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Biomedical subjects

C M Crawford

Publications and source records attributed to C M Crawford.

10 recordsLinked to original sources
PubMed2006

Relationship between indoor and outdoor bio-aerosols collected with a button inhalable aerosol sampler in urban homes.

This field study investigated the relationship between indoor and outdoor concentrations of airborne actinomycetes, fungal spores, and pollen. Air samples were collected for 24 h with a button inhalable aerosol sampler inside and outside of six single-family homes located in the Cincinnati area (overall, 15 pairs of samples were taken in each home). The measurements were conducted during three seasons - spring and fall 2004, and winter 2005. The concentration of culturable actinomycetes was mostly below the detection limit. The median indoor/outdoor ratio (I/O) for actinomycetes was the highest: 2.857. The indoor of fungal and pollen concentrations followed the outdoor concentrations while indoor levels were mostly lower than the outdoor ones. The I/O ratio of total fungal spores (median=0.345) in six homes was greater than that of pollen grains (median=0.025). The low I/O ratios obtained for pollen during the peak ambient pollination season (spring) suggest that only a small fraction penetrated from outdoor to indoor environment. This is attributed to the larger size of pollen grains. Higher indoor concentration levels and variability in the I/O ratio observed for airborne fungi may be associated with indoor sources and/or higher outdoor-to-indoor penetration of fungal spores compared to pollen grains. Practical Implication This study addresses the relationship between indoor and outdoor concentrations of three different types of bio-aerosols, namely actinomycetes, fungal spores, and pollen grains. The results show that actinomycetes are rare in indoor and outdoor air in Midwest, USA. Exposure to pollen occurs mainly in the outdoor air even during peak pollen season. Unexpectedly high fungal spore concentrations were measured outdoors during winter. The presented pilot database on the inhalable levels of indoor and outdoor bio-aerosols can help apportion and better characterize the inhalation exposure to these bio-aerosols. Furthermore, the data can be incorporated into existing models to quantify the penetration of biological particles into indoor environments from outdoors.

Actinomyces↗
PubMed1999

Management of acute lumbar disk herniation initially presenting as mechanical low back pain.

OBJECTIVE: To describe the clinical management with spinal manipulation of a male patient with risk factors for lumbar disk herniation initially suffering from what appeared to be mechanical low back pain that evolved into radiculopathy; also to review issues pertinent to chiropractic/manipulative management of disk herniation. CLINICAL FEATURES: The patient initially suffered from unilateral low back pain and nonradicular/nonlancinating referral to the ipsilateral lower extremity. INTERVENTION AND OUTCOME: Disk herniation-in-evolution was included in the differential diagnosis, which was discussed with the patient, who then gave verbal informed consent for manipulative management. A day or so after the initial manipulation the presentation evolved to include S1 radiculopathy. Computed tomography, just after onset of radiculopathy, confirmed the clinical diagnosis of lumbosacral disk herniation. The patient continued with manipulative management and repeat computed tomography examination after clinical resolution about 2 months later revealed reduction in size of the apparently clinically significant herniation. CONCLUSION: Risk factors for the development of disk herniation should be considered when assessing patients suffering from what appears to be mechanical low back pain. The role played by manipulation in the development of disk herniation in this case was believed to be circumstantial rather than causal. Manipulation was used in the treatment of this patient over a period of approximately 2 months; after this time, clinical and partial computed tomography imaging resolution was evident. Ongoing clinical (neurologic) evaluation of patients with manifest or suspected disk herniation is an important aspect of management. Good-quality trials of manipulation for patients with disk herniation are imperative for the chiropractic profession.

Acute Disease↗
PubMed1997

Shadows of the truth in patients with spinal pain: a review.

OBJECTIVE: Spinal pain with or without referred pain is a major and costly health problem that can arise from many anatomical structures. Sophisticated diagnostic imaging devices cannot show some of these structures, and frequently imaging provides only a shadow of the truth. This review illustrates how symptoms may well have an organic cause that is not detectable by current methods of examination, including imaging. METHOD: This study reviews some histopathological findings that can be associated with spinal pain with or without referred pain but cannot be seen on imaging. RESULT: Some histopathological changes illustrate imaging device limitations. CONCLUSION: Awareness of the considerable limitations of even sophisticated imaging devices is necessary when managing patients with acute or chronic spinal pain with or without referred pain. Symptoms may well be genuine and not of psychogenic origin: a diagnosis of malingering, therefore, should not be made lightly.

Adult↗
PubMed1989

Postburn heterotopic ossification: insights for management decision making.

An analysis of 1,478 consecutive admissions to the University of Kansas Burnett Burn Center revealed 18 patients who developed heterotopic ossification (1.2% incidence). Seventeen patients developed this disease in the elbows; one patient had shoulder involvement. Two patients eventually developed bilateral elbow disease. All patients initially presented with pain and limitation of joint motion. The diagnosis was then confirmed radiographically. All patients suspected of heterotopic ossification received physical therapy consisting of active range of motion only. Ten patients responded to conservative treatment and regained functional range of motion, and eight patients developed refractory ankylosis requiring surgical management. All surgically managed patients achieved a functional range of motion with an average followup of 35.0 months.

Adult↗
PubMedDate not supplied

Heterotopic ossification: are range of motion exercises contraindicated?

The incidence, time of onset, and role of exercise in the progression of heterotopic ossification were documented retrospectively in burn patients. In 12 of 1,066 patients (1.2%) consecutively admitted to a burn center, the abnormal bone formed posteriorly around the elbow joint. The initial signs were localized joint pain and rapid decrease in range of motion, and the average time of onset was 12 weeks after thermal injury. Prior to the diagnosis of heterotopic ossification, all patients were managed with an exercise program of active and active-assisted movements. In patients who persisted with passive and active-assisted range of motion, especially beyond the range of pain-free movements, the ossification progressed to complete ankylosis and required surgical intervention to remove the heterotopic bone. On the other hand, postoperative patients and patients who followed a program of active exercise within the pain-free range gained excellent range of motion. It was concluded that passive stretching of the periarticular structures during the acute phase of heterotopic bone formation is detrimental to the final outcome.

Adult↗
PubMedDate not supplied

Scheuermann's juvenile kyphosis.

OBJECTIVE: Two cases are discussed to illustrate two different presentations, progressions and treatments of Scheuermann's juvenile kyphosis. CLINICAL FEATURES: In one case, a 13-yr-old boy suffered from a 2-yr history of lower back pain. Radiographs demonstrated irregularity of the upper lumbar vertebral endplates, associated with Schmorl's nodes. The second case is one of a 14-yr-old boy who was seen in an orthopedic outpatient clinic. Radiographs revealed wedging of the anterior border of T6, T7, and T8 vertebrae with a thoracic spine kyphotic deformity measuring 72 degrees. INTERVENTION AND OUTCOME: The first case was treated conservatively. The patient maintained his improvement at 6 month follow-up. The second case was initially treated with a brace that the patient did not wear regularly as directed. The kyphotic deformity progressed from 72 degrees to 92 degrees. An operation was performed to reduce the kyphotic curve and prevent further progression. On review 6 yr later, the patient was well without back pain or other complications. The kyphotic curve measured 65 degrees. CONCLUSION: Scheuermann's juvenile kyphosis is a common spinal deformity in the adolescent. A radiographic appearance of wedging of the anterior portion of the vertebral bodies with marked kyphotic deformity suggests the diagnosis of classical Scheuermann's disease. However, the lumbar type of Scheuermann's disease should be considered in young patient with radiographic evidence of irregular vertebral endplates, Schmorl's nodes and a decreased disc space without wedging. Nevertheless, significant progression of the curve in both the typical and atypical types of Scheuermann's disease is rare, but can occur. An algorithm is presented to facilitate decision making in the management of Scheuermann's juvenile kyphosis.

Adolescent↗