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At least 1,477 records · Page 82Linked to original sources
PubMed2005

Cyclo-oxygenase-2 inhibitors : beneficial or detrimental for athletes with acute musculoskeletal injuries?

The major goal of clinicians when treating acute musculoskeletal injuries is to return athletes to their pre-injury level of function, ideally in the shortest time possible and without compromising tissue-level healing. In this regard, a commonly used intervention is the taking of NSAIDs. These are used to limit the amount and duration of inflammation, and to control pain. While NSAIDs have become synonymous with the management of acute musculoskeletal injuries, their efficacy has yet to be proven. This is of particular concern in view of recent research investigating the latest class of NSAIDs - selective cyclo-oxygenase-2 inhibitors (COXIBs). COXIBs were developed to reduce the adverse gastrointestinal (GI) effects of traditional NSAIDs. While they have beneficial anti-inflammatory and analgesic properties, and appear to facilitate earlier return to function following acute injury, the effect of COXIBs on tissue-level healing is currently unknown. In experimental animal models of acute injury, COXIBs have been shown to be detrimental to tissue-level repair. Specifically, they have been shown to impair mechanical strength return following acute injury to bone, ligament and tendon. Clinically, this may have implications for ongoing morbidity and future injury susceptibility. However, the current animal studies have limited translation to the clinical setting, particularly because of significant limitations relating to drug use and dosage in these studies. There is currently no randomised, controlled trial evidence of the tissue-level effects of COXIBs on acute musculoskeletal injuries. In addition to questions relating to the effect of COXIBs on tissue-level healing, further questions regarding the use of these agents have been raised given a recent link being shown between one COXIB (rofecoxib) and an increased risk for adverse cardiovascular events. Whether this finding is related to the individual properties of rofecoxib or is a class phenomenon is the subject of ongoing investigation. However, in light of the potential risks associated with using COXIBs, an acceptable and possibly safer alternative in the management of acute musculoskeletal injuries may be to use traditional NSAIDs. Traditional NSAIDs do carry the potential for greater adverse GI effects and their clinical effects on tissue-level healing remain relatively unknown. However, they do not appear to be associated with adverse cardiovascular effects, and they are effective pain relievers and cheaper alternatives.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Recent developments in chest pain of undetermined origin.

The syndrome of angina-like pain with normal epicardial coronary vessels is a very common and expensive clinical problem. Patients suffering from this condition frequently present a diagnostic challenge. Cardiac and musculoskeletal disorders must be excluded prior to identifying the esophagus as the source of pain. The term "chest pain of undetermined origin" (UCP) has been proposed to refer to this condition. Esophageal dysmotility was previously considered a major source for chest pain; however, recent studies indicate that esophageal reflux is the most common cause of esophageal pain. Two controlled trials of acid suppressive agents in patients with chest pain have shown that omeprazole provides effective pain relief for the majority of these individuals. Visceral hyperalgesia and psychologic disturbances are also commonly noted in patients with UCP. Much remains to be learned about the etiology of visceral hyperalgesia and the precise role of psychologic abnormalities in these patients. Until further information is available, treatment with imipramine or trazodone has been shown to offer effective relief of chest pain for subgroups of patients with UCP. Psychologic intervention is also valuable in the management of some patients. Studies of other therapeutic regimens continue to be conducted.

Angina Pectoris↗
PubMed2004

Congenital abnormalities of the musculoskeletal system: perinatal evaluation and long-term outcome.

Many musculoskeletal malformations can be detected by prenatal US. Whether isolated or part of a syndrome, these anomalies can have a significant impact on the entire life of the individual. Nonfatal conditions may be subtle and become more recognizable in the second and third trimester. After delivery, radiography helps confirm the diagnosis. US, CT, and MRI all have a role in imaging the primary abnormality, the follow-up effects of treatment, and in monitoring for potential complications that may develop over time. Three-dimensional imaging has an increasing role, in US, CT, and MRI, both in the prenatal and postnatal periods.

Female↗
PubMed2006

Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism.

BACKGROUND: It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD) also play an important role in the determining consequences of MSD in terms of sickness absence and health care use. METHODS: A cross-sectional study was conducted among 853 shipyard employees. Data were collected by questionnaire on physical and psychosocial workload, need for recovery, perceived general health, occurrence of musculoskeletal complaints, and health care use during the past year. Retrospective data on absenteeism were also available from the company register. RESULTS: In total, 37%, 22%, and 15% of employees reported complaints of low back, shoulder/neck, and hand/wrist during the past 12 months, respectively. Among all employees with at least one MSD, 27% visited a physician at least once and 20% took at least one period of sick leave. Various individual and work-related factors were associated with the occurrence of MSD. Health care use and absenteeism were strongest influenced by chronicity of musculoskeletal complaints and comorbidity with other musculoskeletal complaints and, to a lesser extent, by work-related factors. CONCLUSION: In programmes aimed at preventing the unfavourable consequences of MSD in terms of sickness absence and health care use it is important to identify the (individual) factors that determine the development of chronicity of complaints. These factors may differ from the well-know risk factors for the occurrence of MSD that are targeted in primary prevention.

Absenteeism↗
PubMed2004

Case studies of ergonomic interventions in automotive parts distribution operations.

Ergonomic job analysis, intervention design, and intervention implementation are essential components of an ergonomics program designed to reduce worker exposure to risk factors associated with musculoskeletal disorders. As part of a 4-year study to reduce overexertion injuries in the service parts division of a major automaker, intervention case studies were identified that could be used at multiple facilities across the division. Interventions were developed and implemented. The three case studies include 1) self-elevating powered vehicle for transporting parts throughout the facility and for reaching to high bin locations; 2) lift and tilt pallet jacks for packing small parts into large bin-like containers; and 3) single-level telescoping conveyor used for delivering hand-held totes for subsequent sorting operations. Several analysis methods were used to assess worker exposure before and after intervention implementation (biomechanical analysis, posture analysis, worker interviews, and activity analysis). Following implementation, a decrease in exposure to risk factors for musculoskeletal disorders was documented. Worker interviews revealed acceptance and agreement that risk factors associated with the targeted tasks were reduced. Each case study includes a description of the implementation hurdles and can serve as both primary and secondary prevention of musculoskeletal disorders. Future work should document worker health and/or symptom changes as well as changes in risk factor exposure.

Accidents, Occupational↗
PubMed2000

Occlusion: what it is and what it is not.

Dental occlusion is much more than the physical contact of the biting surfaces of opposing teeth or their replacements. Occlusion is more comprehensively defined biologically as the coordinated functional interaction between the various cell populations forming the masticatory system as they differentiate, model, remodel, fail, and repair. Morphologic variations are very common and represent the norm. Even though the occlusal or musculoskeletal relationship may not meet the definition of the clinician's concept of an optimum or ideal occlusion, it must be appreciated that for that particular patient, the tissues of the masticatory system may have developed a stable, functional, healthy, and comfortable equilibrium. However, when the functional equilibrium is perturbed or when the occlusion is being re-established, specific treatment criteria are as important today, if not more important with the rapid growth of implant placements, as ever before. Treatment of the occlusion should be considered on an individual basis based on the specific physiologic needs of the various tissue systems within the masticatory system rather than on a preconceived, stereotyped or universal basis. It has long been established and recently proven that proper management of the occlusion is directly correlated to the successful treatment and maintenance of the teeth and, at times, the supporting tissues. On the other hand, it has not, to date, been scientifically proven that occlusion is directly correlated to the musculoskeletal disorders that affect the jaw (temporomandibular joint or masticatory muscle disorders).

Centric Relation↗
PubMed2004

Workstation design in carpet hand-weaving operation: guidelines for prevention of musculoskeletal disorders.

Carpet weavers suffer from musculoskeletal problems mainly attributed to poor working postures. Their posture is mostly constrained by the design of workstations. This study was conducted to investigate the effects of 2 design parameters (weaving height and seat type) on postural variables and subjective experience, and to develop guidelines for workstation adjustments. At an experimental workstation, 30 professional weavers worked in 9 different conditions. Working posture and weavers' perceptions were measured. It was shown that head, neck and shoulder postures were influenced by weaving height. Both design parameters influenced trunk and elbows postures. The determinant factor for weavers' perception on the neck, shoulders and elbows was found to be weaving height, and on the back and knees it was seat type. Based on the results, the following guidelines were developed: (a) weaving height should be adjusted to 20 cm above elbow height; (b) a 10 degrees forward-sloping high seat is to be used at weaving workstations.

Adult↗
PubMed1985

Aging in the musculoskeletal system of rhesus monkeys: II. Degenerative joint disease.

In order to discuss the rate and onset of adult aging in rhesus monkeys, 55 adult animals from the Wisconsin Regional Primate Research Center and the University of Wisconsin Psychology Primate Laboratory were examined. Degenerative joint disease (DJD) at the hip and spine was scored, and loss of passive joint mobility at the hip was measured. Development of DJD at both the hip and spine was significantly and positively correlated with age. Spinal changes, especially at the thoraco/lumbar intervertebral symphyses, appeared to develop somewhat more rapidly than hip degeneration. In some individuals, DJD was observed soon after the completion of growth, but pronounced changes seldom occurred before the middle of the second decade of life. Similarly, age-dependent losses of passive joint mobility appeared to begin early in ontogeny and to become increasingly pronounced in the aging adult. Although interspecific comparisons are difficult due to intraspecies and intraindividual variation, the timing of musculoskeletal aging in the rhesus spine and hip differs from that observed in humans in a way that parallels previously documented species differences in patterns of musculoskeletal growth. These observations and data on age-related change in other systems, suggest that rates and durations of many ontogenetic processes in rhesus monkeys are approximately three times as fast and one-third as long as those of the corresponding human processes. Importantly, differences in the timing of reproduction do not appear to follow the same scaling factor observed in other systems. Although reproduction may, therefore, be under separate control, the consistent pattern observed in other aspects of somatic growth and aging supports the hypothesis (Cutler, 1976; Sacher, 1978) that evolutionary changes in ontogeny have resulted from selection acting upon a few genes with widespread regulatory effects.

Aging↗
PubMed1986

Survey of student clinical practice. Implications for educational programs.

The purpose of this survey was to analyze the content of physical therapy students' clinical education programs. We developed and used patient and student record forms that elicited information on the age and sex of the patient groups, the types of pathological conditions, the number and types of treatments administered, the levels of assessments, the levels of supervision of students by clinical instructors, the time spent with patients, and the specialized educational activities at each facility. One hundred seventy-six students participated in the three-year survey; each student completed 600 hours of study for a total of 105,600 hours. The results of this study revealed that musculoskeletal disorders (47.26%) were reported most frequently; fractures of the lower extremities constituted 10.5% of those disorders. Therapeutic exercise was the most frequently used treatment procedure (57.3%). The data obtained through this survey may be useful for evaluating curricula and developing improved practice-specific education programs.

Bone Diseases↗
PubMed1996

A learning resources centre: its utilization by medical students.

Innovations in medical education have led to the increasing use of problem-based learning techniques, a committee system organization, and more time for independent study in many undergraduate programmes. There has been an increase in availability of alternative methods for presentation of information. To encourage self-directed learning, resources such as computers, videos and models, among others, should be readily available to students. The University of Calgary Faculty of Medicine has provided various resources contained in one area, called the Bacs Learning Resource Centre (BLRC). Since the maintenance and further development of such a centre requires significant resources, it is important to determine student utilization of the various components used in their learning. For those who are about to set up such a learning resource centre this information gives guidance on which materials are most useful. The utilization of the centre by 69 first year medical students was studied using questionnaires. The utilization during a specific course was determined by analysing the entries in the individual log books given to the students at the beginning of the Integrative Course. With the exception of one student, all those who responded to the questionnaire used the Centre, with 20% or less of their total study time being spent there. The BLRC was most used for the Musculoskeletal, Cardiovascular and Reticulo-Endothelial courses. All categories of resources were found to be useful, with the tape/slides least utilized. Utilization was most influenced by the quality of resources available and recommendations by peers. The development of a centre such as the BLRC, with a variety of resources concentrated in one area, suitable for individual or group study and accessible 24 hours a day, should be considered by all medical schools to enhance self-directed learning in medical students.

Alberta↗
PubMed2005

Neuromusculoskeletal computer modeling and simulation of upright, straight-legged, bipedal locomotion of Australopithecus afarensis (A.L. 288-1).

The skeleton of Australopithecus afarensis (A.L. 288-1, better known as "Lucy") is by far the most complete record of locomotor morphology of early hominids currently available. Even though researchers agree that the postcranial skeleton of Lucy shows morphological features indicative of bipedality, only a few studies have investigated Lucy's bipedal locomotion itself. Lucy's energy expenditure during locomotion has been the topic of much speculation, but has not been investigated, except for several estimates derived from experimental data collected on other animals. To gain further insights into how Lucy may have walked, we generated a full three-dimensional (3D) reconstruction and forward-dynamic simulation of upright bipedal locomotion of this ancient human ancestor. Laser-scanned 3D bone geometries were combined with state-of-the-art neuromusculoskeletal modeling and simulation techniques from computational biomechanics. A detailed full 3D neuromusculoskeletal model was developed that encompassed all major bones, joints (10), and muscles (52) of the lower extremity. A model of muscle force and heat production was used to actuate the musculoskeletal system, and to estimate total energy expenditure during locomotion. Neural activation profiles for each of the 52 muscles that produced a single step of locomotion, while at the same time minimizing the energy consumed per meter traveled, were searched through numerical optimization. The numerical optimization resulted in smooth locomotor kinematics, and the predicted energy expenditure was appropriate for upright bipedal walking in an individual of Lucy's body size.

Animals↗
PubMed2005

Long-term complications in survivors of advanced stage neuroblastoma.

BACKGROUND: Few studies have assessed late effects in neuroblastoma (NB) survivors, particularly those with advanced stage disease. METHODS: Retrospective analysis of a cohort of advanced stage NB survivors followed in a late effect clinic at a single institution. Screening tests to detect late effects were tailored depending on the individual's treatment exposures. RESULTS: The study included 63 survivors (31 males). The median age at diagnosis was 3.0 years. The median follow-up from diagnosis was 7.06 years. All patients had surgery and received chemotherapy, 89% received radiation therapy (RT), 62% immunotherapy, and 56% autologous stem cell transplant. Late complications were detected in 95% of survivors and included: hearing loss (62%), primary hypothyroidism (24%), ovarian failure (41% of females), musculoskeletal (19%), and pulmonary (19%) abnormalities. The majority of complications were moderate, with only 4% being life-threatening. Survivors who received cisplatin were at greater risk to develop hearing loss compared to those not so treated (OR 9.74; 95% CI: 0.9-101.6). A total dose of cyclophosphamide greater than 7.4 g was associated with ovarian failure (P = 0.02). CONCLUSIONS: Late complications occur frequently in survivors of advanced stage NB. The majority of these problems are of mild-moderate severity. Long-term follow-up (LFTU) and screening of this population is essential.

Adolescent↗
PubMed2001

Management of hemophilia in developing countries.

Coagulation disorder are common in India. In the absence of any epidemiological studies it is expected that there are at least 50,000 severe hemophilics in our country. The factor concentrates are not easily available in developing countries which poses a major problem while managing severe bleeding episodes in these patients. Various strategies which could be useful while managing these cases in developing countries have been reviewed.

Child↗
PubMed2001

Immunohistochemical localisation of androgen receptor during sex-specific morphogenesis in the fetal mouse.

The distribution of androgen receptors (ARs) in paraffin serial sections of day 17 and day 18 male and female mouse embryos was investigated. In the cranial section of the genital tract AR expression was restricted to Wolffian structures while Müllerian ducts and surrounding mesenchyme were AR negative. In the fusion zone with the urogenital sinus the epithelial components of the vaginal bud were clearly distinguished by differential AR expression, which was faint in the Wolffian ducts, totally missing in the Müllerian ducts, and intense in the sinus ridges with the most intense expression in the morphogenetically active mesenchyme, indicating a new mechanism of negative control of vagina formation via androgens. Expression of ARs outside the genital tract was observed: (1) in loose interstitial mesenchyme extending into the retroperitoneal space up to the coeliac artery, indicating androgen effects during ascent of the kidneys and descent of intraperitoneal organs, (2) in the trigone of the bladder indicating androgen involvement in the development of the vesico-ureteral junction, and (3) in loose mesenchyme between striated muscle fibres and around pelvic skeletal elements, indicating mediation of androgen effects on the musculoskeletal system via loose mesenchyme.

Animals↗
PubMed2006

Dynamic expression of sparc precedes formation of skeletal elements in the Medaka (Oryzias latipes).

Sparc is a secreted calcium-binding glycoprotein that regulates mineralization of bone tissues in mammals. In other vertebrates, its function remains largely unclear. Here, we describe the isolation, genomic organization and expression of the sparc gene in the teleost Medaka (Oryzias latipes), an established vertebrate model for developmental studies. During earliest stages of Medaka embryogenesis, sparc is expressed in the sclerotome compartment of the somites that gives rise to precursor cells of the axial skeleton. Importantly, in this area its expression precedes that of twist-1, which is a crucial regulator of osteoblast formation. Dynamic expression is also found in the floor plate of the neural tube and the notochord. Both structures are passed by migrating skeletal precursors shortly before they differentiate and form the vertebrae. In general, sparc is expressed before the formation and mineralization of bone elements and expression of bone markers like collagen type 1a in the fins and axial skeleton of Medaka embryos. It is also expressed in several non-skeletal tissues of embryos and adult fish, suggesting possible other functions not related to bone mineralization. Taken together, the Medaka sparc gene represents an excellent marker for early sclerotome development. Its restricted and highly dynamic expression suggests a novel function during migration of sclerotome cells and their differentiation into early vertebrae. This marker thus allows the analysis of early skeletal development and formation of extracellular bone matrix in this vertebrate model.

Amino Acid Sequence↗