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At least 1,531 records · Page 85Linked to original sources
PubMed1996

Spontaneous multivessel cervical artery dissection in a patient with a substitution of alanine for glycine (G13A) in the alpha 1 (I) chain of type I collagen.

Cervical artery dissection occurs spontaneously and in multiple vessels with surprising frequency. An underlying arteriopathy is frequently suspected, but specific causes of vascular fragility are rarely identified. We describe a 35-year-old woman who developed multiple cervical artery dissections after scuba diving. She had no stigmata of connective tissue disease apart from bluish sclerae, and no family history of arterial dissection or congenital musculoskeletal disease. Analysis of the COL1A1 gene that encodes the pro alpha 1(I) chains of type I procollagen revealed a point mutation in one allele, resulting in substitution of alanine for glycine (G13A) in about half the alpha 1(I) chains of type I collagen. Genetic disorders of collagen, such as the mild phenotypic variant of osteogenesis imperfecta identified in our patient, should be considered in the differential diagnosis of unexplained cervical artery dissection.

Adult↗
PubMed2001

Use of an antineoepitope antibody for identification of type-II collagen degradation in equine articular cartilage.

OBJECTIVE: To develop an antibody that specifically recognizes collagenase-cleaved type-II collagen in equine articular cartilage. SAMPLE POPULATION: Cartilage specimens from horses euthanatized for problems unrelated to the musculoskeletal system. PROCEDURE: A peptide was synthesized representing the carboxy- (C-) terminus (neoepitope) of the equine type-II collagen fragment created by mammalian collagenases. This peptide was used to produce a polyclonal antibody, characterized by western analysis for reactivity to native and collagenase-cleaved equine collagens. The antibody was evaluated as an antineoepitope antibody by ELISA, using peptides +/- an amino acid at the C-terminus of the immunizing peptide. Collagen cleavage was assayed from equine articular cartilage cultured with interleukin-1 (IL-1), +/- a synthetic MMP inhibitor, BAY 12-9566. Cartilage specimens from osteoarthritic and nonarthritic joints were compared for antibody staining. RESULTS: An antibody, 234CEQ, recognized only collagenase-generated 3/4-length fragments of equine type-II collagen. This was a true antineoepitope antibody, as altering the C-terminus of the immunizing peptide significantly decreased competition for binding in an inhibition ELISA. The IL-1-induced release of type-II collagen fragments from articular cartilage was prevented with the MMP inhibitor. Cartilage from an osteoarthritic joint of a horse had increased staining with the 234CEQ antibody, compared with normal articular cartilage. CONCLUSIONS AND CLINICAL RELEVANCE: We generated an antineoepitope antibody recognizing collagenase-cleaved type-II collagen of horses. This antibody detects increases in type-II collagen cleavage in diseased equine articular cartilage. The 234CEQ antibody has the potential to aid in the early diagnosis of arthritis and to monitor treatment responses.

Animals↗
PubMedDate not supplied

[Klippel-Feil syndrome. Three-dimensional tomographic images].

Klippel-Feil syndrome (KPS) is characterized by congenital vertebral fusion believed to result from faulty segmentation along the embryo's developing axis. The hallmark phenotypic findings of low hairline, short neck, and limited range of motion of the neck are found as al triad in < 50% of patients. Congenital musculoskeletal and systemic anomalies are commonly found. These include, but are not limited to elevation of the scapula, scoliosis and renal and cardiac abnormalities. Here, we present the three-dimensional images by computed tomography of a 9-year-old boy with multiple fusion of the cervical vertebraes.

Child↗
PubMed2002

[STI571 (Glivec)--a new drug for the treatment of chronic myeloid leukemia].

Chronic myeloid leukaemia (CML) is characterised by the occurrence of the Philadelphia (Ph) chromosome (9/22 translocation) and the formation of a fusion protein--the BCR-ABL transcript with constitutive activation of the BCR-ABL tyrosine kinase and consequent changes in the intracellular signal transduction, which is responsible for the deregulated myeloid cell proliferation. STI571 (signal transduction inhibition number 571) is a potent and selective inhibitor of the BCR-ABL tyrosine kinase. In the chronic phase of the disease, normal peripheral blood values are achieved within the first month of treatment in the large majority of patients and in many patients also a cytogenic response within the following months. The results in the advanced phase are far less favourable, which is explained by the development of resistance owing to reactivation of the BCR-ABL signal transduction. Side effects are primarily nausea, vomiting, various rashes, oedema, most often in the periorbital region, and musculoskeletal symptoms, including muscle cramps. Perspectives for treatment with STI571 are described, as are combinations with alpha-interferon and other cytostatics with a synergistic profile.

Antineoplastic Agents↗
PubMed1991

Magnetic resonance imaging of the wrist.

Until recently magnetic resonance imaging of the musculoskeletal system tended to be confined to the larger joints, such as the knee and shoulder. Advances in magnetic resonance technology, especially in the area of improved software and development of surface coils, have made feasible the imaging of smaller joints, such as the wrist. This article reviews the potential applications of magnetic resonance in evaluating disorders of the wrist.

Carpal Tunnel Syndrome↗
PubMed1990

[Health status of postal service workers].

The improvement of health status of post-office workers along with identifying the leading causes of morbidity is an urgent task. The analysis of morbidity according to medical examination data and temporary disability showed the prevalence of nervous diseases among sorters of postal wrappers and letters, circulatory diseases among sorters of printed matter and operators of communication service, musculoskeletal diseases among sorters of postal parcels and wrappers. The deducted equations of multiple regression permitted to establish the impact of medico-social and industrial factors on the development of certain groups of diseases. The greatest impact of industrial factors on the development of morbidity (61-66 percent) was found among sorters of postal wrappers and operators of communication service, whose labour was regarded as hard and strenuous work. High prevalence of neurotic reactions, hypertensive disease, occupational diseases of the bones and organs of movement was found among workers of this branch. The cause-and-effect association between morbidity and industrial factors permitted to substantiate the system of health promoting activities.

Humans↗
PubMed1989

Jaccoud's-type arthropathy: an association with malignancy.

We describe a patient who developed Jaccoud's type arthropathy as an initial manifestation of small cell anaplastic carcinoma of the lung. This is the first time this arthropathy has been reported as a musculoskeletal manifestation of malignancy.

Aged↗
PubMed2005

Reactive joint symptoms following an outbreak of Salmonella typhimurium phage type 135a.

OBJECTIVE: To quantify the incidence and clinical features of reactive arthritis (ReA) developing in a cohort exposed to an outbreak of Salmonella typhimurium phage type 135a, and factors affecting host susceptibility to ReA. METHODS: A screening questionnaire was mailed to 493 patients with confirmed Salmonella infection. Musculoskeletal symptoms and extraarticular manifestations of ReA were quantified. Positive responders with joint pain were invited to participate further, with a detailed history, examination, and investigations including HLA-B27 status. RESULTS: A total of 261/461 (57%) subjects responded to the questionnaire, with 23/54 adults (43%) and 41/207 children (20%) reporting joint symptoms. Although joint pains were less common in children compared with adults, those children affected usually had eye (34%) or mucocutaneous (37%) symptoms. The incidence of ReA was 14.6%, with adults more frequently affected (24%) than children (12%). This may be an underestimate given the large proportion of children involved. Associated clinical features were similar to previous studies, with the distribution of arthritis affecting the lower limbs predominantly in an oligoarticular pattern, as were the extraarticular manifestations and enthesopathy. We found 17% of subjects were HLA-B27 positive, and 55% were still symptomatic after 6 months. CONCLUSION: In an Australian cohort study of a S. typhimurium phage type 135a outbreak, joint symptoms were common, affecting 25% of subjects. The incidence of ReA of 14.6% and the clinical features were comparable to previous studies. There was a small effect of HLA-B27 status on the development of ReA.

Adolescent↗
PubMed2005

Attributes and skills of an effective musculoskeletal consumer.

The OMERACT 7 Effective Musculoskeletal Consumer Workshop brought together people with rheumatoid arthritis, healthcare professionals, and researchers to discuss what they thought made a musculoskeletal consumer effective at managing their disease. Preliminary work before OMERACT provided a draft list of potential characteristics of an effective consumer. Participants at the workshop provided feedback about the list including relevance, missing items, format, and language. The feedback provided was useful and will be incorporated into a revised list to aid in the development of an instrument to measure health consumer effectiveness.

Arthritis, Rheumatoid↗
PubMed1999

The preparticipation physical examination history: who has the correct answers?

OBJECTIVE: To examine whether discrepancies exist between information given by parents and student athletes during the annual preparticipation physical examination (PPE) for athletics, and if present, whether the discrepancies occurred in areas of clinical significance to sports medicine and clearance for participation. DESIGN: Survey. SETTING: Station-based PPEs for area high school student athletes were performed using the form developed by the Preparticipation Physical Evaluation Task Force (PPETF). PARTICIPANTS: High school student athletes and their parents or guardians. MAIN OUTCOME MEASURES: The discrepancy rate (and associated clinical areas of those discrepancies) for information given by parent-student pairs completing a standard historical section of a PPE. RESULTS: Of the high school student athletes who participated in the station-based PPE, 111 (34%) participated in this study. These student athletes completed the PPE form (14 sections with a total of 38 specific questions) independently during an initial session, and then were given an identical PPE form that was completed with the assistance of a parent or legal guardian. Of the 111 parent-student pairs, only 22 (19.8%) histories were in complete agreement. Several questions had very poor agreement, as indicated by a kappa value < or = 0.4. Taken together, 4 of the 14 historical information sections found on the PPE (cardiovascular, neurologic, musculoskeletal, and questions pertaining to weight) accounted for 59% of all discrepancies. Answers to individual questions did not differ significantly between parents and students when analyzed together and then by gender and age. Interestingly, students answered significantly more questions in an affirmative manner than did their parents. CONCLUSION: Using the form developed by the PPETF, parents and student athletes may not provide reliable historical information on which to base participation decisions. In particular, unreliable information may be obtained regarding cardiovascular and musculoskeletal issues, areas that are related to the mortality and morbidity associated with athletic activity.

Adolescent↗
PubMed1994

Clearing athletes for participation in sports. The North Carolina Medical Society Sports Medicine Committee's recommended examination.

The North Carolina Medical Society's Medicine Committee has reviewed current U.S. literature on preparticipation examinations and adopted a documentation form that fits the specific needs of our state. In spite of a recently published comprehensive monograph on preparticipation physical evaluation, no national consensus exists about whether comprehensive preparticipation exams or brief, focused examinations are better. With this in mind, we limited medical history questions to those determined by previous studies to identify specific problems. Also included are evaluations of blood pressure, musculoskeletal, and cardiovascular systems since studies have shown significant yield from these. The same studies find little benefit from the remainder of a comprehensive physical assessment. The recommended evaluation represents a minimal standard and addresses the core areas likely to prevent athletes from participating safely in sports. No recommended exam could cover all issues that affect school-age athletes--health prevention, adolescent development, general medical care, and psychological stresses--but physicians can use the recording form as a starting point and incorporate a more extensive evaluation into the assessment of athletes found to be at increased risk. Consistent use of this examination should promote better detection of sport-specific risks related to cardiovascular disorders, asthma, musculoskeletal problems, concussions, heat-related problems, and general medical problems. The Sports Medicine Committee wants to promote physical activity. Before disqualifying athletes physicians should remember that the disqualification rate in published studies averages only 1%. When questions about the need for disqualification arise, consultation may be advisable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Canadian multidisciplinary core curriculum for musculoskeletal health.

OBJECTIVE: To determine the level of agreement among the Bone and Joint Decade Undergraduate Curriculum Group (BJDUCG) core curriculum recommendations for musculoskeletal (MSK) conditions targeted for undergraduate medical education and what the physicians and surgeons of Canada thought to be important at the postgraduate level of education. METHODS: An 80-item questionnaire was developed. A cross-sectional survey of educators representing 77 Canadian accredited academic programs representing 6 disciplines in medicine that manage patients with MSK conditions was completed. Histograms, Kruskal-Wallis, and principal component analyses were computed. RESULTS: In total, 164/175 (94%) respondents participated in the study. All 80 curriculum items received a mean score of at least 3.0/4.0. Sixty-four out of 80 items were ranked to be at least 3.5/4.0, and 35 items were ranked to be at least 3.8/4.0, suggesting that these items may be core content for all disciplines. CONCLUSION: The World Health Organization declared the years 2000 to 2010 as The Bone and Joint Decade. The main goal is to improve the quality of life for people with MSK disorders worldwide. One aim of the BJD is to increase education of healthcare providers at all levels. The BJDUCG established a set of core curriculum recommendations for MSK conditions. Our study gives reliable statistical evidence of agreement among what the BJDUCG recommended for an MSK core curriculum for medical schools and what the physicians and surgeons of Canada thought to be important for residency education in several disciplines.

Adult↗
PubMed1999

Matrix metalloproteinase inhibitors: applications in oncology.

Matrix metalloproteinases (MMP) are a group of zinc dependent enzymes which include the interstitial collagenases, stromelysins, gelatinases and membrane-type metalloproteinases. They are involved in the remodelling and turnover of the extracellular matrix proteins. They play a role in wound healing and the pathogenesis of arthritis. In malignancies they play a role in tumor invasion, metastasis and angiogenesis. A number of synthetic matrix metalloproteinase inhibitors (MMPIs) have been developed for clinical use. In preclinical tumor models they have shown promising activity in achieving inhibition of MMPs and reducing tumor growth and metastatic spread. Some have also shown additive or synergistic effects with cytotoxic agents. Phase I and II studies in human subjects have defined the main side effects of these agents as being musculoskeletal pains or arthralgias. As they are cytostatic agents rather than cytotoxic in activity conventional measurements of radiological response for assessment are not applicable in trials. Biological activity has been demonstrated in certain cancers by the effects on levels of tumor markers as surrogate markers of tumor response and also by a fibrotic stromal reaction seen in tumor tissue. Newer agents have been developed with selective inhibition of certain MMPs in an attempt to reduce the side effects. A number of phase III human clinical trials evaluating MMPs are being carried out at present but only one has been formally reported so far. This study suggested that marimastat had no survival advantage when compared to chemotherapy with gemcitabine in advanced pancreatic carcinoma. Current trials are assessing efficacy of MMPIs in maintenance of remission after other modalities of therapy or in combination with cytotoxic agents. MMPs have also been demonstrated to play an important role in the articular cartilage destruction seen in both rheumatoid arthritis and osteoarthritis. The use of MMPIs in both ex vivo and in vivo models have shown promising results and trials are in process to assess their potential role in the control of articular destruction. The true therapeutic role of MMPIs await the results of these randomized studies.

Animals↗
PubMed2006

Calcium phosphate cement in musculoskeletal tumor surgery.

BACKGROUND AND OBJECTIVES: Calcium phosphate cement (CPC) is an injectable biocompatible bone substitute that has been used for various applications in orthopedic surgery. However, no extensive clinical studies of the use of CPC to fill bone cavities after curettage of musculoskeletal tumors have been reported. The present study reviewed the results for 56 musculoskeletal tumors treated by curettage and CPC implantation. METHODS: Assessment was based on clinical examination and radiographic findings. Variables for clinical assessment included pain, limb function, and complications. Median follow-up was 18.5 months (range 6-47 months). RESULTS: One patient experienced post-operative fractures. Three patients displayed local recurrence. One patient developed post-operative superficial wound infection, and two patients with large bony defect exhibited non-infectious serous discharge. No serious adverse effects such as deep venous thrombosis, pulmonary embolism were encountered. In all cases, CPC was radiographically well adapted to the surrounding host bone as of final follow-up. CONCLUSIONS: CPC appears to offer a useful bone substitute for the treatment of musculoskeletal tumors. As the follow-up period for this study was short, further long-term follow-up studies are needed.

Adolescent↗
PubMed2004

Validation of an instrument for patient handling assessment.

Nursing personnel are at high risk from work-related musculoskeletal disorders, especially back symptoms. Handling patients has been established as one of the factors playing an important role in the etiology of occupational low back pain. The aim of this study was to develop an instrument for patient handling assessment and to determine its validity and reliability. Instrument validity was established based on content and construct validity. Reliability was estimated through homogeneity, stability (test-retest) and equivalence (interrater) tests. Reliability estimated by internal consistency reached a Cronbach's Alpha coefficient of 0.81. Pearson's correlation coefficient for test-retest reliability was r = 0.92. There was an excellent agreement between observers, according to the k values (Kappa = 0.92). Interobserver (interrater) reliability was assessed by Pearson's correlation coefficient, reaching an r value of 0.84. The agreement between both observers was also fairly good (Kappa = 0.84). The results of the current study show that the instrument seems to be reliable and valid for patient handling assessment.

Back Injuries↗
PubMed2005

The Bath Adolescent Pain Questionnaire (BAPQ): development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents.

Chronic pain causes significant problems in the lives of many adolescents, considerably affecting their physical, psychological and social functioning. The assessment of the multidimensional impact of chronic pain is an essential clinical task. This study reports on the development and psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ); an assessment tool designed specifically for use with adolescents who experience chronic pain. A sample of 222 adolescents (11-18 years) experiencing chronic pain completed the 109-item draft inventory. Participants were recruited from two different UK clinics. All participants responded to items using a 5-point frequency scale. Psychometric evaluation of the data resulted in a reduced inventory length of 61 items. Internal consistency of all seven questionnaire subscales was established using Cronbach's alpha. Comparative validity was undertaken by comparison of all individual subscales with existing validated measures (SCAS, CDI-S, FDI, Brief FAM. PCS and CASAFS). The temporal reliability of each inventory subscale was established using a sub-sample of 30 adolescent participants over a 17-day period. Psychometric evaluation of the data suggests the inventory yields both a reliable and valid assessment of the impact of chronic pain on the lives of adolescents. The BAPQ may offer a comprehensive way to assess the widespread deleterious impact of adolescent chronic pain in both a research and clinical setting. Further investigation is needed on the predictive validity of the subscales. Additional data from samples of patients with diagnoses that are not musculoskeletal in origin would be of great assistance.

Adolescent↗
PubMed1992

Epidemiology of rheumatic diseases in rural and urban populations in Indonesia: a World Health Organisation International League Against Rheumatism COPCORD study, stage I, phase 2.

To determine the incidence of musculoskeletal pain, disabilities, and help seeking behaviour, a questionnaire was administered to a rural population of 2184 men and 2499 women and an urban population of 481 men and 590 women aged over 15 years by house to house interviews with completion rates of 95.2% (rural) and 97.1% (urban). The incidences of pain in the joints, back, or neck were 23.6% (rural) and 31.3% (urban). The incidence of disability due to an inability to walk, lift, carry, and dress was 2.8% (rural) and 0.9% (urban). The percentage of the population with pain who had to stop work owing to disability was 75% (rural) and 78% (urban). Official health care facilities were used by 62% (rural) and 71% (urban) of the population. Traditional health care was used by 87% (rural) and 89% (urban). The high percentage of subjects unable to work was due to a predominance of manual labour occupations (rural, 90%, urban, 80%). The age and sex specific incidence of rheumatic diseases in these populations were similar to other developing and developed countries. The primary rheumatology service was inadequate due to the low priority given by the health service to non-communicable diseases and inadequate rheumatology teaching of the primary health care doctors during undergraduate training. Musculoskeletal pain is a major public health problem in Indonesia and is still not fully appreciated.

Adolescent↗
PubMed2004

[Work ability of subjects with chronic musculoskeletal disorders].

OBJECTIVE: To evaluate the impact of personal, clinical, and occupational aspects on work ability of workers with and without work-related musculoskeletal disorders using the Work Ability Index. METHODS: There were participating 127 workers of industrial production lines of a medium-size multinational company. An approved version of the Work Ability Index, a questionnaire developed by Finland's Institute of Occupational Health, was used. Pain scale was also applied. A descriptive analysis was carried out using the Chi-square test and it was also performed a logistic regression analysis. RESULTS: A significant association was identified between the Work Ability Index and all personal, clinical and occupational aspects. Regression analysis showed that pain and sick leave together accounted for 59% of poor work ability. CONCLUSIONS: Different levels of pain severity were associated with distinct as well as equivalent levels of work ability loss. The results suggest that either pain reports were consistent or being both pain and work ability self-reported they therefore reflect the same perception mechanisms. Future studies might contribute to further understanding the trends found.

Adult↗