear splints for diminution of inflammation and relief of pain as well as for support during heavier activities.

Activities of Daily Living↗
PubMed1982

Splinting in rheumatoid arthritis: II. Evaluation of Lightcast fiberglass polymer splints.

Fifty-four patients with rheumatoid arthritis were fitted with fiberglass polymer Lightcast II hand and wrist splints. When patients were questioned after having worn the splints for 9 to 12 months, the majority responded that the splints were durable, cosmetically acceptable, and for the most part comfortable. The splints were staff manufactured at 1 sitting in less than an hour each.

Arthritis, Rheumatoid↗
PubMed1981

Delayed traumatic vertebral body compression fracture; part I: clinical features.

We have described three patient who sustained trauma to their spines followed by persisting pain. Initial radiographs were negative, but on subsequent examinations compression fractures were demonstrated. This sequence of events resembles the clinical picture described by Kümmell in 1895 with significant differences. A plethora of early written description with minimal radiographic documentation suggests that this is a relatively rare condition. It is appropriate, therefore, to present these cases with the suggestion that traumatic injuries with persisting thoracic or upper lumbar back pain should be followed up radiographically in order to demonstrate the occurrence of subsequent compression fractures. These fractures may be treated with simple braces.

Aged↗
PubMed1977

Hydroarthrosis.

Explore the source record for details and available documents.

Humans↗
PubMed1977

Cylinder splints: their use in the treatment of arthritis of the knee.

Cylinder knee splints afforded significant relief of pain and were not associated with loss of range of motion or muscle strength in 13 of 15 patients. Splints help patients who demonstrate persistent synovitis of the knee, who do not respond to intraarticular injection of steroids, and for whom surgery is not immediately appropriate. The fiberglass polymer used in this study has several advantages over plaster for splints.

Arthritis↗
PubMed1976

Measurement of circumference of the knee with ordinary tape measure.

The circumference of the knees and thighs at three locations was measured in 10 patients on two consecutive occasions by three observers. Analysis of the results for interobserver, intraobserver and among-patient variation established that a change in circumference noted by different observers on two different days is significant if it exceeds 1-5 cm at the midpatella, 2-7 cm at 7 cm above, and 3-5 cm at 15 cm above the patella. If a single observer performs both measurements, the change need exceed only 1-0, 2-0, and 2-7 cm, respectively, to be significant.

Anthropometry↗