Search PubMed⌕ Search

Biomedical subjects

M M LaBan

Publications and source records attributed to M M LaBan.

At least 19 recordsLinked to original sources
PubMed1995

Osteoporotic stress fractures in anorexia nervosa: etiology, diagnosis, and review of four cases.

Anorexia nervosa (AN) is a chronic eating disorder characterized by self-imposed semi-starvation that affects 1% of adolescent females. AN predisposes to osteoporosis through hypothalamic dysfunction, which may lead to elevated cortisol as well as diminished estrogen and progesterone. The osteoporosis associated with AN affects both trabecular and cortical bone and increases the risk of osseous fracture. Fractures in this population may go unrecognized, because planar X-rays may be nondiagnostic for 6 weeks or more. Four women with AN ranging in ages from 22 to 34 with skeletal pain and nondiagnostic roentgenographs are described. Stress fractures in these patients were subsequently identified by bone scan. Although moderate exercise in patients with AN-associated osteoporosis may be beneficial, strenuous exercise can be detrimental, with its potential risk of stress fractures and exacerbation of the underlying neurohormonal abnormalities. This risk for fracture may persist well after improvement in the patient's AN.

Adult↗
PubMed1995

The lumbar herniated disk of pregnancy: a report of six cases identified by magnetic resonance imaging.

Although the mechanical and positional stresses of pregnancy are the primary inciting factors contributing to lumbosacral pain accompanying gestation, in approximately 1:10,000 cases a herniated disk (HNP) can be identified as the proximal cause of pain. Six patients are described, all of whom without antecedent history of pain presented with acute, disabling, gestational lumbosacral, and sciatic radiculopathy. Their ages ranged from 29 to 36, their parity from 0 to 1, and their gestational age at onset of symptoms from 6 weeks to 32 weeks. Each by magnetic resonance imaging (MRI) was identified as having an HNP, 2 at the L4-5 level and 4 at the L5-S1 level. During pregnancy, an MRI evaluation permits a detailed spinal examination without the ionizing effects of x-ray and its acknowledged biological risk to the developing fetus. This potential for an immediate and accurate diagnosis has significant implications for the management and subsequent planning of delivery.

Adult↗
PubMed1992

Electromyographic detection of paraspinal muscle metastasis. Correlation with magnetic resonance imaging.

Electromyographic (EMG) examination demonstrating marked segmental compromise of the posterior primary ramus distal to the spinal root with relative sparing of the anterior ramus may be the earliest objective evidence of paraspinal muscle metastasis. Antecedent studies are often initially normal, failing to disclose the underlying cause of back pain. Although paraspinal muscle metastasis has been histopathologically demonstrated at postmortem, attempts to image the suspected malignancy with computed tomography have been unsuccessful because the tumor in muscle remains isodense. This study reports the use of magnetic resonance imaging (MRI) to substantiate the existence of EMG-suspected paraspinal muscle metastasis. An EMG pattern of segmental posterior primary ramus denervation is not pathognomonic of metastasis. A confirmatory MRI, however, does permit earlier treatment with palliative radiation therapy.

Adenocarcinoma↗
PubMed1992

Intermittent cervical traction: a progenitor of lumbar radicular pain.

Twelve patients treated with cervical traction for complaints of cervical radicular pain subsequently developed lumbar radicular discomfort. Intermittent cervical traction therapy had been initiated at 15 pounds and increased to 30 pounds. Lumbar spine roentgenographs in four patients demonstrated a transitional lumbar vertebrae and ten patients had evidence of spinal osteoarthritis with associated degenerative changes. Abnormal electroneuromyographs were found in four patients. In two additional patients with normal electromyographs, the spinal evoked potentials were asymmetrically slowed suggesting chronic lumbar root compromise. The onset of lumbar radiculopathy after intermittent cervical traction suggests that axial tension induced in the spinal cord's dural coverings can be transmitted to lumbar nerve roots. When these structures are tethered by anatomic variants and/or associated degenerative changes, spinal root excursion may be limited, and lumbar pain may be precipitated by traction.

Adult↗
PubMed1992

Manipulation: an objective analysis of the literature.

Therapeutic manipulation is one of the oldest and most enduring treatment approaches to spinal pain. Multiple clinical trials have been structured to assess its therapeutic efficacy. A review of these reports suggests that in the acute circumstance, manipulation may hasten recovery but is not of significant benefit in the management of chronic spinal pain.

Back Pain↗
PubMed1992

The incidence of post minor traumatic brain injury syndrome: a retrospective survey of treating physicians.

There is a relative lack of information in the literature regarding the epidemiology, functional significance, and clinical resolution of the consequences of minor traumatic brain injury (MTBI). Most retrospective studies to date have been elicited by direct patient interview. Because it was supposed that a minor, but significant, traumatic brain injury would require continuing medical intervention beyond the emergency room contact, a survey was conducted of primary care physicians who were believed to be providing continuing medical care. Had their patients required reevaluations for symptoms of the post-MTBI syndrome? Two hundred fifty-six patients with traumatic brain injury initially seen in the emergency room of two community hospitals were reviewed. One hundred ninety-two (75%) had MTBIs (Glasgow coma scale more than 12 and a negative head CAT scan). One hundred twenty-two physicians were surveyed by mail; 67 (55%) responded. Twenty-one percent of their patients were experiencing symptoms of the post-MTBI syndrome from two to six months after their injuries. Studies relying on patient interviews have also estimated the post-MTBI syndrome at 20%. This correlation implies that "suggestion" does not bias patient interview style research in evaluating the post-MTBI syndrome.

Adult↗
PubMed1990

Low back pain as the presenting symptom of metastatic angiosarcoma.

A case is presented of a patient with the chief complaint of low back pain, who subsequently was found to have lumbar metastatic angiosarcoma. This report emphasizes the need for a thorough medical evaluation in all instances of radicular low back pain. The characteristics of metastatic intramedullary spinal cord tumor are outlined.

Back Pain↗
PubMed1990

The ghost joint: transient osteoporosis of the hip.

Seven adult patients identified as having idiopathic transient osteoporosis of the hip (TOH) are reported. TOH is an uncommon entity, most often seen in women during the third trimester of pregnancy and in middle-aged men. It is characterized by groin pain, limited hip range of motion, nonspecific laboratory findings, localized radiographic evidence of osteopenia, and spontaneous recovery usually within two to nine months. Diagnosis remains dependent on clinical recognition and x-ray confirmation. Radioisotope scanning aids in the diagnosis; both bone and synovial biopsies are often less productive. Treatment consists of joint protection with limited weight bearing, range of motion exercise, progressive ambulation, and analgesics. An awareness of TOH facilities appropriate diagnosis and treatment and curtails unnecessary diagnostic procedures.

Adult↗
PubMed1990

Restless legs syndrome associated with diminished cardiopulmonary compliance and lumbar spinal stenosis--a motor concomitant of "Vesper's curse".

Lumbosacral and associated leg pain and paresthesias arousing patients from a sound sleep, or Vesper's curse, has been previously reported. An increase in right atrial filling pressure reflected in elevated paraspinal venous volumes within the reduced confines of a stenotic lumbar spine has been cited as the cause of this syndrome. Six cases of concomitant nocturnal calf cramps and fasciculations associated with the night pain and paresthesias are reported. In all cases a reduction in cardiopulmonary compliance was noted, with clinical and electromyographic evidence of paraspinal and lower extremity fasciculations increasing at night. Symptoms were relieved by assuming an erect or semi-reclining sleep position. In five of the six reported cases of lumbar spinal stenosis, spondylolisthesis was also present. The motor equivalent of Vesper's curse was evaluated by electromography, evoked potentials, CAT scan, and myelography. The multiple factors involved in the pathomechanics and pathophysiology of lumbar radiculopathy, and spinal stenosis and the role of the paravertebral plexus of veins are reviewed as they relate to the genesis of the restless legs syndrome.

Aged↗
PubMed1989

Periarthrosis of the shoulder associated with diabetes mellitus.

Among the protean complications of diabetes mellitus are contractures of the joints and periarticular soft tissue. These complications have not been well described in the literature. This syndrome of "limited joint mobility," has been reported as occurring in young, insulin-dependent diabetics, with primary involvement of the small joints of the hands. In older diabetics, similar changes have been described with additional contractures developing in the large joints of the upper extremities. This report presents clinical findings occurring in five older diabetics with primary contractures of the shoulder. Theoretical considerations are also discussed regarding the neurophysiology of this entity as well as the current treatment options.

Adult↗
PubMed1989

Computer-generated headache. Brachiocephalgia at first byte.

Twenty-four women employed as computer operators were evaluated for complaints of occipital headaches, as well as neck and shoulder pain. Although the symptoms were highly variable with respect to duration, intensity and distribution, they were mutually consistent in that they started or intensified with the resumption of the work week. The patients varied in age from 25 to 58 with a median average of 48 years. Fifteen demonstrated radiographic evidence of cervical degenerative disc disease and in an additional four, electromyographic evidence of cervical root compromise was present. Multiple precipitating factors were identified in Monday's headache including the predisposing presence of unrecognized impairment of visual acuity in 4 and cervical radiculopathy in 16. Mechanically, prolonged postural cervical hyperextension frequently combined with repetitive head rotation appeared to trigger the discomfort complaints. Undue elevation of the CRT screen, prolonged copying of laterally displaced hard copy, the wearing of bifocals, as well as seating either excessively soft or with a tendency to pitch the operator forward were identified as additional aggravating factors.

Adult↗
PubMed1989

The prevalence of peripheral neuropathy in patients with anorexia nervosa.

A prospective, controlled study was conducted to determine the prevalence of peripheral neuropathy (PN) in patients with anorexia nervosa (AN). Fifty-one patients (49 females, 2 males) between the ages of 12 and 47 (means = 22.5) who met the criteria for AN of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, were randomly selected from an inpatient eating disorders unit during 15 months. Fifty healthy volunteers (41 females, 9 males) between the ages of 17 and 50 (means = 26.5) served as controls. After a neurologic history, all patients were evaluated by physical examination and standardized electrodiagnostic testing. Chi-square contingency testing was used to assess data. Four study group patients (8%) had electrodiagnostic evidence of a sensorimotor PN compared with none in the control group. This is approaching statistical significance (p = 0.13). Three of four patients with AN for at least ten years were among those with PN. The prevalence of subjective symptoms among the study group (65%) as compared to the control group (4%) was of marked significance (p = 5.62 x 10(-10]. In addition, three anorexic patients were found to have an isolated peroneal nerve palsy. We conclude that PN is a notable complication of AN, particularly in long-standing cases. The PN is most likely a product of chronic malnutrition rather than a specific nutrient deficiency. Patients with AN also appear to be at increased risk for developing localized compression neuropathies secondary to subcutaneous tissue loss.

Adolescent↗
PubMed1989

Airport induced "cervical traction" radiculopathy: the OJ syndrome.

The escalation of airline travel compounded by federal deregulation, fostering crowded airports, delayed flights, and inconvenient gate scheduling, has forced the frequent flyer to run from one gate to another, carrying heavy under-the-seat bags. Eleven busy executive, nine men and two women, developed cervical radicular pain complaints associated with weakness and painful dysesthesias in the involved extremity. Four had right C6 root symptoms and seven had left C7 complaints. All had evidence, by x-ray, of cervical degenerative disc disease and three had abnormal electromyograms. Treatment, consisting of intermittent cervical traction after moist heat, as well as a modification of their travel habits including the use of a folding wheeled cart, in every instance resolved these complaints.

Adult↗