ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Lower limb injuries are increasing in frequency as our population paticipates in sports and conditioning activities, even into old age. Older athletes suffer from overuse and degenerative conditions, while younger athletes have more contact sports injuries. Lower limb conditioning with quadriceps resistance in very old persons may result in less trauma and greater mobility, and should be considered for routine care of the very old.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

During the past year, investigations involving the etiology, diagnostic evaluation, and therapy of low back pain have reported interesting new data. The natural history of degenerative intervertebral disk disease may be explained by peripheral annular fiber injury that results in damage to the nucleus pulposus. Diurnal changes in patient clinical symptoms and signs may have a correlate in alteration of spinal mechanics that occurs during the course of a day. The diagnostic evaluation of low back pain continues to be revolutionized by magnetic resonance imaging. Although magnetic resonance imaging is able to detect specific lesions with greater sensitivity than other radiographic techniques, correlation between clinical symptoms and signs and anatomic abnormalities is essential for correct diagnosis. Therapeutic controversies continue concerning the efficacy of chiropractic intervention and transcutaneous electric nerve stimulation for low back pain patients. Microsurgical techniques for disk removal may prove to be associated with less morbidity than diskectomy with laminectomy, but require additional study.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The cervical spine has long been an area in which the assumption is made that no undescribed anatomy and physiology will be forthcoming. Herein described are cervical anatomy and physiology that have not been reported, as well as anatomy that has been extensively described but does not exist. Fresh research needs to be done on the distinctive and poorly understood characteristics of the autonomic nervous system in the cervical spine. Included in research reports are evidence of herniation of intradiscal gas; efficacy of early mobilization of patients with long-standing neck pain; successful surgical treatment relieving severe hemicranial migraine attack; and the use of magnetic resonance imaging in thoracic disk herniation, permitting precise localization and determination of the magnitude of cord compression.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Physiologically, peripheral nerve entrapments show focal slowing, and histologically, segmental demyelination and remyelination occur. Entrapment neuropathies result from direct mechanical injury (eg, chronic low pressure or friction in the carpal tunnel syndrome). Compartment syndromes occur when locally increased pressure within a closed muscle compartment compromises local circulation and neuromuscular function. Perioperative nerve lesions result from acute trauma to susceptible individual nerves during surgical procedures. Overuse syndromes belong to the broad clinical group of repetitive strain disorders, and are injuries caused by cumulative effects on tissues of repetitive physical stress that exceeds physiologic limits (eg, occupation-related focal nerve compressions in certain musicians). Current utilization of neurophysiologic electrodiagnostic studies and neuroimaging technology, such as magnetic resonance imaging, facilitates diagnosis and appropriate therapy in many of the disorders mentioned in this paper.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Shoulder pain has become one of the commonest clinical problems in modern North American society. The pathogenetic mechanisms vary widely, and often times, speculations about the underlying pathology have not been substantiated by investigative studies. In the past year, progress in our knowledge about shoulder pain has not been significant. We discuss the topic by dividing shoulder pain into four categories: 1) shoulder pain of local origin; 2) pain referred to the shoulder; 3) shoulder and neck pain; and 4) shoulder pain and reflex sympathetic dystrophy. It appears that a thorough history taking, an understanding of the psychosocial background of the patient, and a complete physical are equally important in the clinical evaluation of painful shoulders.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

There continues to be an emerging body of literature related to fibromyalgia and the related conditions chronic fatigue syndrome and myofascial pain. During the past year, the most notable contributions included a large multicenter study providing new diagnostic criteria for the classification of fibromyalgia and clinical studies describing the overlap of fibromyalgia, chronic fatigue syndrome, and myofascial pain. Pathophysiologic studies were often preliminary and uncontrolled but the focus of these studies on abnormal nociception, neurohormones, and muscle metabolism provides an exciting hypothesis to unify pain, fatigue, and sleep disturbances, the primary symptoms of fibromyalgia. Unfortunately, new therapeutic trials were neither innovative nor especially encouraging.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This review concentrates on certain areas of current interest in the major rheumatic diseases. In rheumatoid arthritis, there is some epidemiologic evidence that the disease is diminishing in incidence and severity. The possible protective effect on rheumatoid arthritis of the oral contraceptive pill has also attracted attention. There is some evidence that it may act by modifying the disease process. Parity may also be a protective factor in rheumatoid arthritis. Recent twin studies have suggested that the monozygotic concordance rate may be lower than previously believed, suggesting that genetic factors may only account for 20% of the disease. In osteoarthritis, new clinical criteria for the hand, knee, and hip have appeared that require further testing. The finding of a specific mutation of one amino acid of a procollagen II gene in family members with premature osteoarthritis has aroused considerable interest. There has been recent debate on the risk of developing ankylosing spondylitis in the population with HLA B27, although most believe this to be less than 7%. Scleroderma is a rare disease that may be increasing in incidence. One study has suggested the clustering of cases around airports. In the majority of countries, osteoporotic fractures appear to have increased at all ages over the last 30 years, although methods of screening using questionnaires or single bone density measurements are unlikely to be useful as widespread public health measures. The question of estrogen use is increasingly being dominated by the large cardiovascular benefit.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID