Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Musculoskeletal Development”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,585 records · Page 88Linked to original sources
PubMed2000

Field hospital treatment of blast wounds of the musculoskeletal system during the Yugoslav civil war.

The spectrum of wounding and treatment of forty-one patients with musculoskeletal blast injuries at a U.S. military field hospital in the former Yugoslavia was reviewed. Patients underwent wound exploration, irrigation, debridement, broad-spectrum antibiotic therapy, early fracture stabilization, and appropriate reconstructive surgery. Four patients developed wound infections. Two patients died as a result of their injuries (overall mortality 5 percent). There were three below-knee amputations and five other amputations (above-knee, ankle, midtarsal, partial forefoot, and finger). Three patients sustained lumbar burst fractures from mines that exploded under their vehicles, resulting in paraplegia in one case. Our patients underwent 112 surgical procedures, an average of 2.1 per patient. Twenty-two patients (54 percent) had other injuries or conditions in addition to their orthopaedic wounds. There were wide variations in the bone and soft tissue injuries caused by detonating ordnance, and the tissue damage was qualitatively different from that caused by gunshot wounds. Early debridement, leaving wounds open, and treatment with broad-spectrum antibiotics were important factors in wound healing to allow subsequent successful reconstructive surgery in an austere field setting.

Adult↗
PubMed2004

Community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children.

BACKGROUND: The clinical characteristics and virulence factors related to musculoskeletal infections caused by community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) in children are not well-defined. METHODS: In this retrospective study, the demographics, hospital course and outcome of children with musculoskeletal infections were reviewed from medical records and by contacting patients or their physicians. Antimicrobial susceptibilities were determined by disk diffusion. Polymerase chain reaction was performed to detect genes encoding for virulence factors. Mann-Whitney, chi2 and Kaplan-Meier tests were used for statistical analysis. RESULTS: Community-acquired MRSA and community-acquired methicillin-susceptible S. aureus (MSSA) caused musculoskeletal infections in 31 and 28 children, respectively. The median numbers of febrile days after start of therapy were 4 and 1 for MRSA and MSSA patients, respectively (P = 0.001). The median numbers of hospital days were 13 and 8 for the MRSA and MSSA groups, respectively (P = 0.014). At follow-up, 2 patients in the MRSA and 1 in the MSSA group had developed chronic osteomyelitis. pvl and fnbB genes were found in 87 and 90% versus 24 and 64% in the MRSA versus MSSA groups, respectively. (P = 0.00001 and 0.017). Ten patients with pvl-positive strains had complications versus no patients with pvl-negative isolates (P = 0.002). CONCLUSIONS: Febrile days and hospital days were greater in children with musculoskeletal infection caused by MRSA than in those affected by MSSA, but no significant differences were found in the final outcome. pvl and fnbB genes were more frequent in the MRSA than in the MSSA strains. The presence of the pvl gene may be related to an increased likelihood of complications in children with S. aureus musculoskeletal infections.

Adolescent↗
PubMed1996

A perspective on radiology residency curriculum guidelines: results of the 1995 survey of program directors.

RATIONALE AND OBJECTIVES: The development of curriculum guidelines for radiology residency has been found to be favored by 80% of program directors (PDs) nationwide. I surveyed PDs to develop a consensus of opinion concerning minimum training requirements in the subspecialty rotations. METHODS: A survey developed by members of the Ad Hoc Curriculum Committee of the Association of Program Directors in Radiology was mailed to all U.S. PDs. RESULTS: One hundred forty-one (82%) completed responses were received. There was agreement among the PDs about the minimum length of training needed in the various subspecialties. Seventy-four percent of the PDs supported the concept of developing educational objectives and goals in each subspecialty and of specifying procedures in which residents should be trained. Only a minority of PDs thought that the training guidelines should specify minimum numbers of procedures. CONCLUSION: The consensus of PDs is that the radiology residency curriculum should include a minimum of 3 months in each of the following categories: chest radiology, gastrointestinal radiology, musculoskeletal radiology, pediatric radiology, cardiovascular and interventional radiology, sonography, and body computed tomography (CT) scanning. In neuroradiology, inclusive of neuroangiography, neuro CT scanning, and neuro magnetic resonance (MR) imaging, a resident should spend 4 months. At least 2 months should be devoted to each of the following: uroradiology, mammography, body MR imaging, and emergency radiology. A majority of PDs also favored developing educational objectives for each of the subspecialty rotations.

Curriculum↗
PubMedDate not supplied

[Educational proposal focused on ergonomics as prevention tool against musculoskeletal injuries for the nursing staff].

Nursing staff is subject to lesions in the back due to ergonomic factors and inadequate posture. A specific educational proposal for nursing personnel was elaborated with the objective of helping to reduce these lesions. This study presents the development and topics of this educational strategy that was constructed from an analysis of the work environment and of the activities engaged in by this personnel. Themes relative to the anatomy and biomechanics of the vertebral column were presented, as well as general posture orientations, specific ergonomic aspects of nursing tasks and considerations about the movement and transportation of patients.

Back Pain↗
PubMed1992

IgG autoantibody to the collagen-like region of Clq in hypocomplementemic urticarial vasculitis syndrome, systemic lupus erythematosus, and 6 other musculoskeletal or rheumatic diseases.

We previously found that the Clq precipitin in sera from patients with hypocomplementemic urticarial vasculitis syndrome is an IgG autoantibody to Clq. We report here a prevalence study of this autoantibody in 162 patients with musculoskeletal or rheumatic diseases including hypocomplementemic urticarial vasculitis syndrome, systemic lupus erythematosus (SLE), and rheumatoid arthritis uncomplicated by vasculitis. The autoantibody, which binds only to the collagen-like region of Clq, was found almost exclusively in hypocomplementemic urticarial vasculitis syndrome (100%) and SLE (35%) sera. Our results support the idea that among rheumatic diseases, anti-Clq autoantibody develops in disorders characterized by immune complex mediated injury, particularly of cutaneous and glomerular microvasculature.

Alleles↗
PubMed1992

Idiopathic musculoskeletal pain syndromes in children.

Between 1982 and 1990, 81 children with localized or diffuse musculoskeletal pain, for which no cause could be found were seen in a pediatric rheumatology clinic. Forty-one children had localized idiopathic pain and 40 had diffuse idiopathic pain. Twenty-four of the patients with localized idiopathic pain fulfilled criteria for definite reflex neurovascular dystrophy. Thirty-five patients with diffuse idiopathic pain fulfilled criteria for fibromyalgia. Four patients with localized idiopathic pain (10%) developed diffuse idiopathic pain during followup; four patients with diffuse idiopathic pain (10%) had a history of localized idiopathic pain and one patient had previously been diagnosed as having Tietze's syndrome. Recurrences or persistence of pain was very common. Many children had potentially important stressors including single parent families, histories of sexual abuse, and learning difficulties. Idiopathic musculoskeletal pain is a common cause of referral to a pediatric rheumatology clinic and is often associated with significant morbidity.

Adolescent↗
PubMed2002

Complaints of the ageing male based on a representative community study.

OBJECTIVES: To determine (a) the relationship between physical and somatoform complaints, distress and life satisfaction and ageing in the male community and (b) their psychosocial determinants. METHODS: Two stratified random samples of the German male population (total of 2,182 men) were investigated by standardised questionnaires of complaints (MFI-20, GBB), distress (HADS) and life satisfaction. RESULTS: When participants were grouped into six age groups (18-30, 31-40, 41-50, 51-60, 61-70, >70 years), we found a continuous increase of physical, mental and general fatigue, and a reduced activity and motivation associated with age. Exhaustion, cardiovascular and musculoskeletal complaints also increased. This was accompanied by a reduced health satisfaction and increased depression scores. Marked increases of certain complaints occurred in specific age groups. CONCLUSIONS: Community data provide important reference points in evaluating the ageing male. Based on regression analyses we could also demonstrate the contribution of psychosocial vulnerability and protective factors to the development of age-related symptoms.

Activities of Daily Living↗
PubMed2002

The role of rehydration in the prevention of fat embolism syndrome.

We encountered three cases of young sportsmen developing fat embolism syndrome (FES) after sustaining isolated tibial shaft fractures whilst playing football. All fractures were treated with intra-medullary nails and all three patients were kept nil-by-mouth pre-operatively without intravenous fluids. Correction of shock is often quoted as an important factor in the prevention of FES. However, animal studies have shown that dehydration, as opposed to hypovolaemia, may also be of great importance. We therefore examined the specific gravity of the urine of 20 patients with musculoskeletal injuries sustained during sport. The mean urinary specific gravity was significantly higher than that of a control group of 10 members of staff. We emphasise the importance of adequate pre-operative rehydration, especially if injuries were sustained during heavy exercise, as this may reduce the risk of developing FES.

Adolescent↗
PubMed1999

Trisomy 2p syndrome: a fetus with anencephaly and postaxial polydactyly.

We report on a male fetus with partial trisomy 2p21-2pter and monosomy 15q26-15qter due to t(2,15)(p21;q26). This fetus had a typical trisomy 2p phenotype including minor facial anomalies, musculoskeletal defects and two unusual findings: polydactyly and anencephaly. The observation of anencephaly adds support to the theory that genetic material mapping to chromosome band 2p24 is involved in neural tube development. In addition, we propose that a gene on 2p23 may play a role in the morphogenetic patterning of hands and feet.

Abortion, Eugenic↗
PubMed2002

[Sports as a risk factor and therapeutic principle in dermatology].

Sporting activities may exert positive and negative health effects. This applies not only to the cardiovascular and musculoskeletal system, but also to skin. During sporting activities a person is exposed to environmental factors such as temperature, irradiation, and allergens. These factors may play a key role in the development of skin diseases. Mechanical trauma is caused by acute injury as well as chronic damage. Infectious skin diseases caused by viruses, bacteria or fungi can be transmitted by body contact or the use of communal showers or locker rooms. Intake of performance-enhancing substances may provoke skin changes such as striae distensae, androgenetic alopecia, hypertrichosis and acne. Preexisting skin diseases such as psoriasis, lichen planus, vitiligo, polymorphous light eruption, lupus erythematosus, porphyria, urticaria, and acne rosacea may be aggravated by sporting activities. On the other hand, physical exercise has a therapeutic potential which has hardly been exploited by dermatologists. Especially in chronic skin diseases positive effects have been observed. Therapeutic use of team sports has been shown to decrease suffering, depression, and emotional disturbances and increase life quality in patients with atopic eczema, psoriasis, and venous leg ulcers.

Combined Modality Therapy↗
PubMed2006

Designing ergonomic interventions for EMS workers - part II: lateral transfers.

The objective of the current work was to test ergonomic interventions aimed at reducing the low back musculoskeletal loads experienced by firefighters/paramedics (FFPs) providing emergency medical services (EMS) when performing lateral transfers between a bed and a stretcher or between a stretcher and a hospital gurney. The interventions, developed using focus groups, were a bridgeboard to reduce the frictional force resisting the lateral sliding of the patient, the use of rods along each side of the patient to facilitate the grasping and handling of the bedsheet on which the patient is typically transferred, and a single rod that, when rolled in the bedsheet, resulted in the task being changed from a lifting task to a pulling task. Eleven two-person teams laterally transferred a 75 kg dummy with each intervention between a bed and simulated stretcher. Two roles were defined. For the two-sided transfers, the FFP roles were termed "stretcher-side" and "bed-side." Surface electromyographic (EMG) data were collected from 8 trunk muscles from each participant along with spine kinematic data. Additionally, kinetic data were obtained for the FFP in the stretcher-side role. Trunk flexion moments and Erector Spinae activity were reduced for the FFP in the stretcher-side role when using the bridgeboard and the single rod both individually and in combination. The single rod reduced the Erector Spinae activity in the FFP who typically would have been on the bed. For FFPs in both roles the single rod increased Latissimus Dorsi activation relative to the standard bedsheet transfer condition, although, this effect was moderated when the single rod was used in combination with the bridgeboard. Ratings of perceived exertion also supported the use of the single rod relative to the corresponding control condition.

Abdominal Muscles↗
PubMed1997

Morbidity from abdominal radiotherapy in the First United Kingdom Children's Cancer Study Group Wilms' Tumour Study. United Kingdom Children's Cancer Study Group.

Between 1980 and 1986, 384 children were entered into the UKCCSG First Wilms' Tumour Study (UKW1). For 171 patients receiving abdominal radiotherapy (RT) the early and late toxicity has been analysed. Major early toxicity was significantly more likely with whole abdominal (48%) compared with flank (21%) RT (P = 0.007). An increased risk of major early toxicity, which did not reach statistical significance, was seen with right (20.5%) compared with left (7%) flank RT (P = 0.063) and in those treated with a RT dose of > 20 Gy compared with a dose of < or = 20 Gy (P = 0.103). There were 138 evaluable survivors, with a median follow-up of 127 months. Of these, 33 (23.9%) were reported to have late effects, including 27 musculoskeletal (19.6%), four gastrointestinal (2.9%), and three (of 68 girls) ovarian failure (4.4%). There was no apparent effect of age at diagnosis, RT dose or field size on the risk of developing late effects. The continued surveillance of the long term survivors of Wilms' tumour for the late effects of treatment will be important.

Abdomen↗
PubMed1997

Acute bone-marrow oedema in cyclosporin-treated renal transplant recipients.

Transient musculoskeletal pain may occur in renal transplant patients on cyclosporin (CyA). Of 28 consecutive patients transplanted in this unit between 20 January 1995 and 2 May 1996, eight (two published elsewhere) developed this problem. Before transplantation, three of the patients had received prednisone intermittently or continuously for 15, 5 and 2 years, for asthma, crescentic GN and SLE, respectively. All patients had normal hand radiographs prior to transplantation. Five developed acute rejection following transplantation requiring treatment with methylprednisolone; one also required OKT3 (7 days). Weight-bearing joints of the lower limbs became affected at 3-40 weeks (mean 14) following transplantation. MRI changes (T1-, T2-weighted and STIR images) were consistent with acute bone-marrow oedema. Bone scintigrams showed enhanced tracer uptake in affected joints. A spontaneous complete remission occurred in five patients within 4-16 weeks, and this was supported by serial imaging. The other patient underwent core decompression of the femoral heads with relief of symptoms, but MRI showed bilateral avascular necrosis (AVN) of the femoral heads. MRI proved useful in detecting acute bone-marrow oedema and its possible progression to AVN. The former may be either a distinct entity or a forerunner of AVN.

Adolescent↗
PubMed1999

A comprehensive and cost-effective preparticipation exam implemented on the World Wide Web.

Mandatory preparticipation examinations (PPE) are labor intensive, offer little routine health maintenance and are poor predictors of future injury or illness. Our objective was to develop a new PPE for the Stanford University varsity athletes that improved both quality of primary and preventive care and physician time efficiency. This PPE is based on the annual submission, by each athlete, of a comprehensive medical history questionnaire that is then summarized in a two-page report for the examining physician. The questionnaire was developed through a search of MEDLINE from 1966 to 1997, review of PPE from 11 other institutions, and discussion with two experts from each of seven main content areas: medical and musculoskeletal history, eating, menstrual and sleep disorders, stress and health risk behaviors. Content validity was assessed by 10 sports medicine physicians and four epidemiologists. It was then programmed for the World Wide Web (http:// www.stanford.edu/dept/sportsmed/). The questionnaire demonstrated a 97 +/- 2% sensitivity in detecting positive responses requiring physician attention. Sixteen physicians administered the 1997/98 PPE; using the summary reports, 15 found improvement in their ability to provide overall medical care including health issues beyond clearance; 13 noted a decrease in time needed for each athlete exam. Over 90% of athletes who used the web site found it "easy" or "moderately easy" to access and complete. Initial assessment of this new PPE format shows good athlete compliance, improved exam efficiency and a strong increase in subjective physician satisfaction with the quality of screening and medical care provided. The data indicate a need for improvement of routine health maintenance in this population. The database offers opportunities to study trends, risk factors, and results of interventions.

Adolescent↗
PubMed2005

Computer applications in clinical practice.

PURPOSE OF REVIEW: The prospects of improved practice efficiencies and better treatment outcomes have recently focused political attention at high levels upon the use of information technology (IT) in routine clinical care in the US, UK and elsewhere. Providers who treat musculoskeletal diseases need to become familiar with emerging governmental policies, IT industry trends, data standards and communication protocols to equip themselves with a basis on which to evaluate and influence the development of these technologies, which in turn will influence the shape of clinical practice. RECENT FINDINGS: The articles cited are categorized into the topics of government policy regarding electronic medical records (EMRs); data definitions and databases; computers in outpatient clinical encounters; EMRs; patient self-entry of historical data; computer physician order entry; personal digital assistants; and e-mail, the Internet, and the patient/physician encounter. SUMMARY: Government agencies in the US, UK, and elsewhere are at various stages in the implementation of national health information infrastructures. US officials are playing a greater role in prompting physicians to use EMRs and in setting standards for EMR systems. A study by the American College of Rheumatology observed, 'Increasing requirements for provider compliance with quality and outcomes reporting, HIPAA regulations, medical error reduction, including Medicare e-prescribing mandates, and downward pressure on practice revenues will ultimately drive the adoption of EMRs in office practice.' Nonuse will equate to a non-viable practice. Rheumatologists who would control their own destinies must acquaint themselves with, adopt, and exert influence on the development of these technologies with all deliberate speed.

Health Policy↗
PubMed2004

Wilms' tumor in a case with Möbius' syndrome associated with arthrogryposis and mega cisterna magna.

Möbius' syndrome is a rare congenital anomaly characterized by paralysis of the 7th and other cranial nerves and musculoskeletal abnormalities. We report a patient with Möbius' syndrome associated with arthrogryposis and mega cisterna magna in addition to the classic components of this syndrome. The case is interesting because she developed Wilms' tumor at 21 months of age. To our knowledge, this is the first case of this association reported in the literature.

Abnormalities, Multiple↗
PubMed1984

A zomepirac reaction mimicking ectopic pregnancy.

A case is presented of a 29-year old woman who developed sudden onset of abdominal pain, vomiting, near syncope, abdominal tenderness, profound hypotension, and a late menstrual period. The patient was in good health and her only medication was zomepirac for musculoskeletal discomfort. An exploratory mini-laparotomy was performed for the suspicion of a ruptured ectopic pregnancy, but no evidence of hemoperitoneum or of ectopic pregnancy was found. A subsequent pregnancy test was negative, and the episode was attributed to a zomepirac reaction. A review of zomepirac and zomepirac reactions is included.

Adult↗
PubMed1997

Allograft reconstruction of the acetabulum after resection of stage-IIB sarcoma. Intermediate-term results.

Seventeen consecutive patients were managed with an allograft reconstruction of the pelvis (including the acetabulum) following resection of a stage-IIB bone sarcoma during a twelve-year period. The initial diagnosis was chondrosarcoma in nine patients, osteosarcoma in six, Ewing sarcoma in one, and leiomyosarcoma in one. All patients who had osteosarcoma or Ewing sarcoma received chemotherapy preoperatively and postoperatively. Fifteen patients were managed with an allograft-total hip prosthesis composite. Two patients initially were managed with an osteoarticular allograft without a prosthesis, but one had a subsequent revision to an allograft-implant composite. Four patients died with an intact allograft reconstruction. Eight patients survived with an intact allograft reconstruction, and they were followed for at least four years (mean, seven years; maximum, fourteen years). All but one was able to walk in the community with one or two canes at the time of the latest follow-up. There was a high rate of local recurrence, which occurred in three of the seventeen patients, and of infection, which developed in two patients. The five patients had a subsequent hindquarter amputation or removal of the allograft. The mean functional score (and standard deviation), according to the rating system of the Musculoskeletal Tumor Society, was 65 +/- 21.16 per cent (median, 70 per cent; range, 13 to 87 per cent) for the thirteen patients who were thus evaluated. Preservation of the limb and reconstruction with an allograft may be considered as an alternative to hindquarter amputation in carefully selected patients who have a bone sarcoma involving the acetabulum. However, patients who have a high-grade bone sarcoma must be warned that there is a substantial risk of local recurrence or infection. In the present series, more than half of the patients either died or had failure of the reconstruction.

Acetabulum↗