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At least 1,153 records · Page 64Linked to original sources
PubMed1994

[Development of a system for epidemiologic surveillance for the XVII Central American and Caribbean Sport Games, Puerto Rico, 1993].

The probability of recording infectious diseases and injuries to the musculoskeletal system during sports events with a large number of participants is very high. From an historical perspective the distribution and trends of diseases that have an impact on public health have been evaluated by means of epidemiological surveillance systems. However, the application of these epidemiological methods to sports medicine is relatively recent. The utilization of an epidemiological surveillance system during sports events with a large number of participating athletes and countries has been reported in a limited number of competitions. In this article we describe the design of a system for epidemiological surveillance utilized during the XVII Central American and Caribbean Sports Games held in Puerto Rico in 1993, as an example of a surveillance system that could be regularly established in this type of event.

Athletic Injuries↗
PubMed1999

[Current status and perspectives of rehabilitation of musculoskeletal diseases].

Musculoskeletal diseases play a prominent role within the system of rehabilitation due to their high prevalence, the often progressive course they take, and the high amount of disabilities caused by them in occupational and everyday activities. In Germany, almost 50% of about 1 million cases of in-patient rehabilitation per year belong to this diagnostic group. At present, the repercussions of recent changes in legislation and the resulting decrease by about 30% in the use of rehabilitation have considerable influences on the system of in-patient rehabilitation. In addition, rehabilitation hospitals are exposed to a growing competition by the development of out-patient rehabilitation facilities. The present article describes the actual situation, analyses central dimensions of the process of rehabilitation in musculoskeletal diseases as well as the evidence on the efficacy of current rehabilitation programmes, and then informs on the systematic activities aiming at quality assurance in rehabilitation.

Humans↗
PubMedDate not supplied

Ergonomic standards, guidelines, and strategies for prevention of back injury.

Now is the time for ergonomics to be taken seriously. OSHA and other regulatory agencies are concentrating on ergonomic issues, directing greater efforts in developing ergonomic guidelines and standards. Employers are being required to develop multifaceted programs to include prevention, education, and treatment. Ergonomics will become one of the direct responsibilities of ergonomists, safety professionals, and health care providers. Progress in preventing musculoskeletal injuries and illness will depend on the cooperation and availability of trained safety and health professionals who are knowledgeable about ergonomics and the extent of musculoskeletal problems in the workplace. These trained personnel must be able to educate workers and employers about risk factors and to assist them in implementing effective control procedures for prevention. Those responsible for the program will need to keep up-to-date with current engineering and medical trends in the field and be required to keep abreast of the latest legislation and regulations. The challenge is great but the rewards are even greater. Employers implementing ergonomic programs have not only reduced recordable injuries, saved hundreds of thousands of dollars in labor and materials, and reduced turnover, but have experienced increases in production and quality. The reduction in human suffering alone is reason enough to develop an effective proactive ergonomic management program.

Back Pain↗
PubMed2005

Ber-H2 (CD30) immunohistochemical staining of human fetal tissues.

OBJECTIVE: CD30 antigen has long been considered to be restricted to the tumour cells of Hodgkin's disease and of anaplastic large cell lymphoma as well as to T and B activated lymphocytes. It is now apparent that the range of normal and neoplastic cells, which may express CD30 antigen, is much wider than was at first thought. In order to gain insight into the physiological function of CD30 antigen, we studied the distribution of its expression in the tissues of fetuses from week 8th to week 16th. MATERIALS AND METHODS: We investigated the immunohistochemical expression of CD30 antigen in paraffin-embedded tissue samples representing all systems from 30 fetuses after therapeutic abortion at 8th to 10th and 12th to 16th week of gestation, respectively, using the monoclonal antibody Ber-H2. RESULTS: Our results demonstrated that CD30 is expressed early in human fetal development (8th to 10th week of gestation) in several fetal tissues derived from all three germ layers (gastrointestinal tract, special glands of the postpharyngeal foregut, urinary, musculoskeletal, reproductive, nervous, endocrine systems), with the exception of the skin and hematolymphoid system (thymus), in which the antigen is expressed later on (10th week onwards). Expression of CD30 was restricted to the hematolymphoid system in the 12-16 weeks of gestation. No expression of the marker was observed in the respiratory and cardiovascular systems during the entire period examined. CONCLUSIONS: CD30 antigen is of importance in cell development, and proliferation. It is also pathway-related to terminal differentiation in many fetal tissues and organs.

Antibodies, Monoclonal↗
PubMed2005

Perinatal development of respiratory motoneurons.

Breathing movements require the coordinated recruitment of cranial and spinal motoneurons innervating muscles of the upper airway and ribcage. A significant part of respiratory motoneuron development and maturation occurs prenatally to support the generation of fetal breathing movements in utero and sustained breathing at birth. Postnatally, motoneuron properties are further refined and match changes in the maturing respiratory musculoskeletal system. In this review, we outline developmental changes in key respiratory motoneuronal populations occurring from the time of motoneuron birth in the embryo through the postnatal period. We will also bring attention to major deficiencies in the current knowledge of perinatal respiratory motoneuron development. To date, our understanding of processes occurring during the prenatal period comes primarily from analysis of phrenic motoneurons (PMNs), whereas information about postnatal development derives largely from studies of PMN and hypoglossal motoneuron properties.

Animals↗
PubMed2001

Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study.

OBJECTIVE: To estimate the prevalence of chronic regional and widespread musculoskeletal pain in a sample of the general adult population and study the association to age, sex, socioeconomic class, immigration, and housing area. METHODS: A cross sectional survey with a postal questionnaire to 3928 inhabitants on the west coast of Sweden. RESULTS: The age and sex adjusted prevalence of chronic regional pain (CRP) was 23.9% and chronic widespread pain (CWP) 11.4% among 2425 subjects who responded to the complete questionnaire. Odds ratio (OR) for CWP showed a systematic increasing gradient with age and was highest in the age group 59-74 yrs (OR 6.36, 95% CI 3.85-10.50) vs age group 20-34 yrs. CWP was also associated with female sex (OR 1.91, 95% CI 1.41-2.61), being an immigrant (OR 1.83, 95% CI 1.22-2.77), living in a socially compromised housing area (OR 3.05, 95% CI 1.48-6.27), and being an assistant nonmanual lower level employee (OR 1.92, 95% CI 1.09-3.38) or manual worker (OR 2.72, 95% CI 1.65-4.49) vs being an intermediate/higher nonmanual employee. OR for CRP showed a systematic increasing gradient with age and was highest in the age group 59-74 yrs (OR 2.22, 95% CI 1.62-3.05) vs age group 20-34 yrs. CRP was also associated with being a manual worker (OR 1.63, 95% CI 1.19-2.23) vs being an intermediate/higher nonmanual employee. CONCLUSION: Chronic musculoskeletal pain is common in the general population. Sociodemographic variables were overall more frequently and strongly associated with CWP than with CRP, which indicates different pathophysiology in the development or preservation of pain in the 2 groups.

Adult↗
PubMed2006

Capturing cases in workers' compensation databases: the example of neck pain.

BACKGROUND: There is a need to more accurately enumerate workers with musculoskeletal injuries who make lost-time claims to workers compensation boards. The objective of this study is to develop an approach to more accurately enumerate these workers. METHODS: Lost-time claims to the Ontario Workplace Safety & Insurance Board (WSIB) were reviewed. Using neck pain as an example, nature of injury and part of body codes were identified to classify cases. Claims of a random sample of 434 claimants were reviewed. The proportion of claimants classified as having neck pain was computed. RESULTS: The proportion of claimants classified with soft-tissue injuries to the neck varied from 0.88 for codes including "neck/cervical region," 0.69 for "back region" to 0.05 for those coded as "shoulder/upper arm." CONCLUSIONS: Restricting the enumeration of injuries to specific part of body codes can lead to a gross underestimation of the magnitude of soft-tissue disorders in epidemiological studies using workers' compensation data. The proposed approach leads to more accurate enumeration.

Accidents, Occupational↗
PubMed2006

The scleroderma Assessment Questionnaire (SAQ). A new self-assessment questionnaire for evaluation of disease status in patients with systemic sclerosis.

OBJECTIVE: To develop a self-assessment questionnaire and estimate its validity in the evaluation of disease status in patients with systemic sclerosis. PATIENTS AND METHODS: The developed questionnaire (SAQ) consists of 23 questions divided into four groups related to symptoms of vascular, respiratory, gastrointestinal and musculoskeletal dysfunction. One hundred and five patients with systemic sclerosis filled in the SAQ. Answers were assessed on a 0-3 scale and Index of Vascular Status (IVS), Index of Respiratory Status (IRS), Index of Gastrointestinal Status (IGS), Index of Musculoskeletal Status (IMMS) and Index of Disease Status (IDS) were calculated. Mann-Whitney and Kruskal-Wallis tests were used to examine the correlation of index score for particular organ system with various disease damage indicators. RESULTS: Mean score for IVS was significantly higher in patients with finger-tip ulcers or finger-tip osteolysis than in patients without, and was also higher in patients who had more severe capillary damage. Mean score for IRS was significantly higher in patients with pulmonary fibrosis, also in patients with reduced FVC, DLCO and DLCO/VA. Patients with esophageal hypomotility had a higher mean score for IGS than patients with normal esophageal motility. The mean score for IMSS showed a strong correlation with the skin score and was significantly higher in patients with reduced hand motility, joint contractures, muscle weakness or arthralgia/arthritis. The mean score for IDS was significantly higher in patients who had multisystemic involvement. CONCLUSIONS: The Scleroderma Assessment Questionnaire (SAQ) is a sensitive measurement of disease status and level of impairment of different organ systems in patients with systemic sclerosis.

Adult↗
PubMed1994

PET FDG studies in oncology.

Positron emission tomography (PET) studies of cancer with the glucose analog 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) have emerged as both a useful research and clinical method for detecting (diagnosing), staging, and monitoring treatment responses in a variety of neoplasms, including tumors of the brain, head and neck, lung, breast, gastrointestinal and genitourinary systems, lymphatic system, musculoskeletal system, and other organ systems. In addition to FDG, many other positron emitting radiopharmaceuticals are under investigation and development in oncology, but the largest set of clinically relevant results to date has been acquired with FDG. Because most aggressive neoplasms have high glycolytic rates, neoplasms throughout the body may potentially be visualized with PET, using both standard transaxial imaging methods and techniques such as whole body PET imaging for surveying the entire body.

Deoxyglucose↗
PubMed2000

American association of tissue banks: a historical reflection upon entering the 21st century.

The American Association of Tissue Banks (AATB) is a scientific, not-for-profit, peer-group organization founded in 1976 to facilitate the provision of transplantable tissues of uniform high quality in quantities sufficient to meet national needs. The Association was created well before there was governmental oversight of tissue banking. The organization consists of individuals involved in tissue banking, medical users, and scientists in the field. Current structure consists of a 13-member Board of Governors with specific subgroups including Musculoskeletal, Reproductive, Skin, Tissue Bank Councils and Council of Accredited Tissue Banks. A historical review shows the evolution from development of guidelines to publication of standards, and from an inspection conducted by peers to one conducted by an independent, trained professional inspector. Association growth and historical accomplishments are highlighted.

Journal Article↗
PubMed2002

Musculo-skeletal problems associated with pregnancy in women with osteogenesis imperfecta.

Having seen a number of women with osteogenesis imperfecta who developed severe back pain during or just after pregnancy, we wished to determine the likelihood of this and other musculoskeletal problems in pregnancy. We interviewed by telephone 100 women with osteogenesis imperfecta who had, between them, 213 pregnancies between 1957 and 1998. For each pregnancy we recorded the Sillence type for the osteogenesis imperfecta, the mode of delivery and the musculo-skeletal complications. The most common problem was back pain, which was severe in or after 28 pregnancies (13.1%). There was no identifiable relationship to the type of osteogenesis imperfecta or to the mode of delivery. In many cases the back pain could be related to crush fractures of vertebrae. Other problems identified included spinal deformity, non-vertebral fractures, disc problems and ligament problems. We suggest that it may be appropriate to advise the avoidance of long periods of breast feeding in women with OI, particularly in those who have vertebral fractures.

Adolescent↗
PubMed2000

Ergonomics and occupational medicine: future challenges.

Ergonomics has come a long way since the birth of the subject some 50 years ago. It now has an established research base and an appropriate portfolio of methodologies. A brief overview of the subject's development will be presented, with a particular focus on the contribution of ergonomics to our understanding of work related musculoskeletal disorders. Future challenges are also considered in this area, with particular emphasis on the need for a multidisciplinary approach to many industrial problems where the ergonomist, occupational physician and other professionals are needed to tackle existing and future work problems. Additionally, the importance of participatory ergonomics is considered, with respect to understanding and advancing solutions in this area. The issues of the ageing workforce and the challenges that must be met are also outlined. This area again emphasizes the need for a multidisciplinary team approach that is proactive and designed to maximize the health and wellbeing of workers at all ages, whilst also ensuring a full and productive life.

Aging↗
PubMed1984

Clinical education model for staff training in orthopedic manual therapy.

We designed a clinical education model for training staff orthopedic physical therapists to provide basic skills in orthopedic manual therapy. The program evolved in a health maintenance organization, where a large number of patients with acute and chronic musculoskeletal disorders receive care. As physical therapy became primary in the treatment of these patients, the staff needed to develop specialized clinical skill. We divided the program into four phases: Phase I--Lecture Series, Phase II--Evaluation of Clinical Skill, Phase III--Self-directed Study, and Phase IV--Re-evaluation. This clinical education assures the staff physical therapist of a supportive learning environment. The program enhances clinical development by identifying individual strengths and weaknesses and providing a positive framework for improvement and self-evaluation.

Clinical Competence↗
PubMedDate not supplied

Factors predictive of immobilization complications in pediatric polytrauma.

OBJECTIVES: To determine in a cohort of children with polytrauma which variables are predictive of the development of complications related to immobilization. DESIGN: A retrospective study of children with polytrauma and at least one major musculoskeletal injury. A stepwise forward logistic regression analysis was used to determine variables predictive of complications related to immobilization. PARTICIPANTS: Ninety-three children with polytrauma were studied; motor vehicle incidents accounted for 80 percent of the injuries. The average age was 8.0 +/- 4.1 years. There were 152 fractures in the ninety-three children. The average Modified Injury Severity Scale (MISS) was 24.5 +/- 13.6. There were thirty-five complications in twenty-two children, and four children died. RESULTS: Two variables were predictive of complications related to immobilization: age and MISS score. Complications related to immobilization were positively associated with being older than seven years of age (p = 0.027; odds ratio = 9.5; 95 percent confidence interval 1.4, 64.9) and having a MISS score greater than forty (p = 0.005; OR = 14.1; 95 percent confidence interval 2.2, 89.1). Timing of surgery showed a trend (p = 0.097) but did not reach statistical significance. CONCLUSIONS: Complications of immobilization in children with polytrauma are associated with age greater than seven years and a MISS score greater than forty. Further study is needed to evaluate the effect of early fracture stabilization. Timing of osteosynthesis showed a trend but did not reach statistical significance in this study.

Abbreviated Injury Scale↗
PubMed1994

Epidemiological and financial aspects of the use of non-steroidal anti-inflammatory analgesics.

The availability of many new nonsteroidal anti-inflammatory drugs (NSAIDs) has increased the total consumption during the past 20 years. The cost of different NSAID brands varies considerably probably reflecting increased research and development costs rather than a true therapeutic benefit for the patient. The current therapeutic problem in the treatment of musculoskeletal conditions with NSAIDs is to make a balanced analysis between benefits, risks, and costs. Assessment of risks and benefits should focus on the large subgroup (about 40%) of elderly NSAID users over 60 years who clearly stand at increased risk of NSAID-induced gastrointestinal complications. In the treatment of osteoarthritis more trials are needed to compare NSAIDs with plain analgesics (e.g. paracetamol).

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Diastematomyelia in adults. A review.

A consecutive series of 45 cases of diastematomyelia in adults is analyzed. The majority of patients were females with a 3.4:1 female to male ratio. The ages ranged from 19 to 76 with a mean of 37.8 years. The lesion was usually located in the lumbar region. In 17 patients the development of symptoms was associated with specific incidents or events, usually trauma. Twelve patients had pre-existing static musculoskeletal or neurologic abnormalities and 20 had cutaneous spinal lesions suggesting dysphraphism. The symptoms and signs included pain and a variety of sensorimotor and/or sphincteric abnormalities. Metrizamide CT scanning proved to be the most useful diagnostic procedure. Only 4 patients were investigated by MRI and from the information available its role in the diagnosis of adult diastematomyelia is not established. Twenty-three of 24 patients treated by surgery showed marked improvement.

Adult↗
PubMed2000

Ninth Asia Pacific League of Associations for Rheumatology (APLAR) Congress, Beijing, China, 21-26 May, 2000.

The Congress covered the broad field of rheumatology, with participants from China, the Asia Pacific League of Associations of Rheumatology (APLAR) region and the rest of the world. The programme consisted of a mix of plenary lectures, concurrent symposia, workshops, free paper sessions and poster presentations. Basic sciences were well represented, with the general theme of inflammatory cytokines being of particular interest. One plenary lecture and a number of other presentations addressed the problem of atherosclerosis and rheumatic diseases. Diseases prominent in the region, such as Behcet's disease and Takayasu's disease, were represented with large series. Other areas of interest were musculoskeletal infections in HIV-positive patients and the management of spondyloarthritis. Although the use of the most recently developed drugs is restricted in the APLAR region because of cost factors, there were symposia on the latest pharmacological advances such as COX-2 technology, leflunomide and anti-tumour necrosis factor (TNF) therapy.

China↗
PubMedDate not supplied

[Determination of regional rate of glucose metabolism in lumbar muscles in patients with generalized tendomyopathy using dynamic 18F-FDG PET].

Generalized tendomyopathy (GTM), or fibromyalgia (FM), is a disease characterized by wide-spread pain in the musculoskeletal system which usually begins at a single site, e.g., as low-back pain or cervical syndrome, and develops into generalized pain over months or years. The disorder affects primarily women, beginning around the age of 35 and reaching its peak during or after the menopause. Its etiology is still unknown. Secondary forms are observed particularly in rheumatoid arthritis. In order to get more information on FM we determined the local metabolic rate of glucose in vivo in the skeletal muscle (lumbar region) with dynamic 18F-FDG positron emission tomography (PET). 2 healthy volunteers and 6 female patients with FM reaching in age from 31 to 53 years were scanned. As 18F-FDG PET scanning is a metabolic tool, it is crucial to observe standardized conditions of metabolic steady-state. We used, therefore, the hyperinsulinemic euglycemic insulin clamp technique to stimulate the myogenic glucose uptake under stable plasma-glucose levels. The local metabolic rates of glucose utilization were estimated with a non-linear least squares fit on the 3 compartment 18F-FDG-model. A lumped constant of 0.67 was assumed. Under glucose clamp conditions patients with FM showed a significantly (p < 0.001) lower metabolic rate of glucose (4.3 +/- 1.1) mumol/100 g tissue/min compared with normal volunteers (8.5 +/- 2.3 mumol/100 g/min). Due to a significantly (p < 0.005) increased glucose backflow from tissue into the vascular space (k2 in the kinetic model) the rate of phosphorylation was markedly reduced in patients with FM.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗