Biomedical subjects

J P Crawford

Publications and source records attributed to J P Crawford.

At least 19 recordsLinked to original sources

PubMed1999

Chiropractic intervention in the treatment of joint and soft tissue disorders.

The concept of manual therapy, specifically manipulation of the bodily joints as in the practice of chiropractic, can no longer be deemed an invalid system of health care. Practiced for over 2,000 years by a variety of ancient civilizations, the art of manipulation for the purpose of correcting and restoring joint function has continued to flourish, despite opposition. The climate, however, is changing. The art of chiropractic is increasingly being seen as a uniquely devised and administered technique whereby high velocity, low amplitude thrusting maneuvers are specifically directed by the skilled practitioner toward spinal segments and peripheral articulations in an effort to correct aberrant mechanical function. The corrections are effected while utilizing the transverse and spinal processes of individual vertebrae as contacting levers. Hippocrates is credited with the advice to, "look well to the spine for the cause of disease," as displaced or degenerative vertebrae m! ! ay irritate spinal nerve roots while exiting the intervertebral foramina and, consequently, interfere with normal nerve function. Similarly, it is a fundamental precept of chiropractic philosophy that irritation of the nervous system by mechanical, chemical, or psychogenic means is considered as causative in the development of disease. The scientific evidence associated with chiropractic intervention in the treatment and management of musculoskeletal disorders and visceral diseases is growing. This paper discusses the history, philosophy, and efficacy of joint manipulation and its influence on the development of chiropractic treatment.

Chiropractic↗

PubMed1988

Pharmacological modulation of localized inflammatory reactions: the nonsteroidal anti-inflammatory drug as an adjunct to therapy.

An experimental model was utilized to examine the physiological effects of nonsteroidal anti-inflammatory compounds on locally induced inflammatory lesions in laboratory rabbits. The modulation of specific parameters associated with the inflammatory response, was monitored in vivo using radiolabeled cells and proteins, following the local administration of either indomethacin (INDO), acetylsalicylic acid (ASA) or sterile saline (as control) in the dermis. In one half of the dorsal aspect of each animal, Arthus-type dermal lesions were induced in triplicate, while similar sites were prepared at identical time periods (1-4, and 6 h) on the contralateral halves. In these latter sites, either INDO or ASA was administered (100 micrograms/site). The non-drug-treated lesions served as intrinsic controls when the inflammatory parameters of vascular permeability, neutrophil (polymorphonuclear) leukocyte infiltration and hemorrhage were investigated. Also, sterile saline or drug-injected, noninflamed sites prepared in each half served as further controls. Statistical analysis indicated a significant suppression of the above-named inflammatory parameters when either INDO or ASA was applied to localized inflammatory sites, as compared to non-drug-treated lesions. This study may serve to illustrate the value of deploying nonsteroidal anti-inflammatory preparations, topically, when conservatively managing the acute patient in clinical practice.

Animals↗

PubMed1988

Chiropractic management of spondylolisthesis with spondylolysis of the pars interarticularis: an example of the single-case study experimental design.

Case records permeating the chiropractic literature, although claiming success utilizing conservative therapies, often are founded on isolated circumstances rather than scientific data. A detailed examination of such reports reveals a void with respect to definitive and specific approaches for the diagnosis and clinical management of disorders synonymous with chiropractic clinical practice. At best, therefore, such reports are fraught with empiricism, illustrating only the experiences of individual clinicians. The underlying difficulty encountered in reporting information on purely didactic grounds is likely due to the absence of a mechanism by which improvement in biomechanical function may be precisely and adequately quantified. In direct contrast, controlled clinical trials, as in medical research, offer the luxury of statistical clarity as to the selection of one treatment regimen over another. Researchers have indicated that the single-case study experimental design may be of value in chiropractic clinical practice, allowing for the formulation of deductive conclusions derived from each case. To facilitate the process, implementation of both retrospective and prospective aspects are proposed modifications to the general scheme. It is the purpose of this article to employ the concept of the single-case study experimental design, illustrating a condition commonly encountered in chiropractic clinical practice, that of spondylolisthesis. In so doing, we attempt to adhere to the prescribed format, while outlining both the retrospective and prospective aspects, commensurate with such a problem within the clinical setting.

Adult↗

PubMed1988

Anterior interosseous nerve paralysis: cubital tunnel (Kiloh-Nevin) syndrome.

Paralysis of the anterior interosseous nerve may occur for a variety of reasons. It has been suggested that such a malady presents clinically more often than is recognized. Some authors attribute this to a general misunderstanding or ignorance of the precise anatomical distribution and motor function of this branch of the median nerve. The neuropathy produces a clinical scenario with a characteristic disturbance of the "pinch grip." Spontaneous recovery has been reported, but is said to be delayed and incomplete. Surgical exploration of the nerve may reveal a biomechanical basis for irritation, and decompression maneuvers may result in rapid and complete recovery. It is important to recognize, however, the value of conservative measures, including mobilization and adjustive procedures, which may be specifically directed to the elbow joint and other regions of the upper extremity. Such techniques may assist in reducing restrictive influences comprising the nerve and associated tissues. The benefits of electrotherapy may prove invaluable and, perhaps, should be considered prior to more radical procedures. Therefore, the practitioner should be wary of the potential to approach such a condition from the chiropractic perspective of treatment and management, which may yield rewarding sequellae.

Chiropractic↗

PubMed1986

Testicular torsion after orchiopexy with nonabsorbable sutures.

Testicular torsion occurring three years after bilateral orchiopexy is described. The antecedent orchiopexy was accomplished using 2-0 proline sutures and transseptal fixation of the contralateral testicle. A history of bilateral orchiopexy should not interfere with diagnosing torsion in the acute scrotum. Doppler ultrasound and nuclear imaging scan are auxiliary tools that should be used when available, but should not preclude expeditious surgical treatment of suspected torsion.

Adolescent↗

PubMed1986

Infected suture granuloma simulating mass of urachal origin: case report.

We report a case of an infected suture granuloma. The patient presented with a solid mass located superior to the dome of the bladder. Evaluation showed a normal intestinal tract and absence of a primary bladder abnormality. Based on these findings the mass was considered to be of urachal origin but surgical excision revealed that the mass was an infected suture granuloma. Suture granuloma should be considered in patients who have had previous inguinal surgery, particularly when associated with the use of nonabsorbable suture.

Abdominal Neoplasms↗

PubMed1986

Immune complex deposition in the development of acute synovitis in the rabbit knee joint: quantitative, kinetic and morphological aspects.

The pathology of acute synovitis induced by immune complexes was investigated in this study. The reversed passive Arthus method of lesion induction was utilized, in conjunction with radiolabeled cell and protein markers, to quantitate inflammatory parameters and ascertain their kinetics in the synovial tissues of the rabbit. The rates of increased vessel permeability, polymorphonuclear leukocyte infiltration and platelet deposition were studied using 125-I-albumin, 51-CR-PMN-leukocytes and 111-In-platelets, respectively. Increase in vessel permeability over time was found to directly correlate with increased leukocyte infiltration (r = 9.08; P less than 0.01). Similar correlations between vascular permeability and platelet accumulation, and leukocyte infiltration and platelet accumulation, were not observed. The histological evaluation of synovial lesions corroborated the kinetic findings.

Acute Disease↗

PubMed1986

The management of hypertensive disease: a review of spinal manipulation and the efficacy of conservative therapeusis.

When considering the ailments that plague mankind, certainly one of the enigmatic conditions is hypertensive disease. This perplexing disorder is recognized insidiously in the clinical setting. It is believed to occur because of the complex interactions of a variety of factors which act on the components of the blood vasculature. Although afflicted individuals may appear relatively asymptomatic, the additive influences of such factors eventually culminate in deleterious sequelae. Overall, hypertension appears to be related to stress, diet and lifestyle. The autonomic nervous system, particularly its sympathetic component, appears to mediate such accumulated factors, affecting the overall clinical scenario of hypertension. Although generally aligned with the aging process, this condition also may affect younger individuals. Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regimens, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice.

Chiropractic↗

PubMed1985

Acute inflammation induced by immune complexes in the microcirculation.

The aims of the studies presented in this publication were to elucidate the morphology and quantitate the kinetics of an inflammatory reaction elicited by immune complexes and to ascertain the role of complement in the reaction. The hallmark of both the direct active (DAA) and reversed passive (RPA) Arthus reactions was the accumulation of immune precipitates and polymorphonuclear leukocytes (PMNs) in and around vessels. Using fluoresceinated antigen as a tracer, immune complexes localized in the lumina and walls of venules and small veins in the DAA and in the wall of vessels and perivascularly in RPA. PMNs accumulated at these same sites, phagocytosed the fluoresceinated complexes and became degranulated. The precise localization of immune complexes was achieved by examining the same tissue sections first by fluorescence microscopy, followed by conventional staining and examination by light microscopy. Marked stasis of the microcirculation was observed, particularly in DAA, in which a few immune complex-containing PMNs were entrapped in a mass of densely packed red blood cells. Some edema was observed in early lesions and definitive separation of collagen fibers was noted in lesions older than 2 hr. Hemorrhage became the dominant characteristic of both types of reactions from 2 hr onward. By administering radiolabeled cells, proteins, and microspheres as a "pulse," given at various times before sacrifice, the quantitation and kinetics of the inflammatory lesions elicited by immune complexes could be elucidated. In RPA all parameters quantitated reached a peak soon after elicitation of the reaction (2-4 hr), which is in keeping with other forms of acute inflammation. In DAA there was some difficulty in assessing the quantitation because of interanimal variations and because of progression of the inflammatory lesions, as the antigen diffused peripherally from the site of its injection. Peak activities occurred in 4- to 8-hr-old lesions. These observations and a comparison of the center and periphery of the lesions, strengthen the contention that the RPA and DAA have common features and features which differ. In common are immunological mechanisms (antigen-antibody interaction and complement activation) and cellular events (polymorphonuclear leukocyte chemotaxis, phagocytosis, and release of lysosomal contents). Different features are the site of immune complex formation and its sequelae. In RPA they form primarily in the wall of venules and small veins and hence have a marked effect on increase in vessel permeability. In the DAA most of the complexes form and the leukocytes accumulate in the lumen of the same vessels.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1984

Vascular ischemia of the cervical spine: a review of relationship to therapeutic manipulation.

Techniques employed by chiropractors in adjusting fixations of the cervical spine have often been a subject of criticism by other health care professionals. A primary concern is the potential risk of vascular occlusion in this region, subsequent to manipulative therapy. Although rare when compared to the millions of such manipulations given over a corresponding period of years, several reports exist to support the possibility of such an occurrence. Recent evidence, however, suggests that manipulation alone may not be solely contributory. Other extrinsic and intrinsic factors may play important roles in predisposing individuals who seek chiropractic intervention. Such factors are reviewed with the intention of establishing chiropractic professional awareness to such entities and to illustrate the need for a greater corroboration among health care professionals.

Cervical Vertebrae↗

PubMed1982

Pathways to inflammation induced by immune complexes: development of the Arthus reaction.

The changes associated with inflammation induced by immune complexes (reversed passive Arthus reaction induced with egg albumin-anti-egg albumin) were quantitated and the kinetics of the various vascular phenomena were ascertained. Hyperemia, increase in vascular permeability, platelet accumulation, and polymorphonuclear (PMN) leukocyte accumulation occurred relatively early after induction of the inflammatory lesions, and peaked in 2-4 h. Hemorrhage peaked in 6-h-old lesions. Morphological studies confirmed that almost all infiltrating cells were PMN leukocytes and immunofluorescent tracer studies showed immune complexes in vessel walls as early as 15 min after i.v. injection of the fluoresceinated antigen and the intradermal injection of antibody. By 8 h the progression of the lesions had subsided and by 24 h there were signs of resolution. A pathway for the development of the inflammatory lesions induced with immune complexes is proposed.

Animals↗

PubMed1980

Experimental type 2 herpes simplex ophthalmitis in the newborn rat.

An animal model for the study of type 2 herpes simplex virus (HSV2) ophthalmitis is described. Wistar rats were inoculated intracerebrally with HSV2 at 0, 5, 10, 15, 20, or 30 days of age. Eyes and brain from all animals, whether they survived or succumbed with encephalitis, were collected for microscopic and virologic studies. Up to 20% or more of the HSV2-inoculated rats had lesions in the cornea, uveal tract, and/or retina. Herpetic keratiis occurred in a few animals while the eyelids were still fused, indicative of internal spread of HSV2. Intranuclear inclusions were observed in corneal epithelium and neural retina, and herpesvirus particles were demonstrated in the cornea, iris, and retina. Lesions of the cornea and iris were also visualized by scanning electron microscopy. Virus was isolated from over 40% of the eyes tested. In general, titers of the virus in the eyes were less than those in the brains of HSV2-inoculated rats. The newborn rat thus represents another animal model to study herpetic ophthalmitis. Unlike most studies, ocular lesions were produced by a route other than the usual topical or intraocular inoculation of the virus.

Animals↗

PubMed1979