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Results for “Musculoskeletal System”

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At least 901 records · Page 50Linked to original sources

PubMed1999

The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study.

OBJECTIVES: The purpose of the Eurofetus Study was to evaluate the accuracy of the antenatal detection of malformations by routine ultrasonographic examination in unselected populations. STUDY DESIGN: All ultrasonographic diagnoses of malformations and the outcomes of the fetuses were prospectively recorded in 61 European obstetric units over a 3-year period (1990-1993). Also recorded were all cases of malformation diagnosed after abortion or birth for the mothers who underwent follow-up in these centers. RESULTS: Of 3685 malformed fetuses, 2262 had received diagnoses during pregnancy (sensitivity, 61.4%). Of a total number of 4615 malformations, 2593 were detected (sensitivity, 56.2%). The detection sensitivity was higher for the major than for the minor abnormalities (73.7% vs 45.7%), and the diagnosis was made earlier in the pregnancy (24.2 weeks vs 27.6, P <. 01). Overall, 55% of the major abnormalities were detected within 24 gestational weeks. Within each severity group the accuracy of detection depended on the system. For the major abnormalities it was better for the central nervous system (88.3%) and urinary tract (84. 8%) but lower for the heart and great vessels (38.8%). Detection of minor abnormalities was also effective for the urinary tract (89.1%) but not for the heart and great vessels (20.8%) or the musculoskeletal system (18%). Detection of abnormalities had an influence on the rate of termination of pregnancy. The rate of live births for the mothers bearing fetuses with major abnormalities was lower than that for the mothers in whom no abnormalities were detected, mainly because of the higher rate of elective terminations of pregnancy in the former group. CONCLUSION: Systematic ultrasonographic screening during pregnancy can now detect a large proportion of fetal malformations, although some still escape detection.

Blood Vessels↗

PubMed1982

Agenesis of the vermis with fusion of the cerebellar hemispheres, septo-optic dysplasia and associated anomalies. Report of a case.

Agenesis of the cerebellar vermis with fusion of the dentate nuclei and cerebellar hemispheres (rhombencephalosynapsis) is a rare cerebral malformation. We report the case of a 7-h-old girl whose mother had taken the drug phencyclidine during the first 6 weeks of pregnancy. Absence of septum pellucidum, hypoplasia of the commissural system, optic nerves, chiasm and tracts, moderate hydrocephalus, and agenesis of the posterior lobe of the pituitary were also found. Extracranial congenital anomalies involved the cardiovascular, respiratory, urinary, and musculoskeletal systems. Death was secondary to severe respiratory distress and bradycardia. The literature concerning this rare form of cerebellar malformation is reviewed.

Abnormalities, Drug-Induced↗

PubMed1997

A longitudinal study of pain: reported pain from middle age to old age.

OBJECTIVE: Describe patterns of pain reporting over a span of 24 years. DESIGN: Individuals were interviewed on four occasions (1968, 1974, 1981, 1992). PARTICIPANTS: Representative sample (n = 321) of the Swedish population aged 53-63 at baseline. MEASURES: Self-reported pain in the chest, abdomen, and musculoskeletal system (back or hips, shoulders, hands, elbows, legs, or knees). RESULTS: Less than 1% reported chest or abdominal pain on all four occasions. Whereas 21.8% of the sample reported musculoskeletal pain on all four occasions. More than half of the sample reported some kind of pain on three or four occasions. Women reported more severe and more persistent pain compared with men. There were more people who developed pain during the 24-year period than there were who became pain free. An increase in pain was equally common for chest and musculoskeletal pain, but a decrease in pain was much more common for musculoskeletal pain than chest pain. CONCLUSIONS: Cross-sectional studies have shown differing age patterns in pain. This longitudinal study demonstrates different patterns for men and women and for different pain localities.

Aged↗

PubMed1991

[Analysis of health and life status of a urban population of Botucatu, São Paulo (Brazil). IV. Morbidity reported in domiciliary interviews, 1983-1984].

The objective of the study was to analyse the referred morbidity of the urban population resident in the city of Botucatu, S. Paulo State, Brazil for the period 1983-1984 was analysed. Data was obtained from a sample population of 7,075 persons (12 per cent of the population) by means of household interviews using two pre-codified questionnaires applied by trained lay interviews under supervision. The recall period of the events was fixed at three weeks. The variables studied were: sex, age, schooling, "per capita" income, and referred morbidity (complaints, symptoms, common accidents, and diagnoses). The results showed that 56 percent reported episodes of illness to a total of 6,649. Women of 50 or more years old presented the highest frequency of complaints. There was no variation of occurrence of episodes in terms of "per capita" income. The prevalence of illness episodes was 939 per thousand persons. There was a predominance of complaints relating to the respiratory system (20 per cent of complaints), mainly acute respiratory infections; on a second level was signs, symptoms and ill-defined conditions (19 per cent), followed by diseases of the musculoskeletal system, of the nervous system and of the circulatory system (about 9%) and, finally, diseases of the digestive system and lesions and poisoning (8%). Specific rates of prevalence according to groups of diseases (ICD) and to the variables of study were estimated. The difficulties of comparing these results with those given by other works, because of the lack of homogeneity in the criteria adopted for obtaining information, are commented on.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2000

Approaches to learning spatial relationships in gross anatomy: perspective from wider principles of learning.

When students learn spatial relationships in gross anatomy, as in other areas of study, fundamentals should be learned first; otherwise confusion results. The fundamentals in gross anatomy are defined not in conceptual terms but by principles of visual perception. In particular, they derive from Gestalt principles such as collinearity and symmetry, which generally make learning and recognition of visual patterns easier. The collinearity (straight line formations) and symmetry in the body cavities are obvious when one studies the empty cavities, or body cavities with only a few symmetrical structures in place. These principles are, however, totally obscured if one starts one's study, as in traditional dissection, with the body cavities crammed full of a complex mass of interlocking organs. and their ducts, vessels, etc. Therefore, it is recommended that learning gross anatomy (especially of the body cavities) would be an easier exercise if it started with empty body cavities, then building up, with a careful sequence of prosections, to the more complex and realistic anatomy of the full cavities. This system of learning is perceptually preferable to traditional dissection. However, it needs to be enlivened in several ways, e.g., with respect to design principles evident in anatomical structure (especially for the musculoskeletal system), developmental processes, and sometimes by explicit reference to clinical relevance.

Anatomy↗

PubMed2005

Motor maps and synergies.

Consider the process of raising and lowering the arm in the sagittal plane. Different parts of different muscles operate over different sectors of the angular range. How and why does the nervous system implement this differential muscle activation according to joint angle? We contend that such control depends on the adaptive formation of motor maps. These solve the problem of redundancy in the musculoskeletal system by connecting a relatively small number of cortical columns in the motor cortex to a large number of alpha motor neuron pools. We argue that motor maps are formed such that each functional muscle is activated in proportion to its moment arm about the movement. Because of this the required agonist and antagonist turning forces are generated with a minimum demand for metabolic energy. We know from biomechanical principles that, at any given posture, those muscle fibres that change length most in response to a small joint-angle change are those with the greatest moment arm. Likewise those that change least have the smallest. By establishing a model of the polynomial relationships between the lengths of functional muscles l and the corresponding changes in joint angles theta, the nervous system can generate signals partial differentiallj/ partial differentialthetai (where lj is the length of the jth functional muscle and thetai is the magnitude of the ith elemental movement). These signals create motor maps by modulating the gains of descending motor pathways. As a result, functional muscles are activated in proportion to their moment arms. This reduces the demand for metabolic energy to a minimum. Since moment arms change with joint angle, it also accounts for the experimental observations above. Such motor mapping effectively provides a minimum energy "wired-in" synergy. Established in utero, motor maps are the first stage of synergy formation and provide the basis for the development of subsequent task-dependent synergies.

Biomechanical Phenomena↗

PubMed1993

Extracorporeal photochemotherapy in progressive systemic sclerosis.

BACKGROUND: Extracorporeal photochemotherapy, an immune-modulating form of therapy, has been shown to be effective in the treatment of autoimmune diseases. We evaluated the effects of extracorporeal photochemotherapy in the treatment of patients with progressive systemic sclerosis (PSS). METHODS: Nine patients with active progressive systemic sclerosis were treated with extracorporeal photochemotherapy on 2 successive days monthly. The duration of therapy ranged from 6 to 21 months. RESULTS: A significant improvement was noted in the skin, musculoskeletal system, functional index, and symptoms including Raynaud's phenomenon, dyspnea, fatigue, dysphagia, and arthralgias, as well as improvement of cutaneous ulcers. Stabilization of the pulmonary function studies was also noted in the majority of patients over the course of therapy. No serious side effects were noted throughout the course of therapy in the 9 patients. CONCLUSIONS: The results suggest that photopheresis may be beneficial in selected early cases of progressive systemic sclerosis.

Activities of Daily Living↗

PubMed2005

Core stability and its relationship to lower extremity function and injury.

Core stability may provide several benefits to the musculoskeletal system, from maintaining low back health to preventing knee ligament injury. As a result, the acquisition and maintenance of core stability is of great interest to physical therapists, athletic trainers, and musculoskeletal researchers. Core stability is the ability of the lumbopelvic hip complex to prevent buckling and to return to equilibrium after perturbation. Although static elements (bone and soft tissue) contribute to some degree, core stability is predominantly maintained by the dynamic function of muscular elements. There is a clear relationship between trunk muscle activity and lower extremity movement. Current evidence suggests that decreased core stability may predispose to injury and that appropriate training may reduce injury. Core stability can be tested using isometric, isokinetic, and isoinertial methods. Appropriate intervention may result in decreased rates of back and lower extremity injury.

Abdominal Muscles↗

PubMed1997

Association of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index with measures of disease activity and health status in patients with systemic lupus erythematosus.

OBJECTIVE: To examine the internal consistency and validity of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) with respect to disease activity, health status, and medication score. METHODS: A prospective cross sectional study of patients with systemic lupus erythematosus (SLE) attending a specialist lupus outpatient clinic between July 1994 and February 1995. The internal consistency of the SDI components was examined using Cronbach's coefficient alpha. The associations of the SDI components with disease activity measured by the British Isles Lupus Assessment Group (BILAG) index, health status measured by the Medical Outcomes Study (MOS) Short Form 20, and with a medication score were analyzed using Spearman's rank correlation coefficient (p). RESULTS: 133 women and 8 men ranging in age from 20.1 to 88.7 years (mean 41.1, SD 12.5) were studied. With few exceptions, the components of the SDI that reflect damage in different organ systems were not associated with each other. We found a significant although weak relationship between some related SDI and BILAG components (p 0.25 to 0.28; p < 0.01). While damage to the musculoskeletal system was associated with limitations in physical functioning measured with the MOS Short Form 20 (p-0.30; p < 0.01) and renal damage inversely with fatigue (p-0.23; p < 0.01) there was no significant relationship of other SDI components with the MOS Short Form 20. Renal and neuropsychiatric damage were associated significantly with the medication score (p 0.27 and 0.23; p < 0.01). CONCLUSION: The components of the SDI are valid in that they are associated with disease activity in the respective organ systems and some of them with a medication score. However, damage in different organ systems in SLE does not follow a common pattern. It is thus suggested that the SDI profile be used in addition to the SDI total score as an endpoint in clinical and epidemiological studies.

Adult↗

PubMed1999

Osteoinductive growth factors in preclinical fracture and long bone defects models.

Fracture healing is a specialized form of the reparative process that the musculoskeletal system undergoes to restore skeletal integrity. This biologic process is a consequence of a complex cascade of biologic events that result in the restoration of bone tissue, allowing for the resumption of musculoskeletal function. Several growth-promoting substances have been identified at the site of skeletal injury and appear to play a physiologic role in fracture healing. This article reviews the effects of these osteoinductive growth factors on bone healing as elucidated by both preclinical in vivo fracture and diaphyseal defect healing models.

Animals↗

PubMed1986

Cyclic impacts on heel strike: a possible biomechanical factor in the etiology of degenerative disease of the human locomotor system.

The cyclic impacts induced by heel strike when walking were studied using both a high-resonance-frequency force plate and a low-mass skin-mounted accelerometer. The data were computer analyzed. The results showed that during normal human walking, the locomotor system is subjected to repetitive impact loads at heel strike, lasting about 5 ms and consisting of frequency spectra up to and above 100 Hz. The natural shock-absorbing structures in the musculoskeletal system have viscoelastic time-dependent mechanical behavior, which is relatively ineffective in withstanding sudden impulsive loads. Degenerative joint diseases may thus be seen as a late clinical result of fatigue failure of the natural shock absorbers, submitted to deleterious impacts over a period of time.

Adult↗

PubMed2003

The musculoskeletal complications seen in type II diabetics: predominance of hand involvement.

The musculoskeletal complications of diabetes mellitus (DM), which are the most common endocrine arthropathy, have been generally ignored and poorly treated compared with other complications such as neuropathy, retinopathy and nephropathy. Like other quality of life issues, the musculoskeletal disability of DM has not been investigated effectively. The incidence of diabetic foot has decreased thanks to excellent foot care, but the hand is still an important target for diabetic complications. The aim of this study was to investigate early diabetic musculoskeletal complications on the basis of a collaborative multidisciplinary study design. For this purpose 78 patients (mean age 57.8 +/- 11.9 years, 55 women and 23 men) who had type II DM for 15 years maximally and 37 non-diabetic controls (mean age: 55.7 +/- 11.5, 27 women and 10 men) were randomly selected for inclusion in the study. All patients were evaluated by the Rheumatology, Orthopedic Rehabilitation and Hand Rehabilitation Divisions. Dupuytren's disease was present in 17 (21.8%) of 78 diabetic subjects as the most frequent and statistically significant complication of the musculoskeletal system. In correlation and logistic regression analysis, only retinopathy was significantly associated with duration of diabetes and diabetic foot. Long-term prospective randomised controlled trials on the effects of exercise in preventing musculoskeletal complications and disability in diabetics are needed.

Adult↗

PubMed2003

Alkaptonuric ochronosis: a case with multiple joint replacement arthroplasties.

Alkaptonuria is an extremely rare hereditary disorder of metabolism which may affect various systems. Degeneration of the articular surfaces in major joints leads to complications, which may further necessitate joint replacements. In this report, a case of advanced alkaptonuria with multiple joint replacements is presented and musculoskeletal system involvement in this disorder is reviewed.

Aged↗

PubMed2002

Clinical assessment of musculoskeletal disorders in workers exposed to hand-arm vibration.

OBJECTIVES: To describe the clinical assessment of musculoskeletal disorders among vibration-exposed workers and to review the experimental and epidemiological studies of the effects of vibration on the musculoskeletal system of the upper limbs. METHODS: A total of 212 references in English was found in Pub Med for the years 1980-2000 that dealt with clinical assessment. Many of these references were reviews and few were original research dealing with test performance in diagnostic procedures. RESULTS: The reported effects on bone are osteoporosis and cysts in the hands. Experiments have shown injuries to muscle cells in animals and additional physiological loading of muscles in humans by vibration. Low-frequency vibration exposure of high magnitude was associated with osteoarthrosis in the elbow, wrist and acromioclavicular joint and symptoms in the elbow and shoulder. Impacts, jerks and blows with high-energy transfer to the hands at low frequency might have the potential to result in musculoskeletal disorders considering the general model for injuries. Furthermore, the observed associations with vibration exposure and musculoskeletal disorders might result from the strong dynamic and static joint loading and the repetitive hand-arm motions required in tasks where hand-held machines are used. The clinical assessment of musculoskeletal disorders in workers exposed to hand-arm vibration consists of the clinical and exposure history and evaluation of the physical and laboratory findings. Since most patients with musculoskeletal disorders who are exposed to vibration are also exposed to other ergonomic stressors, accommodation of the injured worker has to take the whole work system into account (task, technology, environment and organisation). CONCLUSIONS: The scientific evidence that vibration per se is a risk factor for musculoskeletal disorders is still weak although there is strong evidence that job tasks with vibrating machines are associated with musculoskeletal disorders. The clinical assessment of musculoskeletal disorders in exposed patients imposes special requirements.

Arm↗

PubMedDate not supplied

Multidetector CT of musculoskeletal disease in the pediatric patient: principles, techniques, and clinical applications.

Computed tomography (CT) plays an important role in the evaluation of musculoskeletal disease in the pediatric patient. With the advent of high-performance 16-section multidetector CT, images can be produced with subsecond gantry rotation times and with submillimeter acquisition, which yields true isotropic high-resolution volume data sets; these features are not attainable with older spiral CT technology. Such capabilities are particularly helpful in the evaluation of pediatric patients by virtually eliminating the need for sedation and minimizing dependence on patient cooperation. The role of three-dimensional (3D) volume imaging in the evaluation of pediatric musculoskeletal disease continues to evolve, with this technique becoming increasingly important in detection and characterization of lesions as well as in decisions about patient care. Specific designs and protocols for multidetector CT studies can be selected to minimize radiation dose to the patient. Principal clinical applications of 3D CT in evaluation of the pediatric musculoskeletal system include developmental abnormalities, trauma, neoplasms, and postoperative imaging.

Adolescent↗

PubMed2006

What explains the trot-gallop transition in small mammals?

The transition from trot to gallop in quadruped mammals has been widely hypothesized to be a strategy to minimize the energetic costs of running. This view, however, has been challenged by some experimental evidence suggesting instead that this transition might be triggered by mechanical cues, and would occur when musculoskeletal stresses reach a certain critical value. All previous experiments to test those hypotheses have used relatively large species and their results, therefore, may not be applicable to small mammals. In this study we evaluated the effect of carrying loads on the locomotor energetics and gait transitions of the rodent Octodon degus running on a treadmill. Metabolic rate and cost of transport increased about 30% with a 20% increment in body mass. This increment was higher than expectations based on other mammals, where energy consumption increases in proportion to the added mass, but similar to the response of humans to loads. No abrupt change of energy consumption between gaits was observed and therefore no evidence was found to support the energetic hypothesis. The trot-gallop transition speed did not vary when subjects were experimentally loaded, suggesting that the forces applied to the musculoskeletal system do not trigger gait transition.

Animals↗

PubMed2005

[Health reasons for work disability among municipal transport drivers].

BACKGROUND: The health condition of public transport drivers is one of the factors playing a role in assuring safety of passengers taking use of this kind of transportation means. Therefore, the assessment of pathologies occurring in this occupational group is essential from the prevention point of view. Drivers employed in the municipal transport system are at particular risk. The aim of the study was to define health reasons of work disability among bus and tram drivers in general and to indicate pathologies responsible for disabilities in particular. MATERIALS AND METHODS: The study covered 940 drivers (including 788 men and 152 women) employed in a municipal transportation enterprise during the years 1996-2000. Bus (30%) and tram (22%) drivers as well as transport service workers (48%), aged over 45 years, but under the retirement age, were eligible for the study. The analysis of temporary work disability during a five-year period was based on sickness absence, sickness absence rate and the average duration of sickness absence. RESULTS: The analysis revealed that diseases of the circulatory system form the major group of pathologies responsible for total sickness absence among bus drivers (43%), tram drivers (27%) and transport service workers (27%). These disease are also a leading cause of earlier retirement. They mostly include ischemic heart disease in bus drivers and hypertension in tram drivers. Cancers (pleura, kidney and eye) were responsible for 9% of sickness absence in the group of male tram drivers, whereas endocrine, nutritional and metabolic diseases and immunity disorders (diabetes, disorders of thyroid gland) in 16% of female tram drivers. Diseases of the musculoskeletal system were major causes of sickness absence among female tram drivers (24%), whereas malignant and benign neoplasms of breast and uterine myoma in 24% of female transport service workers. CONCLUSIONS: The results of the analysis are in agreement with the literature findings and provide explicit evidence that employment in the municipal transport system is the risk factor responsible for the development of serious diseases such as musculoskeletal disorders and neoplasms. Bearing this in mind, this occupational group (bus and tram drivers) should be covered by specially designed prevention programs to protect them against these pathologies, turning special attention to health promotion at and outside workplace.

Aged↗

PubMed1985

Tensor network theory of the metaorganization of functional geometries in the central nervous system.

Here we present an elaboration and a quantitative example for a hypothetical neuronal process, implementing what we refer to as the metaorganization principle. This process allows the internalization of external (body) geometries into the central nervous system (CNS) and a reciprocal and equally important action of the CNS geometry on the external (body) geometry. The hypothesis is based on the distinction, within the CNS, between covariant sensory and contravariant motor vectorial expressions of the extrinsic geometry. These sensory and motor expressions, given in natural co-ordinate systems, are transformed from one to the other by a neuronal network which acts as a metric tensor. The metric tensor determines the relationship of these two expressions and thus comprises the functional geometry of the system. The emergence through metaorganization of networks that implement such metric function is viewed as the result of interactions between the covariant motor execution which generates a physical action on the external world (via the musculoskeletal system) and the covariant sensory proprioception which measures the effect of such motor output. In this transformation of contravariants to covariants by the physical geometry of the motor system, a covariant metric tensor is expressed implicitly. However, co-ordinated motor action requires its dual tensor (the contravariant metric) which is assembled in the CNS based on the metaorganization principle, i.e. the ability of CNS and external geometries to mold one another. The two metric transformations acting on each other detect error signals whenever the match of the physical and functional geometries is imperfect. Such error signals are utilized by the metaorganization process to improve the match between the two metrics, so that with use the internal representation becomes increasingly homeometric with the geometry of the external world. The proposed physical process by which the metaorganization principle is implemented is based on oscillatory reverberation. If covariant proprioception is used as a recurrent signal to the motor apparatus, as if it were a contravariant motor expression, then reverberations at their steady-state yield the eigenvectors and eigenvalues of the system. The stored eigenvectors and eigenvalues can serve, respectively, as a means for the genesis of a metric (in the form of its spectral representation) with the given eigenvectors and as a means of comparing the eigenvalues that are implicit in the external body geometry and those of the internal metric.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗