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At least 865 records · Page 48Linked to original sources
PubMed1999

Biomechanics of total hip arthroplasty.

The biomechanics of the hip joint provide an understanding of the development, evolution, and treatment of many disabling conditions of this joint. The available methods of biomechanical analysis include in vitro studies, in vivo studies, and theoretical mathematic analyses. The information obtained from these analyses have enabled the design of therapeutic programs to alleviate the symptoms of, and possibly delay the progression of, hip disease. The design of surgical procedures has been based on alterations of the biomechanics of the hip. These procedures have proven useful for treating pathologies such as osteoarthritis, hip dysplasia, and hip fractures. The study of biomechanics and biomaterials are integral to the current success of total hip arthroplasty in achieving pain relief and functional restoration.

Animals↗
PubMedDate not supplied

Risk of hypoparathyroidism after surgery for carcinoma of the thyroid.

The reported incidence of postoperative hypoparathyroidism varies from 3% to 32%, and many surgeons are reluctant to perform a total thyroidectomy because of the risk of permanent damage to the parathyroid glands. We prospectively studied three groups of patients for evidence of acute parathyroid damage: group A consisted of 29 patients with total thyroidectomies; group B, 21 controls with partial thyroidectomies; and group C, 29 patients with total thyroidectomies that had been performed several months to years earlier. Functional status of the glands was measured by serum parathormone, calcium, and phosphorus levels. Although these levels fell postoperatively, they remained within normal limits. None of the long-term follow-up patients (group C) was found to have hypoparathyroidism, leading us to conclude that this risk may be overstated in the literature.

Calcium↗
PubMed2002

Sublingual atropine for sialorrhea secondary to parkinsonism: a pilot study.

Sialorrhea is a relatively common symptom in idiopathic Parkinson's disease and related conditions for which most of the accepted treatments are either highly invasive or may cause substantial systemic side effects. This study describes an open-label pilot study of sublingual atropine drops for the treatment of sialorrhea in 7 patients (6 with Parkinson's disease, 1 with progressive supranuclear palsy). Participants demonstrated statistically significant declines in saliva production, both objectively and subjectively. Self-reported drooling severity showed a significant decline between baseline and 180 minutes, t(6) = 3.240 P < 0.025 (eta(2) = 0.636), and between baseline and 1 week, t(6) = 4.583 P < 0.005 (eta(2) = 0.778). Objectively measured saliva production decreased significantly between baseline and the 1-week follow-up, t(6) = 2.711 P < 0.05 (eta(2) = 0.551). Delirium occurred in 1 patient (concurrent with a urinary tract infection), and 2 patients experienced worsening of hallucinations (active hallucinosis was concealed by both individuals to allow participation in the trial). The remaining trial participants did not experience any anticholinergic side effects. This trial shows that, in selected patient populations, sublingual atropine is a simple and inexpensive treatment for sialorrhea associated with parkinsonism.

Administration, Sublingual↗
PubMed2003

Fear of falling and postural control in Parkinson's disease.

This study investigated the relationship between fear of falling (FOF) and qualitative and quantitative postural control in Parkinson's disease (PD). Fifty-eight nondemented PD patients were studied along with age-matched healthy controls. The degree of FOF was estimated using the Activities-specific Balance Confidence scale. Qualitative postural control was evaluated using a component of the Unified Parkinson Disease Rating Scale. Postural control was quantified, using centre of pressure measures obtained from a force plate, for eight standing balance tests of different challenges. The results showed that FOF was more evident for PD patients when compared with healthy individuals of similar age. Furthermore, FOF was significantly associated with a qualitative estimate of postural control in PD; individuals with PD who had a greater degree of posture impairment reported greater FOF. The results also showed that an estimate of FOF may help to explain quantitative postural instability in PD. FOF, when coupled with a qualitative estimate of postural control, was able to explain a greater amount of variation in quantitative balance performance for five of the eight balance tests. When considered independently, the qualitative measure of postural control, in general, could not well predict quantitative balance performance. The greater degree of FOF and its possible association with altered postural control suggests that FOF should be considered as an important, independent risk factor in the assessment and treatment of postural instability in patients with PD.

Accidental Falls↗
PubMed2003

Unique form of propriospinal myoclonus as a possible complication of an enteropathogenic toxin.

Propriospinal myoclonus is an uncommon form of spinal myoclonus propagated, presumably, by slowly conducting polysynaptic intraspinal pathways. Although most patients demonstrate no clear etiology, a variety of disorders have been linked to this abnormal movement, including trauma, multiple sclerosis, tumors, and infectious disorders such as herpes zoster, human immunodeficiency virus, and Lyme disease. We describe 2 young male patients from the same town in Northern Ontario, Canada, exposed to an outbreak of Escherichia coli O157:H7 from contaminated municipal water, who developed identical clinical and electrophysiological features suggestive of a rhythmic form of propriospinal myoclonus with activity alternating between abdominal and paraspinal muscles. A toxin-mediated microvascular thrombosis is proposed as a possible pathogenic mechanism underlying this novel association.

Adult↗
PubMed2001

Methods for digital video recording, storage, and communication of movement disorders.

Video technology has now reached a level of sophistication that allows easy digitization. Digital video can be easily edited, reproduced, incorporated into databases, and posted on intra- and Internet sites for clinical use and demonstration purposes. Numerous methods exist for the production of digital video. This article synthesizes and simplifies the available methodologies in order to easily choose the technology that is the most appropriate for the movement disorder specialist's end use. Depending on available resources, issues such as cost, ease, and time to conversion are discussed. In addition, our experience with the use of one of the methodologies is briefly presented.

Humans↗
PubMed1995

Chronic acquired hepatocerebral degeneration: case reports and new insights.

Chronic acquired hepatocerebral degeneration (CAHD) is a heterogeneous disorder that can occur with a primary neurologic, hepatic, or combined presentation. Little has been added to the understanding of this disorder since the detailed, early clinical and pathological descriptions. The spectrum of clinical presentations can be neuropsychiatric (apathy, lethargy, excessive somnolence), a movement disorder (ataxia, tremor, chorea, parkinsonism, myoclonus, dystonia), or both. Cortical laminar necrosis and polymicrocavitation in the cortex and basal ganglia are combined with cerebral and cerebellar atrophy. Microscopically, Alzheimer type II astrocytes and cytoplasmic glycogen granules are characteristic. Recent neuroradiological observations in patients with liver failure have shown a specific magnetic resonance (MR) imaging appearance with a hyperintense T1 signal in the pallidum, putamen, and, rarely, mesencephalon. Using clues from a similar MR appearance in patients receiving total parenteral nutrition as well as animals given parenteral manganese, and the knowledge that manganese is cleared by the hepatobiliary system, deposition of manganese in the brain is postulated in patients with CAHD. In this review we describe three cases of CAHD with detailed clinical and radiological documentation and discuss the aforementioned pathogenetic mechanisms.

Animals↗
PubMed1997

Epidemic diseases and host clustering: an optimum cluster size ensures maximum survival.

The risk of infection is generally believed to increase with gregariousness. Using a discrete time spatial simulation model we tested the effect of host clustering on transmission of infection within a population. Over a large parameter range, an optimum cluster size was observed to ensure maximum probability of escaping infection. Although the within cluster transmission increased with cluster size, the between cluster distance increased thereby decreasing the probability of transmission across clusters. The probability of stochastic extinction of the pathogen also increased with increasing cluster size. Thus contrary to the popular belief, clustering can be an effective strategy to minimize the risk of infections.

Computer Simulation↗
PubMed1995

Exercise in middle-aged adults: self-efficacy and self-presentational outcomes.

BACKGROUND: Whereas self-efficacy expectations have been identified as important determinants of exercise participation patterns, little empirical work that examines efficacy expectations as outcomes of exercise participation or their theoretical relationship to other psychological outcomes associated with exercise has been conducted. In the context of middle-aged males and females, the present study attempted to integrate social cognitive and impression management perspectives with respect to anxiety associated with exercise. METHODS: Formerly sedentary subjects participated in a 5-month exercise program with assessments of physique anxiety, efficacy, outcome expectations, and anthropometric variables prior to and following the program. RESULTS: Both acute bouts and long-term participation in exercise resulted in significant increases in self-efficacy. In turn, these changes in efficacy and initial positive outcome expectations were significant predictors of reductions in physique anxiety, even when controlling for the influence of gender and reductions in body fat, weight, and circumferences. CONCLUSIONS: The findings are discussed in terms of the implications for structure and content of exercise environments and the utility of the proposed theoretical integration. Strategies for enhancing beliefs regarding health and fitness outcomes associated with exercise rather than appearance outcomes may be required to maximize reductions in negative body image.

Anthropometry↗
PubMed1985

Jogger's fracture and other stress fractures of the lumbo-sacral spine.

The posterior rings of the lower lumbo-sacral vertebrae are subject to stress fractures at any part - pedicle, pars, or lamina. The site of fracture is apparently determined by the axis of weight bearing. The three illustrative clinical examples cited include a jogger with a laminar fracture, a ballet dancer with pedicle fractures, and a nine-year-old boy with fractures of pars and lamina. Chronic low back pain is the typical complaint with stress fractures of the lower lumbo-sacral spine. Special imaging techniques are usually needed to demonstrate these lesions, including vertebral arch views, multi-directional tomography, and computed tomography (CT).

Adolescent↗
PubMed1994

Tear of the biceps femoris tendon.

The clinical and operative findings of an isolated rupture of the biceps femoris tendon are described. The immediate suture and the initial postoperative treatment with a knee brace limiting extension to 20 degrees and flexion to 70 degrees resulted in a free range of motion and full activity of the biceps femoris.

Adult↗
PubMed1983

Facilitation of diazepam action by anticonvulsant agents against picrotoxin induced convulsions.

A subeffective dose (2 mg/kg) of diazepam produced only 50% protection against picrotoxin-induced (PTX) convulsions in rats. Simultaneous administration of GABA and other GABA-ergic substances such as piracetam and sidium valproate, which did not have any effect by themselves, potentiated diazepam action. The onset of convulsions and mortality due to PTX were significantly delayed. The other conventional anticonvulsants phenobarbitone, phenytoin and ethosuximide also enhanced the protective effect of diazepam. Inosine, a putative benzodiazepine ligand, also enhanced diazepam action. These observations are explained on the basis of data from in vitro studies indicating that GABA-ergic agents and barbiturates enhance both the number of benzodiazepine binding sites and benzodiazepine binding. The protective effect of clonidine, however, may be mediated by a different mechanism unrelated to the GABA-ergic system.

Animals↗