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Biomedical subjects

M I Jayson

Publications and source records attributed to M I Jayson.

At least 55 records · Page 3Linked to original sources
PubMed1995

Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey.

STUDY DESIGN: This report gives the results of a population-based cross-sectional mailed questionnaire, with prospective follow-up of survey responders and nonresponders. OBJECTIVE: To determine the 1-month period prevalence of low back pain in an adult population in the United Kingdom and to estimate the effect of nonresponse bias. SUMMARY OF BACKGROUND DATA: Previous United Kingdom population studies have reported a 1-year period prevalence of low back pain of 37%. However, the definitions of low back pain have varied, and the influence of nonresponse rarely has been reported. METHODS: The study population was made up of all 7669 adults (18 to 75 years old) registered with two family practices in a sociodemographically mixed suburban area. The questionnaire, including a pain drawing to identify the site of any pain, was mailed to the entire study population. Two repeat mailings were sent to nonresponders. Family practice consultations about low back pain by individuals from the study population were monitored over the following 12 months using computerized records of all surgery contacts. RESULTS: Of the study population, 4501 (59%) responded. The 1-month period prevalence of low back pain was 39% (35% in males, 42% in females). The age distribution was unimodal, with peak prevalence in those aged 45 to 59 years old. Responders to the first mailing had a small but nonsignificant increase in prevalence compared with those who responded to the second or third mailing. Nonresponders had a subsequent consultation rate for low back pain that was 22% lower than that for the survey responders. CONCLUSIONS: After considering potential differences in nonresponders, the estimated 1-month prevalence of low back pain was between 35% and 37%. Prevalence figures in survey responders may overestimate the true population prevalence by a modest amount.

Adolescent↗
PubMed1995

Herniated intervertebral disc-associated periradicular fibrosis and vascular abnormalities occur without inflammatory cell infiltration.

STUDY DESIGN: Prospective histologic comparison of perineural tissues from patients requiring decompression surgery for herniated intervertebral disc with those from cadaveric controls. OBJECTIVES: To examine the significance of herniated intervertebral-disc-associated perineural vascular and fibrotic abnormalities with respect to back pain symptom generation. SUMMARY OF BACKGROUND DATA: Previous cadaveric studies have demonstrated perineural vascular congestion, dilatation, and thrombosis and perineural and intraneural fibrosis occurring in association with herniated intervertebral disc. It was suggested that these neural abnormalities were the result of ischemia, due to venous outflow obstruction, and also represented a possible cause of ongoing back pain symptoms. Criticisms of such a conclusion arose, however, because the possibility could not be excluded that these abnormalities were the result of postmortem artifact. METHODS: Histologic and immunohistochemical comparison of discal and peridiscal tissues removed from 11 patients with radiographically proven herniated intervertebral disc requiring decompressive surgery and from 6 fresh cadavers without history of back pain in life. RESULTS: Histology and immunohistochemistry of perineural and extraneural tissues from patients revealed vascular congestion, neovascularization, and endothelial abnormalities including luminal platelet adhesion, in association with reductions in von Willebrand factor levels, together with perivascular and perineural fibrosis. Elevated fibrogenic cytokine concentrations were also detected in patients' tissues. These changes occurred without evidence of inflammation and were absent in cadaveric control tissues. CONCLUSIONS: The vascular abnormalities detected in patients may represent an important etiopathologic factor predisposing to intraneural and perineural fibrosis, and hence to chronic pain symptoms, after disc herniation. It seems important to preserve the perineural microcirculation following disc herniation.

Adult↗
PubMed1995

Jacques Forestier.

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗
PubMed1995

Number of children as a risk factor for low back pain in men and women.

OBJECTIVE: To estimate the influence of the number of liveborn children on the risk of low back pain. METHODS: The study design was a cross-sectional population-based survey. The 4,501 respondents to a postal survey were asked to provide data on the occurrence of low back pain and on any children they had. Data on some potential confounding variables were also obtained. RESULTS: There was an increased risk of low back pain in those who were married compared with those who were unmarried, among both men (odds ratio 1.7) and women (odds ratio 1.6). Among married individuals, there was a linear trend of increasing risk with increasing numbers of children. CONCLUSION: The risk of low back pain is related more to childrearing than to childbearing, although this effect might be partially mediated by unknown confounders associated with increasing family size.

Adolescent↗
PubMed1995

Measurement of the time course of bending of the back in the sagittal plane.

A simple, inexpensive method has been developed for measuring the position of the back, projected onto the sagittal plane, during flexion. Light-emitting diodes (LEDs) were attached to the skin overlying the T6, L1, L3 and L5 vertebrae. They started to flash, at a controlled frequency, at the beginning of movement from an upright to a flexed position. The positions of the markers together with the initial (upright) and final (flexed) positions of the back were recorded on a single photograph. A plumb line provided a vertical reference. Times were determined from the flashing frequency. Vertical and horizontal components of the position were measured from the photograph; their resultant represented total displacement at a given instant in time. The results were scaled so that the displacements were expressed as a fraction of their maximum value, and time was expressed as a fraction of the total movement time. The reproducibility of the technique was tested by making repeated measurements from a single healthy volunteer. At any instant, the horizontal, vertical and resultant displacements of the T6 marker could be determined to within 7% of their maximum values; the resultant displacement of the L5 marker could be determined to within 10%. The results from the other markers were less reliable.

Adult↗
PubMed1995

Influence of physical, psychological and behavioural factors on consultations for back pain.

Over 34,000 questionnaires were used to study occurrence and consultations for back pain in the community. The 12-month period prevalence was 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both sexes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Questionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.05; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1.79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily activity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08-2.09), but was negatively associated with back pain in women aged over 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negatively associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalence of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables. Thus back pain was substantially more common in women compared to men over 55 yr. Psychiatric morbidity, cigarette smoking and obesity were associated with back pain at all ages, but the effect of physical exercise appeared to change with age. Further studies are required to explain the sex differences and nature of the associations.

Adolescent↗
PubMed1995

Sustained-release transdermal glyceryl trinitrate patches as a treatment for primary and secondary Raynaud's phenomenon.

A randomized, double-blind, placebo controlled, cross-over study was conducted to determine the clinical efficacy of and patient tolerance to sustained-release glyceryl trinitrate (GTN) patches in the treatment of Raynaud's phenomenon. The patients studied were those with primary Raynaud's disease (n = 21) and patients with Raynaud's phenomenon secondary to systemic sclerosis (n = 21). GTN patches (0.2 mg/h) were found to be effective in reducing the number (P < 0.05) and severity of Raynaud's attacks (P < 0.05) in both groups of patients. Objective assessments by infrared thermography did not show any significant improvement when the patients were on GTN patches (P > 0.05). Headaches, refractory to treatment, led to the withdrawal of eight patients from the study and occurred in approximately 80% of the remaining patients. Thus, in spite of the subjective efficacy, the frequent headaches will limit the use of GTN patches in Raynaud's phenomenon. Elucidating the mechanism of action of the beneficial and adverse effects of GTN at the molecular level may shed light on the pathogenesis of Raynaud's phenomenon and its treatment.

Administration, Cutaneous↗
PubMed1995

Altered levels of soluble adhesion molecules in rheumatoid arthritis, vasculitis and systemic sclerosis.

We compared the levels of soluble adhesion molecules E-selectin (sE-selectin), intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) alongside von Willebrand factor (vWf), CRP and rheumatoid factor in 40 patients in serum by ELISA, rheumatoid factor by sheep red blood cell agglutination and CRP by immunonephelometry. Compared to controls, increased sE-selectin was found in patients with RA (P = 0.0015), vasculitis (P < 0.0003) and SSc (P = 0.0126), whilst raised sICAM-1 was found in RA (P < 0.0003), vasculitis (P < 0.0003) and SSc (P < 0.0378). sVCAM was lower in RA than in controls (P = 0.0102), but was unchanged in vasculitis or in SSc. vWF was raised in RA (P = 0.0102), vasculitis (P < 0.0003) and SSc (P < 0.0003). In a Spearman's rank analysis of all the data, vWf correlated with sVCAM-1 and sICAM-1 (both P < 0.001), sE-selectin with sICAM-1 (P < 0.001) and sVCAM with sICAM-1 (P < 0.005). Levels of rheumatoid factor correlated with those of sE-selectin (P = 0.003) and sVCAM-1 (P = 0.012), but there were no correlations between any index and CRP. The strongest correlations within the RA group were between sICAM and sVCAM (P = 0.001), in vasculitis it was between sE-selectin and sICAM (P < 0.001), and in SSc it was between sE-selectin and sVCAM (P = 0.019). These data suggest that the differing levels of vWf, sE-selectin and sICAM-1 in the inflammatory vasculitides may be useful in establishing a role for leucocyte/endothelial adhesion in these diseases.

Adult↗
PubMed1994

Syringomyelia as a complication of spinal arachnoiditis.

SUMMARY OF BACKGROUND DATA: The authors report a 46-year-old female patient who was referred to this unit for assessment of chronic postsurgical back pain. She reported severe burning pain in the lumbar region accompanied by burning pain and loss of sensation in the lower limbs. She had previously undergone lumbar spinal surgery on three occasions preceded by myelography. METHODS: Examination revealed generalized weakness and hypertonicity of both lower limbs with loss of all sensory modalities below D7. RESULTS: The MRI scanning of the thoracic spine showed an extensive complex syrinx within the thoracic cord. CONCLUSIONS: She underwent syringopleural shunting, and her condition has remained stable.

Arachnoiditis↗
PubMed1994

The effect of vibration on back discomfort and serum levels of von Willebrand factor antigen: a preliminary communication.

The von Willebrand factor (vWf) is a complex protein whose release is a marker for endothelial damage; serum levels of its antigen (vWFAg) can be used as a marker for such changes. We measured the levels of back discomfort and vWFAg in 11 subjects following 25-min periods of (1) lying down, (2) sitting upright, (3) vibrating whilst sitting and (4) sitting upright. Back discomfort appeared and vWf levels were significantly increased following sitting upright, compared with lying flat, and increased further following vibration. They fell thereafter with a period of sitting still upright. These results demonstrate that vibration has a significant effect in increasing back discomfort and the serum levels of vWFAg, and it is possible that vibration may induce vascular damage within the spine.

Adult↗
PubMed1994

Plasma TGF beta in systemic sclerosis: a cross-sectional study.

OBJECTIVES: To determine whether the active 25 kDa form of the fibrogenic cytokine transforming growth factor beta (TGF beta) can be detected in plasma from patients with systemic sclerosis and to examine the relationship between plasma TGF beta and clinical markers of disease severity and serum concentrations of the aminoterminal peptide of type III procollagen (PIIINP) (a laboratory marker of the fibrotic process). METHODS: A cross sectional study was made of 39 patients with systemic sclerosis (11 diffuse and 28 limited), nine patients with primary Raynaud's disease and 60 healthy controls. TGF beta 1 and TGF beta 2 were measured by enzyme linked immunosorbent assay (ELISA) (sensitivity 100 pg/ml) and PIIINP by radioimmunoassay. RESULTS: TGF beta 1 was detected in plasma from six of 39 patients with systemic sclerosis but not in any patient with primary Raynaud's disease or healthy controls. TGF beta 2 was not detected in plasma from patients or controls. No clear relationship was demonstrated between TGF beta 1, clinical features or PIIINP concentrations. CONCLUSIONS: The 25 kDa form of TGF beta 1 can be detected in the plasma of some patients with systemic sclerosis. This provides limited support for the hypothesis that this cytokine plays a role in the pathogenesis of this disease. However, longitudinal studies, particularly in early diffuse disease, are required to clarify the relationship between circulating TGF beta 1 and disease activity.

Adult↗