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At least 469 records · Page 26Linked to original sources
PubMed1995

Fungal infections in the Netherlands. Prevailing fungi and pattern of infection.

BACKGROUND: Species of fungi have specific characteristics in geographic distribution, and they have a predilection for certain body areas. OBJECTIVE: To obtain information about the prevailing fungi and their pattern of infection in the Netherlands. METHODS: An analysis was made of the results of mycological examinations carried out in subjects referred to the mycological laboratory of the Department of Dermatology, University Hospital Leiden, the Netherlands, in the period of 1972-1992. RESULTS: The feet, extremities and groin were most commonly infected. The feet and extremities were mainly infected with dermatophytes (Trichophyton rubrum), but in the groin Candida albicans accounted for 49.9% of the fungal infections. Onychomycosis ranked third in prevalence (17.3% of all fungal infections). The main etiologic agent in the toenails was T. rubrum, but in fingernails C. albicans seems to be at least as important as T. rubrum. On the trunk (mainly the chest, especially in women) and buttocks C. albicans was again the main etiologic agent for fungal infections. Dermatophytes accounted for only 32.4% and 14.2% of the fungal infections on the buttock and trunk, respectively. On the buttock and trunk T. rubrum was the main etiologic agent as far as dermatophytes are concerned. On the trunk, Microsporum canis and M. ferrugineum were of some importance as well. The prevalence of tinea capitis was very low and accounted for only 0.7% of all fungal infections. CONCLUSION: Cutaneous candidosis accounted for 30.3% of all fungal infections and is therefore important. On the chest, buttocks, groin and finger-nails, the prevalence of C. albicans is higher than that of dermatophytes.

Arthrodermataceae↗
PubMed1997

Urocanic acid isomers: relation to body site, pigmentation, stratum corneum thickness and photosensitivity.

Urocanic acid (UCA), present in the stratum corneum as trans-UCA, absorbs ultraviolet (UV) radiation and isomerizes to cis-UCA. Cis-UCA has been demonstrated to initiate suppression of selected immune responses in several experimental systems. Topical application of UCA-containing products reduces UV-induced erythema, but a role for endogenous UCA in photoprotection has not been reported. In this study the relationship between UCA isomers, pigmentation, minimal erythema dose (MED), and stratum corneum thickness was investigated. Pigmentation, concentration of total UCA, and the percentage present as the cis-isomer was measured in 36 healthy subjects, skin type I-IV, at six UV-exposed and nonexposed body sites: forehead, chest, back, outer upper arm, inner upper arm, and buttock. The MED was determined by phototesting on buttock skin, and a punch biopsy for measurement of stratum corneum thickness was taken adjacent to the site of the phototest. The percentage of cis-UCA was significantly higher in UV-exposed than on nonexposed areas. A small intraindividual variation in total UCA was found, being high on the buttock and the arm, lowest on the forehead. The subject to subject variation of total UCA was considerable at all body sites. No correlation was found between total UCA and MED, skin type, pigmentation, or stratum corneum thickness.

Adolescent↗
PubMed1987

The critical hypogastric circulation.

Eleven patients had ischemic complications secondary to ligation, hypoperfusion, exclusion, or thrombosis of the hypogastric arteries after aortoiliac reconstruction or spontaneous aortoiliac thrombosis. Ligation of one hypogastric artery resulted in persistent ipsilateral buttock claudication in three patients. Bilateral acute hypogastric artery ischemia occurred in eight patients and resulted in paralysis in all eight patients, buttock necrosis in four patients, anal and bladder sphincteric dysfunction in two patients, and colorectal ischemia in three patients. Five of these patients (63 percent) died. The mortality rate was 100 percent when buttock necrosis developed. In most of these patients, the neurologic deficit suggested ischemic injury of the lumbosacral plexus rather than spinal cord ischemia. These complications occurred despite patent bypass grafts to the iliac or femoral vessels. These observations suggest that it is essential to maintain patency of the hypogastric vessels in all aortoiliac reconstructions.

Aged↗
PubMed2004

Piriformis syndrome: Correlation of muscle morphology with symptoms and signs.

OBJECTIVE: To determine the relation of symptoms and pain provocation tests to abnormal piriformis morphology among people with chronic buttock pain. DESIGN: Each of 2 clinical symptoms and 2 clinical signs were compared with the abnormal morphology found on ultrasound. The pain-free side was used as an internal control. SETTING: A tertiary referral center. PARTICIPANTS: A series of 27 consecutive patients (26 women, 1 man; average age, 48 y) with chronic low lumbosacral or buttock pain, who presented to a musculoskeletal clinic over a 12-month period, underwent ultrasound assessment of piriformis muscle morphology. Four patients were excluded because their body mass index was in excess of 30 kg/m 2 . INTERVENTION: The symptomatic piriformis muscle was injected with bupivacaine after pain was assessed on a visual analog scale (VAS), using the resisted abduction test. MAIN OUTCOME MEASURE: A 70% reduction of pain on the VAS was considered positive for pain in the piriformis muscle. RESULTS: Odds ratios (ORs) and 95% confidence intervals were calculated comparing each of the signs and symptoms with normal morphology. The highest ORs were found for pain on walking up inclines (10.8), referred pain (5.3), and pain on needling the piriformis muscle (6.0). CONCLUSIONS: This study did not provide a criterion standard for the diagnosis of piriformis syndrome, but it did support the syndrome as a contributing factor in chronic buttock pain and very low back pain.

Anesthetics, Local↗
PubMed2004

Hypogastric artery bypass to preserve pelvic circulation: improved outcome after endovascular abdominal aortic aneurysm repair.

OBJECTIVE: This study was carried out to compare the functional outcomes after hypogastric artery bypass and coil embolization for management of common iliac artery aneurysms in the endovascular repair of aortoiliac aneurysms (EVAR). METHODS: Between 1996 and 2002, 265 patients underwent elective or emergent EVAR. Data were retrospectively reviewed for 21 (8%) patients with iliac artery aneurysms 25 mm or larger that involved the iliac bifurcation. Patients underwent hypogastric artery bypass (n = 9) or coil embolization (n = 12). Interviews about past and current levels of activity were conducted. A disability score (DS) was quantitatively graded on a discrete scale ranging from 0 to 10, corresponding to "virtually bed-bound" to exercise tolerance "greater than a mile." Worsening or improvement of symptoms was expressed as a difference in DS between two time points (-, worsening; +, improvement). RESULTS: There was no difference in age (72.6 +/- 7.3 years vs 73.1 +/- 6.4 years), sex (male-female ratio, 8:1 vs 11:1), abdominal aortic aneurysm size (60.1 +/- 5.9 mm vs 59.3 +/- 7.0 mm), or number of preoperative comorbid conditions (1.9 +/- 0.8 vs 2.1 +/- 0.8) between hypogastric bypass and coil embolization groups, respectively. Mean follow-up was shorter after hypogastric bypass (14.8 vs 20.5 months; P <.05). There was no difference in the mean overall baseline DS between the bypass and the embolization groups (8.0 vs 7.8). Six (50%) of the 12 patients with coil embolization reported symptoms of buttock claudication ipsilateral to the occluded hypogastric artery. No symptoms of buttock claudication were reported after hypogastric bypass (P <.05). There was a decrease in the DS after both procedures; however, coil embolization was associated with a significantly worse DS compared with hypogastric artery bypass (4.5 vs 7.3; P <.001). In 4 (67%) of 6 patients with claudication after coil embolization symptoms improved, with a DS of 5.4 at last follow-up. This was significantly worse than in patients undergoing hypogastric artery bypass, with a DS of 7.8 at last follow-up (P <.001). There was no difference between the groups in duration of procedure, blood loss, length of hospital stay, morbidity, or mortality (0%). CONCLUSIONS: Hypogastric artery bypass to preserve pelvic circulation is safe, and significantly decreases the risk for buttock claudication. Preservation of pelvic circulation results in significant improvement in the ambulatory status of patients with common iliac artery aneurysms, compared with coil embolization.

Aged↗
PubMedDate not supplied

Piriformis syndrome in a patient after cesarean section under spinal anesthesia.

OBJECTIVES: The diagnosis, pathogenesis, and treatment of piriformis syndrome as a cause of persistent buttock and hip pain after spinal anesthesia are presented in this case report. CASE REPORT: A 29-year-old woman presented 5 days after cesarean delivery with sudden onset of pain in the left buttock and left hip radiating to the posterior knee with fever. She was subsequently diagnosed with piriformis syndrome. CONCLUSIONS: Back pain with radiation into the buttocks after spinal anesthesia is frequently attributed to the spinal procedure itself. However, prolonged sitting and weight bearing in the upright position after cesarean delivery can cause sciatic nerve compression at the sacroiliac joint with concomitant irritation, inflammation, and spasm of the piriformis muscle. Piriformis syndrome is frequently underdiagnosed in the obstetric population. Because the diagnosis of piriformis syndrome is based mainly on clinical signs and symptoms, the clinician must have a high index of suspicion.

Adult↗
PubMed1999

Effects of altering cycling technique on gluteus medius syndrome.

OBJECTIVE: We discuss how altering the cycling technique of a cyclist receiving periodic chiropractic care helped in the management of gluteus medius syndrome. CLINICAL FEATURES: A 24-year-old male amateur cyclist had numbness and tingling localized to a small region on the superior portion of the right buttock. The area involved demonstrated paresthesia to light touch sensory evaluation. The cyclist had received chiropractic adjustments 2 days before the onset of the symptoms. One week earlier, the patient began riding a new bicycle with different gearing than his previous one. Manual-resisted muscle testing created soreness in the lumbosacral area and buttocks. Trigger points were identified in the right gluteus medius. Standing lumbar spine flexion was 70 degrees, limited by tight hamstrings. INTERVENTION AND OUTCOME: Because the patient was already receiving periodic chiropractic care, no passive therapy was used. Patient education regarding the difference in gear selection in bicycles of a higher quality was provided. He was instructed to train in lower gears than he had previously used and to maintain a cadence of 70 to 90 revolutions of the pedals per minute. After 2 days, the paresthesia on the right buttock resolved. The trigger points were only mildly tender with minimal residual soreness of the involved muscles. CONCLUSION: Management of gluteus medius syndrome by altering the cadence and gear development for a bicyclist is discussed. Either frank or cumulative injury to the gluteus medius muscle is the typical etiologic factor for this syndrome. Repetitive strain of the patient's gluteus medius muscle as a result of poor cycling technique appeared to be the cause here. Knowledge of bicycle fitting, training techniques, and bicycle mechanics appeared necessary to resolve the problem.

Adult↗
PubMed2003

The effect of ultraviolet radiation exposure on the prevalence of mast cells in human skin.

BACKGROUND: Dermal mast cells have been implicated as important effector cells in innate immunity, hypersensitivity responses and ultraviolet (UV)B-induced suppression of cell-mediated immune responses to contact allergens. Humans, like mouse strains, display variations in dermal mast cell prevalence. The factors determining these differences are yet to be fully elucidated. In mice, expression of the receptor for stem cell factor, c-kit, on dermal mast cells correlates with prevalence. OBJECTIVES: To evaluate dermal mast cell prevalence and mast cell c-kit expression in non-sun-exposed and sun-exposed skin in the same donor. METHODS: In 14 subjects, biopsies of skin (4 mm) were sampled from the skin sites of buttock, inner arm, shoulder and back of hand skin and dermal mast cell prevalence quantified. Non-sun-exposed buttock and chronically sun-exposed hand skin were evaluated for mast cell expression of c-kit and elastin content, a feature of photoageing and surrogate marker of UV exposure. RESULTS: The prevalence of dermal mast cells was significantly higher in hand skin than in the three other anatomically different skin sites. Significant correlations were observed in hand but not buttock skin between increasing dermal mast cell densities, extent of elastin content in the papillary dermis and age of the subject. Cellular expression of c-kit correlated with mast cell prevalence in hand skin. However, no relationship was observed in hand skin between c-kit expression, elastin content and age. CONCLUSIONS: The prevalence of mast cells in human skin is altered by factors that are intrinsic (mechanisms regulating c-kit expression) and extrinsic (chronic sun exposure), and the fact that the associations of mast cell prevalence with age is explained by the latter being a correlate of cumulative sun exposure.

Adult↗
PubMed1983

Effect of injection site on the bioavailability of an oxytetracycline formulation in ruminant calves.

The oxytetracycline (OTC) disposition was studied in a group of six calves following the administration of an oxytetracycline-10 per cent formulation (i) intravenously (i.v.), (ii) subcutaneously (s.c.) in the lateral neck, and intramuscularly (i.m.) in (iii) the lateral neck, (iv) the shoulder (M. triceps brachii), and (v) the buttock (M. semitendineus). The dose levels used for the intravenous route and other routes were respectively 17.0 +/- 2.3 and 18.3 +/- 1.25 mg OTC/kg. The peak OTC concentrations (Cmax) were achieved with the s.c. and i.m. routes between 4 and 8 hours after injection, the highest being found after application in the shoulder (Cmax:6.9 +/- 0.82 microgram/ml plasma). The Cmax for the s.c. and other i.m. routes in application was similar to each other, ranging from 5.0 to 5.5 micrograms/ml plasma. For different points in time after injection the partial bioavailability was calculated. At 52 h post injection (p.i.) maximal bioavailability was observed for the i.m. shoulder route, viz. 98.1 +/- 7.0 per cent of the administered dose, while at 76 h p.i. similar bioavailabilities were achieved for the i.m. neck and shoulder route, namely 93.3 +/- 8.9 and 99.4 +/- 4.2 per cent, respectively. The lowest bioavailability (83.1 +/- 13.4 per cent) was obtained following the i.m. buttock route at 76 p.i. An obvious irritating effect was observed after s.c. application in the neck an di.m. injection in the buttock, which had disappeared at 5 days p.i. It is assumed that the longer persistence of OTC in plasma resulting with the latter two routes of administration was due to this irritation effect.

Analysis of Variance↗
PubMed2003

Can loaded interface characteristics influence strain distributions in muscle adjacent to bony prominences?

Pressure distributions at the interface between skin and supporting tissues are used in design of supporting surfaces like beds, wheel chairs, prostheses and in sales brochures to support commercial products. The reasoning behind this is, that equal pressure distributions in the absence of high pressure gradients is assumed to minimise the risk of developing pressure sores. Notwithstanding the difficulty in performing reproducible and accurate pressure measurements, the question arises if the interface pressure distribution is representative of the internal mechanical state of the soft tissues involved. The paper describes a study of the mechanical condition of a supported buttock contact, depending on cushion properties, relative properties of tissue layers and friction. Numerical, mechanical simulations of a buttock on a supporting cushion are described. The ischial tuberosity is modelled as a rigid body, whereas the overlying muscle, fat and skin layers are modelled as a non-linear Ogden material. Material parameters and thickness of the fat layer are varied. Coulomb friction between buttock and cushion is modelled with different values of the friction coefficient. Moreover, the thickness and properties of the cushion are varied. High shear strains are found in the muscle near the bony prominence and the fat layer near the symmetry line. The performed parameter variations lead to large differences in shear strain in the fat layer but relatively small variations in the skeletal muscle. Even with a soft cushion, leading to a high reduction of the interface pressure the deformation of the skeletal muscle near the bone is high enough to form a risk, which is a clear argument that interface pressures alone are not sufficient to evaluate supporting surfaces.

Adipose Tissue↗
PubMed1989

Fatty acid composition of adipose tissue in humans: differences between subcutaneous sites.

We compared the fatty acid composition of adipose tissue from three different sites, one deep-seated site (perirenal) and two subcutaneous sites (abdominal and buttock), in 143 autopsied adult humans aged 24-61 y. The proportion of saturated fatty acids was highest in the perirenal adipose tissue and lowest in buttock adipose tissue. The proportions of monounsaturated fatty acids in the three sites were in the reverse order. Linoleic and linolenic acids were similar in the three adipose-tissue sites, an important finding for those concerned about the essential fatty acids, which are solely derived from the diet. The results clearly show that the fatty acid composition of the two subcutaneous fat depots differ significantly. We conclude that abdominal fat is more saturated than buttock fat.

Abdomen↗
PubMed2004

A preliminary study of bottom care effects on premature infants' heart rate and oxygen saturation.

The purposes of this study were to explore (1) the effect of buttock care (BC) on premature infant heart rate (HR) and oxygen saturation (SpO(2)), and (2) the effect of buttock lifting angle during BCs on HR and SpO(2). The study used a repeated measure design. A convenience sample of 11 premature infants in the neonatal intensive care unit (NICU) of a medical center were studied during 30 BC events. The subjects were of a gestational age of less than and 37 weeks, and postnatal age of less than one month, without known congenital abnormalities and without having been treated with sedatives during the study. Infant HR and SpO(2) were measured at a 30-second interval 10 minutes before and during, and 15 minutes after BC. Maximal lifting angles of BCs during the procedure were recorded. Based on the infant's individual responses to BC, 63.3% of BCs induced an increase in HR and a decrease in SpO(2), defined as the change in HR and SpO(2) greater than two standard deviations from the baseline. In addition, 30% of BCs resulted in cardiac decelerations. The extent of the difference found in these change patterns in HR or SpO(2) were all significant (p <.01) and their mean recovery times were longer than 10 minutes. More HR acceleration events occurred as the BC lifting angle exceeded </= 30 degrees, and more HR deceleration events were found as the angle > 30 degrees (p =.035). Buttock care can have a significant impact on premature infant physiological stability. The BC lifting angle may play an important role in HR acceleration or deceleration. Careful observation before and after BC for premature infants is recommended.

Buttocks↗
PubMed2002

A case of chronic perianal pyoderma treated with the recycled skin graft method.

We present here a case of chronic perianal pyoderma (CPP), who was treated with a novel skin graft. The patient was a 28-year-old male who had suffered from painful abscesses and nodules on his buttocks for over 10 years. Although the abscesses and nodules were initially restricted to one buttock, they gradually spread over both buttocks. He visited our hospital in July of 2000. He was clinically diagnosed as CPP and treated with oral doses of antibiotics. When admitted to our hospital in September of 2000, an anal fistula was also found. The operations for CPP and anal fistula were simultaneously performed. After the anal fistula treatment, the lesions of CPP were totally resected. In this procedure, we removed the epidermis and upper dermis from the excised CPP lesions and grafted them on the defects of the excised lesion. There has been no recurrence of the CPP. This operation procedure, which we call the "recycled skin graft method" is less invasive, because a donor site for the skin graft is unnecessary. We considered it to be as one of the effective treatments for CPP.

Adult↗
PubMed2004

Association between melanoma and dermal mast cell prevalence in sun-unexposed skin.

BACKGROUND: Both exposure to intermittent intense sunlight during childhood and ultraviolet (UV) radiation-induced immunomodulation have been directly associated with melanoma development. In mice, the prevalence of dermal mast cells determines susceptibility to UVB-induced systemic suppression of contact hypersensitivity responses and thus may affect immunological responses to melanoma antigens. OBJECTIVES: To determine the relevance of murine studies of dermal mast cell prevalence to human melanoma pathogenesis. METHODS: The prevalence of mast cells was examined in sun-unexposed buttock skin of 45 melanoma patients and 68 control volunteers who had no history of skin cancer development. Buttock skin was studied because mast cell prevalence is stable with ageing and the confounding effects of environmental UV exposure are minimized. RESULTS: Using tissue immunostaining, the buttock skin from melanoma patients had a significantly higher dermal mast cell prevalence (mean +/- SEM 38 +/- 2 mast cells mm(-2)) than controls (32 +/- 2 mast cells mm(-2)) (P = 0.02). Analysis by binary logistic regression showed that the association between mast cell prevalence and melanoma outcome was not significantly altered by skin phototype. CONCLUSIONS: The immunomodulatory effects of mast cell products in UV-irradiated skin may contribute significantly to the initiation and development of human cutaneous malignant melanoma.

Adult↗
PubMed2005

Angiokeratoma circumscriptum naeviforme: successful treatment with carbon-dioxide laser vaporization.

BACKGROUND: Angiokeratoma circumscriptum naeviforme (ACN) is an unusual type of localized angiokeratoma that occurs more frequently in females and is usually located on the buttocks or thighs, showing a unilateral distribution. ACN usually causes large lesions, which may require laser ablation because they often are too extensive to perform surgical excision. Carbon-dioxide laser is a known alternative for treating angiokeratomas. OBJECTIVE: Report of two cases of ACN treated with carbon-dioxide laser vaporization. PATIENTS AND METHODS: A 28-year-old woman with a hyperkeratotic, violaceus plaque on her left buttock and a 24-year-old woman with a similar lesion on her right buttock were treated with a carbon-dioxide laser. Two laser passes were performed on each lesion within a single session. RESULTS: A successful cosmetic aspect of treated areas was obtained, with minimal pigmentary or textural changes. After a 2-year follow-up in the first patient and a 6-month follow-up in the second patient, no recurrence of the lesions was observed. CONCLUSIONS: Our results, obtaining relevant cosmetic improvement after a few sessions of treatment, with low morbidity and minimal secondary effects, suggest that continuous-wave carbon-dioxide laser vaporization is a safe and effective treatment for ACN.

Adult↗
PubMed2004

Ultrasonographic subepidermal low-echogenic band, dependence of age and body site.

BACKGROUND/PURPOSE: The presence of an age-dependent subepidermal low-echogenic band (SLEB) is well established at specific body sites. Several studies have also proposed it to be a marker of photoaging, but only few studies have included children in their material, and UVR exposure has predominantly been evaluated as differences between body sites with different UVR exposure. The aim of this study was to further investigate the existence of SLEB and exploring its relation to both age and body site/UVR exposure. METHODS: In all 137 healthy volunteers from 4 to 68 years of age were included. In vivo high-frequency ultrasonography (B-mode, 20 MHz) was obtained from sun-exposed and sun-protected skin in a period with negligible environmental exposure to solar UVR. The SLEB was evaluated both visually and quantitatively. RESULTS: We found a significant correlation between visual scoring of SLEB and dermal echogenicity, which supports the usefulness of SLEB scoring. We found that the grade (existence and development) of SLEB increased significantly with age at both the forehead and at the dorsal aspect of the forearm, where a well-defined SLEB was absent in children and present in over 50% of adults above the age of 40 years. No such age dependence was found either at the buttock or at the shoulder, and remarkably a well-defined SLEB was present in 37% of the adolescents at the buttock. CONCLUSION: These results indicate that the age-related increase in SLEB grade at highly sun-exposed body sites might be attributed to UVR exposure. The presence of SLEB in both the young and at the sun-protected buttock points to a multifactorial etiology, where anatomical differences may play an important role as well as water content. SLEB might not be a very sensitive and specific marker of photoaging.

Adolescent↗
PubMed2007

Support force measures of midsized men in seated positions.

Two areas not well researched in the field of seating mechanics are the distribution of normal and shear forces, and how those forces change with seat position. The availability of these data would be beneficial for the design and development of office, automotive and medical seats. To increase our knowledge in the area of seating mechanics, this study sought to measure the normal and shear loads applied to segmental supports in 12 seated positions, utilizing three inclination angles and four levels of seat back articulation that were associated with automotive driving positions. Force data from six regions, including the thorax, sacral region, buttocks, thighs, feet, and hand support were gathered using multi-axis load cells. The sample contained 23 midsized subjects with an average weight of 76.7 kg and a standard deviation of 4.2 kg, and an average height of 1745 mm with a standard deviation of 19 mm. Results were examined in terms of seat back inclination and in terms of torso articulation for relationships between seat positions and support forces. Using a repeated measures analysis, significant differences (p<0.05) were identified for normal forces relative to all inclination angles except for forces occurring at the hand support. Other significant differences were observed between normal forces behind the buttocks, pelvis, and feet for torso articulations. Significant differences in the shear forces occurred under the buttocks and posterior pelvis during changes in seat back inclination. Significant differences in shear forces were also identified for torso articulations. These data suggest that as seat back inclination or torso articulation change, significant shifts in force distribution occur.

Adult↗
PubMed1998

Neck and other muscle pains in autonomic failure: their association with orthostatic hypotension.

Neck pain in the suboccipital and paracervical region ('coathanger' configuration) is often reported by patients with autonomic failure and orthostatic hypotension. The frequency of this pain, along with pains in the buttock and calf regions, was determined by questionnaire in two major groups with primary chronic autonomic failure--pure autonomic failure (PAF) and multiple system atrophy (MSA). Comparisons were made with Parkinson's disease, cerebellar degeneration and other disorders in which neurological symptoms overlap but in which there was neither autonomic failure nor orthostatic hypotension. Neck pain was present in 93% of patients with PAF, 51% of patients with MSA and 38-47% of the non-autonomic groups. Buttock pain was present in smaller but similar proportions (8-19%) of each group, like calf pain (23-37%). Neck pain in PAF and MSA differed from that in the other groups in being relieved by sitting or lying flat and in being associated with factors that lower blood pressure in these patients. Buttock pain was posturally related in PAF and MSA; for calf pain there was no difference between groups. Neck pain was related to the degree of orthostatic hypotension; in PAF patients, whose postural blood-pressure fall was greater than that in MSA, there was a greater frequency of neck pain.

Adult↗