Harms and benefits of screening to prevent cervical cancer.
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Adult↗
Biomedical subjects
Peter A Smith
Publications and source records attributed to Peter A Smith.
Rectus femoris transfer for children with cerebral palsy: long-term outcome.
The purpose of this study was to evaluate the long-term results of rectus femoris transfer in cerebral palsy children with stiff-knee gait. Thirty-eight affected limbs in 24 children were evaluated preoperatively and 1 year postoperatively by gait analysis, with 26 limbs in 18 patients having final study, averaging 4.6 years postoperatively. Functional ambulatory status was evaluated based on Hoffer's criteria on ambulation. There were statistically significant improvements of 9.8 degrees in maximum swing-phase knee flexion and 7.0 degrees in total range of knee motion at 1 year, with a small loss of knee extension in stance. At final gait analysis, the improvement in the swing-phase knee flexion was maintained, but improvement in total range of knee motion was decreased. There were no significant changes in temporal parameters. Improvement in swing-phase knee flexion and foot clearance after rectus femoris transfer was associated with loss of knee extension at long-term follow-up. Hamstring lengthening in patients who develop excessive stance-phase knee flexion may be necessary.
Adolescent↗
Neuropathic pain: drug targets for current and future interventions.
Nociceptive pain alerts the body to potential or actual tissue damage. By contrast, neuropathic pain, which results from injury or damage to the nervous system, persists long after all signs of the original injury have disappeared. This type of maladaptive pain presents a significant clinical problem, as it responds poorly or unpredictably to classical analgesics. There is also no single, uniformly well-tolerated drug that is reliably helpful. Current understanding of the etiology of neuropathic pain reveals seven potential targets for therapeutic intervention. These are: 1) ectopic activity in damaged peripheral nerves; 2) increased excitability in spinal dorsal horn neurons; 3) restoration or augmentation of GABAergic inhibition in the dorsal horn; 4) supraspinal and affective mechanisms; 5) alterations in the sympathetic nervous system; 6) spinal peptidergic mechanisms; and 7) spinal excitatory amino acid receptors. Current therapeutic approaches, using drugs such as gabapentin, anticonvulsants, ketamine or methadone, and potential new approaches are discussed in the context of these seven drug targets.
Chronic Disease↗