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PubMedDate not supplied

Pediatric orthopaedics: developmental norms.

Development of the musculoskeletal system occurs throughout childhood. This article provides an overview of normal musculoskeletal growth and development and describes some of the common variations seen in children. Knowledge of the normal patterns of growth and common problems can help nurses identify children who require further evaluation and treatment.

Adolescent↗
PubMed2004

A phase I and pharmacological study of the matrix metalloproteinase inhibitor BB-3644 in patients with solid tumours.

BB-3644 is an oral, broad-spectrum matrix metalloproteinase inhibitor (MMPI) structurally related to marimastat and BB-94. It is also >10-fold more active than marimastat in inhibiting the processing of cell-bound TNF-alpha. Preclinical studies suggested a favourable toxicity profile when compared to marimastat, and therefore it was selected for clinical evaluation. Patients with advanced solid tumours against which established treatments had failed, or for which no satisfactory treatment exists and of good performance status, were eligible. Treatment consisted of twice daily (bd) oral BB-3644 for 84 days. The initial dose was 5 mg bd, and subsequent cohorts were treated with 10, 20 and 30 mg bd. In all, 22 patients were enrolled. The dose-limiting toxicity (DLT) was musculoskeletal pain. For 28 days of treatment with BB-3644, 20 mg bd was the maximum tolerated dose (MTD), as at 30 mg bd, six of nine patients developed significant musculoskeletal toxicity by day 28. Following chronic oral dosing (>28 days) with BB-3644, three of five patients treated at 10 mg bd developed musculoskeletal DLT by day 84, defining the MTD as 5 mg bd. As dose-limiting musculoskeletal toxicity was encountered at doses of BB-3644 unlikely to provide an advantage over currently available MMPIs, further evaluation is not recommended.

Administration, Oral↗
PubMed1989

[Development of functional stability of the musculoskeletal system in athletes in childhood and adolescence].

Based on the experience gained in sports medicine a review is given on the development of functional stability of the musculoskeletal and locomotive system in actively sporting children and adolescents. Inadequate physical exercise during the growth periods may result in maladaption. Children retarded in their musculoskeletal development exhibit a reduced exercise tolerance. A training system with a high amount of exercises strengthening muscles in general may improve the efficiency of the locomotive system. In school children deficient muscular training results in a progressive reduction of stretching capacity of back and thigh (upper part) muscles. With a view to primary prevention of premature disturbances of the musculoskeletal and articular systems more attention has to be attached to the development of functional stability by adequate physical training both at school and during free-time activities.

Adolescent↗
PubMed1999

Conclusions regarding the influence of exercise on the development of the equine musculoskeletal system with special reference to osteochondrosis.

This paper summarises and interrelates the findings of a large-scale multidisciplinary investigation to assess the influence of exercise on the development of the equine musculoskeletal system in general and of osteochondrosis in particular, up to age 5 months. Forty-three foals, genetically predisposed to develop OC, were divided into 3 exercise groups: box-rest, box-rest with training and free pasture exercise. At 5 months, all foals were weaned and 8 foals per group were subjected to euthanasia for postmortem examination. The remaining 19 foals were placed together and subjected to euthanasia at age 11 months. Foals were clinically and radiographically monitored during life, muscle and tendon biopsies were taken and gait analysed kinematically. After euthanasia, all major musculoskeletal tissue components (bone, articular cartilage, tendon and muscle) were analysed extensively using a wide variety of techniques. Radiographic monitoring of the stifle and hock joints and postmortem analysis of all diarthrodial joints led to the conclusion that osteochondrosis is a dynamic and very common process in which lesions cannot only develop, but may regress spontaneously during the 'windows of susceptibility' of the various joints, making the clinically diagnosed forms of osteochondrosis into the tip of an iceberg. Closure of the 'window of susceptibility' may be determined by the metabolic status of the chondrocyte which was shown to be inferior in older lesions. Exercise had no influence on the number of lesions, but was related to the distribution of lesions within the joint. There was some evidence that growth rate may be one of the most important intrinsic factors that determine the occurrence of OC. Lack of exercise (box-rest) generally delayed the development of the tissues that make up the equine musculoskeletal system. This was evident in bone mineral density (BMD) at various sites, chemical composition of tendon and of articular cartilage, and in the development of gait. In most cases, this delay was compensated for when box confinement was lifted after 5 months. However, there were indications that this was not true for some collagen characteristics of articular cartilage where the withholding of exercise at early age may therefore have a lifelong effect. The training protocol used (rather high-intensity exercise superimposed on a basic box-rest regimen) appeared to have long lasting negative effects, affecting chondrocyte viability long after the training protocol had ended. A same tendency was seen in bone (decrease in BMD) and tendons (decreases in proteoglycan and hyaluronic acid content). It is concluded that, during the first months postpartum, the equine musculoskeletal system passes through a very dynamic period of growth-related development and intense alteration. In this period, the system is vulnerable to adverse influences that may result in developmental orthopaedic disease. However, regenerative capacity is still high, also in those tissues that are notorious for their lack of repair capacity in the mature individual, such as articular cartilage and tendon. Exercise seems to be an important factor in the determination of the final make-up (and hence biomechanical strength) of these tissues and, therefore, is a potentially powerful tool for the enhancement of injury resistance.

Animals↗
PubMed1995

Developmental patterns of histamine-like immunoreactivity in the mouse.

We studied the appearance and distribution of histamine (HA) during mouse embryogenesis, neonatal period, and adulthood using a specific rabbit HA antiserum and indirect immunofluorescence. HA first appeared on the Embryonic Day 13 (E13) in scattered mast cells in the gastrointestinal (GI) muscularis externa and liver. The splenic primordium contained a dense population of intensely HA-immunoreactive (HA-ir) cells from E13 on. From E15 to the birth, HA was detected in many embryonic cell types. On E15, the first HA-ir epithelial endocrine cells appeared in the oxyntic mucosa. In addition to the HA-ir cells in GI tract and liver, some nerve cells in ganglia of the peripheral nervous system (PNS), some fibers in spinal and cranial nerves, nerve fibers in mesenterium, and nerve plexuses of the gastrointestinal muscularis externa were HA-ir from E15 on. Occasional HA-ir nerve fibers were detected within the glandular epithelium of the oxyntic mucosa, pancreas, and salivary glands during late embryogenesis. During the same period, bright fluorescence was observed in cells of the kidney convoluted tubules and pancreatic islet cells. From E14 on, mast cells exhibiting bright fluorescence were scattered throughout the connective tissue of the fetus, and their number increased rapidly with age. Their density was especially high in subcutaneous connective tissue. Embryonic epidermal cells showed faint HA immunoreactivity. In musculoskeletal tissues, developing bone and occasional striated muscle cells exhibited HA immunoreactivity. Interestingly, most cells in liver showed transiently weak HA immunoreactivity during embryogenesis. In adult mouse, HA was stored only by scattered mast cells, oxyntic epithelial cells, and neurons in the tuberomamillary nucleus of the brain. The other HA-containing embryonic cells were negative for HA in adult mouse. In conclusion, HA immunoreactivity is widely distributed in epithelial, neuronal, and mast cells in various organs during mouse embryogenesis.

Animals↗
PubMed2006

Costs of work-related musculoskeletal disorders (MSDs) in developing countries: Colombia case.

The real burden of occupational diseases, specifically work-related musculoskeletal disorders (MSDs), and its impact on workers' productivity is not known. The situation is critical in developing countries where only cases that cause workers' disability are recorded. In this study, the incidence of MSDs in Colombia was estimated by using the age and gender specific double incidence rate of repetitive strain injuries diseases in Finland for 2002. The results showed that the estimated number of MSDs recorded in Colombia during 2005 was 23,477 cases at the rate of 11.6 cases per 10,000 workers. The estimated total cost of these MSD cases relative to workers' productivity was 171.7 million US Dollars, representing around 0.2% of Colombia's Gross Domestic Product for 2005. The systematic appraisal of the incidence of MSDs and their associated cost on workers' productivity are necessary in developing countries to reduce the costly impact on productivity and to increase workers' well-being.

Adolescent↗
PubMed2001

An ergonomic study of chronic musculoskeletal pain in schoolchildren.

OBJECTIVE: Schoolchildren developing chronic musculoskeletal pain from carrying heavy backpacks (hereafter referred to as "pain") is a worldwide issue. The present study of two cohorts, consisting of 248 Indian and 103 American schoolchildren aged 9.0 to 20.6 years, using a semi-objective pain criteria, sought to answer the questions: Can pain be correlated with Body Mass Index (BMI), Weight Carried, Strength, Mood or Body Fat? What are the similarities and differences between the Indian and American schoolchildren in the above context? METHODS: After obtaining parental consent, the schoolchildren completed a questionnaire. Then, they were weighed with and without carry-on items and their height as recorded. Isometric arm and shoulder strengths were measured using the Jackson Strength Tester. Using a Skinfold Caliper, skinfold thicknesses at the right triceps and calf was measured. Using the Borg Pain Scale the students assessed the pain experienced from their own backpacks, rated the acute pain experienced while carrying a standard 10 kg. or 7 kg. backpack. RESULT: Half the schoolchildren reported pain located primarily in the shoulders and back (where most students carry their backpacks). Pain did not correlate with study variables (p > 0.05), and the student moods were mostly happy or neutral. Americans are five times as stressed or sad than the Indians, and the average weight carried decreased as the grade increased. The mean of the age, height, arm and shoulder strengths, and BMI for the 5th to 8th grade schoolchildren (younger groups) and the 9th to 12th grade schoolchildren (older groups), in India, was lower than their American counterparts (p < 0.05). In contrast, the weight carried to school by the Indian children was higher (p < 0.05). The mean pain level perceived by both the younger and older groups in both countries, was not statistically different (p > 0.05). CONCLUSION: Musculoskeletal pain in schoolchildren due to carrying heavy backpacks is a significant problem. There are some similarities, but a number of differences between the Indian and American schoolchildren. Implementing the Pain Prevention Screening is expected to minimize pain, if not lead to a pain-free child.

Adolescent↗
PubMed2002

Co-ordinated strategy of prevention and control of the biomechanical factors associated with the risk of musculoskeletal disorders.

OBJECTIVES: To propose a cost-effective set of methods (strategy) to improve biomechanical working conditions and prevent the development of musculoskeletal disorders. METHODS: The strategy was developed according to the philosophy already used for other aspects of working conditions. It was then tested in ten industrial situations with various characteristics, to check its understanding, its usability, and its efficiency. RESULTS: The strategy includes a five-page leaflet ( screening) aimed at motivating the operators to check the problems and bring about immediate solutions if possible. A stage-2 observation checklist is then proposed to guide the discussions during a meeting of the protagonists (workers and management). The assistance of an occupational health practitioner might become indispensable at stage 3 to deepen the analysis of the remaining problems, while experts are requested only in exceptional cases (stage 4, expertise). This strategy was positively judged by the users and proved to be effective in motivating and co-ordinating the protagonists. CONCLUSION: The strategy proved to consider effectively all biomechanical aspects that might contribute to the development of musculoskeletal disorders (MSDs). It proved also to be participatory, placing the operators and their management at the centre of the intervention as the main actors, and organising when to turn to an occupational health practitioner or an expert for assistance.

Belgium↗
PubMed1998

Rehabilitation in haemophilia--options in the developing world.

Musculoskeletal care is provided in many different settings by many different providers. Physicians are better prepared to treat acute diseases, acute manifestations and have problems in following chronic patients and to preventing losses of functional independence. Haematoma affecting muscles and joints is the most common musculoskeletal finding in haemophilic patients. Proper treatment is fundamental to prevent disability. Treatment aims at restoring the original muscle trophism and strength because joint stability is dependent on the uniform distribution of muscle power over different joint surfaces. Physical rehabilitation continues until complete anatomical and functional recovery is achieved. Coordination and proprioceptive stimulation complement the exercises to recover original muscle strength. Recurrent haemorrhages usually progress to chronic synovitis, the leading cause of motor disability and joint degeneration in haemophilic patients. Moreover, chronic synovitis is a predisposing factor for repetitive episodes of haemarthrosis, a leading cause of joint deformities and severe muscle atrophy. At this point, an efficient treatment alternative should be put into effect to restrain bleeding and prevent synovitis-related joint degeneration, which is synovectomy. Synovectomy is an effective alternative, less costly and easier to perform. Rifampicin synovectomy is advantageous because it is safe, not aggressive to the patient, can be repeated if necessary, and it does not prevent the use of either radiotherapy or surgery after, if necessary. Once the sequelae have set in, treatment tends to be conservative, and it aims at giving the patient functional independence for gait and other activities. The most common limb deformities seen in these patients are knee and elbow flexion, but the patient should also be assessed for compensatory scoliosis, hyperlordosis and lower limb length discrepancies. Chronic joint pain is a rather common complaint in this patient population with early arthrosis, and special drugs and physical treatment must be put into action. Rehabilitation is often inexpensive and very efficient.

Developing Countries↗
PubMed2006

Three major haplotypes of the beta2 adrenergic receptor define psychological profile, blood pressure, and the risk for development of a common musculoskeletal pain disorder.

Adrenergic receptor beta(2) (ADRB2) is a primary target for epinephrine. It plays a critical role in mediating physiological and psychological responses to environmental stressors. Thus, functional genetic variants of ADRB2 will be associated with a complex array of psychological and physiological phenotypes. These genetic variants should also interact with environmental factors such as physical or emotional stress to produce a phenotype vulnerable to pathological states. In this study, we determined whether common genetic variants of ADRB2 contribute to the development of a common chronic pain condition that is associated with increased levels of psychological distress and low blood pressure, factors which are strongly influenced by the adrenergic system. We genotyped 202 female subjects and examined the relationships between three major ADRB2 haplotypes and psychological factors, resting blood pressure, and the risk of developing a chronic musculoskeletal pain condition-Temporomandibular Joint Disorder (TMD). We propose that the first haplotype codes for lower levels of ADRB2 expression, the second haplotype codes for higher ADRB2 expression, and the third haplotype codes for higher receptor expression and rapid agonist-induced internalization. Individuals who carried one haplotype coding for high and one coding for low ADRB2 expression displayed the highest positive psychological traits, had higher levels of resting arterial pressure, and were about 10 times less likely to develop TMD. Thus, our data suggest that either positive or negative imbalances in ADRB2 function increase the vulnerability to chronic pain conditions such as TMD through different etiological pathways that imply the need for tailored treatment options.

Adolescent↗
PubMedDate not supplied

[Cosmophysical fluctuations and development of the human embryo].

An analysis of the dependence of embryonic pathology development on heliocosmic factors is conducted and regular changes of the appearance of different kinds of pathology depending on heliocosmic situations in different months of the year are shown. Periods of conception of increasing amount of children with different disturbances of development coincide with values of the Wolf's number and sun-radiation stream density of certain ranges in comparison with the mean values, the same indexes are in conformity with the periods of conception of children having haemolytic disease and diabetic foetopathy.

Anemia, Hemolytic, Congenital↗
PubMed2003

Mechanisms leading to musculoskeletal disorders in dentistry.

BACKGROUND: The authors reviewed the implications of prolonged, seated working postures on dental operator health and the potential development of musculoskeletal disorders, or MSDs. TYPES OF STUDIES REVIEWED: The authors reviewed studies to assess the mechanisms associated with the development of musculoskeletal pain and MSDs among dental operators. Some studies investigated work duration, operator positioning and the physiological effects of various static sitting postures. Others explored the relationships between prolonged muscle contraction and muscle imbalances, as related to the development of pain and MSDs. RESULTS: This review advances the idea that the causes of musculoskeletal pain and disorders common to dental operators are multifactorial. Physiological changes that accompany these disorders can be related to practices used by today's operators-primarily being seated for prolonged periods. Studies associated such postures with increased disk pressures and spinal hypomobility, which are factors that may lead to degenerative changes within the lumbar spine and low back pain or injury. There is a relationship shown between prolonged, static (motionless) muscle contractions and muscle ischemia or necrosis. Weak postural muscles of the trunk and shoulder may lead to poor operator posture. As muscles adapt by lengthening or shortening to accommodate these postures, a muscle imbalance may result, leading to structural damage and pain. CLINICAL IMPLICATIONS: A significant number of today's dental operators experience musculoskeletal pain and are at risk of developing serious MSDs. A thorough understanding of the underlying physiological mechanisms leading to these problems is necessary to develop and implement a comprehensive approach to minimize the risks of a work-related injury.

Chronic Disease↗