Chronic pain and depression: a review.
Explore the source record for details and available documents.
Antidepressive Agents↗
Biomedical subjects
M Thomas
Publications and source records attributed to M Thomas.
A teaching tool for children in self care.
Explore the source record for details and available documents.
Child↗
Surgical treatment of low backache and sciatica.
A comparison between 86 patients with low back pain who underwent surgery and 32 who did not showed that laminectomy is an effective treatment for many patients in whom conservative treatment has failed. Surgery should be undertaken sooner rather than later (preferably within a year), both because a good outcome is less likely with longer duration of symptoms and because long periods of disability and time off work can in this way be avoided.
Adult↗
[Physiopathology of human obesity].
Our knowledge of hunger and bodyweight regulation is gradually increasing. There are wide interindividual variations in nutritional needs and therefore in susceptibility to gross overweight. Obesity is associated with disturbances in neurosensorial, hormonal and metabolic regulations which are now much better understood. Studies of certain ethnic groups in which obesity is particularly prevalent contribute to the genetic approach to the condition. As in animals, where obesity models correspond to mono- or polygenic transmissions, it is probable that in human beings obesity is a syndrome with multiple causes.
Humans↗
[Ultrasensitive TSH and thyroliberin test in patients hospitalized for depression].
In this prospective study of 35 patients hospitalized for depression, TSH levels were measured before and after stimulation by TRH. The type of depression was determined and its intensity was evaluated by means of the HARD scale. Subjects with systemic disease or receiving treatments known as being likely to influence TSH levels had been excluded. In none of these 35 patients was the TSH level below the lower limit of normal values, nor was there any blunting of response to TRH. These results suggest that depression is not a cause of TSH fall and that a low TSH level with normal hormonaemia must call for scintiscanning, even in depressed subjects.
Adult↗
[Rope pulley isokinetic system in shoulder rehabilitation--initial results].
AIM: Of this study was to evaluate the results of a shoulder rehabilitation program of different shoulder diseases, based on an isokinetie pulley system ("Moflex", Recotec/Bernina, Swiss). METHOD: In this prospective study 70 patients participated in a standardized rehabilitation program (instability: n = 19; rotator cuff disorders: n = 23; impingement syndrome without lesion: n = 16; others: n = 12; operative therapy: n = 47). The major aspect of the program was an isokinetic pulley system. RESULTS: Isokinetic training with the used device affords strict monitor-feedback to avoid critical torque values. Strength which was attained without relevant pain was almost linearly increased by a mean of 31% until the 20th day of rehabilitation, workload by 79%. At the end of the rehabilitation program the strength of the affected (mostly dominant) shoulder was 15% higher than in the unaffected shoulder; the respective workload values were almost equal. CONCLUSION: These first results demonstrate the value of the isokinetic pulley system in the rehabilitation of the investigated shoulder diseases. The equipment may be used already in an early postoperative state. First results of strength increases using an isokinetic pulley system in shoulder rehabilitation are presented.
Adult↗
[Pulley system isokinetic training in knee rehabilitation--initial results].
AIM: The purpose of this study was to evaluate the results of a knee rehabilitation program after knee surgery, based on an isokinetic pulley System (Moflex, Recotec/Bernina, Switzerland). METHOD: In this prospective study, 73 patients participated in a standardized rehabilitation program (ACL reconstruction, ACL/all: n = ;51; patellar tendon, ACL/P: n = 30; semitendinosus tendon, ACL/S: n = 21; arthroscopic meniscus resection: n = 22). The major aspect of the program was an isokinetic pulley system with an implemented, linearly working knee device. RESULTS: Isokinetic training with the used device affords strict monitor feed-back to avoid critical torque values. Concentric training strength and workload which were attained without relevant pain were increased by about 130% within a mean of 16 rehabilitation days. At the end of the rehabilitation program, the maximum concentric strength of the affected knee measured by a rotating isokinetic system (Cybex, Kaphingst, Lahntal) increased by about 69% and amounted to about 90% of that of the unaffected knee. CONCLUSION: These first results demonstrate the value of the isokinetic pulley system in the rehabilitation after knee surgery as described above. The equipment may be used already in an early postoperative stage by the use of a passive or active-assistive mode. First results of strength increases using an isokinetic pulley system in knee rehabilitation are presented.
Adult↗
[Normal values of the shoulder strength in dependency on age and gender--comparison with the constant, UCLA, ASES scores and SF36 health survey].
AIM: The purpose of this study was to establish normal strength values of shoulder abduction in a male and female population aged between 6 to 90 years. These values were compared to the sex- and age-related values given by Constant for an Irish population, referred to as Constant 1991. Further strength values resulting from fixation of the measuring device at the deltoid insertion or at the wrist were compared. The assessment and comparison of shoulder function using different shoulder scores (Constant, UCLA, ASES) and the SF-36 was another aim of this study. METHOD: 120 male and 120 female probands were examined. For interpretation age- and sex-related groups of 20 probands each were used (group 1: 6 - 15 years; group 2: 16 - 30 years; group 3: 31 - 45 years; group 4: 46 - 60 years; group 5: 60 - 70 years, group 6: 71 - 90 years). Subjective and objective clinical parameters were registered, shoulder abduction strength was obtained using an isometric measuring device with fixation points at the deltoid insertion and at the wrist and the respective torque values were calculated. The shoulder function was quantified using Constant, UCLA and ASES scores. With the exception of group 1, the quality of life was measured with the SF-36 health-status questionnaire. RESULTS: Normal values of the shoulder abduction strength and valuation according to the Constant score are given for a German reference group related to age and gender. In addition to the Constant score more values for children are given. Strength values measured at the deltoid insertion (fixation point 1, FP1) and wrist (fixation point 2, FP2) are in a linear relation. Thus FP1 = 2.5 x FP2 and FP2 = 0.4 x FP1. If torque values instead of strength are used, 25 points correspond to 50 Nm. Total score values calculated by the use of the Constant score (methods published 1991) were markedly higher in groups 3 - 6 related to the values of Constant in the Irish population; the main reason is the higher abduction strength in our population. There exists a good relation between the Constant, UCLA and ASES scores (Constant 1991). The results of the SF-36 health survey were similar to the results of Bullinger et al. 1996. CONCLUSION: The normal values of C. R. Constant of an Irish population differ in part to those of our groups due to the different strength values. Our values may be more representative for German patients. The linear regression between strength values measured at a fixation point at the deltoid insertion or the wrist facilitates the calculation of each point from the other. This allows a comparison of the results of studies with different fixation points. The additional calculation of the torque allows a comparison of different studies independently of the fixation point of the strength measuring device.
Adolescent↗
[Musculoskeletal biopsies in an open 0.5-T-MR system].
INTRODUCTION: MR-guided interventions have been successful in different medical disciplines. The aim of this paper is to report our results with the application of MR-guided biopsies of musculoskeletal lesions using an open 0.5-T-MR scanner and further to discuss these results on the basis of the available literature. PATIENTS AND METHODS: Between 1998 and 2003 30 patients (average age 44.1 years) underwent a total of 31 biopsies. The interventions were performed in an open 0.5-T MRI system using an active optical localization system as well as a navigation system. For the motion tracking we used T (1)-weighted real-time sequences with 0.25 pictures per second. For the sampling MR-compatible instruments were used that were specially developed for this purpose. The data of this retrospective investigation are based on the evaluation of the patient documents and the radiological findings. On the basis of the histological findings the technical success rate and the histological overall accuracy were determined. RESULTS: In 81 % of the biopsies the histological diagnosis was correct. In cases of suspected inflammation the histological accuracy was smaller (70 %). No differences were observed between skeletal and soft-tissue lesions. The technical success rate amounted to 77.5 %. No procedural or anesthesiological complications occurred. The mean operating time amounted to 65 min including the time for motion tracking. DISCUSSION: In cases of suspected lesions of the musculoskeletal system, the MR-guided biopsy represents a promising and safe procedure to get a histological diagnosis. In cases of sufficient size of the lesion sampling of a representative probe is possible. On account of the outstanding performance in soft-part contrasting, the sensitive structures surrounding the lesion can be saved. Substantial disadvantages of the procedure are the high costs for personal and material and the long operating time.
Adult↗
[Functional value of the Sauerbruch arm].
Since 1988 to the beginning of 1993 we have performed 20 Sauerbruch-muscle-tunnels by 16 patients. (1 forearm-, 17 biceps- and 2 pectoralis-tunnels) All tunnels correspond our expectations - expect 1 tunnel. The functional result of the prosthesis is dependent on the interest of the patients and their intention to forget the handicap. We recommended to use the prosthesis with sensitive feedback by patients, who have clear performances about their future live, after a long talk with the orthopedic surgeon. The suspicion of the disablement ideas decided the failure.
Activities of Daily Living↗
Vulnerability of waterborne diseases to climate change in Canada: a review.
This project addresses two important issues relevant to the health of Canadians: the risk of waterborne illness and the health impacts of global climate change. The Canadian health burden from waterborne illness is unknown, although it presumably accounts for a significant proportion of enteric illness. Recently, large outbreaks with severe consequences produced by E. coli O157:H7 and Cryptosporidium have alarmed Canadians and brought demands for political action. A concurrent need to understand the health impacts of global climate changes and to develop strategies to prevent or prepare for these has also been recognized. There is mounting evidence that weather is often a factor in triggering waterborne disease outbreaks. A recent study of precipitation and waterborne illness in the United States found that more than half the waterborne disease outbreaks in the United States during the last half century followed a period of extreme rainfall. Projections of international global climate change scenarios suggest that, under conditions of global warming most of Canada may expect longer summers, milder winters, increased summer drought, and more extreme precipitation. Excess precipitation, floods, high temperatures, and drought could affect the risk of waterborne illness in Canada. The existing scientific information regarding most weather-related adverse health impacts and on the impacts of global climate change on health in Canada is insufficient for informed decision making. The results of this project address this need through the investigation of the complex systemic interrelationships between disease incidence, weather parameters, and water quality and quantity, and by projecting the potential impact of global climate change on those relationships.
Animals↗
Synthesis and photochemical behaviour of a T-T dimer containing an amide linkage.
A T-T dimer characterized by an amide linkage to replace the phosphodiester backbone has been synthesized using a modified radical strategy. The new synthetic approach makes use of a thymidin-3'-yl phosphorodithioate derivative as a precursor of 3'-allyl-3'-deoxythymidine. Standard chemical transformations of this derivative led to the desired T-T dimer incorporating an amide bond. The latter was irradiated with 254 nm wavelength light to yield mainly cyclobutane and [6-4] photoadducts.
Amides↗
Forces, moments, and acceleration acting on a restrained dummy during simulation of three possible accidents involving a wheelchair negotiating a curb: comparison between lap belt and four-point belt.
The objective of this study was to determine the effect of two types of restraining belts (lap belt and a four-point belt) on an instrumented dummy during three situations: wheelchair hitting straight into curb (SIC); wheelchair falling straight off a curb (SOC); wheelchair falling diagonally off a curb (DOC). A fully instrumented (50th percentile Hybrid III) dummy was seated in a standard wheelchair and restrained with one of the belts. The wheelchair rolled down a ramp reaching a platform at 2.4 miles per hour (comfortable walking speed). Three types of experiments were performed: SIC, SOC, DOC. Each experiment was repeated at least three times. Forces, moments, and acceleration were monitored and recorded via 48 sensors placed at the head, spine, and limbs. All experiments were videotaped and photographed. The data were averaged and compared with standards that have been previously established in car crash testing and with data recently obtained in a similar study using a nonrestrained dummy. Our results showed that in the SIC experiments, low magnitude forces, moments, and acceleration of no clinical significance were recorded with both types of belts. The wheelchair remained upright and the dummy safely seated. In the SOC experiments, the two belts prevented the dummy's ejection from the chair and, thus, have been effective in lowering the forces, moments, and acceleration and preventing significant injuries to the head and neck regions. In the DOC experiments, the lap belt proved to be somewhat more effective than the four-point belt in lowering the extension forces at the upper neck and the moments at the lower neck below injury levels. It also kept the head injury criteria well below injury level. We postulate that the four-point belt was less effective because of its more extensive body fixation, which leads to concentration of moments and forces at the head and lower neck regions. The results of this study show that restraining systems can enhance the safety of wheelchair occupants in certain incidents. It has been demonstrated that the lap belt is as effective as the four-point belt system in SIC and SOC incidents. In DOC falls, neither belt could prevent falls and trauma to the head and neck region. The lap belt, however, was somewhat superior. We recommend that wheelchairs be equipped with a lap belt and patients be encouraged to buckle-up while using the wheelchair outdoors.
Acceleration↗
Intracranial paracrine interleukin-2 therapy stimulates prolonged antitumor immunity that extends outside the central nervous system.
To explore the potential efficacy of local cytokine delivery against tumors in the central nervous system (CNS), C57BL6 mice were simultaneously given intracranial injections of tumor challenge and of irradiated B16F10 melanoma cells transduced to secrete interleukin-2 (IL-2). Intracranial IL-2 therapy generated antitumor responses capable of extending the survival of animals that received simultaneous intracranial tumor challenge either locally or at distant sites in the brain. Nontransduced melanoma cells had little effect. Animals that survived intracranial IL-2 therapy and tumor challenge showed prolonged survival compared with controls when challenged with a second tumor dose 70 days after initial treatment. In addition, animals that rejected intracranial tumors were also protected from tumor growth upon rechallenge at sites outside the CNS (i.e., subcutaneous tumor challenge). Conversely, identical or 10-fold larger doses of IL-2-transduced cells administered by subcutaneous injection failed to generate protection against intracranial tumor challenges. Elimination of T-cell and natural killer (NK) subsets using gene knockout mice and antibody-depletion techniques demonstrated that NK cells were most important for the initial antitumor response, whereas CD4+ T-cells were not necessary. These studies demonstrate that local IL-2 therapy in the brain not only generates an immediate local antitumor immune response, but also establishes long-term immunologic memory capable of eliminating subsequent tumor challenges within and outside of the CNS. Furthermore, the antitumor response to paracrine IL-2 in the brain differed significantly from that in the flank, suggesting that the intrinsic CNS cells involved in initiating immunity within the brain have different cytokine requirements from their peripheral counterparts.
Adjuvants, Immunologic↗
Physical biochemistry of calcification.
Explore the source record for details and available documents.
Animals↗
Vasodilator effects of sulfinpyrazone in dogs.
The hemodynamic effects of sulfinpyrazone were investigated in 12 anesthetized dogs. Bolus injections into a coronary artery (1--500 mg) and a femoral artery (10--300 mg) and intravenous infusions (10 and 20 mg/min up to 500 mg) were given. After intracoronary injection, coronary dilatation occurred for over 20 min without major changes in cardiac muscle function. Femoral vasodilatation was also induced by local injection. Slow intravenous infusion resulted in inconsistent changes of coronary blood flow. However, in one instance, coronary dilatation was observed at a plasma level of 27.8 microgram/ml, which is comparable with that reached in man after standard oral dosage. Thus, sulfinpyrazone has coronary vasodilator effects which may have relevance to patient therapy.
Animals↗
The relationships of skeletal injuries with trauma score, injury severity score, length of hospital stay, hospital charges, and mortality in children admitted to a regional pediatric trauma center.
Thirty-four-hundred and seventy-two children were consecutively admitted for acute traumatic injuries over a 34 month period to the Children's National Medical Center. The study comprised 805 patients who sustained 953 fractures and dislocations. The male to female ratio was 2:1. Age at the time of admission was evenly distributed over 16 years, with a mean of 8.3 years. Pedestrian accidents and falls each accounted for 34% of the musculoskeletal injuries, whereas motor vehicle accidents accounted for an additional 13%. The femur was the most commonly fractured bone, representing 22% of all fractures and dislocations, followed by the humerus (16%), tibia/fibula (12%), ankle/foot (13%), and radius/ulna (8%). Nine percent of the fractures were open. The average length of hospital stay was 8.6 days, and the average cost per hospital admission was $8,765. The mortality rate was 3%. Central musculoskeletal injuries (spine, clavicle/scapula, and pelvis) in our hospitalized patients were associated with the longest hospital stays and intensive care unit admissions, and lowest Trauma Scores, as well as the highest Injury Severity Scores, hospital charges, and mortality rates.
Accidents, Traffic↗
Use of 64copper measurements to diagnose canine copper toxicosis.
Inherited canine copper toxicosis is a serious problem in Bedlington terriers and West Highland White terriers, and may also be a problem in other less-studied breeds. Affected dogs become ill at midlife with progressive and ultimately fatal liver disease. Treatments for removal of copper and prevention of copper accumulation are available, but are most effective if begun before the dog becomes ill. Until recently diagnosis has not been available until the dog is 1 year of age, and then only by an invasive liver biopsy with determination of liver copper concentration. The authors studied the use of 64copper for early diagnosis of canine copper toxicosis. Two procedures were evaluated. The first involved measuring the concentration of 64copper in blood 24 hours after oral administration of the radioisotope. At this time, 64copper was associated primarily with ceruloplasmin secreted into the blood by the liver. This procedure is useful in the diagnosis of the human counterpart, Wilson's disease. However, the authors found it to be nondiscriminatory between affected and unaffected dogs. In contrast, the second procedure, which involved measuring 64copper excreted in stool during 48 hours after an intravenous dose of radioisotope, yielded results that differentiated most affected and unaffected dogs.
Animals↗