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PubMed1978

Factors influencing manual muscle tests in physical therapy.

To determine whether it is the amount or the duration of the force applied manually by the tester, or both, that determines the tester's perception of the strength of the hip flexor or abductor muscles, an electromechanical device was designed which was placed between the tester's hand and the subject's limb. With the device we measured the force applied to the limb, the time interval during which it was applied, and the angular position of the limb during the entire test. In 240 such tests, the testers' ratings of the differences in strength between the right and left sides were correlated with seven variables involving force and time. It was found statistically that the impluse--that is, the duration of the tester's effort multiplied by the average applied force during each test--was the factor that most influenced the tester in the ratings.

Adolescent↗
PubMed2026

Adding Rib Mobilization to Diaphragm Release Techniques in Patients With Non-Specific Neck Pain: Randomized Controlled Trial.

BACKGROUND: Non-specific neck pain (NSNP) is a frequent issue that can negatively affect both mobility and function. Recently, there has been growing interest in newer therapeutic approaches, including rib mobilization and diaphragm release techniques, as potential ways to address NSNP and support better outcomes for those affected. PURPOSE: To find out the immediate effects of how (DRT) combined with (RMT) affects the level of pain and the extent to which patients' functional abilities are improved in cases of NSNP. METHODS: For this prospective RCT, 96 participants aged 20 to 45 years were randomly assigned to one of three equal groups based on their pain score (VAS). Group B engaged in (DRT) for 40 minutes, three times weekly for 8 weeks, in contrast to Group A, which got both RMT combined with DRT. Group C (active control) received advice and some exercises. Measurements were collected before and after the intervention; the primary outcomes included pain severity, evaluated using a visual analog scale (VAS); active neck range of motion (ROM), measured with a cervical range of motion (CROM) device; and neck flexion endurance. Additionally, the secondary outcome of neck-related disability was assessed using the Neck Disability Index (NDI). RESULTS: No statistically significant difference was identified among the three groups at baseline; nevertheless, a treatment effect emerged after 8 weeks (p = 0.001 and f-value = 4.15, ƞ2 = 0.306). A statistically significant time-treatment interaction was seen when comparing the pre- and post-treatment periods in groups A and B (p = 0.001, f-value = 3.16, ƞ2 = 0.251). CONCLUSION: The addition of rib mobilization to diaphragm release techniques in patients with non-specific neck pain resulted in statistically significant improvements in pain intensity, cervical flexion, right lateral rotation, left lateral rotation, right rotation, and neck flexor endurance, with moderate to large effect sizes for pain reduction and cervical motion. However, no statistically significant differences were observed between groups for cervical extension, left rotation, or the Neck Disability Index (NDI), and only a marginal clinical improvement in NDI was noted in Group A. The observed benefits in the combined intervention group may not be attributable solely to rib mobilization. The increased treatment complexity and greater therapist interaction inherent in the combined approach could also have influenced the outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT07133646.

Humans↗
PubMed1979

Competency: the what, why, and how of it.

Competency is a frequently used term in the physical therapy profession, but many physical therapists are unclear about its definition and its meaning in professional activity. This article describes the operational definition of competency as used in the practice of physical therapy by members of the Association; describes the development of the manual, Competencies in Physical Therapy: An Analysis of Practice; offers direction in possible uses of the manual; and suggests future uses for the manual in Association activity.

Clinical Competence↗
PubMed1977

[Encephalic syndrome following trauma of the cervical vertebrae in childhood].

The author, by explaining and taking the "encephalic syndrome", which was first described in 1949 by Bärtschi and Rochaix, as a base, gives a detailed description of a corresponding syndrome for the age of childhood. After discussing the clinical symptomatology, course of disease, etiology, and pathogenesis, he describes the method of differential diagnosis that allows a clear distinction to be made between the encephalic syndrome and commotio cerebri and commotio spinalis. From a stock of 50 patients with vertebragenic headache it was possible to isolate 5 cases with encephalic syndromes due to cervical vertebral column traumata. The actual number of such cases would doubtless be much higher if it would be possible for pediatric neurologists to examine all cases of craniocerebral traumata in children. The clinical characteristic - according to anamnestic, actual clinical, and catamnestic findings - was a chronical and progressive symptomatology of headache after the disappearance of symptoms of commotion with resistance to therapy with conservative agents since this is a vertebragenic type of headache ("cervical migraine") caused by either a blockade of the upper cephalic joints or insufficiency of ligaments. The necessity of establishing a specific diagnosis arises from the fact that this allows the ailment to be treated by methods of manual and physical therapy, relieving both mother and child from the diagnosis of damage to the brain, which is highly disadvantageous to them from a social prognosis point of view.

Brain Concussion↗
PubMed2025

Machine learning-based analysis of the impact of 5' untranslated region on protein expression.

The 5' untranslated region (5'UTR) plays a crucial regulatory role in messenger RNA (mRNA), with modified 5'UTRs extensively utilized in vaccine production, gene therapy, etc. Nevertheless, manually optimizing 5'UTRs may encounter difficulties in balancing the effects of various cis-elements. Consequently, multiple 5'UTR libraries have been created, and machine learning models have been employed to analyze and predict translation efficiency (TE) and protein expression, providing insights into critical regulatory features. On the one hand, these screening libraries, based on TE and mean ribosome load, struggle to accurately quantify protein expression; on the other hand, a precise method for quantifying 5'UTRs necessitates a significantly costlier library. To resolve this dilemma, we constructed a library utilizing firefly luciferase as the reporter to measure accurate protein expression. In addition, we optimized the library construction method by clustering mRNA sequences to reduce redundant data and minimize the size of the dataset. This dual strategy by increasing accuracy and reducing dataset size was found to be effective in predicting the 5'UTRs from the PC3 cell line.

5' Untranslated Regions↗
PubMed1979

[Iatrogenic damage to the nervous system].

A survey is given of the most important findings in respect of iatrogenic damage to the nervous system on the basis of published reports and the author's own findings, taking special account of lumbar puncture and suboccipital puncture, myelography, contrast-medium encephalography, ventriculography and cerebral angiography. The possibility of damage such as the danger of embolism in diagnostic and therapeutic vascular puncture is referred to. Among the lesions caused in the course of therapy, the side-effects of treatment with drugs, effects of radiation, effects resulting from anesthesia, sequelae of neural therapy and of manual manipulations, sequelae of operations, and postvaccinal encephalopathies are discussed. The necessity of systematic morphological examinations for exact assessment of ioatrogenic lesions is stressed. Iatrogenic damage due to neglect of diagnostic and therapeutic measures is also considered.

Anesthesia↗
PubMed1979

Teaching autistic children to use sign language: some research issues.

Three questions are raised with respect to the use of sign language as an alternative system of communication for nonverbal autistic children. First, does teaching a child to sign facilitate speech development? The data suggest that following simultaneous communication training, mute children are not likely to learn to talk; however, a combination of simultaneous communication training and separate vocal training may have a synergetic effect on speech development. In contrast, children who initially have good verbal imitation skills apparently show gains in speech following simultaneous communication training alone. Second, what is the upper limit of sign acquisition? Data suggest that abstract concepts, syntax, and generative skills can be taught. Procedures used in the operant conditioning of speech may prove useful in training complex signing skills. Third, does sign acquisition result in a general improvement in adaptive functioning? It appears that following sign training, some children do show increases in spontaneous communication, decreases in self-stimulatory behavior, and improvement in social skills. However, these outcomes are often difficult to interpret. Some data are described that help clarify the relationship between sign training and general behavioral improvement.

Adaptation, Psychological↗
PubMedDate not supplied

Analysis of a manual calculation technique for isocentric dose determination.

A method is presented for manual calculation of the dose to points off the central ray for isocentric radiation therapy. A simplified technique for manual calculation is derived from a more general formula used in the computer dosimetry program developed by Sloan-Kettering Memorial Hospital in New York. The manual method assumes certain variables in the general case to be constant. The technique is evaluated by comparing its results to those of the computer program in three hypothetical examples.

Algorithms↗
PubMedDate not supplied

Clotting, activated partial thromboplastin and coagulation times in monitoring heparin therapy.

The automated-activated coagulation time, manual-activated coagulation time and the activated partial thromboplastin time were compared to the whole blood clotting time in the measurement of hypocoagulation of heparinized blood. The normal ranges and degree of reproducibility were determined for each clotting assay. Each method was examined for its sensitivity to various concentrations of heparin. In addition, blood samples from patients treated with heparin were assayed by all four methods and their results were compared. The results indicated that the manual-activated clotting time correlated best with the whole blood clotting time, was sensitive to low concentrations of heparin, formed a discernible clot within a convenient time period in blood containing high concentrations of heparin, was reproducible and was easily performed.

Blood Coagulation Disorders↗
PubMed1977

Treatment of chronic salmonella carriers. Study with 40 cases of S. typhi, 19 cases of S. paratyphi b and 28 cases of S. enteritidis strains.

The present stage of our studies suggests that, provided a highly effective combined therapy is, and can be, carried out correctly, all excreters can be cured of their chronic carrier state by chemotherapy within 8-12 weeks. Although we cannot recommend a universal therapeutic regimen for all patients, a highly effective 'basic therapy' (RMP+TSP) is available for the majority of the cases, needing occasional modification, depending on the specific requirements of the individual patient as shown by the result of the serum activity determination. This method saves the patient from toxic inconveniences caused by inadequate treatment, it shortens the treatment time and makes cholecystectomy superfluous - unless it is considered necessary out of a different indication in which case it should certainly be done. We cannot share the often expressed view that Salmonella enteritidis excreters cannot be cured, a view which is found even in the most recent manuals. The same applies to the view that therapy is not necessary because it would delay cure. It is indispensable to establish a close cooperation between the public health authorities and the private physician, and we therefore wish to sincerely thank all colleagues and Public Health Officers for their collaboration.

Adolescent↗
PubMed1979

[H.R.P.-System 2000: a new universally applicable ventilation system for single or limited multiple use with high bacteriologic-hygienical safety (author's transl)].

A new bacteriologically safe system for artificial respiration, H.R.P.-System 2000, is presented. Only two different SETS for artificial respiration of prematures, newborns and infants (P.N.J.) and adults, children and todlers (A.T.) are necessary. They can be adapted very easily on different types of respirators. Besides the tubing and expiratory valve the H.R.P.-SETS include a highly efficient electronically controlled humidifier working on the principle of gas bubbling through a heated water bath, a special tracheal tube adapter with an automatic water exhaust and flexible gas-reservoir for manual ventilation as well as C.P.A.P. or I.M.V. therapy. The H.R.P.-SETS are available as steril disposables. Resterilisation with gas on several occasions is possible. In a control study on thirty children, mainly premature infants and newborns a conventional SET, similar to the Bennett respiration system with disposable tubing and the H.R.P.-SETS are compared under the conditions of our intensive care unit. Using the criteria of serial bacteriological examinations of the tracheo-bronchial secretions and clinical criteria, H.R.P.-SETS proved superior. Artificial respiration without bacterial contamination by hospital strains for more than 10--14 days seems to be possible as a routine in newborns and children.

Adult↗
PubMed1976

Steroid myopathy in connective tissue disease.

In eight women with polymyositis (three patients), systemic lupus erythematosus (SLE) (three patients), rheumatoid arthritis (one patient) and shoulder-hand syndrome (one patient), weakness developed during high dose prednisone therapy. These women were studied using serial functional and manual muscle tests, determination of serum glutamic oxaloacetic transminase (SGOT), creatine phosphokinase (CPK) and serum aldolase levels, and urinary excretion of creatine. Insidious onset of weakness was characteristic. Myalgias were seen in five patients and unusual sudden weakness in two. Weakness was always most severe in the pelvic girdle muscles; there was a lesser involvement of shoulder girdle and distal muscles. Serum muscle enzyme levels were normal in all cases, but urinary creatine excretion was invariably increased and proved to be the most sensitive laboratory indicator for clinical diagnosis and for monitoring patient improvement. Serial urinary creatine excretion and serum enzyme studies were of value in differenting steroid myopathy from a flare of myositis in patients with connective tissue disease. Diagnosis and effective management were achieved by the use of readily available laboratory and clinical procedures without resorting to muscle biopsy.

Adolescent↗
PubMed1979

Principles of examination and treatment in manual medicine.

Manual medicine is a diagnostic and therapeutic technique, comprising the use of the hands. It is a complement to general medical diagnosis and therapy of the locomotor system, underlining the value of the information which can be obtained by manual contact with the patient. Particularly the physician's work within manual medicine will be discussed. Some general medical principles are looked upon as obvious: The physician's general responsibility, the necessity of a correct diagnosis, prescription of correct medication or surgery, organization of rehabilitation and evaluation of work capacity.

Contracture↗
PubMed2026

Relationships between cannabis and cocaine use in a randomized trial of combined buprenorphine and naltrexone for DSM-IV cocaine dependence.

BACKGROUND: Cannabis is the most commonly used drug in the United States, and among people who use cannabis, polysubstance use is common and understudied. We aimed to examine the association of tetrahydrocannabinol (THC) positive urine drug screen (+UDS) with the odds of submitting a cocaine + UDS during cocaine use disorder treatment. METHODS: We conducted a secondary data analysis of a previously reported double-blind, placebo-controlled clinical trial, CTN0048. Participants meeting criteria for opioid abuse/dependence were assigned to receive extended-release naltrexone and one of three conditions of buprenorphine (placebo, 4 mg/day, 16 mg/day) for 8 weeks. Generalized estimating equations (GEE) were used to analyze urine samples (Liu et al., 2018) collected over time, examining the association between THC + UDS and cocaine + UDS during treatment. RESULTS: Participants (n = 301) averaged 46 (SD = 8.64) years of age, were majority male (78.41 %), non-Hispanic (89.70 %), and African American (66.45 %). GEE results indicated that patients who submitted THC + UDS had significantly higher odds of submitting cocaine + UDS compared to participants who submitted THC-negative UDS across the 25 time points examined (OR = 1.47, 95 % CI = 1.21-1.79, p = 0.00). Time (OR = 0.9998, 95 % CI: 0.9997, 0.9999, p = 0.018) and the covariate of sex assigned at birth (OR = 1.77, 95 % CI = 1.13-2.77, p = 0.013) were also significant in the model, indicating very small decreases in the odds of submitting a cocaine + UDS over time for all patients and 77 % higher odds of submitting cocaine + UDS for females. CONCLUSION: THC + UDS was associated with increased odds of submitting a cocaine + UDS during treatment. Further investigation is needed to discern whether decreasing THC use will result in reduced cocaine use; however, these results suggest that it may be beneficial to counsel patients on cannabis use cessation both before and during treatment for cocaine use, as it is related to cocaine use treatment outcomes. TRIAL REGISTRATION: Secondary data analysis of ClinicalTrials.gov, TRN: NCT01402492 ("A randomized study to test the safety and effectiveness of buprenorphine in the presence of naltrexone for the treatment of cocaine dependence"; National Drug Abuse Treatment Clinical Trials Network (CTN) clinical trial: CTN0048), Registration date: 27 July 2011.

Humans↗