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At least 721 records · Page 40Linked to original sources

PubMed1999

Mind, muscles and motoneurones.

This review considers some of the adaptations which take place in the central nervous system to allow optimal performance of the musculoskeletal system for the smallest to the largest "efforts". Mental imagery of exercise helps performance but the way in which it works is multifactional: it evokes muscle contraction sufficient to activate muscle receptors. Furthermore, it is possible for subjects to focus specifically on control of particular muscles even without feedback from them. On the other hand maximal voluntary efforts, at least in isometric and in concentric contractions, can drive the motoneurones sufficiently to ensure full force production by the muscle. Many neural factors contribute to maintain force output during repetitive activity, including a feedback loop whereby increased central command during fatigue acts to enhance muscle perfusion. As peripheral muscle fatigue develops, changes occur in the excitability of the motor cortex. Recent evidence suggests that "central" factors leading to reduced drive to muscles in isometric contractions act "upstream" of motor cortical output.

Biofeedback, Psychology↗

PubMed1992

[Transcatheter embolization of tumors of the muscular and skeletal systems].

The value of transcatheter embolisation of tumours of the musculoskeletal system is discussed on the basis of 26 cases. All procedures were performed following diagnostic angiography (DSA). By preoperative vascular occlusion it was possible to prevent major blood loss during surgery, provided the operation was carried out within three days of embolisation. Reduction in size of some large inoperable metastases before radio-iodine therapy is another indication for embolisation. As a palliative measure, vascular occlusion can be used for reducing otherwise untreatable skeletal pain and for the management of arteriovenous malformations. Bleeding from a tumour can be controlled by vascular occlusion. Our results indicate that transcatheter embolisation is an effective and reliable technique.

Adolescent↗

PubMed2025

Systematic meta-analysis of the toxicities and side effects of the targeted drug lenvatinib.

BACKGROUND: Lenvatinib, an effective targeted drug for various cancers, has clinical medication safety concerns due to its toxicities and side effects. OBJECTIVE: This study evaluated lenvatinib-induced any adverse events (any AEs) and nine aspects: vascular toxicities related to the circulatory system (vascular toxicities, blood system, and heart), toxicities of the skin and its appendages (skin/subcutaneous tissue and taste system), toxicities of the respiratory system (respiratory, thoracic, and mediastinal and respiratory tract), toxicities of the nervous system (nervous system and general), toxicities of the digestive system (gastrointestinal and liver), toxicities of the urinary system, toxicities of the endocrine and metabolic system (endocrine and metabolism/nutrition), toxicities of the musculoskeletal system, and other severe toxicities. Toxicities and side effects were stratified by severity into any and ≥3 grades for analysis. PATIENTS/MATERIALS AND METHODS: Multiple databases were searched for lenvatinib cancer clinical studies (cohort studies and randomized controlled trials) from inception to December 31, 2024; toxicity and side effect data were extracted and analyzed. RESULTS: Nine high-quality studies were included, showing that lenvatinib is effective in cancers but has notable toxicities. Taking hypertension as an example, for any grade, the risk ratio (RR) was 2.34 with a 95% confidence interval (CI) of [2.09, 2.62], a Z-value of 14.74, and a P-value <0.00001; for grade ≥3, the RR was 2.60 with a 95% CI of [2.21, 3.06], a Z-value of 11.44, and a P-value <0.00001. CONCLUSION: Lenvatinib is effective for cancer but toxic, and this study supports its rational clinical use.

Humans↗

PubMed1995

Role of NO mechanism in cardiovascular effects of diaspirin cross-linked hemoglobin in anesthetized rats.

The role of nitric oxide (NO) in the cardiovascular actions of diaspirin cross-linked hemoglobin (DCLHb) was studied in anesthetized rats. The regional circulatory and systemic hemodynamic effects of DCLHb (400 mg/kg iv) were studied using a radioactive microsphere technique in control (untreated) and L-arginine (a NO precursor) pretreated rats. DCLHb produced a significant increase in blood pressure (75%), cardiac output (42%), stroke volume (36%), and total peripheral resistance (45%), without affecting heart rate, when administered to control rats. L-Arginine pretreatment significantly attenuated DCLHb-induced systemic hemodynamic effects. DCLHb-induced increase in blood flow to the skin and spleen was completely blocked, and that to the heart was partially blocked, by L-arginine pretreatment, suggesting that cardiovascular actions induced by DCLHb could be antagonized by the NO precursor L-arginine. The NO synthase (NOS) inhibitor NG-nitro-L-arginine methyl ester (L-NAME) produced significant increases in regional vascular resistance, leading to a decrease in blood flow to all the organs except the heart, where an increase in blood flow and a decrease in vascular resistance was observed. DCLHb, when administered in L-NAME-pretreated rats, accentuated the decrease in blood flow to the gastrointestinal system, spleen, mesentery and pancreas, skin, and musculoskeletal system. These studies provide evidence that the NO precursor L-arginine can attenuate the effects of DCLHb and that DCLHb can potentiate the effect of the NOS inhibitor L-NAME. The role of NO in the mechanism of action of DCLHb was further studied by estimating plasma guanosine 3',5'-cyclic monophosphate (cGMP) in control, DCLHb-treated, L-NAME-treated, and L-NAME followed by DCLHb-treated rats. DCLHb and L-NAME significantly decreased the concentration of circulating cGMP in blood plasma. L-NAME pretreatment potentiated DCLHb-induced decrease in cGMP levels. Because the formation of cGMP is stimulated by NO, these studies provide additional evidence for the involvement of NO in the mechanism of action of DCLHb. It is concluded that NO plays an important role in the cardiovascular effects of DCLHb.

Animals↗

PubMedDate not supplied

Rhoads lecture--1988. Bulk or bounce--the object of nutritional support.

Wasting of muscle and a negative nitrogen balance are obvious effects of malnutrition, and have led to the use of anthropometric measurements and nitrogen balance for its assessment. A positive nitrogen balance and an increase in limb muscle circumference are believed to be solid indices of the beneficial effects of nutritional support. In experiments with growing rats and in young children, nitrogen retention and growth are recognized to be the desirable effects of optimal nutritional intake. This concept has been applied to malnourished adult humans (nongrowing) who have been considered potentially able to "regrow" the lost tissue. Although it is true that patients receiving long-term (greater than 6 months) home total parenteral nutrition (TPN), gain body weight and nitrogen over many months and years of observation, these processes are not seen during shorter (less than 40 days) periods of nutritional intervention given in hospital. Despite adequate intakes of nitrogen and calories, little or no significant increase in total body nitrogen is seen in a variety of patients receiving TPN in hospital over several weeks, but nutritional support does appear to improve outcome in the form of reduced complications after a period of support so short that body composition is barely altered. For example, Young and Hill showed that although amino acids and amino acids plus calories both resulted in equivalent sparing of body nitrogen, the latter was associated with quicker wound healing and fewer complications. Thus, the outcome and body composition data suggest that reversal of the adverse effects of malnutrition is not based on improvement of the traditional parameters of nutrition, such as gain in body nitrogen, or a demonstrable increase in muscle mass, or in plasma proteins. On the basis of the foregoing evidence, there are grounds for suspecting that functional abnormalities in adult humans may not be the result of simple loss of lean tissue and therefore may recover before such lean tissue is regained. This hypothesis is supported by the observation of Klidjian et al who showed that muscle force is a good measure of outcome. One of the major organ systems of the human body is the musculoskeletal system, and therefore it would seem important to determine the effect of malnutrition on that system. Previous studies of muscle function have been largely related to the examination of fatigue, myopathy, and endocrine-metabolic abnormalities. Subsequently we undertook initial studies of muscle function in very malnourished patients as outlined below.

Animals↗

PubMed1983

Angiotensin-converting enzyme in sarcoid perivasculitis.

A young woman was treated with topical and oral steroids for sarcoidosis manifested by systemic symptoms, involvement of the respiratory and musculoskeletal systems, and anterior uveitis. Her symptoms, ocular findings, pulmonary function, and serum angiotensin-converting enzyme level all improved in response to therapy. After tapering the steroid dosage retinal perivasculitis developed associated with a small but significant elevation of the serum angiotensin-converting enzyme level. Increasing the dosage of oral steroids resulted in prompt resolution of her retinal findings but no change in the level of the serum angiotensin-converting enzyme. This suggests that changes in the serum angiotensin-converting enzyme level may not parallel the course of ocular sarcoidosis limited to the posterior segment.

Administration, Oral↗

PubMed1996

The immune response: the afferent arm.

The key to understanding afferent immunity is the mechanism of activation of T lymphocytes by specialized antigen presenting cells, which bind antigenic peptide to Class II major histocompatibility molecules, and stimulate T cells via Signal 1 (antigen) and Signal 2 (costimulation). The best studied costimulatory pathway is the interaction of B7-1 or B7-2 ligand molecules on antigen presenting cells with CD28 or CTLA-4 receptors on T cells. T cell signaling occurs through the T cell receptor-CD3 complex and is augmented by cosignaling via CD4, CD8, and CD45. The activation of T cells to alloantigen occurs by either a direct pathway of recognition of allogenic major histocompatibility molecules (with or without an associated endogenous peptide), or by an indirect pathway of recognition of processed donor alloantigens via recipient antigen presenting cells. Afferent immunity on the musculoskeletal system is of special interest because of the absence of viable donor antigen presenting cells in processed grafts that makes them susceptible to the indirect pathway of alloantigen recognition.

Animals↗

PubMed2005

High- versus low-field MR imaging.

The role of MR imaging as a noninvasive technique in the detection and evaluation of musculoskeletal diseases is unquestionable. Most of the studies reported in the literature are based on high-field MR imaging. Initial studies performed with low-field-strength have reported unsatisfactory results in the assessment of the musculoskeletal system. Recent improvements, however, have generated a renewed interest in low-field-strength MR imaging. This article presents the principal applications and results published in the literature.

Humans↗

PubMed1988

[Clinical use of gradient echo sequences of longer repetition times].

Studies designed to optimise image contrasts of gradient echo sequences showed, that especially repetition times between 250 and 500 ms in combination with adequate echo times and flip angles provide new image contrasts. The clinical purpose of gradient echo sequences with longer TR was systematically evaluated in 450 patients. A major advantage of GE sequences was the low signal intensity of fat and bone tissue. On the other hand different pathologic changes showed a high signal intensity in comparison to T2 weighted spin echo sequences as well. With the possibility of multiple slices GE sequences were of outstanding diagnostic value especially in MR of soft tissue and of the musculoskeletal system. T2 weighted SE sequences provided no additional informations and could therefore be omitted in a great number of examinations.

Abdomen↗

PubMed1976

Teratogenesis.

In this presentation the scope of the problem of teratogenesis and the essentials of teratology are briefly reviewed. The teratogenicity of any compound is a reflection of a complex interaction of the compound with both the maternal and fetal tissues, the genetic background of the fetus, and the time sequence of gestational events. Under such circumstances the implication of a single compound as a teratogen is difficult, a fact reflected in the high percentage of congenital morphologic abnormalities for which no cause can be ascribed. Four compounds--thalidomide, anticonvulsants, alcohol, and folic acid antagonists--with a known teratogenetic effect on the musculoskeletal system are discussed, as is the role of the orthopedic surgeon in teratology.

Abnormalities, Drug-Induced↗

PubMed2006

Tendon excursion and gliding: clinical impacts from humble concepts.

As integral components of the musculoskeletal system, the primary function is transmission of muscle forces to the skeletal system. Proper excursion and gliding of the tendon determine the efficiency of this function. Studies of the tendon excursion and gliding based on two simple mechanical concepts have resulted in several significant clinical implications.

Biomechanical Phenomena↗

PubMed1990

Magnetic resonance imaging of pediatric musculoskeletal trauma.

MRI is an important tool for evaluating acute and chronic injuries to the musculoskeletal system. It is effective in demonstrating abnormalities in the knee and hips and in detecting bone and ligamentous trauma that is not evident radiographically.

Bone Marrow↗

PubMed2002

The use of Roentgenstereofluorogrammetry to predict the 3-D spatial coordinates of points in low speed events.

Imaging technologies such as cine-radiography, cine-MRI, and X-ray stereo photogrammetry have become popular diagnostic tools in biomechanical studies of musculoskeletal systems. However, their widespread use for research purposes has been restricted due to their high cost and somewhat limited availability. In an attempt to develop a reliable low cost system, a dual-fluoroscopic system capable of tracking the 3-D spatial motion of discrete landmark points in real time was developed. A simple methodology was developed to convert the analog fluoroscopic images to digital files for post-processing. A custom computer code based on the principles of X-ray stereo photogrammetry was also developed to predict 3-D coordinates from the 2-D images from the individual flouroscopes. The goal of the current study was to assess the accuracy and resolution of this system by using it to predict the motion of a test point following a known curvilinear trajectory. Our system predicted the time-varying motion and path of the test point within 0.25%. However, the current system is limited to studying low speed events only (max event frequency of 3Hz) due to the limited sampling frequency of the A/D conversion employed here.

Biomechanical Phenomena↗

PubMedDate not supplied

Interventional musculoskeletal radiology.

Interventional procedures constitute a significant proportion of musculoskeletal radiology. Percutaneous needle biopsy is the ultimate diagnostic technique for the evaluation of musculoskeletal neoplasms and infections. The procedure is accurate, rapid, and safe. It is ideally suited for the diagnosis of metastatic disease and round cell neoplasms. Several needle procedures have been used for the diagnosis and treatment of low back pain. Diskography is primarily a diagnostic test used to determine the symptomatic disk level when multilevel disk disease is present and also to diagnose internal disk disruption. Nerve block with local anesthetic is also used to locate the symptomatic level in patients with multilevel abnormalities. Epidural steroid injection is a therapeutic procedure that commonly is used in patients with low back pain and has been shown to be most effective in patients with disk herniation. Facet joint injection with local anesthetic and steroid is performed to diagnose and treat the facet syndrome. Other needle procedures in the musculoskeletal system include sacroiliac joint aspiration and injection, prosthetic joint aspiration to evaluate potential infection, distention arthrography, and injections of the coccyx for coccydynia.

Adrenal Cortex Hormones↗

PubMed1996

[MR tomography (MRT) of the skeleton, peripheral soft tissues and joints--current overview].

A review: The skeleton, the peripheral soft tissues, and the joints have become important indications to use MRI routinely. About 25-35% of daily examinations focus on these anatomic sites. Superior contrast resolution, the option of different imaging planes, and the unsurpassed visualization of bone marrow, fibrous and hyaline cartilage, ligaments, and tendons are the reasons for the overwhelming success of this imaging method. MRI often provides the direct way to diagnosis. More and more the so-called "step by step" approach to diagnosis by imaging methods is being abandoned in favor of the primary use of MRI. The present survey summarizes the main indications for MRI in the field of the musculoskeletal system, in adults as well as in children. Special topics like tumors, inflammation, ischemia, and trauma are discussed. Some anatomic sites like the carpal joint, the shoulder, and the knee are presented in more detail.

Adult↗

PubMed2004

Musculoskeletal ultrasound.

Over the last few years a sonographic revolution has occurred in rheumatology. Ultrasonography has been shown to be capable of substantially changing the traditional approach to most clinical problems in daily rheumatological practice because of its ability to allow a quick, safe and inexpensive access to otherwise undetectable anatomical information on the early targets of most rheumatic diseases. Ultrasonography completes the physical examination in a rapid and accurate manner and allows the detection of a wide spectrum of pathological findings involving different anatomical structures in the musculoskeletal system. Guidance for intervention (joint aspiration, synovial or soft tissue biopsy, joint or tendon sheath injection) is a major application of ultrasonography. Sonographic guidance is particularly useful when fluid collections are very small or when the inflammatory process is adjacent to anatomical structures that could be seriously damaged by the injection.

Humans↗

PubMed1999

Future and new developments in musculoskeletal ultrasound.

Improvements in high-resolution gray-scale imaging and clinical expertise performing musculoskeletal ultrasound will undoubtedly continue. Development of digital beam formers, two-dimensional arrays along with exploitation of nonlinear techniques to achieve higher resolution and use of ultrasound contrast to improve flow sensitivity will all contribute to the utility of ultrasound in the musculoskeletal system. It behooves the radiologic community to become familiar with these techniques, not only for economic reasons, but also because of the rich complement of future applications of this modality. The few potential applications mentioned here may only scratch the surface of what is possible. In addition to improved images of tissue morphology, ultrasound may play a role in functional and quantitative assessment of soft tissues. It may likewise play a role in the evaluation of prosthetic implants, bone mineralization, and cartilage integrity. Thus, the role of this modality in future musculoskeletal applications may significantly impact clinical diagnosis and therapy.

Humans↗

PubMed1991

The limping child.

Evaluation of a limping child requires careful consideration and a basic knowledge of potential problems affecting the child. The most important point is not to miss or delay diagnosis of the septic hip. This is truly an orthopedic emergency. Complaints of knee pain should not throw the physician off the track of a diagnosis of hip disease. It is also important to be aware of how the medical history affects the musculoskeletal system. Many causes of limp are best analyzed by repeat examination and stepwise laboratory and radiographic evaluation. One should realize that a painful limp can be caused by something as mundane as a thorn in the heel or as serious as a tumor of the spine: Be suspicious.

Bone Diseases↗