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Biomedical subjects

C R Cramer

Publications and source records attributed to C R Cramer.

6 recordsLinked to original sources
PubMed1999

A reconditioning program to lower the recurrence rate of brachial plexus neurapraxia in collegiate football players.

OBJECTIVE: To present clinical techniques for managing class I brachial plexus neurapraxia (BPN) in collegiate football players. BACKGROUND: During a football career, up to 50% of college football players develop BPN. It is difficult to return the player to practice and competition without many recurrences during the same season. Postseason reconditioning programs may improve the outcome by allowing the injured nerves a chance to heal adequately. Flexibility and strength of the neck and shoulder girdle are the focus of this proposed postseason BPN reconditioning program. This clinical technique is designed to reduce or eliminate inflammation, weakness, and hypomobility that contribute to reinjury of the brachial plexus and the resulting class I BPN. DESCRIPTION: After the football season, the team physician performs a mandatory follow-up examination. Any pathology that may be exacerbated is ruled out before beginning this program. Conservative management is prescribed during the first 4 weeks postseason. Then an 8-week period of aggressive reconditioning is initiated. Players begin manual resistance and Nautilus neck machine exercises 3 times per week. A cervical spine mobilization and modified shoulder resistance program is performed 2 days per week. Subsequently, players proceed with modification of the general neck and shoulder program used by the rest of the squad. Shoulder pad and neck orthoses selection should be reviewed to ensure that the best protection against reinjury is used when the athlete returns to play. To minimize any chance of recurrence, a progressive pattern of gradually increasing collision work is employed after the athlete is cleared by the physician. CLINICAL ADVANTAGES: Postseason observation of players after 1 year should reveal decreased recurrence of brachial plexus injury. The reconditioning program format, together with protective equipment considerations, may have a significant effect in reducing or eliminating the recurrence of BPN in football players.

Journal Article↗
PubMed1998

Fibromyalgia and chronic fatigue syndrome: an update for athletic trainers.

OBJECTIVE: Primary fibromyalgia syndrome (PFS) and chronic fatigue syndrome (CFS) are clinical conditions characterized by a variety of symptoms, including prominent fatigue, myalgia, and sleep disturbances. Although the incidence of these syndromes is infrequent, when manifested, they can completely disrupt the life and career of those affected. When they are manifested within the physically active population, they can jeoardize the futures of the most promising athletes. DATA SOURCES: Public documents available from the U. S. Department of Health and Human Services, Public Health Services, and the National Institutes of Health were researched. MEDLINE and CINAHL were researched back to 1988 with the following key words: chronic fatigue syndrome, primary fibromyalgia syndrome, sports participant, physically active, mononucleosis, myalgia, rehabilitation, reconditioning, athlete, and sports medicine. DATA SYNTHESIS: The definition of CFS in 1988 included disabling fatigue of unknown case of at least 6 months' duration. Primary fibromyalgia syndrome was once considered a subsyndrome of CFS. PFS is diagnostically characterized as a nonarticular rheumatism. The "yuppie flu" was a catch phrase of the 1980s for CFS, which was then named chronic Epstein-Barr virus syndrome. Initially the condition was thought of as simple infectious mononucleosis, but we now have a medically defined set of symptoms to describe what are called CFS and PFS. Training interruptions, feelings of loss of control, and concerns over possible psychologic or psychiatric referral can occur. Relaxation therapy, exercise, image therapy, serotonin supplementation, and antiviral therapy are in clinical trials now as the best options for management of CFS and PFS. CONCLUSIONS/RECOMMENDATIONS: Current statistics on those affected by CFS and PFS in the general population are less than 2% for CFS and 2% for PFS. Comprehensive documentation of signs, symptoms, and complaints, along with judicious physician follow-up, are important during the course of treatment leading up to and following a diagnosis of CFS or PFS. Professional evaluation of the affected player's neuropsychological status is important and necessary as a care plan is developed.

Journal Article↗
PubMed1983

Chronic interstitial nephritis associated with gold therapy.

A patient suffered chronic interstitial nephritis after receiving large quantities of gold salts for rheumatoid arthritis. Gold deposits were seen with transmission electron microscopy and confirmed by microprobe x-ray analysis both within renal tubular epithelial cells and interstitial macrophages and free within the renal interstitium. Clinical resolution of renal failure followed discontinuation of therapy with gold salts. Probable mechanisms of injury to renal tubular epithelial cells include uptake of gold by tubular epithelial cells and incorporation of gold into mitochondria, with subsequent cellular injury; interstitial deposits probably occur after necrosis of tubular epithelial cells, with release of gold into the interstitium and resultant inflammation. Thus, chronic interstitial nephritis can be added to the patterns of renal injury seen after gold therapy for rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1983

Recurrent oriental cholangiohepatitis.

The cases of two patients with recurrent oriental cholangiohepatitis are discussed. This syndrome, which has hitherto been rarely encountered in the Western hemisphere, may be seen with increasing frequency because of the influx of immigrants from southeast Asia. Patients typically present with symptoms of recurrent cholangitis. Findings at operation consist of primary bile duct stones associated with intrahepatic and extrahepatic ductal strictures. Surgical therapy is internal biliary bypass to prevent recurrent bile duct obstruction from stones. Even with such treatment, recurrence of cholangitis is common.

Adult↗