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Biomedical subjects

R P Sheon

Publications and source records attributed to R P Sheon.

At least 19 recordsLinked to original sources
PubMed1997

Repetitive strain injury. 1. An overview of the problem and the patients. The Goff Group.

Assembly-line workers, house painters, and many others whose activities entail repetitive motions can end up with swelling, pain, and limited movement in the affected muscles. Often, use of the six steps described in this article brings fairly rapid functional improvement and prevents recurrences, with a minimum of medical intervention. In some cases, though, recovery is prolonged or the outcome is unusual. The authors present additional factors to consider in such cases, such as psychosocial concerns, worker fraud, and ergonomic problems. Part 2 of this article, beginning on page 72, details six common repetitive strain injuries.

Cumulative Trauma Disorders↗
PubMed1997

Repetitive strain injury. 2. Diagnostic and treatment tips on six common problems. The Goff Group.

Repetitive strain injury is caused by recurrent overuse, resulting in microtrauma to tissues. Local pain and tenderness, weakness, inflammation, and limited function are common findings. Some of the strain injuries seen most often are carpal tunnel syndrome, trigger finger, shoulder impingement syndrome, tennis elbow, thoracic outlet syndrome, and myofascial pain disorders. Often, treatment can be started at the initial visit, after systemic disorders have been ruled out. A vital step is elimination of aggravating factors, such as improper posture, inadequate attention to ergonomic factors at work, and contributory habits (e.g., jaw or hand clenching). Use of simple joint-protection measures can alleviate much of the discomfort. Appropriate self-help strategies used at home may restore flexibility and strength with a minimum of medical intervention, but pain relief must be achieved before patients can be expected to follow through with rehabilitation efforts. Use of ice packs, massage, NSAIDs, or topical pain-relief agents is often helpful. Prompt, temporary pain relief can also be achieved with injection of a local anesthetic-corticosteroid mixture. Persistent disability should prompt consideration of psychosocial factors. In addition, fraudulent claims of disability do occur. Although physicians should make every effort to support legitimate claims of work-related injury, they should also be aware of the possibility that activities outside of work (e.g., sports participation, accidental injuries) may be contributing factors.

Adrenal Cortex Hormones↗
PubMed1992

Peripheral nerve entrapment, occupation-related syndromes, and sports injuries.

The use of magnetic resonance imaging to detect nerve entrapment disorders is described in this review as well as more basic clinical tests for the carpal tunnel syndrome. Overuse syndrome remains controversial. Symptoms may arise from overuse outside the workplace; prospective electrodiagnostic study of median nerve latency shows no difference between persons doing repetitive hand tasks and those applying for these jobs. Conditioning for young and old sports participants is reviewed as well as the injuries they suffer. Magnetic resonance imaging of asymptomatic knees reveals meniscus lesions more often than not.

Athletic Injuries↗
PubMed1991

Injuries of the lower extremity, painful lesions, compartment syndrome, and soft tissue calcification.

Lower limb injuries are increasing in frequency as our population participates 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.

Calcinosis↗
PubMed1990

Early-onset primary osteoarthritis and mild chondrodysplasia. Radiographic and pathologic studies with an analysis of cartilage proteoglycans.

Three generations of a nonconsanguineous family with premature onset of primary (idiopathic) osteoarthritis (OA) were studied for clues to the etiopathogenesis of their disorder. Articular symptoms began in their second and third decades of life and involved multiple joints, both typical and atypical for primary OA. Radiographs of the majority of involved peripheral joints showed abnormalities typical of primary OA. Evidence of chondrodysplasia was found in the spines. Pathologic examination of femoral heads obtained at total hip arthroplasty from 3 affected family members showed moderate to severe OA. Articular cartilage proteoglycans from these specimens were evaluated for aggregatability with hyaluronic acid, levels of chondroitin sulfate and keratan sulfate, and core protein structure. The results from each patient's specimen differed from the results of the other specimens. We conclude that this family's disorder, primary OA associated with a mild chondrodysplasia, was a late-onset overlap form of an epiphyseal dysplasia, that a defect common to hyaline articular and physeal cartilage was primary, and that a single structural proteoglycan abnormality was not likely to be the underlying cause.

Cartilage↗
PubMed1982

The incidence of malignant disease in patients receiving cytotoxic therapy for rheumatoid arthritis.

One hundred and twenty-six patients with definite or classical rheumatoid arthritis admitted to hospital between 1965 and 1974 for cytotoxic therapy were studied for the presence and type of malignant disease. Each of the cytotoxic treated patients was age and sex matched to a rheumatoid arthritis patient admitted to hospital during the same years but who did not receive cytotoxic therapy. There was no increase in malignancy in the cytotoxic treated group over the control group.

Acute Disease↗
PubMed1980

Regional soft tissue rheumatic pain syndromes: a common challenge in daily practice.

Soft tissue pain syndromes, problematic in themselves, may aggravate other underlying disorders. The physician who is familiar with the characteristic features of each of the many syndromes may more readily recognize them in practice. Treatment should be tailored to the individual and based on a home exercise program. Success of treatment corroborates the diagnosis and may prevent a state of chronic incapacitating pain.

Adult↗
PubMed1977

Malignancy in rheumatic disease: interrelationships.

Patients with inflammatory arthritis and malignancy comprise two distinct populations. One group represents the chance occurrence of malignancy and rheumatic disease. These patients have symmetric polyarthritis, chiefly classic rheumatoid arthritis, and react positively to the rheumatoid factor test. There is no temporal relationship between tumor onset and rheumatic disease onset. In the second group, there may be a causal relationship between the malignancy and the rheumatic disease. These patients have asymmetric rather than symmetric arthritis and test results are negative for rheumatoid factor. There is a close temporal relationship between the onset of the tumor and the onset of the rheumatic disease. The mortality rate is significantly higher than in patients with symmetric polyarthritis. In 80 percent of women with asymmetric arthritis and malignancy, the tumor is mammary carcinoma. This indicates the advisability of a careful breast examination in this group of women.

Adult↗
PubMed1975

Cell-mediated immunity in systemic lupus erythematosus: alterations with advancing age.

Cell-mediated immunity (CMI) was tested in young patients with systemic lupus erythematosus (SLE) (mean age 30.9 years), in elderly patients with SLE (mean age 70.8 years), and in young and elderly control subjects. Pre-existing CMI as evaluated by skin test response to PPD and mumps antigens and the response of peripheral blood lymphocytes in culture to the mitogen phytohemagglutinin was not significantly different in thefour groups. However, the mean area of induration to Candida antigen was significantly less in both groups of elderly patients, suggesting a diminution of CMI with advancing age. Elderly control subjects and elderly patients with SLE had a significant decrease in incidence and severity of skin-test response when sensitized with 2-4-dinitrochlorobenzene (DNCB), suggesting that the capacity to respond to a new antigen is impaired in the elderly, with and without SLE. Young SLE patients were easily sensitized to DNCB and developed strong skin-test responses to Candida antigen suggesting normal CMI in the young SLE group. SLE is a milder disease in the elderly. If, as seems likely, cell-mediated immune injury is of importance in the pathogenesis of SLE, then these data are consistent with the possibility that an altered state of CMI in the elderly modifies the clinical expression of SLE.

Adult↗