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PubMed1999

Improving population-based cervical cancer screening in general practice: effects of a national strategy.

OBJECTIVE: To assess the effects of a Dutch national prevention programme, aimed at general practitioners (GPs), on the adherence to organizational guidelines for effective cervical cancer screening in general practice. To identify the characteristics of general practices determining success. DESIGN: A prospective questionnaire study with pre- and post-measurement (before and 15 months after the introduction of the national programme). SETTING AND STUDY PARTICIPANTS: A random sample of one-third of all 4758 Dutch general practices. One GP was asked to participate per practice. INTERVENTION: A national GP prevention programme to improve population-based prevention of cervical cancer combining various methods for quality improvement in general practice, performed on a national, district and practice level. Outreach visitors were a key strategy in bringing about behavioural changes. MAIN OUTCOME MEASURES: The proportion of practices adhering to 10 recommendations (in four guidelines) to organize effective cervical cancer screening. RESULTS: After 15 months, all Dutch practices showed significant improvement in adherence to nine out of 10 recommendations. Two recommendations, in particular 'identifying women who should be medically excluded from screening' and 'sending a reminder to non-compliers' showed the largest absolute increases of 26% and 33%, respectively. Besides more intensive support of outreach visitors, practice characteristics such as 'computerization' and 'delegation of many clinical tasks to the practice assistant' were important in improving the adherence to guidelines. CONCLUSION: The national programme, with a combination of various methods for quality improvement, appeared to be effective in improving the organization of cervical screening in general practice. Computerization and, to a lesser extent, delegation of many clinical tasks to the practice assistant and more intensive support to practices, positively influenced the effectiveness of the national programme.

Documentation↗
PubMed1982

Perinatal effects of cervical vibration.

Possible perinatal effects of elective cervical vibration during first-stage labor were studied in 20 subjects. Assessment of fetal status was based on biophysical and biochemical methods, whereas at birth the infant was evaluated clinically and biochemically. With the reservation required by the small sample it is concluded that cervical vibration by itself is perinatally safe.

Acid-Base Equilibrium↗
PubMed2002

[The effect of cervical spine instability on sympathetic cervical spondylosis].

OBJECTIVE: To investigate the effect of cervical spine instability on sympathetic cervical spondylosis. METHODS: Twelve patients with cervical spondylosis showing sympathetic symptoms from 1992 to 2 000 were evaluated for cervical spine instability, immobilization of collar brace, MRI and surgical results. RESULTS: Radiologic evaluation cervical instability was observed radiologically in 7 of the 12 cases. Collar brace was obviously effective in 5 of the 12 cases and slightly effective in 7 cases. MRI showed abnormal signal for instability of the cervical spine in 7 cases. Surgery was markedly effective in 7 cases and moderately effective in 4 cases. CONCLUSION: Cervical spine instability was an important factor for sympathetic cervical spondylosis, which can be improved effectively by surgery.

Adult↗
PubMed1998

Cervical foraminotomy: an effective treatment for cervical spondylotic radiculopathy.

Between 1983 and 1994, posterior cervical foraminotomy as described by Frykholm was performed on 89 patients with exclusively radicular symptoms caused by cervical osteophytes. The main presenting feature was arm pain. Objective neurological signs were present in 50% of the patients. At mean postoperative follow-up of 8.6 months, 95.5% of patients reported excellent or good results, while 4.5% were not improved. No patient was rendered worse following the procedure. There were no deaths and the complication rate was 2.2%. Further surgery for recurrent root symptoms was required by 6.7% of patients. Our findings are in keeping with the good results and low complication rate of this procedure as described in other studies. Informal inquiries suggest that this procedure is not widely used, at any rate in the United Kingdom, and we present this series in order to emphasize the efficacy and safety of this procedure.

Adult↗
PubMed1992

Effects of cervical collars on standing balance.

The effect of cervical collars on standing balance in two age groups was examined. Twenty healthy women aged 60 to 78 years and 20 healthy women aged 18 to 29 years stood on a Kistler force platform with and without a cervical collar. Total, lateral and anteroposterior sway velocity were measured in each of three positions; long-base stance and eyes open, wide-base stance and eyes open, and wide-base stance and eyes closed. Analysis of variance showed no significant difference (p < .05) between the collar and no collar conditions for any of the standing balance measures. Older women had significantly more sway velocity (p < .001) than younger women during long-base standing both with and without the collar. Also they showed significantly more sway velocity in both the total (p < .01) and the anteroposterior (AP) directions (p < .001) of wide-base standing. There were no significant lateral sway velocity differences (p < .05). With eyes closed, sway velocity was greater in all age groups. In the wide-based condition there were significant differences in sway velocity between AP (p < .001) and total and lateral (p < .01). These results indicate that a cervical collar does not disturb standing balance in healthy women in the age groups tested.

Adult↗
PubMed1975

Experimental cervical myelopathy. Effects of ischemia and compression of the canine cervical spinal cord.

The authors report experiments designed to test the effect of regional ischemia induced by selective vascular ligations and anterior compression of the cervical cord at two adjacent segments (C-4, C-5) in the same dog. They conclude that local ischemia of the cervical cord, caused by local deformation, when superimposed on a regional reduction in spinal cord blood flow, accounts for the myelopathy of cervical spondylosis whether produced experimentally in animals or occurring naturally in man.

Animals↗
PubMed2005

Uterine effect of cervical buffeting: role of the cervicouterine reflex in coitus.

OBJECTIVE: To investigate the hypothesis that cervical buffeting during coitus effects reflex relaxation and dilatation of the corpus uteri (CorU) smooth muscle; that mechanism acts to suck the ejected semen into the CorU. STUDY DESIGN: The CorU response to electrical and mechanical stimulation of the CU was recorded in 22 healthy women (mean age, 38.2 +/- 7.6 SD years). Cervical electrical stimulation was effected by an electromyographic needle electrode and mechanical stimulation by pencil electrode. The test was repeated after individual anesthetization of the CU and CorU and after normal saline injection. RESULTS: Slow waves, superimposed or followed by action potentials, were recorded at rest from the CorU electrode. Electrical or mechanical stimulation of the CU effected a significant reduction of the electric wave parameters and pressure in the CorU; this response was reproducible. Separate stimulation of the anesthetized CU or CorU did not evoke the response, while saline infiltration did. CONCLUSION: CU stimulation resulted in diminished CorU electrical activity and pressure; that presumably indicates uterine wall relaxation. Repeated CU buffeting apparently leads to an intermittent uterine pressure decline, with resulting semen siphonage from the vagina to the uterus. Diminished CorU electrical activity and pressure on cervical stimulation or buffeting might be mediated through the cervicouterine inhibitory reflex. This reflex seems to be evoked by penile thrusting during coitus and may prove of diagnostic significance in sexual disorders.

Action Potentials↗
PubMed2005

Complications and side effects of cervical and lumbosacral selective nerve root injections.

OBJECTIVE: To determine the incidence of complications and side effects of cervical and lumbosacral selective nerve root injections (SNRIs). DESIGN: Prospective, nonrandomized controlled trial of consecutive patients with independent interviews for immediate, 1-week, and 3-month follow-ups. SETTING: Tertiary, academic spine center. PARTICIPANTS: Of 160 patients eligible for SNRI, 151 underwent 306 SNRIs (study group). Sixty patients who had not undergone any intervention served as the control group. INTERVENTIONS: Diagnostic and therapeutic fluoroscopically guided cervical and lumbosacral SNRIs. Lidocaine (Xylocaine) was used in the diagnostic injections and a mixture of lidocaine and betamethasone was used in the therapeutic injections. MAIN OUTCOME MEASURES: Complications and side effects experienced during the procedure were recorded by the interventionalist. Side effects and complications experienced immediately, 1 week, and 3 months after injection were determined through independent interviews using a questionnaire format. The control group was independently interviewed using the same questionnaire. RESULTS: There were no major complications, such as death, paralysis, spinal nerve injury, infection, or allergic reaction, during the study. Ninety-one percent of subjects had no side effects during the procedure. A positive response on interview was reported by 39.4% of the study subjects immediately after the procedure. Lumbosacral SNRI side effects were as follows: increased pain at the injection site (17.1%); increased radicular pain (8.8%); lightheadedness (6.5%); increased spine pain (5.1%); nausea (3.7%); nonspecific headache (1.4%); and vomiting (0.5%). Immediate side effects from cervical SNRI were as follows: increased pain at injection site (22.7%); increased radicular pain (18.2%); lightheadedness (13.6%); increased spine pain (9.1%); nonspecific headache (4.5%); and nausea (3.4%). At the 1-week interview, comparison of the study and control groups showed statistical significance for the following: pain at injection site, cervical ( P =.001) and lumbar ( P =.005); nonspecific headache, cervical ( P =.019); and nonspinal headache, cervical ( P =.002). At 3 months, 2 subjects complained of increased neck pain and 1 reported heartburn and fluid retention. Two lumbar SNRI subjects were lost to follow-up. CONCLUSIONS: There were no major complications with cervical and lumbosacral SNRIs, although various minor side effects occurred.

Adult↗
PubMed2001

[Effects of cervical vertebra rehabilitation pill on antiinflammation and analgesia].

OBJECTIVE: To study the effects of cervical vertebra rehabilitation pill on anti-inflammation and analgesia. METHODS: Hot board and body distortion induced by acertic acid methods were applied in mice for analgesia experiment. Granuloma induced by cotton ball implantation tumefaction in feet induced by carrageenin in rats and auricle tumefaction induced by croton oil in mice were applied for anti-flammation experiment. RESULTS: Cervical vertebra rehabilitation pill could significantly prolong the latent period of pain reaction induced by hot board in mice and markedly decrease the frequency of body distortion induced by acertic acid. Cervical vertebra rehabilitation pill also could significantly inhibit the tumefaction in feet induced by carrageenin, reduce the degree of tumefaction in auricle induced by croton oil in mice and inhibit the formation of granuloma induced by cotton ball implantation in subcutaneous part. CONCLUSION: Cervical vertebra rehabilitation pill has significant effects on anti-inflammation and analgesia.

Analgesics↗
PubMed1994

The effects of cervical headgear on dentofacial structures.

A study was made on the effects of cervical headgear on dentofacial structures, especially non-erupted teeth, in the early and late mixed dentition periods. Pretreatment and post-treatment cephalometric evaluation was done on 8 patients in the early mixed dentition period and 10 patients in the late mixed dentition period. The results showed that any reference line passing through Ptm point should not be used to evaluate the efficiency of cervical headgear, and that such headgear is more effective on non-erupted teeth in early mixed dentition.

Bicuspid↗
PubMedDate not supplied

Effects of cervical vagus nerve stimulation on hypothalamic neuronal activity.

The effects of cervical vagus nerve stimulation on the activity of 56 neurons recorded in various parts of the rat brain were determined. Recordings were made from neurons in both the ipsilateral and contralateral hemispheres during vagus nerve stimulation. Both frequency, 10 to 100 Hz, and voltage, 1 to 20 V, of 0.5 msec pulses were applied to the nerve in a random manner over a 4 sec period while monitoring ongoing single neuronal activity. Frequency response relationships were established for 64% of the lateral preoptic-lateral hypothalamic-medial forebrain bundle (LPA-LH-MFB) neurons which were tested. Four types of LPA-LH-MFB neuronal responses were observed. Twenty percent of the neurons increased in discharge frequency as stimulation frequency was increased, 9% increased in discharge frequency as stimulation frequency was decreased, 23% decreased in discharge frequency as stimulation frequency was increased, and 14% decreased in discharge frequency as stimulation frequency was decreased. Increasing the stimulation voltage always enhanced the magnitude of the effects observed due to changing the stimulation frequency. Neurons observed in some other parts of the brain were not affected by the same stimulation. In addition, cells tested in the LPA-LH-MFB area which were previously tested and affected by gastric distension were also affected similarly by vagus nerve stimulation. Results are discussed in terms of peripheral afferent control over LPA-LH-MFB neuronal activity related to ingestive behavior.

Afferent Pathways↗
PubMed1998

The effect of cervical traction combined with rotatory manipulation on cervical nucleus pulposus pressures.

OBJECTIVE: To study experimentally the effect of cervical traction combined with rotatory manipulation on the pressure of the cervical nucleus pulposus. DESIGN: Randomized experimental study. SETTING: Institute of Clinical Anatomy and Biomechanics, the First Military Medical University, GuangZhou, China. SUBJECTS: Twelve fresh cervical spines, from C7 to occipital bone, were obtained from cadavers of patients who had died from acute brain death. INTERVENTION: State A: under different traction forces, the cervical spine was rotated. State B: the cervical spine was rotated first and then tractioned. State C: the cervical spine was tractioned and rotated simultaneously. MAIN OUTCOME MEASURES: The cervical spine was tractioned and rotated by the Material Test System (MTS), and pressures of the cervical nucleus pulposus of C3-4, C4-5 and C5-6 were measured using pressure sensors. RESULTS: (a) When the traction force increased, the pressure fell continuously in the 200-N tractioned spines; the pressure increased slightly when the sample was rotated. (b) The pressure fell to a certain extent when the state of cervical spine was restored. (c) In state A, the pressure fell obviously and increased slightly under a 200-N traction force and then the sample was rotated; in state B, the pressure first increased to a certain extent and then fell slightly and in state C, the pressure underwent no change in the main. CONCLUSIONS: The results of this research suggest that rotatory manipulation of cervical spine under traction was the safest of the three procedures and the traction force used in clinical treatment may be a little smaller.

Cervical Vertebrae↗
PubMed1987

Neuroparalytic keratitis and the effect of cervical sympathectomy following operative procedures for trigeminal neuralgia.

A study of 248 patients who underwent operative procedures for trigeminal neuralgia over a nineteen year period is presented, with particular reference to those who developed neuroparalytic keratitis to see if cervical sympathectomy had any protective effect on the cornea. 51 patients underwent cervical sympathectomy, 46 as a prophylactic procedure, and 5 as a treatment for neuroparalytic keratitis. Of these patients 3 (5.9%) developed neuroparalytic keratitis, but 2 of them had had an inadequate sympathectomy. Forty seven patients who did not undergo cervical sympathectomy had either an anaesthetic cornea or a reduced corneal reflex, and of these 11 (23.4%) developed neuroparalytic keratitis. An adequate cervical sympathectomy therefore appears to have a protective effect on the cornea against the development of neuroparalytic keratitis.

Cervical Plexus↗
PubMed2002

Effect of cervical instability in sympathetic cervical spondylosis.

OBJECTIVE: To investigate the etiology and treatment of sympathetic cervical spondylosis (SCS). METHODS: Twenty patients who with SCS had undergone operations for sympathetic cervical spondylosis were reviewed retrospectively from 1988 to 2000. Lateral views in flexion and extension of pre- and postoperative cervical X-ray were analyzed to quantify cervical instability. RESULTS: Cervical instability was detected at one level in seven patients, two levels in ten patients, three levels in three. Cervical instability mainly occurred at C(3)-C(4) and C(4)-C(5). Cervical epidural block had a short time effect in the greater part of patients. Cervical discectomy and fusion at unstable segment was carried out in all 20 cases. The effective rate was 90%. CONCLUSIONS: Cervical instability at C(3)-C(4) or C(4)-C(5) maybe an important factor in the etiology of sympathetic cervical spondylosis. Cervical epidural block may provide diagnostic information. Anterior cervical fusion were effective to treat sympathetic cervical spondylosis.

Adult↗
PubMed2002

Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion.

STUDY DESIGN: A biomechanical study was performed using cadaveric cervical spine specimens. OBJECTIVE: To determine the effect of cervical spine fusion on adjacent-level intradiscal pressure. SUMMARY OF BACKGROUND DATA: Clinical studies have reported that patients with spinal fusion are at greater risk of pathology and early disc degeneration at adjacent levels. It is hypothesized that eliminating motion at one level leads to hypermobility and increased forces at adjacent levels, thus increasing the rate of disc degeneration. METHODS: Six cadaveric cervical spine specimens were tested. Specimens were stabilized at T1 and loaded at C3 to 20 degrees of flexion and 15 degrees of extension. Intradiscal pressures and segmental motion at C4-C5 and C6-C7 were recorded first on intact specimens, and then after anterior cervical plating at C5-C6. Changes in intradiscal pressure and segmental motion were calculated and statistically analyzed using a paired Student t test. RESULTS: Intradiscal pressures were significantly increased during flexion at both adjacent levels. The pressure increased by 73.2% at C4-C5 (P = 0.002), and by 45.3% at C6-C7 (P = 0.006). Intradiscal pressures increased at both adjacent levels during extension, but not significantly. During flexion, segmental motion increased at both adjacent levels, with greater increases at C4-C5. During extension, segmental motion increased at both adjacent levels, with greater increases at C6-C7. CONCLUSIONS: Clinical studies have reported increased rates of disc degeneration at levels adjacent to fusion. It is believed that eliminating motion through fusion shifts the load to the adjacent levels, causing earlier disc degeneration. This study has shown that significant increases in intradiscal pressure and segmental motion occur at levels adjacent to fusion during normal range of motion. These results may partially explain the mechanism of early disc degeneration at levels adjacent to cervical spine fusion.

Biomechanical Phenomena↗