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PubMed2004

Expression and regulation of RB1CC1 in developing murine and human tissues.

RB1-inducible coiled-coil 1 (RB1CC1) is a novel molecule implicated in the regulation of RB1 (retinoblastoma 1) expression. However, information about the RB1CC1 gene is limited and its function remains somewhat obscure. The present study analyzes the expression and promoter activities of RB1CC1 in developing murine and human tissues. Rb1cc1 was abundantly expressed from an early stage of the mouse embryo throughout development. Immunohistochemical analyses revealed that Rb1cc1 was ubiquitous in the mouse, rather than in the human embryo, especially in the musculoskeletal system, heart and neural tissues. Promoter activity was highest in a region located about 300 bp immediately upstream of exon 1 in both the mouse and human RB1CC1 genes, suggesting that this region is a core promoter. The promoter activity of RB1CC1 was generally higher in mice than in humans, and suppressive with intron 1, especially in humans. These results suggested that more Rb1cc1 is expressed throughout developing murine than in human tissues, and that RB1CC1 expression is controlled more stringently by modification at intron 1 in humans than in mice.

Animals↗
PubMed2006

Muscle fatigue and endurance during repetitive intermittent static efforts: development of prediction models.

Localized muscle fatigue has received growing attention as a potential design variable and exposure metric in research towards prevention of musculoskeletal disorders in the workplace. While fatigue during sustained static work has been investigated extensively, effects during tasks comprising work-rest cycles are less clear. Work-rest models for static intermittent work have been presented in several reports, but the applicability is often limited to specific conditions. A study was conducted that facilitated a description of the relationships between static intermittent efforts and muscle endurance and fatigue. Exercises consisted of 1 h (maximum) of repetitive static arm abductions, involving a range of muscle contraction levels (10-30% maximum voluntary exertion), duty cycles (0.2-0.8) and cycle times (20-180 s). A between-subject central composite experimental design was used and 15 different exercise conditions were examined with six participants (three females and three males) for each. Along with endurance times, temporal changes related to fatigue were monitored using muscle strength, ratings of discomfort and electromyography (EMG) obtained from the middle-deltoid muscle during the contraction phase of the work cycles. The results of this study showed the influence of contraction level and duty cycle on the majority of fatigue measures used, while cycle time tended to affect EMG spectral measures. Using a response surface methodology, several fatigue prediction models and contour plots were developed that can be employed as an aid for design and evaluation of light repetitive static tasks. Good correspondence was generally found between discomfort rating and other measures of fatigue, suggesting the usefulness of this measure for rapid assessments of local fatigue in the workplace.

Adult↗
PubMed2006

European first aid guidelines.

AIM: Our objectives were to determine the most effective, safe, and feasible first aid (FA) techniques and procedures, and to formulate valid recommendations for training. We focussed on emergencies involving few casualties, where emergency medical services or healthcare professionals are not immediately present at the scene, but are available within a short space of time. Due to time and resource constraints, we limited ourselves to safety, emergency removal, psychosocial FA, traumatology, and poisoning. Cardiopulmonary resuscitation (CPR) was not included because guidelines are already available from the European Resuscitation Council (ERC). The FA guidelines are intended to provide guidance to authors of FA handbooks and those responsible for FA programmes. These guidelines, together with the ERC resuscitation guidelines, will be integrated into a European FA Reference Guide and a European FA Manual. METHODS: To create these guidelines we used an evidence-based guideline development process, based on the methodology of the Scottish Intercollegiate Guidelines Network (SIGN). RESULTS: The recommendations cover FA for bleeding, wounds, burns, spinal and head trauma, musculoskeletal trauma, and poisoning, as well as safety and psychosocial FA. CONCLUSIONS: Where good evidence was available, we were able to turn science into practice. Where evidence was lacking, the recommendations were consensus-based. These guidelines provide systematically developed recommendations and justifications for the procedures and techniques that should be included in FA manuals and training programmes.

Europe↗
PubMed1989

Congenital musculoskeletal malformations in neonates.

A total of 13321 consecutive live births were studied for the incidence of congenital musculoskeletal malformations (CMSM) in neonates in relation to mother's age, parity, social class, sex and birth weight of the child. In all, 64 CMSM were observed in 54 neonates (4.054 per thousand live births). Congenital talipes equinovarus was the commonest CMSM while polydactyly and arthrogryposis were the next common CMSM in order of frequency. CMSM were more commonly seen in lower socio-economic class and in low birth weight babies.

Adolescent↗
PubMed2004

Reconstruction surgery for patients with musculoskeletal tumor, using a pasteurized autogenous bone graft.

BACKGROUND: The pasteurized autogenous bone graft (PABG) is a new method to reuse resected and diseased autogenous bones after heat treatment at a comparatively low temperature (60 degrees C-65 degrees C). METHODS: The subjects of this study were ten patients with musculoskeletal tumor who underwent surgery with a PABG in the 6 years between 1995 and 2000. RESULTS: The pasteurized bone developed into bone union in all patients, except for the elderly patients who required repeat surgery. There were no infected patients. The PABG was performed by three different types of reconstruction, a segmental method, an intercalary method, and a combination method with an artificial joint as a spacer. No local recurrence of tumor the pasteurized bone was observed from in any patient. CONCLUSION: The PABG appears to be a comparatively easy, safe, inexpensive, and effective reconstruction method for musculoskeletal tumors. The pasteurized autogenous bone graft (PABG) is a new method to reuse resected and diseased autogenous bones after heat treatment at a comparatively low temperature (60 degrees C-65 degrees C).

Adolescent↗
PubMed2000

Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis.

OBJECTIVES: To assess the effects of folic acid and folinic acid in reducing the mucosal and gastrointestinal (GI) and haematologic side effects of low-dose of Methotrexate (MTX) in patients with Rheumatoid Arthritis (RA) and to determine whether or not folate supplementation alters MTX efficacy. SEARCH STRATEGY: We searched the Cochrane Controlled Clinical Trial's Register (CCTR), the Cochrane Musculoskeletal Group Specialized Register and Medline up to and including June 1999, using the search strategy developed by the Cochrane Collaboration (Dickersin 1994). We also handsearched the following: (i) bibliographic references; (ii) current contents of the last 6 months; (iii) abstracts of the rheumatology meetings; and (iv) all issues of four journals; Journal of Rheumatology, Arthritis & Rheumatism, Clinical and Experimental Rheumatology, and British Journal of Rheumatology. All languages were included. Principal investigators were also contacted in order to look for unpublished literature. SELECTION CRITERIA: We selected all double-blind, randomized, placebo-controlled, clinical trials (RCTs), in which adult RA patients were treated with a low dose of MTX (<20 mg / week) concurrently with folate supplementation. DATA COLLECTION AND ANALYSIS: Two observers extracted the data and assessed the quality of the trials. (BS, Z0) The overall treatment effect across trials was calculated using a fixed effect model. Disease activity was evaluated using standardized mean differences to ensure comparability across outcome measures. Results are presented with 95% Confidence Inervals (95% CI). Subgroup analyses were conducted evaluating different doses and sensitivity analysis looking at the quality of the trials. Publication bias was assessed with an inverted funnel plot technique. Heterogeneity of the trials was measured using a standard chi square test. Costs per month in different countries were compared. MAIN RESULTS: Of the 12 trials retrieved, 7 met the inclusion criteria. The total sample included 307 patients, of which 147 were treated with folate supplementation, 80 patients with folinic acid and 67 patients with folic acid. A 79% reduction in mucosal and GI side effects was observed for folic acid [OR = 0.21 (95% CI 0.10 to 0.44)]. For folinic acid, a clinically but non-statistically significant reduction of 43% was found [OR = 0. 57 (95% CI 0.28 to 1.15)]. No major differences were observed between low and high doses of folic or folinic acid. Haematologic side effects could not be analyzed, since details of each haematologic side effect by patients were not provided. No consistent differences in disease activity parameters were observed when comparing placebo and folic or folinic acid at low or high doses, although patients on high dose folinic acid had an increase in the number of tender joints, but not swollen joints. Large differences in costs across countries were found, but folinic acid was more expensive in all. REVIEWER'S CONCLUSIONS: The results support the protective effect of folate supplementation in reducing MTX side effects related to the oral and GI systems. We could not determine if folic was different from folinic acid. Therefore, for folinic acid to be considered cost-effective it must be found more effective than folic acid at reducing MTX side effects.

Antirheumatic Agents↗
PubMed2005

Muscle function and dysfunction in health and disease.

Skeletal muscles of the trunk and limbs developmentally originate from the cells of the dermomyotomal compartment of the somite. A wealth of knowledge has been accumulated with regard to understanding the molecular regulation of embryonic skeletal myogenesis. Myogenic induction is controlled through a complex series of spatiotemporal dependent signaling cascades. Secreted signaling molecules from surrounding structures not only initiate the myogenic program, but also influence proliferation and differentiation decisions. The proper coordination of these molecular events is thus critical for the formation of physiologically functional skeletal muscles. Hereditary congenital skeletal muscle defects arise due to genetics lesions in myogenic specific components. Understanding the mechanistic routes of congenital skeletal muscle disease therefore requires a comprehensive knowledge of the developmental system. Ultimately, the application of this knowledge will improve the diagnostic and therapeutic methodologies for such diseases. The aim of this review is to overview our current understanding of skeletal muscle development and associated human congenital diseases.

Animals↗
PubMed2002

[Disk-related diseases of the lumbar spine as an example for the critical interaction between clinical diagnosis and occupational disease].

First an overview of the significance of musculoskeletal diseases in terms of national economy and social politics is given, and then the historical development of the occupational disease "disk-related spinal disorders" is outlined. The most important court decisions and the actual state of jurisprudence on this matter are summarized, emphasizing the questions which still have to be answered in the course of medical evaluation of a spinal occupational disease. Based on a joint research project on the spinal effects of whole-body vibrations, an analysis of lumbar X-rays is presented which aimed at detecting specific patterns of response corresponding to the respective extent of strain. In spite of a statistically significant relationship between the clinical diagnosis of a lumbar syndrome and the severity of the degenerative radiological changes on the one hand and vibration exposure on the other hand, the evaluation of the lumbar X-rays did not show any clear radiological pattern related to the exposure. Furthermore, starting points for prevention are discussed. With regard to whole-body vibration, the technical possibilities of reducing the amount of vibration load are still not completely exhausted. However, during preventive measures of occupational health usually carried out as medical screening examinations, the occupational health physician again will face some of the same problems which have already been met with respect to the medical evaluation. Thus, a suggestion is made to modify the traditional concepts of the Professional Industrial Associations on occupational diseases in order to take into account the peculiarities of disk-related spinal disorders.

Accidents, Occupational↗
PubMed2005

Biomechanics of rehabilitation.

The biomechanics of motion and rehabilitation are complex, with many tissue types and structures involved. In addition, consideration must be given to the stage of tissue healing with some injuries, such as fractures.A more thorough knowledge of some of the infrequently discussed biomechanical aspects of musculoskeletal tissues and motion during rehabilitation, combined with known features of tissue recovery, should enhance the development of rehabilitation programs for patients.

Animals↗
PubMed2005

Echocardiographic assessment of left ventricular morphology and function in patients with Emery-Dreifuss muscular dystrophy.

BACKGROUND: Emery-Dreifuss muscular dystrophy (EDMD) characterized by musculoskeletal abnormalities is often associated with atrioventricular conduction disturbances. Although some EDMD patients were reported to develop dilated cardiomyopathy, there are limited data on their left ventricular (LV) performance. METHODS: Therefore, we echocardiographically assessed 27 men (23 cases aged 26.4+/-6.8 years with X-linked, and four cases aged 22.2+/-8.6 years with autosomal dominant (AD)) EDMD. Control group included 16 male healthy controls aged 24.8+/-6.0 (18-37) years. RESULTS: Although LV end diastolic dimension was similar in EDMD and controls (4.9+/-0.6 and 4.99+/-1.1 cm, ns), dilated left ventricle was found in three X-linked EDMD subjects. LV ejection fraction was significantly reduced in EDMD (62.3+/-1% vs. 71.2+/-2%, p=0.01) and was below 50% in six (22.2%) X-linked EDMD patients. Doppler analysis disclosed prolonged isovolumetric relaxation time of the left ventricle in the studied group. This finding may indicate impaired LV relaxation. CONCLUSION: A significant subgroup of X-linked EDMD patients shows pronounced abnormalities of left ventricular function. This warrants cardiologic follow up of EDMD patients.

Adolescent↗
PubMed2003

Interface pressure data and the prediction of driver discomfort in road trials.

An objective measure that will predict discomfort reliably, and which can be used at an early stage in the development of a vehicle and its seating, would have the potential to reduce the prevalence of musculoskeletal problems associated with driving. This paper reports on an extended road trial study to further investigate the potential value of pressure distribution data in the prediction of reported discomfort. Road trial data were collected from three cars and then interface pressure data were recorded for each of the three seats. Clear differences were identified between the cars with respect to reports of discomfort. However, no clear relationship was found between interface pressure data and reported discomfort.

Automobile Driving↗
PubMed1993

Human standing posture: multi-joint movement strategies based on biomechanical constraints.

We developed a theoretical framework for studying coordination strategies in standing posture. The framework consists of a musculoskeletal model of the human lower extremity in the sagittal plane and a technique to visualize, geometrically, how constraints internal and external to the body affect movement. The set of all feasible accelerations (i.e., the "feasible acceleration set" or FAS) that muscles can induce at positions near upright were calculated. We found that musculoskeletal mechanics dictate that independent control of joints is relatively difficult to achieve. When muscle activations are constrained so the knees stay straight, to approximate the typical postural response to perturbation, the corresponding subset of the feasible acceleration set greatly favors a combination of ankle and hip movement in the ratio 1:3 (called the "hip strategy"). Independent control of these two joints remains difficult to achieve. When near the boundary of instability, the orientation and shape of this subset show that the movement strategy necessary to maintain stability, without taking a step, is quite restricted. Hypothesizing that regulation of center-of-mass position is crucial to maintaining balance, we examined the feasible set of center-of-mass accelerations. When the knees must be kept straight, the acceleration of the center of mass is severely limited vertically, but not horizontally. We also found that the "ankle strategy", involving rotation about the ankles only, requires more muscle activation than the "hip strategy" for a given amount of horizontal acceleration. Our model therefore predicts that the hip strategy is most effective at controlling the center of mass with minimal muscle activation ("neural effort").

Ankle Joint↗
PubMedDate not supplied

Four assessment tools of ergonomics interventions: case study at an electric utility's warehouse system.

An ergonomics program was developed in a Midwestern electric utility warehouse system. Tasks problematic with respect to work-related musculoskeletal disorders (WMSDs) affecting both the back and upper extremities were identified and engineering controls were implemented. Quantitative analysis was performed on each task before and after ergonomics intervention to evaluate exposure to the risk of WMSDs. Four methods were used to evaluate the risk of exposure to injury before and after ergonomics intervention: the 1991 National Institute for Occupational Safety and Health (NIOSH) lifting equation, the Static Strength Prediction Program, the Lumbar Motion Monitor, and the Borg psychophysical assessment of effort. Results from applying these four methods to the reengineered tasks showed that the probability of low-back disorder risk factors was reduced by as much as 29%, the percentage of people capable of performing tasks was increased by as much as 90%, the NIOSH Lifting Index was reduced from above 2.0 to less than 2.0, and the psychophysical assessment of effort was consistently reduced from the "heavy or strong" range to the "light or moderate" range.

Back Injuries↗