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Biomedical subjects

S Haldeman

Publications and source records attributed to S Haldeman.

53 records · Page 3Linked to original sources
PubMed1982

Colonic dysfunction in multiple sclerosis.

Multiple sclerosis is a central nervous system disease frequently accompanied by urinary symptoms and severe constipation. In order to investigate the pathophysiology of these symptoms, we studied colonic motor and myoelectrical activity, as well as colonic volume-pressure relationships (colonometrograms) and have correlated these data with cystometry and electrophysiologic studies of the central and peripheral somatosensory nervous system. The study group consisted of 7 patients with advanced multiple sclerosis marked by symptoms and signs of somatic and visceral nervous system dysfunction including severe constipation. Ten normal volunteers served as control subjects. The multiple sclerosis group demonstrated electrophysiologic evidence of lesions in the somatosensory neuroaxis central to the lumbosacral spinal cord. Abnormal cystometrograms suggested visceral central nervous system dysfunction. Colonometrograms in the multiple sclerosis group demonstrated a more rapid pressure rise than in the control group (p less than 0.01). The multiple sclerosis group failed to demonstrate the postprandial increase in colonic motor and myoelectrical activity observed in the control group (p less than 0.01). Abnormal colonometrograms and absent postprandial colonic motor and myoelectric responses may be features of visceral neuropathy in patients with advanced multiple sclerosis and severe constipation.

Colon↗
PubMed1981

Continuous monitoring of bladder and urethral pressures: new technique.

A new technique for continuous monitoring of intravesical and intraurethral pressures was developed and utilized in a group of male patients to overcome the disadvantages associated with previously employed liquid and air-coupled systems. This technique permitted recording under physiologic conditions and provided information on a continuous basis concerning changes in the intravesical and intraurethral pressures in patients with multiple urologic symptoms. With further modifications this technique promises to further our understanding of the dynamics of the lower urinary tract under various conditions of stress.

Adult↗
PubMed1980

Controlled clinical trials of manipulation: a review and a proposal.

Manipulation has been widely used for the treatment of back disorders for centuries. However, until recently, randomized clinical trials have not been used to study the effectiveness of the various forms of manipulation. A review of recently published clinical trials indicates that manipulation is probably superior to certain control or sham treatments. This review also indicates that further randomized clinical trials are desirable and suggests the features that will be necessary in future trials of manipulation.

Back Pain↗
PubMedDate not supplied

Cervicogenic headaches: a critical review.

BACKGROUND CONTEXT: The notion that headaches may originate from disorders of the cervical spine and can be relieved by treatments directed at the neck is gaining recognition among headache clinicians but is often neglected in the spine literature. PURPOSE: To review and summarize the literature on cervicogenic headaches in the following areas: historical perspective, diagnostic criteria, epidemiology, pathogenesis, differential diagnosis, and treatment. STUDY DESIGN/SETTING: A systematic literature review of cervicogenic headache was performed. METHODS: Three computerized medical databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Mantis) were searched for the terms "cervicogenic" and "headache." After cross-referencing, we retrieved 164 unique citations; 48 citations were added from other sources, for a total of 212 citations, although all were not used. RESULTS: Hilton described the concept of headaches originating from the cervical spine in 1860. In 1983 Sjaastad introduced the term "cervicogenic headache" (CGH). Diagnostic criteria have been established by several expert groups, with agreement that these headaches start in the neck or occipital region and are associated with tenderness of cervical paraspinal tissues. Prevalence estimates range from 0.4% to 2.5% of the general population to 15% to 20% of patients with chronic headaches. CGH affects patients with a mean age of 42.9 years, has a 4:1 female disposition, and tends to be chronic. Almost any pathology affecting the cervical spine has been implicated in the genesis of CGH as a result of convergence of sensory input from the cervical structures within the spinal nucleus of the trigeminal nerve. The main differential diagnoses are tension type headache and migraine headache, with considerable overlap in symptoms and findings between these conditions. No specific pathology has been noted on imaging or diagnostic studies which correlates with CGH. CGH seems unresponsive to common headache medication. Small, noncontrolled case series have reported moderate success with surgery and injections. A few randomized controlled trials and a number of case series support the use of cervical manipulation, transcutaneous electrical nerve stimulation, and botulinum toxin injection. CONCLUSIONS: There remains considerable controversy and confusion on all matters pertaining to the topic of CGH. However, the amount of interest in the topic is growing, and it is anticipated that further research will help to clarify the theory, diagnosis, and treatment options for patients with CGH. Until then, it is essential that clinicians maintain an open, cautious, and critical approach to the literature on cervicogenic headaches.

Cervical Vertebrae↗
PubMedDate not supplied

The electrodiagnostic evaluation of nerve root function.

Electrodiagnostic testing is an important part of the investigation of spinal nerve root and cord function. These tests are utilized to confirm and document suspected neuronal lesions. Characteristics of a spinal nerve root lesion, including chronicity, level, sensory or motor dysfunction, and severity, can be estimated by utilizing multiple testing procedures. Tests available include needle electromyography. H-reflexes, F-responses, bulbocavernosus reflex responses, and somatosensory evoked responses recorded over the spine and head. Each test has unique advantages and disadvantages and none can be considered of sufficient sensitivity to exclude the other tests. By using case examples the lack of correlation between electrodiagnostic testing and spinal pain has been illustrated.

Adult↗