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PubMed2006

Comparison of active motor items in infants born preterm and infants born full term.

PURPOSE: The study was designed to compare active motor items at term age of infants born very preterm, very low birth weight (VPT-VLBW) and without impairments with infants born full-term (FT) and healthy and to evaluate a method of assessment using video recordings and computer software. METHOD: Video recordings of head lag and head righting on pull to sit, head control in sitting, and hip flexion in prone were obtained at term age for 29 infants born VPT-VLBW and 22 infants born FT. Motor items were analyzed using digitizing computer software. RESULTS: Infants born VPT-VLBW had less head lag on pull to sit than infants born FT, p = 0.005. No other differences were found for the remaining motor items. The method of assessment demonstrated high intrarater reliability (intraclass coefficient correlation (3,1) = 0.77-0.997). CONCLUSIONS: Infants born VPT-VLBW who are at "low risk" performed at term age similarly to healthy infants born FT on four active motor items. The reliability of the measurement method supports the method's further development.

Child Development↗
PubMed1996

Insulin-like growth factor I promotes growth selectively in fetal sheep in late gestation.

Insulin-like growth factor I (IGF-I) is required for normal fetal growth and skeletal maturation in late gestation, because null mutations of the IGF-I gene in mice reduce fetal weight and retard ossification of bones. To determine if, conversely, increased abundance of IGF-I promotes fetal growth and skeletal maturation, fetal sheep were infused intravascularly with recombinant human IGF-I (n = 7) (26 +/- 3 micrograms. h-1.kg-1) from 120 to 130 days gestation and compared with controls (n = 15). IGF-I infusion increased plasma IGF-I concentrations by 140% (P = 0.002) and weights of fetal liver, lungs, heart, kidneys, spleen, pituitary, and adrenal glands by 16-50% (P < 0.05). Weights and/or lengths of the fetus, placenta, gastrointestinal tract, individual skeletal muscles, and long bones were unchanged by IGF-I. However, IGF-I increased the percentage of proximal epiphyses of long bones present (P < 0.05) and their cross-sectional areas by 15 to 38% (P < 0.05). These results show that IGF-I promotes growth of major fetal organs, endocrine glands, and skeletal maturation in vivo, consistent with IGF-I actively controlling and not merely facilitating fetal growth. The variable response of different tissues may partly reflect tissue specificity in growth requirements for additional factors.

Animals↗
PubMed1975

Training and certifying the internist for primary care.

Internists are well prepared to offer patients continuing and comprehensive medical care of the highest quality. Residencies must include training for the provision of primary care without compromising excellence. The teaching and practice of general internal medicine are the principal functions of Departments of Internal Medicine. Modern facilities for ambulatory care and an environment conducive to the development of internists for primary care are required. Establishment of new residency positions in general internal medicine is advocated, as is appropriate funding for education in the ambulatory patient setting. Experience with disciplines such as dermatology, office gynecology, musculoskeletal medicine, ophthalmology, otolaryngology, and psychiatry should be assured. The Board will include material relevant to primary care in its Certifying Examination.

Certification↗
PubMed2001

Spaceflight alters bone mechanics and modeling drifts in growing rats.

BACKGROUND: Alterations in bone metabolism may be a particularly serious consequence of spaceflight and a major obstacle to long-term space exploration. The effects of spaceflight on bone mechanics are unclear. This study examined the effects of spaceflight on bone mechanics in a growing rat model during a 17-d mission aboard the space shuttle (STS-78). METHODS: There were 18 rats that were divided into 3 experimental groups: flight rats (n = 6), ground-based control rats housed in an animal enclosure module (AEM, n = 6), and ground-based control rats housed in standard vivarium caging (n = 6). At the conclusion of the mission, rat femurs were tested in three-point bending followed by static and dynamic bone histomorphometry. RESULTS: Maximum stress was unaffected by spaceflight, but flexural rigidity was significantly decreased in flight animals. Much of the decrease appeared to be the result of decreases in tissue properties (elastic modulus) rather than structural changes within the bone. No significant differences in cortical bone mass or geometry were observed. In contrast, endocortical resorption was significantly decreased in flight rats accompanied by a nonsignificant decrease in periosteal bone formation, suggesting alterations in bone modeling drifts during spaceflight. For nearly all measured indices, ground-based AEM rats displayed values intermediate to flight and ground-based vivarium rats. CONCLUSIONS: Spaceflight can impair tissue properties in femoral cortical bone during growth without significant decreases in bone mass or geometry.

Adaptation, Physiological↗
PubMed1995

Mineral distribution in rat skeletons after exposure to a microgravity model.

Exposure to space flight models induces changes in the distribution of bone mineral in the human skeleton that has the features of a gravitational gradient. Regional bone mineral measurements with dual energy x-ray absorptiometry (DEXA) in male adults exposed to head-down tilt bed rest for 30 days show non-significant decrements in the pelvis and legs with 10% increases in the head region. Horizontal bed rest for 17 weeks reveals losses of bone mineral ranging from 2.2 to 10.4% from the lumbar spine to the calcaneus and an increase of 3.4% in the skull. Investigation of this phenomena would be most definitively carried out in an animal model. One candidate is the flight simulation model in the rat which removes body weight from the hind limbs and induces a cephalad fluid shift by suspending the animal by the tail. Weanling rats exposed to this model showed bone mineral to be lower in the hind limbs and higher in the skull after 3 weeks. These findings are similar in older 200 g animals after 2 weeks tail suspension. The purpose of this study was to determine the effect of age on the distribution of skeletal mineral in this model.

Aging↗
PubMed2004

The risk of adverse reproductive and developmental disorders due to occupational pesticide exposure: an overview of current epidemiological evidence.

The epidemiological studies presented in this paper refer to the association between agricultural occupation of parents and the incidence of infertility, congenital malformations, miscarriage, low birthweight, small-for-gestational-age (SGA) birth, preterm delivery and stillbirth. The results of the analyses showed that employment in agriculture increases the risk of specific morphological abnormalities in sperm, including the decreased sperm count per ejaculate and declined percentage of viable sperm. In general, no effect of exposure to pesticides on sexual hormones was observed. The data on the effect of employment in agriculture on the time to pregnancy are unequivocal, but most of them suggest that there is a relationship between the decreased fecundability ratio and pesticide exposure. Nor does the research on the sex ratio of offspring provide explicit results. The analyses indicate that parental employment in agriculture could increase the risk of congenital malformations in the offsprings, particularly such as orofacial cleft, birthmarks in the form of hemangioma as well as musculoskeletal and nervous system defects. The data on the effect of occupational exposure to pesticides on birthweight are inconsistent. Although most of epidemiological studies do not reveal a significantly increased risk of SGA, a slower pace of fetal development corresponding to SGA in the population of women exposed to pyrethroids has been recently reported. There are also some indications that exposure to pesticides may contribute to stillbirth and female infertility. The literature review suggests a great need to increase awareness of workers who are occupationally exposed to pesticides about their potential negative influence on fertility and pregnancy outcome. In the light of existing although still limited evidence of adverse effects of pesticide exposure on fertility during the preconceptual period, it is necessary to reduce the exposure to pesticides.

Agricultural Workers' Diseases↗
PubMed2005

[Obesity as a cause and result of disability].

The aim of the review is to determine complex relations between obesity and disability. Obesity is defined as an abnormal, pathologic increase in body fat. This disease results from environmental factors, like: low level of physical activity, excessive intake of high energy food and genetic predisposition to storage of fat. The health consequences of obesity are chronic diseases: diabetes mellitus type 2, dyslipidemia, coronary heart disease, gallbladder disease, osteoarthritis, sleep apnea, certain types of cancers and also psychosocial problems, which together have an adverse effect on quality of life. The consequences of this comorbidities and conditions are also higher rates of disability in this group of people. Limitations in everyday functioning of the overweight and obese people are the consequence of comorbidities, for example: diseases of the circulatory system and late diabetic complications. The leading cause of disability (especially in functional area) is impairement of the musculoskeletal system, caused by excessive weight, for ex. chronic back pain. In this case the mechanism of "vicious cycle" is observed where sedentary lifestyle contributes to obesity and obesity exacerbates disability. The role of physical inactivity in the development of weight gain emphasises the fact that among people with disabling conditions rates of obesity are significantly higher.

Body Mass Index↗
PubMedDate not supplied

Health promotion for middle-aged Isan women, Thailand: a participatory approach.

It is increasingly clear that non-communicable diseases (NCDs), including cancer, diabetes, hypertension and atherosclerosis, are important not only for the developed but also the developing world. Prevention efforts depend on community-based interventions and for these to be successful a participatory approach is necessary. The present paper describes experiences with middle-aged females living in a village in Isan, the Northeastern area of Thailand, focusing on the steps necessary to develop trust between researcher and subjects, the actual conditions of the women involved and their problems. From this base a number of interventions are planned taking into account the wishes of the villagers themselves, including a project to facilitate participation in physical exercise, a prime measure for prevention of cancer and other NCDs.

Age Factors↗
PubMed1994

Assessment and management of pain in the elderly.

Due to the high prevalence of musculoskeletal disorders, cancer, and other medical conditions in elderly patients, pain is a significant concern for this age group and their caregivers. Despite the frequent experience of pain in this population, few assessment and management techniques have been developed and tested to treat pain in the elderly. To provide effective pain relief, medical-surgical nurses must know how to adapt assessment and management techniques for elderly patients.

Age Factors↗
PubMed1997

Use of antibiotic-impregnated polymethyl methacrylate in horses with open or infected fractures or joints: 19 cases (1987-1995).

OBJECTIVE: To evaluate the clinical efficacy of antibiotic-impregnated polymethyl methacrylate (PMMA) in horses with open or infected fractures or joints in which internal fixation or external coaptation devices were used. DESIGN: Retrospective case series. ANIMALS: 19 horses in which antibiotic-impregnated PMMA was used as part of the treatment regimen. PROCEDURES: Medical records of each horse were reviewed, and owners and trainers were contacted to provide additional information. RESULTS: Musculoskeletal problems in these horses included 10 fractures of long bones, 2 comminuted phalangeal fractures, 5 joint injuries, and 2 chronically septic joints in which ankylosis was stimulated. Nine horses had open fractures, 8 had closed wounds and developed infection after internal fixation of fractures, and 2 had chronically septic joints. Bony union was achieved in 15 of 19 horses. Twelve horses were discharged from the hospital and survived long term. Gentamicin sulfate, tobramycin sulfate, amikacin sulfate, and cefazolin sodium were used in PMMA. CLINICAL IMPLICATIONS: Use of antibiotic-impregnated PMMA provided high local concentrations of antibiotics and should be considered in the treatment of horses with open fractures and acute and chronic bone and joint infections.

Amikacin↗
PubMed2007

Workplace interventions for workers with musculoskeletal disabilities: a descriptive review of content.

BACKGROUND: Despite the convergence of scientific data to the effect that interventions in the workplace promote a healthy return to work, the interventions carried out in the real work environment appear to be very heterogeneous and ill-defined. OBJECTIVE: The goal of this review is to identify the different objectives pursued through the workplace interventions carried out in the context of a rehabilitation program, and to describe the activities involved. METHODS: A descriptive review of the literature, including various research designs, was carried out. RESULTS: This review reveals great heterogeneity in the content of interventions offered in the workplace to workers with musculoskeletal disabilities. The objectives of workplace interventions may range from gathering information in order to reproduce work demands in a clinical setting, to gradually exposing workers to the demands of the real work environment, or permanently reducing the demands of the work situation. A descriptive analysis of the literature also brings to light the diversity of actions carried out, human resources used, and workplace environments involved, while highlighting the few documented process outcome evaluations that have been done of workplace interventions. CONCLUSION: It is recommended that in future research in this area, efforts be made to better describe the components of the interventions, to develop process outcomes representing the multidimensional results obtained in the workplace, and to differentiate between temporary and permanent modifications made to the work situation.

Ergonomics↗
PubMed2006

The ABJS Nicolas Andry Award: Tissue engineering of bone and ligament: a 15-year perspective.

Musculoskeletal repair is a major challenge for orthopaedic surgeons. The burden of repair is compounded by supply constraints and morbidity associated with autograft and allograft tissue. We report 15 years of research regarding tissue engineering and biological substitutes for bone and ligaments. Our approach has focused on biomaterial selection, scaffold development, cell selection, cell/material interaction, and growth factor delivery. We have extensively tested poly(ester), poly(anhydride), poly(phosphazene) derivatives, and composite materials using biocompatibility, degradation, and mechanical analyses for bone and ligament tissue engineering. We have developed novel three-dimensional matrices with a pore structure and mechanical properties similar to native tissue. We also have reported on the attachment, growth, proliferation, and differentiation of cells cultured on several scaffolds. Through extensive molecular analysis, in vitro culture condition analysis, and in vivo evaluation, our findings provide new methods of bone tissue regeneration using three-dimensional tissue engineered scaffolds, bioactive bone cement composite materials, and three-dimensional tissue engineered scaffolds for ligament regeneration.

Animals↗
PubMed2004

Risk factors to musculoskeletal disorders and anthropometric measurements of Filipino manufacturing workers.

This study looked into the risk factors to musculoskeletal disorders and established anthropometric measurements of Filipino workers in 29 manufacturing industries. Anthropometric measurements of 1,805 workers were taken, and 495 workers were surveyed. Limitation of motion was found in 0.8% of the respondents, affectation in activities of daily living was seen in 1.6% and 3.2% felt discomfort in the head and neck. Upper trunk and low back pain was experienced by 23.8%. Odds ratio results (p = .05) showed that it is 29 times likely for workers to develop low back pain when they stand for 2-8 hrs a day than when they sit all the time. Anthropometry can be used for the design of workstations and work furniture.

Adolescent↗
PubMed1996

Work-related musculoskeletal symptoms among car mechanics: a descriptive study.

A questionnaire concerning musculoskeletal symptoms (MSS) and working environment was answered by 100% of 103 car mechanics in 12 different garages. Almost all the mechanics had been troubled with MSS at work the past year. The most common MSS were symptoms from the low back, neck, head and shoulders. When asked which symptoms had been most troublesome at work most mechanics reported symptoms from the low back, upper back, shoulders and neck. Symptoms from the shoulders, low back and upper back were associated with absence from work due to MSS (OR = 4.2, 2.3 and 2.1 respectively). Mechanics between the ages of 30 and 40 reported significantly more shoulder symptoms than both younger and older colleagues (p < 0.001). It seems that symptoms from the back and shoulders restrain car mechanics, work more than any other MSS. The mechanics' most common working postures may contribute to the development of back and shoulder symptoms.

Adult↗
PubMed1986

Altered fetal growth and development in a patient with Turner's syndrome.

Fertility in cases of Turner's syndrome is rare. In cases where conception does occur, spontaneous abortion and structural and chromosomal defects commonly are discovered. A review of the literature and a case report are presented in which pregnancy was complicated by severe intrauterine growth retardation and musculoskeletal deformities of the fetus.

Abnormalities, Multiple↗
PubMed2004

SB-236057: Critical window of sensitivity study and embryopathy of a potent musculoskeletal teratogen.

BACKGROUND: SB-236057 is a potent skeletal teratogen in rodents and rabbits. The study objective was to identify the critical developmental window of compound sensitivity and to characterize the early onset of SB-236057 embryopathy. METHODS: SB-236057 was orally administered to Sprague Dawley dams at 100 mg/kg/day on days 6-7, 8-11, 12-14, or 15-17 postcoitus (pc). The critical window of sensitivity was identified to occur between days 8-11 pc. Dams were then dosed on days 8-11 pc and embryos were evaluated by histochemical procedures on days 11, 13, or 15 pc. RESULTS: Axial malformations were evident by day 11 pc. Analysis of the cartilaginous skeleton revealed missing posterior axial skeletal elements. However, only about one-third of the malformed fetuses exhibited obvious rib and vertebrae abnormalities, and none of the affected fetuses exhibited abnormal appendicular skeletal elements. Expression pattern of sonic hedgehog in the notochord and floor plate was not affected, suggesting ventral midline signaling was not disrupted. Histological analysis demonstrated hypoplastic and/or missing musculature in proximity to the ribs and vertebrae. Caspase 3 analysis revealed no increases in apoptotic cells in the musculature. Confocal analysis of the limbs demonstrated truncated peripheral nerve formation and shortening of the appendicular musculature. CONCLUSIONS: SB-236057 is speculated to alter paraxial mesoderm programming. Many of the skeletal malformations may be caused secondarily from musculature abnormalities, suggesting that the myotome may be particularly sensitive to the compound. Furthermore, the finding that peripheral nerve trajectories were altered along the axis and in the limb suggests that SB-236057 may alter early embryonic signaling pathways necessary for neuronal differentiation/axonal guidance that occur subsequently in embryo-fetal development.

Animals↗
PubMed1992

Designing methods for musculoskeletal conditioning in weightlessness.

There is an immediate need to find methods to combat the skeletal muscle deconditioning that occurs in microgravity. Important features to be considered for any ergometer or exercise method to be used as a countermeasure against musculoskeletal deconditioning in space include heavy muscular loading of the postural muscles of the lower limbs and that eccentric and concentric muscle activations can be performed. Those are major requirements to produce optimal gains in strength and muscle mass at 1-g and probably to counteract muscle atrophy and strength loss in microgravity. Resistance exercise with a strength-ergometer, using the fly-wheel principle was carried out at a low oxygen cost and required no external power supply. We have developed a resistance training system employing this ergometer so that force and power production easily can be monitored and calibrated. It is suggested that the features of this ergometer meet the presented requirements for use during long-term space missions.

Animals↗

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