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PubMed2000

The disease profile of Texas prison inmates.

PURPOSE: Whereas prison inmates are reported to exhibit poorer overall health status and higher rates of health care utilization than the general population, no current information exists on the overall disease profile of the U.S. prison population. The present study examined the prevalence of major acute and chronic conditions in one of the nation's largest prison populations. METHODS: The study population consisted of 170,215 Texas Department of Criminal Justice (TDCJ) inmates who were incarcerated between August 1997 and July 1998. Information on medical conditions and sociodemographic factors was obtained from an institution-wide medical information system. RESULTS: Infectious diseases (29.6%) constituted the most prevalent major disease category among inmates. This was followed by diseases of the musculoskeletal system and connective tissue (15.3%), diseases of the circulatory system (14.0%), mental disorders (10.8%), and diseases of the respiratory system (6.3%). Among the specific conditions examined, evidence of tuberculosis infection without active pulmonary disease (20.1%) was found to be the most prevalent condition, followed by hypertension (9.8%), asthma (5.2%), low back pain (5.1%), and viral hepatitis (5.0%). CONCLUSIONS: The present study shows that for a number of conditions, the prison population exhibited prevalence rates that were substantially higher than those reported for the general population. Moreover, estimates for a number of diseases varied substantially according to age, race, and gender. Understanding the disease profile in U.S. incarcerated populations will permit correctional administrators to develop more efficient health care delivery systems for prison inmates.

Adolescent↗

PubMed1992

Hypomelanosis of Ito: diagnostic criteria and report of 41 cases.

We conducted a 20-year prospective review of 41 pediatric patients with a diagnosis of hypomelanosis of Ito. No evidence pointed to hereditary transmission of the disease. Associated extracutaneous pathology was mainly of the nervous and musculoskeletal systems. Three of 19 patients had chromosomal anomalies. Hypomelanosis of Ito is a clinically well-characterized syndrome in which chromosomal instability may be a component. Criteria for its presumptive and definitive diagnosis are proposed.

Abnormalities, Multiple↗

PubMed1985

The influence of muscle model complexity in musculoskeletal motion modeling.

A comparative study of four different muscle models in a musculoskeletal motion problem is made. The models vary in complexity from the simple input-output model to the more complex model of Hatze [1]. These models are used to solve a minimum time kicking problem using an optimal control algorithm. The results demonstrate the strong influence of the model choice on the various predicted kinematic and kinetic parameters in the problem. The study illustrates some of the advantages and disadvantages involved in trade-offs between model complexity and practicability in musculoskeletal motion studies. The results also illustrate the importance of appropriate detailed parameter estimation studies in the mathematical modeling of the musculoskeletal system.

Humans↗

PubMedDate not supplied

[Musculoskeletal disorders and quality of life in health care providers working in patient transportation].

The aim of this study was to evaluate musculoskeletal symptoms, quality of life and tasks perceived as most tiring by health care workers performing a patient transfer service for a city hall administration in the countryside of São Paulo state. A questionnaire was used for collecting demographic and occupational data; an instrument derived from the "Nordic Questionnaire"; a questionnaire to evaluate quality of life (SF 36) and the BORG scale. In this study, 82% workers reported at least one musculoskeletal symptom over the twelve previous months. Quality of life was affected in the following aspects: pain, social aspects, and vitality. Workers felt that all tasks related to patient transfer required intense physical effort which compromised their musculoskeletal system.

Humans↗

PubMed1996

The cardiopulmonary system and movement dysfunction.

Physical therapy primarily involves the identification and treatment of problems related to movement. Movement dysfunction usually is attributed to impairments of the neuromuscular and musculoskeletal systems. The cardiopulmonary system plays an important role in movement because of its function of transporting oxygen to skeletal muscle. Abnormalities of the cardiovascular and pulmonary systems can produce limitations in physical function. The purposes of this article are to describe the steps involved in the transfer of oxygen from atmospheric air to skeletal muscles and to provide examples of problems that can occur with each step of the process. Common signs and symptoms of potential problems involving the cardiovascular and pulmonary systems also will be discussed.

Cardiovascular System↗

PubMed2002

Stability analysis for postural control in a two-joint limb system.

The stability behavior of a multi-joint limb with electrically activated muscles provides important clues for postural control of motor tasks. The stability property of the musculoskeletal system can be characterized with its eigenvalues evaluated at operating postures in the workspace. A planar arm model with shoulder and elbow joints and three pairs of antagonistic muscles was constructed in ADAMS. Stability behavior of shoulder and elbow joints was analyzed using the loci of eigenvalues in the s-plane. In the analysis of open-loop cocontraction of antagonist muscles with increasing activation from 5% to 100%, the eigenvalues of the shoulder and elbow joints were confined within the left half of the s-plane in a stripe of +/- j 0.5, and moved toward left onto the real axis. The shoulder eigenvalues were generally nearer to the imaginary axis than the elbow ones, indicating a more oscillatory behavior at the shoulder joint than that at the elbow joint. The effects of joint configuration evaluated within the workspace from 40 degrees to 110 degrees for the elbow and from 40 degrees to 120 degrees for the shoulder showed that the elbow eigenvalues were more prone to configuration changes, particularly elbow angles. We also developed a simulation paradigm for sampled data FES control systems that contain a mixture of continuous time components and sampling and hold effects. This simulation paradigm is useful for realistic simulation of local feedback controller performance.

Computer Simulation↗

PubMed1996

The incidence of congenital malformations in a Turkish population.

OBJECTIVE: To determine the incidence and types of congenital anomalies in a Turkish population. METHOD: The total number of neonates (9160) born in the Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine during 1988-1995 were studied retrospectively. Newborns with congenital anomaly were identified from their birth registries. The total incidence, types and combined anomalies were determined. Also, the relationship between congenital anomalies and maternal age and/or gender were investigated. For statistical evaluation, Chi-square test, Yates correction and Fisher's exact tests were used where appropriate. RESULTS: The overall congenital anomaly incidence was 1.11% and the NTD incidence was 0.27% in our population. Anencephaly was the second most common NTDs with the ratio of 40%, following the spina bifida cases. There was a significant difference between female and male newborns with ancephalocele (P < 0.05). Urogenital system anomalies were found to be the second most common type of malformation with an incidence of 0.21%. Facial and musculoskeletal system abnormalities were the third and fourth most common malformations. Omphalocele incidence in our population was 5 in 9160 births and gastrochisis was 1 in 9160 births. CONCLUSION: The overall congenital anomaly incidence in newborns in our population is 1.11%. The most common malformations were CNS and urogenital abnormalities. NTDs incidence was 0.27% in a Turkish population.

Age Factors↗

PubMed2006

Low-level mechanical signals and their potential as a non-pharmacological intervention for osteoporosis.

BACKGROUND: exercise is recognised as a critical regulatory signal to the skeletal system, but which specific aspects of exercise are responsible for influencing bone mass and morphology and resisting fractures remains unknown. Recent data indicate that extremely low-level mechanical signals are anabolic to bone, and thus may be used, non-invasively, as a form of 'passive' exercise to positively influence skeletal status. OBJECTIVE: to summarise recent experimental studies on the effect of low-level mechanical signals (hypothesised to serve as a surrogate for the spectral content of muscle contractility) as a potential non-pharmacological intervention for osteoporosis. RESULTS: low magnitude mechanical signals are anabolic to bone if applied at a high frequency (15-90 Hz). Long-term animal studies (1 year) show that these low-magnitude mechanical signals can increase cancellous bone volume fraction, trabecular thickness, trabecular number and enhance bone stiffness and strength. Studies in the mouse have shown that these low-level signals will stimulate bone formation rate and labelled surface in cortical and cancellous bone, but the molecular and genetic regulation of this mechanosensitivity is extremely complex. Preliminary studies in children with disabling conditions and post-menopausal women indicate that such signals can be efficacious in reversing and/or preventing bone loss. CONCLUSIONS: considering that the strains (deformations) that result from these low-level vibrations are far below (<1/1000th) those which may cause damage to the bone, we believe they represent a unique, non-pharmacological prophylaxis for osteoporosis. Given that so many physiologic systems are tuned to specific frequencies, such as sight, hearing and touch, it should not be entirely surprising that the musculoskeletal system would be responsive to frequency as well.

Animals↗

PubMed1993

Bacterial arthritis.

The 1992 literature on septic arthritis reiterated the factors that portend a poor outcome in septic arthritis. However, we still know very little about how to improve the outcome for such patients. Infections of the musculoskeletal system may be more common among patients with HIV than the reported cases indicate. Bacterial endocarditis is frequently associated with musculoskeletal complaints. Low back pain may be a presenting manifestation. Acute gout and septic arthritis can cause peripheral arthritis in some patients with bacterial endocarditis. Septic arthritis can present unusual manifestations and can occur as a complication of arthroscopic surgery; the risk factors for its development after arthroscopy have been identified. Arthroscopy as a therapeutic procedure to drain an infected joint is discussed.

Adult↗

PubMed1997

Etiology and pathophysiology of chronic tendon disorders in sports.

In sports medicine, a chronic overuse injury is defined as a long-standing or recurring orthopedic problem and pain in the musculoskeletal system, which started during exertion due to repetitive tissue microtrauma (1). Repetitive microtrauma, which is basically repeated exposure of the musculoskeletal tissue to low-magnitude forces, results in injury at the microscopic level, and no single acute trauma is normally involved in the pathogenesis of an overuse injury. In chronic tendon disorders, 'overuse' implies that the tendon has been strained repeatedly to 4-8% strain until unable to endure further tension, whereupon injury occurs (2). The structure of the tendon is disrupted micro- or macroscopically by this repetitive strain, i.e. collagen fibrers begin to slide past one another, causing break-age of their cross-linked structure, and denaturate; inflammation, edema and pain result. Thus, tendinitis, peritendinitis, tenosynovitis, insertion tendinitis, tendinous bursitis or apophysitis is the earliest clinically recognizable manifestation of overuse tendon injury (3).

Athletic Injuries↗

PubMed1983

[Studies on the serum aldolase activity in workers with muscle disorders caused by vibration work].

Recently, vibrating tools such as chain saws, pneumatic hammers, rock drills, riveters, and grinders have been widely introduced in various industries in order to increase efficiency and to reduce the burden of labor. The disease due to hand-arm vibration often causes serious damages to the operator's body, more particularly of the circulatory, peripheral nervous, osteo-articular and muscular systems. Many kinds of examinations such as roentgenography, electromyography, and sthenometry have been used to diagnose the damage to the musculoskeletal systems. Among these, the measurement of muscular strength, evaluated by grip and pinch strength, is widely used in mass examinations of vibration hazards but this is not always effective in precise recognition of the decrease in muscular strength. In the present study, therefore, in order to diagnose the severity of muscle disorders objectively, serum activities of aldolase (ALD), creatine phosphokinase (CPK) and lactate dehydrogenase (LDH), which are called "muscle enzymes," were determined in 260 chain saw operators aged 40 to 59 years. The same tests were performed for 46 healthy subjects (controls) of a similar age-range, who had a very short experience handling bush cleaners. All chain saw operators were classified into four groups according to the total chain saw operating time (TOT): 1) 58 operators with up to 2,500 hours' experience, 2) 70 with 2,500-5,000 hours' experience, 3) 74 with 5,000-10,000 hours' experience, and 4) 58 with over 10,000 hours' experience. The relationships were investigated in their enzyme activities on the one hand, and their TOT, muscular strength and numbness and pain symptoms related to muscle disorders of the upper extremities on the other hand. The following results were obtained: 1) Serum ALD and LDH activities in chain saw operators increased in proportion to the decrease in muscular strength. The activity of ALD showed a tendency to increase with increased TOT. The ALD activity in the group with over 5,000 hours' experience was significantly higher than that in the control group. However, no relationships were observed between CPK, LDH activities and TOT. 2) In chain saw operators with numbness and pain symptoms, ALD activity in the group with 2,500 hours' experience was significantly higher than that in the control group. However, no obvious relationships were found between CPK, LDH activities and numbness and pain symptoms. 3) In chain saw operators with muscular weakness in addition to numbness and pain symptoms, ALD activity in the group with over 2,500 hours' experience was significantly higher than that in the control group.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1991

Sarcoidosis: clinical manifestations, epidemiology, therapy, and pathophysiology.

Sarcoidosis is an idiopathic granulomatous disease involving one or more multiple organ systems, characterized by the histologic finding of noncaseating epithelioid cell granulomas. The disease has a predilection for intrathoracic structures; the musculoskeletal system is less frequently involved. Most osseous lesions in sarcoidosis are visible in the small joints of the hands and feet. Articular disease may present as an acute or chronic polyarthritis. Muscle involvement in sarcoidosis is generally asymptomatic. Neurologic findings of the central and peripheral nervous systems may occur in sarcoidosis. Subcutaneous nodules are of diagnostic value. Sarcoid vasculitis may involve small and large blood vessels. Sarcoidosis of the exocrine glands may mimic Sjögren's syndrome. Spontaneous remission of disease often occurs. Treatment with nonsteroidal anti-inflammatory agents, corticosteroids, antimalarials, radiation therapy, and immune-modulating drugs may be beneficial in the treatment of sarcoidosis.

Adrenal Cortex Hormones↗

PubMed2005

Muscle contracture emulating system for studying artificially induced pathological gait in intact individuals.

When studying pathological gait it is important to correctly identify primary gait anomalies originating from damage to the central nervous and musculoskeletal system and separate them from compensatory changes of gait pattern, which is often challenging due to the lack of knowledge related to biomechanics of pathological gait. A mechanical system consisting of specially designed trousers, special shoe arrangement, and elastic ropes attached to selected locations on the trousers and shoes is proposed to allow emulation of muscle contractures of soleus (SOL) and gastrocnemius (GAS) muscles and both SOL-GAS. The main objective of this study was to evaluate and compare gait variability as recorded in normal gait and when being constrained with the proposed system. Six neurologically and orthopedically intact volunteers walked along a 7-m walkway while gait kinematics and kinetics were recorded using VICON motion analysis system and two AMTI forceplates. Statistical analysis of coefficient of variation of kinematics and kinetics as recorded in normal walking and during the most constrained SOL-GAS condition showed comparable gait variability. Inspection of resulting group averaged gait patterns revealed considerable resemblance to a selected clinical example of spastic diplegia, indicating that the proposed mechanical system potentially represents a novel method for studying emulated pathological gait arising from artificially induced muscle contractures in neurologically intact individuals.

Adaptation, Physiological↗

PubMed2004

[Prevalence of physical diseases, health behavior and health care utilization in single homeless men: a cross sectional study].

OBJECTIVE: The aim of this cross-sectional study was to establish the prevalence of physical diseases, the subjective evaluation of their own health and health care utilization in the actually homeless and a comparison group of formerly homeless. METHODS: A representative sample of 82 homeless and 37 formerly homeless was studied. Instruments were a physical examination and a standardized interview. The latter included parts of the assessment of the German cardiovascular disease prevention study and the questionnaire "Funktionseinschränkungen" (functional impairments) by Potthoff (1982). RESULTS: Disease prevalence was high. The main diagnoses fell within the categories of defective dental status (over 80%), ophthalmologic diseases (over 60%) and diseases of the liver and musculoskeletal system (over 40% each). Morbidity in the formerly homeless was even higher. In both groups the subjective evaluation of their own health was unrealistically positive. Risk factors for cardiovascular diseases were high. Health care utilization was mainly acute. CONCLUSIONS: The medical care of the homeless in standard medical services is insufficient and could be improved by especially tailored projects which should include education about risk factors. Formerly homeless continue to show high disease prevalence.

Adult↗

PubMedDate not supplied

Volume-rendered three-dimensional spiral CT: musculoskeletal applications.

Spiral computed tomography (CT) is a powerful modality for evaluation of the musculoskeletal system, particularly when coupled with real-time, volume-rendering reconstruction techniques. Including volume-rendered spiral CT in routine musculoskeletal imaging protocols can change management in a significant number of cases. In cases of trauma, subtle fractures--particularly those oriented in the axial plane--are better seen on volume-rendered images. Complex injuries can be better demonstrated with volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily demonstrated to the orthopedic surgeons. The use of intravenously administered contrast material allows simultaneous evaluation of osseous and vascular structures within the affected area. Evaluation of suspected infectious or neoplastic disease is also aided by including volume-rendered imaging in the musculoskeletal spiral CT examination. The extent of disease can be thoroughly evaluated with volume-rendered images, and therapeutic planning--be it surgical or medical--is aided by the anatomic information available from volume-rendered images. Postoperative studies in patients with orthopedic hardware also benefit from volume-rendered imaging. Volume rendering eliminates most streak artifact and produces high-quality images on which the relationships among hardware, bones, and bone fragments are well demonstrated.

Abscess↗

PubMed2005

Workrelated risks and health problems of working children in urban Istanbul, Turkey.

The purpose of this cross-sectional study was to identify the work-related risks and health problems of working children. The sample included 167 working boys. These boys were chosen from schools giving occupational education in the industrial part of Istanbul. A questionnaire and worksite assessment checklists, developed by the researchers, were used as data gathering tools. Data were collected from the boys' schools and workplaces. From this data, it was found that 24.6% of the boys were jewelers, 32.3% were car mechanics and 43.1% were hairdressers. Findings revealed that 30.5% of the boys, who were engaged in child labor, were poor and dropped out of school to assist their families. Boys, whose mean age was 17.6 +/- 1.2, had been working since they were 13 yr old. The boys were also found to work 66.4 h a week, which was an unexpectedly high result considering the 35 hours limitation set by the laws of Turkey for working children. As for work-related risks, chemical risks for boys working as hairdressers (p<0.01), and using sharp tools and accidents for boys working as car mechanics were more common than the other groups (p<0.001, p<0.001). Boys working as hairdressers mostly had respiratory system problems, skin problems, and headache (p<0.001, p<0.001, p<0.001). Those working as car mechanics had nose/throat problems, and musculoskeletal system problems (p<0.001, p<0.01). Among those working as jewelers, eye-related problems were common (p<0.001). It was concluded from the findings of the present study that child labor creates an unhealthy environment for children.

Adolescent↗

PubMed2002

Progressive systemic sclerosis-clinical manifestations and anesthetic considerations.

Progressive systemic sclerosis (PSS), also known as scleroderma, is a complex disease that involves multiple organ systems. Patients with PSS can pose significant challenge for an anesthesiologist. As the disease progresses, profound pulmonary, gastrointestinal, renal, cardiac, and musculoskeletal system changes occur. An anesthesiologist should understand these complex pathophysiological processes in order to minimize potential risks including aspiration and other pulmonary complications. In addition, the potential for reduced renal function and intraoperative hypothermia-induced vasospasm must be considered. Meticulous preoperative assessment and diagnostic evaluation along with prudent intraoperative management is critical to minimize potential postoperative complications.

Anesthesia↗

PubMed2006

Competence levels in musculoskeletal medicine: comparison of osteopathic and allopathic medical graduates.

BACKGROUND: Consistent with osteopathic principles and practice, the nation's colleges of osteopathic medicine (COMs) have emphasized the significance of the musculoskeletal system to the practice of medicine. The authors hypothesized that graduating COM students would, therefore, demonstrate superior knowledge and competence in musculoskeletal medicine when compared with graduates of allopathic medical schools. METHODS: The authors asked graduating COM students to complete a standardized and previously validated 25-question basic competency examination on musculoskeletal medicine in short-answer format. Originally developed and validated in the late 1990s, the examination was distributed to allopathic medical residents at the beginning of their residencies. The authors compare their results with those reported by Freedman and Bernstein for allopathic residents. RESULTS: When the minimum passing level as determined by orthopedic program directors was applied to the results of these examinations, 70.4% of graduating COM students (n=54) and 82% of allopathic graduates (n=85) failed to demonstrate basic competency in musculoskeletal medicine. Similarly, the majority of both groups failed to attain the minimum passing level established by the directors of internal medicine programs (graduating COM students, 67%; allopathic graduates, 78%). CONCLUSION: In an examination of competence levels for musculoskeletal medicine, students about to graduate from a COM fared only marginally better than did their allopathic counterparts. To ensure that all graduating COM students have attained a level of basic competence in musculoskeletal medicine, the authors recommend further study as a prelude to evaluation of the didactic and clinical curriculum at all 22 COMs and their branch campuses.

Clinical Competence↗