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Sample records for chronic lateral epicondylitis

  1. Arthroscopic treatment for chronic lateral epicondylitis

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    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC in patients with chronic lateral epicondylitis that was refractory to conservative treatment. METHODS: Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS for pain. RESULTS: A total of 15 patients (9 men and 6 women were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100. The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used ( p 0.05. CONCLUSION: Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.

  2. Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

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    Nicola Massy-Westropp

    2012-01-01

    Full Text Available Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis. Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation. Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

  3. Extracorporeal shock wave treatment for chronic lateral epicondylitis (tennis elbow).

    Science.gov (United States)

    Ho, C

    2007-01-01

    (1) Electrohydraulic, electromagnetic, or piezoelectric devices are used to translate energy into acoustic waves during extracorporeal shock wave treatment (ESWT) for chronic lateral epicondylitis (CLE) of the elbow (elbow tendonitis or tennis elbow). These waves may help to accelerate the healing process via an unknown mechanism. (2) Results from randomized controlled trials have been conflicting. Half of the studies showed statistically significant improvement in pain in the treatment group, and half of the studies had data showing no benefit over placebo for any measured outcomes. (3) Limited evidence shows that ESWT is cheaper than arthroscopic surgery, open surgery, and other conservative therapies, such as steroid infiltrations and physiotherapy, that continue for more than six weeks. (4) The lack of convincing evidence regarding its effectiveness does not support the use of ESWT for CLE.

  4. Tennis Elbow (Lateral Epicondylitis)

    Science.gov (United States)

    .org Tennis Elbow (Lateral Epicondylitis) Page ( 1 ) Tennis elbow, or lateral epicondyliti s, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause ...

  5. Safety and efficacy of extracorporeal shock wave therapy for chronic lateral epicondylitis.

    Science.gov (United States)

    Furia, John P

    2005-01-01

    Efficacy and safety of extracorporeal shock wave therapy (ESWT) were investigated in 36 patients with chronic lateral epicondylitis--9 patients receiving and 27 patients not receiving worker's compensation. All patients were treated with a single application of 3200 shock waves. Twelve weeks after treatment, the mean visual analog scale score for the entire group improved from 8.0 to 2.5 (P elbows (77.8%) were rated excellent or good on the Roles and Maudsley scale. There were no significant differences in outcome measures among the subgroups. There were no significant complications. ESWT is an effective treatment for chronic lateral epicondylitis. Worker's compensation status did not affect outcomes.

  6. Treatment of lateral epicondylitis.

    Science.gov (United States)

    Johnson, Greg W; Cadwallader, Kara; Scheffel, Scot B; Epperly, Ted D

    2007-09-15

    Lateral epicondylitis is a common overuse syndrome of the extensor tendons of the forearm. It is sometimes called tennis elbow, although it can occur with many activities. The condition affects men and women equally and is more common in persons 40 years or older. Despite the prevalence of lateral epicondylitis and the numerous treatment strategies available, relatively few high-quality clinical trials support many of these treatment options; watchful waiting is a reasonable option. Topical nonsteroidal anti-inflammatory drugs, corticosteroid injections, ultrasonography, and iontophoresis with nonsteroidal anti-inflammatory drugs appear to provide short-term benefits. Use of an inelastic, nonarticular, proximal forearm strap (tennis elbow brace) may improve function during daily activities. Progressive resistance exercises may confer modest intermediate-term results. Evidence is mixed on oral nonsteroidal antiinflammatory drugs, mobilization, and acupuncture. Patients with refractory symptoms may benefit from surgical intervention. Extracorporeal shock wave therapy, laser treatment, and electromagnetic field therapy do not appear to be effective.

  7. COMPARISON OF ACTIVE RELEASE TECHNIQUE AND MYOFASCIAL RELEASE TECHNIQUE ON PAIN, GRIP STRENGTH & FUNCTIONAL PERFORMANCE IN PATIENTS WITH CHRONIC LATERAL EPICONDYLITIS

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    Parth Trivedi

    2014-06-01

    Full Text Available Background & Purpose: Lateral epicondylitis is the most common lesion of the elbow. Tennis elbow or lateral epicondylitis is defined as a syndrome of pain in the wrist extensor muscles at or near their lateral epicondyle origin or pain directly over the lateral epicondyle. So, the aim of this study was to compare the effectiveness of Active Release Technique (ART and Myofascial Release Technique (MFR in the treatment of Chronic Lateral Epicondylitis (CLE. Methodology: The study included thirty-six patients with Chronic Lateral Epicondylitis of age group range between 30 to 45 years. Patients were randomly divided into three groups: Control Group (A, Active Release Technique Group (B and Myofascial Release Technique Group (C. The patients were treated for 4 weeks and three outcome measures: 0-10 NPRS, Hand Dynamometer and PRTEE were taken for assessment and analysis at baseline and after 4th weeks was done. Result: In this study the result showed that Active Release Technique and Myofascial Release Technique were effective in all three outcome measures when compared to Control Group. Myofascial Release Technique was more effective in improving grip strength & reducing pain & disability when compared to Active Release Technique.(p<0.05 Conclusion: Active Release Technique and Myofascial Release Technique are effective in patients with Chronic Lateral Epicondylitis. Myofascial Release Technique demonstrated better outcomes than Active Release Technique in the management of Chronic Lateral Epicondylitis.

  8. Diagnosing and treating lateral epicondylitis.

    OpenAIRE

    1994-01-01

    Lateral epicondylitis is often encountered in primary care. Although its diagnosis can be fairly straightforward, its treatment is often difficult. This review examines the epidemiology, pathophysiology, and clinical presentation of tennis elbow. Management options are discussed.

  9. Percutaneous Soft Tissue Release for Treating Chronic Recurrent Myofascial Pain Associated with Lateral Epicondylitis: 6 Case Studies

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    Ming-Ta Lin

    2012-01-01

    Full Text Available Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis. Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin’s technique. Pain intensity (measured with a numerical pain rating scale, pressure pain threshold (measured with a pressure algometer, and grasping strength (measured with a hand dynamometer were assessed before, immediately after, and 3 months and 12 months after the treatment. Results. For every individual case, the pain intensity was significantly reduced (P<0.01 and the pressure pain threshold and the grasping strength were significantly increased (P<0.01 immediately after the treatment. This significant effectiveness lasts for at least one year. Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

  10. Percutaneous soft tissue release for treating chronic recurrent myofascial pain associated with lateral epicondylitis: 6 case studies.

    Science.gov (United States)

    Lin, Ming-Ta; Chou, Li-Wei; Chen, Hsin-Shui; Kao, Mu-Jung

    2012-01-01

    Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis. Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs) due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin's technique. Pain intensity (measured with a numerical pain rating scale), pressure pain threshold (measured with a pressure algometer), and grasping strength (measured with a hand dynamometer) were assessed before, immediately after, and 3 months and 12 months after the treatment. Results. For every individual case, the pain intensity was significantly reduced (P < 0.01) and the pressure pain threshold and the grasping strength were significantly increased (P < 0.01) immediately after the treatment. This significant effectiveness lasts for at least one year. Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

  11. Lateral epicondylitis of the elbow.

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    Tosti, Rick; Jennings, John; Sewards, J Milo

    2013-04-01

    Lateral epicondylitis, or "tennis elbow," is a common musculotendinous degenerative disorder of the extensor origin at the lateral humeral epicondyle. Repetitive occupational or athletic activities involving wrist extension and supination are thought to be causative. The typical symptoms include lateral elbow pain, pain with wrist extension, and weakened grip strength. The diagnosis is made clinically through history and physical examination; however, a thorough understanding of the differential diagnosis is imperative to prevent unnecessary testing and therapies. Most patients improve with nonoperative measures, such as activity modification, physical therapy, and injections. A small percentage of patients will require surgical release of the extensor carpi radialis brevis tendon. Common methods of release may be performed via percutaneous, arthroscopic, or open approaches.

  12. LATERAL EPICONDYLITIS OF THE ELBOW.

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    Cohen, Marcio; da Rocha Motta Filho, Geraldo

    2012-01-01

    Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. The word epicondylitis suggests inflammation, although histological analysis on the tissue fails to show any inflammatory process. The structure most commonly affected is the origin of the tendon of the extensor carpi radialis brevis and the mechanism of injury is associated with overloading. Nonsurgical treatment is the preferred method, and this includes rest, physiotherapy, cortisone infiltration, platelet-rich plasma injections and use of specific immobilization. Surgical treatment is recommended when functional disability and pain persist. Both the open and the arthroscopic surgical technique with resection of the degenerated tendon tissue present good results in the literature.

  13. Lateral epicondylitis: review of injection therapies.

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    Judson, Christopher H; Wolf, Jennifer Moriatis

    2013-10-01

    Lateral epicondylitis has several different treatment methods, with no single agreed upon therapy. This article summarizes the current literature on injection therapies for lateral epicondylitis. Glucocorticoid, botulinum toxin, autologous blood, platelet-rich plasma, hyaluronic acid, polidocanol, glycosaminoglycan, and prolotherapy injections are discussed.

  14. Late surgical results of reattachment to bone in repair of chronic lateral epicondylitis.

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    Pruzansky, Mark E; Gantsoudes, George D; Watters, Nathan

    2009-06-01

    All cases of lateral epicondylitis surgically treated in Dr. Pruzansky's office practice between October 1986 and December 2005 yielded 24 elbows for this study. Patients were treated with surgical débridement and direct repair to bone through bone tunnels (18 elbows), repair with suture anchors (3 elbows), or augmentation with autologous tendon graft and reattachment to bone via suture anchors (3 elbows). This series represents the earliest reattachment cases to be reported, and with the longest follow-up. Mean follow-up (both telephone and office interviews) was 64.7 months. All patients reported satisfaction and graded their outcomes as good or excellent. Mean time to full painless preinjury level of use of the elbow was 4.3 months for patients who underwent simple repair and 2.75 months for patients repaired with a graft. Surgical reattachment of the débrided extensor tendon of origin of the elbow to bone, either directly or with autologous tendon graft, provided pain relief and return to preinjury level of function in a predictable manner. Both primary repair and tendon graft procedures can be used in primary and salvage surgeries in tennis elbow cases in which conservative treatment fails.

  15. Lateral epicondylitis: a review of the literature.

    Science.gov (United States)

    Waseem, Mohd; Nuhmani, S; Ram, C S; Sachin, Yadav

    2012-01-01

    Lateral epicondylitis (Tennis Elbow) is the most frequent type of myotendinosis and can be responsible for substantial pain and loss of function of the affected limb. Muscular biomechanics characteristics and equipment are important in preventing the conditions. This article present on overview of the current knowledge on lateral Epicondylitis and focuses on Etiology, Diagnosis and treatment strategies, conservative treatment are discussed and recent surgical techniques are outlined. This information should assist health care practitioners who treat patients with this disorder.

  16. Ultrasonographic findings of lateral epicondylitis of humerus

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    Choi, Joon Hyuk; Ha, Doo Heo [Pundang CHA Univ., Seongnam (Korea, Republic of)

    2002-03-01

    To evaluate the ultrasonographic findings of lateral epicondylitis and their relationship with clinical outcome. The findings of ultrasonographic examinations of eighteen elbow joints in 15 patients (M:F=5:10; age:38-65(mean, 47.6) years) with lateral epicondylitis were reviewed. Two patients underwent surgery, two were not treated, and the remaining 11 were treated conservatively. Symptomatic improvement was noted 1 week after conservative treatment in two cases, at 2 weeks in five cases, at 3 weeks in three cases, and at 5 weeks in one case. With patients in the 90 degree flexed elbow position and in a supinated wrist, weexamined the extensor carpi radialis brevis (ECRB) tendon around the lateral epicondyle using ultrasound equipment with a 7-11 MHz linear transducer. The findings were assessed in terms of swelling of the tendon, changes in its echotexture, the presence of calcification of cystic degeneration, loss of the hypoechoic band between the tendon and bony cortex of the lateral epicondyle, cortical irregularity of the lateral epicondyle, and fluid collection around the tendon. Any relationships between each ultrasonographic finding and the treatment interval after which symptomatic improvement was noted were evaluated. In the 18 joints, change was heterogeneous hypoechogenicity in 13, and heterogeneous mixed echogenicity in three. Other ultrasonographic findings were swelling of the tendon in ten cases, loss of the hypoechoic band in 14, cortical irregularity in five, calcification in four, cystic degeneration in nine, and fluid collection around the tendon in four. In patients treated conservatively, there was no statistically significant difference between each ultrasonographic finding and the treatment interval after which symptomatic improvement was noted. Ultrasonography can be used to assess changes in the ECRB tendon and lateral epicondyle occurring in lateral epicondylitis, but fails to provide information on the rapidity of symptomatic

  17. Magnetic Resonance Imaging of Patients With Chronic Lateral Epicondylitis: Is There a Relationship Between Magnetic Resonance Imaging Abnormalities of the Common Extensor Tendon and the Patient's Clinical Symptom?

    Science.gov (United States)

    Qi, Liang; Zhang, Yu-Dong; Yu, Rong-Bin; Shi, Hai-Bin

    2016-02-01

    The aim of the study is to determine the inter-reliability and intra-observer reliability of magnetic resonance imaging (MRI) for lateral epicondylitis and investigate whether there is a potential relationship between MRI abnormalities of the common extensor tendon (CET) and its clinical symptom.The study group comprised 96 consecutive patients (46 men and 50 women) with a clinical diagnosis of chronic lateral epicondylitis, which were examined on 3.0 T MR. An MRI scoring system was used to grade the degree of tendinopahty. Three independent musculoskeletal radiologists, who were blinded to the patients' clinical information, scored images separately. Clinical symptoms were assessed using the Patient-Rated Tennis Elbow Evaluation (PRTEE).Of all the patients, total 96 elbows had MRI-assessed tendinopathy, including 38 (39.6%) with grade 1, 31 (32.3%) with grade 2, and 27 (28.1%) with grade 3. Inter-observer reliability and intra-observer agreement for MRI interpretation of the grades of tendinopathy was good, and a positive correlation between the grades of tendinopathy and PRTEE was determined.MRI is a reliable tool in determining radiological severity of chronical lateral epicondylitis. The severity of MR signal changes positively correlate with the patient's clinical symptom.

  18. Dynamic extensor brace for lateral epicondylitis.

    NARCIS (Netherlands)

    Faes, M.; Akker, B. van den; Lint, J.A. de; Kooloos, J.G.M.; Hopman, M.T.E.

    2006-01-01

    Lateral epicondylitis (tennis elbow) is a common, often disabling ailment. Based on the failure of current therapies, a new dynamic extensor brace has been developed. In this study, the effects of application of this brace for 3 months on the most important and disabling symptoms of patients with la

  19. Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow

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    Gyaneshwar Tonk

    2014-01-01

    Conclusions: Treatment of patients with chronic lateral epicondylitis with PRP extract reduced pain and significantly increased function, exceeding the effect of low level laser therapy on long term followup. Low-level laser therapy is better in the short term period, but on long term followup injection PRP therapy is better than laser therapy in lateral epicondylitis.

  20. Effect of Acupotomy Therapy on Lateral Epicondylitis Diagnosed by Ultrasonography

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    Lim Nara

    2011-06-01

    Full Text Available Purpose: This observation was to report the clinical effects of acupotomy in treating lateral epicondylitis. Methods: Three patients diagnosed with lateral epicondylitis were treated with acupotomy. Two were male and one was female. The improvement of symptom were evaluated by visual analog scale (VAS and self-consciousness symptoms of Cozen test. Results: After one treatments, patient's chief complaint and the pain near the lateral epicondyle while cozen test were notably improved. Conclusions: This study demonstrates that oriental medical treatment with acuputomy therapy has significant effect in improving symptoms of lateral epicondylitis. As though we had not wide experienced in this treatment, more research is needed.

  1. Comparative Effectiveness of Injection Therapies in Lateral Epicondylitis

    DEFF Research Database (Denmark)

    Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell

    2012-01-01

    Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available.......Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available....

  2. Autologus Blood Injection for Recurrent Lateral Epicondylitis

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    M. Dehghani, M.D.

    2007-09-01

    Full Text Available Background and purpose: Tennis elbow is a common complaint. Several treatment strategies, such as corticosteroid injections and physical terapy and braces have been described with no predictable efficacy. The purpose of this study was to evaluate prospectively the result of refractory lateral epicondylitis with autologus blood injections.Materials and Methods: Twenty two patients with lateral epicondylitis were injected with 2 mL of autologous blood under the extensor carpi radialis brevis. All patients had failed the two previous non surgical treatments including all or combination of physical therapy, splintinge, non steroidal anti-inflammatory medication and prior steroid injection. The patients were evaluated with patient-rated Tennis Elbow Evaluation (PRTEE.Results: The average fallow-up period was 7.3 months (range, 4-10mo. After autologus blood injection, the average pain score decreased from 43.7 to 9.1 (P-value < 0.001. The average functional score decreased from 42.4 to 10.1 (P-value <0.001.Conclusion: On the basis of this study, this minimally invasive treatment advocates refractory Tennis elbow.

  3. Chronic hyperglycemia increases the risk of lateral epicondylitis: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS)

    OpenAIRE

    Otoshi, Kenichi; Takegami, Misa; Sekiguchi, Miho; Onishi, Yoshihiro; Yamazaki, Shin; Otani, Koji; Shishido, Hiroaki; Fukuhara, Shunichi; Kikuchi, Shinichi; Konno, Shinichi

    2015-01-01

    Background: Although humeral epicondylitis is a common health problem, there have been no reports that describe its prevalence in Japanese general population, and relatively little is known about its etiology and associated risk factors. Questions/purposes: This study aimed to clarify the prevalence of humeral epicondilitis in Japanese general population, and investigate the associated risk factors using the data from a cross-sectional study of the Locomotive Syndrome and Health Outcome in Ai...

  4. The three-portal technique in arthroscopic lateral epicondylitis release

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    Ashok Gowda

    2017-01-01

    Full Text Available Lateral epicondylitis, commonly referred to as tennis elbow, is a syndrome characterized by pain over the origin of the common extensor muscles of the fingers, hand and wrist at the lateral epicondyle. Reports of 70-90% response to conservative treatment at one year have been documented in the literature though refractory cases often require surgical management. Arthroscopic treatment of lateral epicondylitis allows for intra-articular visualization for concomitant pathology and localization of the Extensor Carpi Radialis Brevis tendon. Additionally, compared to the open technique, the arthroscopic technique has a lower morbidity and an earlier return to work and activity. Here we describe a three portal technique for improved visualization in arthroscopic lateral epicondylitis release.

  5. Lateral epicondylitis in tennis: update on aetiology, biomechanics and treatment

    OpenAIRE

    2007-01-01

    Lateral epicondylitis (tennis elbow) is the most frequent type of myotendinosis and can be responsible for substantial pain and loss of function of the affected limb. Tennis biomechanics, player characteristics and equipment are important in preventing the condition. This article presents an overview of the current knowledge on lateral epicondylitis, and focuses on treatment strategies. Conservative and surgical treatment options are discussed, and recent techniques are outlined.

  6. Acupuncture for Lateral Epicondylitis: A Systematic Review

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    Hongzhi Tang

    2015-01-01

    Full Text Available Objective. This systematic review aimed to assess the effectiveness and safety of acupuncture for lateral epicondylitis (LE. Methods. Seven databases and the WHO International Clinical Trials Registry Platform Search Portal were searched to identify relevant studies. The data were extracted and assessed by two independent authors, and Review Manager Software (V.5.3 was used for data synthesis with effect estimate presented as standard mean difference (SMD and mean difference (MD with a 95% confidence interval. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE was used to assess the level of evidence. Results. Four RCTs with 309 participants were included with poor methodological quality. Participants who received acupuncture and acupuncture plus moxibustion with material insulation were likely to have an improvement in elbow functional status and/or myodynamia. The overall quality rated by GRADE was from very low to low. Two studies reported that the needle pain would be the main reason for the dropout. Conclusion. For the small number of included studies with poor methodological quality, no firm conclusion can be drawn regarding the effect of acupuncture of elbow functional status and myodynamia for LE. This trial is registered with CRD42015016199.

  7. Common extensor origin release in recalcitrant lateral epicondylitis - role justified?

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    Mukundan Cibu

    2010-05-01

    Full Text Available Abstract The aim of our study was to analyse the efficacy of operative management in recalcitrant lateral epicondylitis of elbow. Forty patients included in this study were referred by general practitioners with a diagnosis of tennis elbow to the orthopaedic department at a district general hospital over a five year period. All had two or more steroid injections at the tender spot, without permanent relief of pain. All subsequently underwent simple fasciotomy of the extensor origin. Of forty patients thirty five had improvement in pain and function, two had persistent symptoms and three did not perceive any improvement. Twenty five had excellent, ten had well, two had fair and three had poor outcomes (recurrent problem; pain at rest and night. Two patients underwent revision surgery. Majority of the patients had improvement in pain and function following operative treatment. In this study, an extensor fasciotomy was demonstrated to be an effective treatment for refractory chronic lateral epicondylitis; however, further studies are warranted.

  8. Lateral and medial epicondylitis: role of occupational factors.

    Science.gov (United States)

    Shiri, Rahman; Viikari-Juntura, Eira

    2011-02-01

    Epicondylitis is a common upper-extremity musculoskeletal disorder. It is most common at the age of 40-60 years. Epicondylitis seems to affect women more frequently than men. Diagnosis of epicondylitis is clinical and based on symptoms and findings of physical examination. The prevalence of lateral epicondylitis in the general populations is approximately 1.0-1.3% in men and 1.1-4.0% in women and that of medial epicondylitis is nearly 0.3-0.6% in men and 0.3-1.1% in women. The incidence rate of medical consultations has been estimated at 0.3-1.1 for lateral and 0.1 for medial epicondylitis per year per 100 subjects of general practice populations. Of occupational risk factors, forceful activities, high force combined with high repetition or awkward posture and awkward postures are associated with epicondylitis. The number of studies is limited to work-related psychosocial factors and the effects are not as consistent as those of physical load factors. Topical non-steroidal anti-inflammatory drugs, corticosteroid injections and acupuncture provide short-term beneficial effects. Workload modification should be considered, especially in manually strenuous jobs. According to clinical case series, surgical treatment has shown fair to good results; however, the efficacy of surgical treatment has not been evaluated in randomised controlled trials. Poorer prognosis of epicondylitis has been reported for individuals with high level of physical strain at work, non-neutral wrist postures during work activity and for those with the condition on the dominant elbow. Modification of physical factors could reduce the risk or improve the prognosis of epicondylitis.

  9. An alternative approach to treating lateral epicondylitis. A randomized, placebo-controlled, double-blinded study

    NARCIS (Netherlands)

    Nourbakhsh, Mohammad Reza; Fearon, Frank J.

    2008-01-01

    Objective: To investigate the effect of noxious level electrical stimulation on pain, grip strength and functional abilities in subjects with chronic lateral epicondylitis. Design: Randomized, placebo-control, double-blinded study. Setting: Physical Therapy Department, North Georgia College and Stat

  10. Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline

    DEFF Research Database (Denmark)

    Krogh, Thøger Persson; Fredberg, Ulrich; Stengaard-Pedersen, Kristian

    2013-01-01

    Lateral epicondylitis (LE) is a common musculoskeletal disorder for which an effective treatment strategy remains unknown.......Lateral epicondylitis (LE) is a common musculoskeletal disorder for which an effective treatment strategy remains unknown....

  11. Epicondilite lateral do cotovelo Lateral epicondylitis of the elbow

    Directory of Open Access Journals (Sweden)

    Marcio Cohen

    2012-01-01

    Full Text Available A epicondilite lateral, também conhecida como cotovelo do tenista, é uma condição comum que acomete de 1 a 3% da população. O termo epicondilite sugere inflamação, embora a análise histológica tecidual não demonstre um processo inflamatório. A estrutura acometida com mais frequência é a origem do tendão extensor radial curto do carpo e o mecanismo de lesão está associado à sua sobrecarga. O tratamento incruento é o de escolha e inclui: repouso, fisioterapia, infiltração com cortisona ou plasma rico em plaquetas e a utilização de imobilização específica. O tratamento cirúrgico é recomendado quando persistem impotência funcional e dor. Tanto a técnica cirúrgica aberta quanto a artroscópica com ressecção da área tendinosa degenerada apresenta bons resultados na literatura.Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. The word epicondylitis suggests inflammation, although histological analysis on the tissue fails to show any inflammatory process. The structure most commonly affected is the origin of the tendon of the extensor carpi radialis brevis and the mechanism of injury is associated with overloading. Nonsurgical treatment is the preferred method, and this includes rest, physiotherapy, cortisone infiltration, platelet-rich plasma injections and use of specific immobilization. Surgical treatment is recommended when functional disability and pain persist. Both the open and the arthroscopic surgical technique with resection of the degenerated tendon tissue present good results in the literature.

  12. Cyriax physiotherapy for tennis elbow/lateral epicondylitis.

    Science.gov (United States)

    Stasinopoulos, D; Johnson, M I

    2004-12-01

    Tennis elbow or lateral epicondylitis is one of the most common lesions of the arm with a well defined clinical presentation, which significantly impacts on the community. Many treatment approaches have been proposed to manage this condition. One is Cyriax physiotherapy. The effectiveness and reported effects of this intervention are reviewed.

  13. Pulsed radiofrequency on radial nerve under ultrasound guidance for treatment of intractable lateral epicondylitis.

    Science.gov (United States)

    Oh, Dae Seok; Kang, Tae Hyung; Kim, Hyae Jin

    2016-06-01

    Lateral epicondylitis is a painful and functionally limiting disorder. Although lateral elbow pain is generally self-limiting, in a minority of people symptoms persist for a long time. When various conservative treatments fail, surgical approach is recommended. Surgical denervation of several nerves that innervate the lateral humeral epicondyle could be considered in patients with refractory pain because it denervates the region of pain. Pulsed radiofrequency is a minimally invasive procedure that improves chronic pain when applied to various neural tissues without causing any significant destruction and painful complication. This procedure is safe, minimally invasive, and has less risk of complications relatively compared to the surgical approach. The radial nerve can be identified as a target for pulsed radiofrequency lesioning in lateral epicondylitis. This innovative method of pulsed radiofrequency applied to the radial nerve has not been reported before. We reported on two patients with intractable lateral epicondylitis suffering from elbow pain who did not respond to nonoperative treatments, but in whom the ultrasound-guided pulsed radiofrequency neuromodulation of the radial nerve induced symptom improvement. After a successful diagnostic nerve block, radiofrequency probe adjustment around the radial nerve was performed on the lateral aspect of the distal upper arm under ultrasound guidance and multiple pulsed treatments were applied. A significant reduction in pain was reported over the follow-up period of 12 weeks.

  14. Therapeutic Observation on Tuina plus Electroacupuncture for Lateral Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    Li Shi-sheng; Wu Yao-chi; Zhang Jun-feng; Zhou Jing-hui

    2014-01-01

    Objective: To observe the clinical efficacy of tuina combined with electroacupuncture (EA) in treating lateral humeral epicondylitis. Methods: Totally 118 patients were randomly allocated into a treatment group and a control group, 59 cases in each. The patients in the treatment group were treated with tuina combined with EA treatment, while those in the control group were treated by EA alone. Clinical efficacies of the two groups were compared after the treatment. Results: The total effective rate was 93.2% in the treatment group, versus 84.7% in the control group, and the difference was statistically significant (P Conclusion: Tuina combined with EA treatment for lateral humeral epicondylitis has a significant effect.

  15. THE IMPACT OF LATERAL EPICONDYLITIS ON QUALITY OF LIFE

    Directory of Open Access Journals (Sweden)

    Kavita Sudhakar

    2015-08-01

    Full Text Available Background: Lateral epicondylitis is a work related disorder which is considered to be due to over-use or over-stress of the wrist extensors of the forearm. The patient suffers from pain and decreased function which affects the basic activities in daily life. This reduction in function leading to disability may affect the quality of life as it includes items related to self care, usual activities, emotional problems, pain etc. The present study was conducted to study the impact of Lateral epicondylitis on quality of life. Methods: 52 subjects diagnosed with Lateral epicondylitis were included in the study according to the inclusion and exclusion criteria. Outcome measures were: pain using Visual analog scale, functional disability using Patient rated tennis elbow evaluation and health-related quality of life using Short Form 36. Results: A significant positive correlation was found between pain and functional disability (p<.001. A significant negative correlation between pain and physical (p=.014 and mental (p=.052 component summary scores of quality of life was found. A significant negative correlation was found between functional disability and physical (p=.002 and mental (p=.015 component summary scores of quality of life. Also a significant correlation was found between physical and mental component summary scores of quality of life (p<.001. Conclusions: Significant correlation was seen between pain, functional disability and quality of life. This suggests that with an increase in severity of pain there is increase in functional disability with lower QOL both physically and mentally.

  16. EFFECTIVENESS OF MEDIAL TO LATERAL TAPING WITH EXERCISE PROGRAMME IN SUBJECTS WITH LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    Bhavana Dattaram Desai

    2014-09-01

    Full Text Available Background: Medial to lateral tapping and exercise programme has been found to be effective in Lateral epicondylitis. The purpose to find the combined effect of Medial to lateral tapping with exercise programme for subjects with lateral epicondylitis on pain intensity and functional ability. Method: An experimental study design, selected 40 subjects with Lateral epicondylitis randomized 20 subjects each into Study and Control group. Control group received only exercise programme while study group received combined medial to lateral tapping with exercise programme thrice a week for 4 weeks. Pain intensity was measured using Visual analogue scale and functional ability was measured using Patient Rated Tennis Elbow Evaluation questionnaire before and after 4 weeks of treatment. Results: When the post-intervention means were compared between Study and Control group after 4 weeks of treatment found statistically significant difference in the improvement in outcomes measures in means of VAS and PRTEE before and after intervention within the groups. Conclusion: It is concluded that the Medial to lateral tapping with exercise programme is more effective than the exercise programme in reduction of pain and improve functional abilities for subjects with Lateral epicondylitis. Key Words: Lateral epicondylitis, Medial to lateral tapping, Exercise programme, Pain, Functional ability, Tennis Elbow.

  17. Corticosteroid injection for tennis elbow or lateral epicondylitis: a review of the literature

    OpenAIRE

    2010-01-01

    Lateral epicondylitis or tennis elbow is a painful and functionally limiting entity affecting the upperextremity and is frequently treated by hand surgeons. Corticosteroid injection is one of the most common interventions for lateral epicondylitis or tennis elbow. Here, a review of the medical literature on this treatment is presented.

  18. Corticosteroid injection for tennis elbow or lateral epicondylitis: a review of the literature.

    Science.gov (United States)

    Saccomanni, Bernardino

    2010-07-15

    Lateral epicondylitis or tennis elbow is a painful and functionally limiting entity affecting the upperextremity and is frequently treated by hand surgeons. Corticosteroid injection is one of the most common interventions for lateral epicondylitis or tennis elbow. Here, a review of the medical literature on this treatment is presented.

  19. DIAGNOSTIC ACCURACY OF PROVOCATIVE TESTS IN LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    G Saroja

    2014-12-01

    Full Text Available The aim of the present study was to analyze the diagnostic accuracy of the commonly used provocative tests in the diagnosis of lateral epicondylitis (LE. Cozen’s test, Mills test and Maudsley test are most widely used. Till date no studies have been reported on the diagnostic accuracy of these tests. Musculoskeletal ultrasonography serves as a gold standard tool in the diagnosis of LE. Thirty subjects participated in the study. Baseline measurements of pain severity, elbow joint mobility, hand grip strength and three provocative tests were recorded by the principal investigator. A second investigator accompanied the subjects for musculoskeletal ultrasonography who was blinded of the test results. The thickness of common extensor tendon, echo texture and lateral epicondyle bony contour was measured. The test results of the three provocative tests with ultrasonographic findings were analyzed. The sensitivity for Cozen’s test, Maudsley test and Mills test was found to be 84%, 88% and 53% respectively. The specificity for Cozen’s Maudsley and Mills test was found to be 0%, 0% and 100% respectively. Mills test showed significant area under receiver operator curve (ROC i.e. (0.769, which explains that the test has good diagnostic accuracy. This validation study, concludes that Mills test has an excellent diagnostic value for ruling in LE.

  20. Risk factors in lateral epicondylitis (tennis elbow): a case-control study.

    Science.gov (United States)

    Titchener, A G; Fakis, A; Tambe, A A; Smith, C; Hubbard, R B; Clark, D I

    2013-02-01

    Lateral epicondylitis is a common condition, but relatively little is known about its aetiology and associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and quantify the relative contributions of some constitutional and environmental risk factors for lateral epicondylitis in the community. Our dataset included 4998 patients with lateral epicondylitis who were individually matched with a single control by age, sex, and general practice. The median age at diagnosis was 49 (interquartile range 42-56) years . Multivariate analysis showed that the risk factors associated with lateral epicondylitis were rotator cuff pathology (OR 4.95), De Quervain's disease (OR 2.48), carpal tunnel syndrome (OR 1.50), oral corticosteroid therapy (OR 1.68), and previous smoking history (OR 1.20). Diabetes mellitus, current smoking, trigger finger, rheumatoid arthritis, alcohol intake, and obesity were not found to be associated with lateral epicondylitis.

  1. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kotnis, Nikhil A. [McMaster University, Departments of Radiology, Hamilton, ON (Canada); Sheffield Teaching Hospitals, Department of Medical Physics and Medical Imaging, Sheffield (United Kingdom); Chiavaras, Mary M. [McMaster University, Departments of Radiology, Hamilton, ON (Canada); Harish, Srinivasan [McMaster University, Departments of Radiology, Hamilton, ON (Canada); St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada)

    2012-04-15

    The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis. (orig.)

  2. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation.

    Science.gov (United States)

    Kotnis, Nikhil A; Chiavaras, Mary M; Harish, Srinivasan

    2012-04-01

    The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis.

  3. The Clinical Report on 2 Cases of Lateral Epicondylitis Treated by Scolopendrid Aquacupucture Therapy

    Directory of Open Access Journals (Sweden)

    Jang-Woo Park

    2006-12-01

    Full Text Available Objective : The purpose of this study is to examine if scolopendrid acuacupucture may be effective to the lateral epicondylitis. Methods : Using scolopendrid aquacupucture, we injected a small dose of it to the affected area and operated 2 pre and post treatment test; VAS(visual analogue scale, PPT(pressure pain threshold. Results : The scolopendrid aquacupucture treatment led to improvement in the pain and symptom of lateral epicondylitis by all efficacy measures. After scolopendrid aquacupucture treatment, there was improvement in VAS, PPT. Conclusion : This results suggest that scolopendrid aquacupucture is good method for treatment of lateral epicondylitis. so we suggest the possibility to use this new remedy for the lateral epicondylitis.

  4. Treatment of lateral epicondylitis of the elbow with shock waves.

    Science.gov (United States)

    Ko, J Y; Chen, H S; Chen, L M

    2001-06-01

    In a prospective clinical study, the effectiveness of shock wave treatment for lateral epicondylitis in 56 elbows in 53 patients (27 men and 26 women) with an average age of 46 years was investigated. Three patients received treatment for both elbows. Each elbow was treated with 1,000 impulses of shock waves at 14 kV. A 100-point scoring system was used for evaluation including 40 points for pain, 30 points for function, 20 points for strength, and 10 points for elbow motion. The intensity of pain was measured using a visual analogue scale from 0 to 10. The overall results were 13.2% excellent, 44.7% good, 36.8% acceptable, and 5.3 unchanged in 35 patients with 12 weeks followup; 30.8% excellent, 42.3% good, and 26.9% acceptable in 25 patients with 24 weeks followup. Considerable improvement was observed from 6 weeks to 6 months after the treatment. None of the patients' symptoms became worse. The results of nine patients who also received a second treatment were good in three patients, acceptable in five patients, and unchanged in one patient. There was no device-related problems, systemic, or local complications. Shock wave therapy may offer a new and safer nonoperative treatment for patients with lateral epidoncylitis of the elbow.

  5. Lateral epicondylitis: This is still a main indication for extracorporeal shockwave therapy.

    Science.gov (United States)

    Thiele, S; Thiele, R; Gerdesmeyer, L

    2015-12-01

    Extracorporeal shockwave therapy (ESWT) is used in a number of indications in the medical field. A number of tendinopathies show good and excellent results due to evidence based medicine. The treatment of lateral epicondylitis is known to show conflicting results. This overview of the published RCT's on ESWT for lateral epicondylitis tries to show the reasons for this conflicting data-base and point out, why we think that this is still a main indication for extracorporeal shockwave therapy.

  6. New Developments in the Use of Biologics and Other Modalities in the Management of Lateral Epicondylitis.

    Science.gov (United States)

    Kahlenberg, Cynthia A; Knesek, Michael; Terry, Michael A

    2015-01-01

    Lateral epicondylitis is a common source of elbow pain. Though it is often a self-limited condition, refractory lateral epicondylitis can lead to problems with activities of daily living and sometimes requires sick leave from work. Therefore prompt treatment is essential. Histopathologic studies have suggested that lateral epicondylitis is a tendinopathy, associated with apoptosis and autophagy, rather than a tendonitis associated with inflammation. Although corticosteroids have been used for short-term treatment, recent studies have suggested that they are not helpful and may even be harmful and delay healing in the treatment of lateral epicondylitis. Researchers have recently begun to investigate the use of biologics as potential treatment options for lateral epicondylitis. Autologous blood preparations including platelet rich plasma (PRP) and autologous whole blood injections (ABIs) have been proposed in order to deliver growth factors and other nutrients to the diseased tendon. Stem cell therapies have also been suggested as a method of improving tendon healing. This review discusses the current evidence for the use of PRP, ABI, and stem cell therapies for treatment of lateral epicondylitis. We also review the evidence for nonbiologic treatments including corticosteroids, prolotherapy, botulinum toxin A, and nitric oxide.

  7. New Developments in the Use of Biologics and Other Modalities in the Management of Lateral Epicondylitis

    Directory of Open Access Journals (Sweden)

    Cynthia A. Kahlenberg

    2015-01-01

    Full Text Available Lateral epicondylitis is a common source of elbow pain. Though it is often a self-limited condition, refractory lateral epicondylitis can lead to problems with activities of daily living and sometimes requires sick leave from work. Therefore prompt treatment is essential. Histopathologic studies have suggested that lateral epicondylitis is a tendinopathy, associated with apoptosis and autophagy, rather than a tendonitis associated with inflammation. Although corticosteroids have been used for short-term treatment, recent studies have suggested that they are not helpful and may even be harmful and delay healing in the treatment of lateral epicondylitis. Researchers have recently begun to investigate the use of biologics as potential treatment options for lateral epicondylitis. Autologous blood preparations including platelet rich plasma (PRP and autologous whole blood injections (ABIs have been proposed in order to deliver growth factors and other nutrients to the diseased tendon. Stem cell therapies have also been suggested as a method of improving tendon healing. This review discusses the current evidence for the use of PRP, ABI, and stem cell therapies for treatment of lateral epicondylitis. We also review the evidence for nonbiologic treatments including corticosteroids, prolotherapy, botulinum toxin A, and nitric oxide.

  8. US National Practice Patterns in Ambulatory Operative Management of Lateral Epicondylitis.

    Science.gov (United States)

    Buller, Leonard T; Best, Matthew J; Nigen, David; Ialenti, Marc; Baraga, Michael G

    2015-12-01

    Lateral epicondylitis is a common cause of elbow pain, frequently responsive to nonoperative management. There are multiple operative techniques for persistently symptomatic patients who have exhausted conservative therapies. Little is known regarding US national trends in operative management of lateral epicondylitis. We conducted a study to investigate changes in use of ambulatory procedures for lateral epicondylitis. Cases of lateral epicondylitis were identified using the National Survey of Ambulatory Surgery and were analyzed for trends in demographics and use of ambulatory surgery. Between 1994 and 2006, the population-adjusted rate of ambulatory surgical procedures increased from 7.29 to 10.44 per 100,000 capita. The sex-adjusted rate of surgery for lateral epicondylitis increased by 85% among females and decreased by 31% among males. Most patients were between ages 40 and 49 years, and the largest percentage increase in age-adjusted rates was found among patients older than 50 years (275%) between 1994 and 2006. Use of regional anesthesia increased from 17% in 1994 to 30% in 2006. Private insurance remained the most common payer. Awareness of the increasing use of ambulatory surgery for lateral epicondylitis may lead to changes in health care policies and positively affect patient care.

  9. [Elbow dislocation and lateral epicondyle fracture in a five year-old girl. Case report].

    Science.gov (United States)

    Rincón, D; Guzmén, R; Camacho, J; Abril, C

    2014-01-01

    Traumatic elbow dislocation in the pediatric population is a particularly unusual injury. It was first described by Stimson in 1900 and almost 100 years later revisited by Tachdjian in 1990. Three percent of cases are associated with lateral epicondyle fracture, so this is an infrequent injury that has been described in only a few papers as case reports. The mechanism of injury is not clearly known, nor is the best type of treatment or its complications. We report herein the case of a five year-old girl with fracture dislocation of the lateral epicondyle who was managed with closed reduction and percutaneous fixation with Kirschner nails, with good functional results.

  10. Poorer elbow proprioception in patients with lateral epicondylitis than in healthy controls: a cross-sectional study

    DEFF Research Database (Denmark)

    Juul-Kristensen, B.; Lund, H.; Hansen, K.

    2008-01-01

    Two groups of women, 15 patients with lateral epicondylitis and 21 healthy controls, were studied to compare proprioception in the elbows and knees between the groups. Outcome measures were absolute error and variable error for joint position sense and for threshold to detection of a passive...... movement. Both absolute error and variable error of threshold to detection of a passive movement were greater in the lateral epicondylitis-diagnosed elbows than in the controls' elbows (lateral epicondylitis, 1.8 degrees vs controls 1.1 degrees, P = .026; lateral epicondylitis, 0.8 degrees vs controls 0.......3 degrees, P = .015), and there was a tendency toward a greater absolute error of joint position sense compared with the control elbows (lateral epicondylitis, 8.2 degrees vs controls, 5.6 degrees; P = .078). Absolute error of joint position sense was greater in the elbows than in the knees of the lateral...

  11. Poorer elbow proprioception in patients with lateral epicondylitis than in healthy controls: a cross-sectional study.

    Science.gov (United States)

    Juul-Kristensen, Birgit; Lund, Hans; Hansen, Klaus; Christensen, Hanne; Danneskiold-Samsøe, Bente; Bliddal, Henning

    2008-01-01

    Two groups of women, 15 patients with lateral epicondylitis and 21 healthy controls, were studied to compare proprioception in the elbows and knees between the groups. Outcome measures were absolute error and variable error for joint position sense and for threshold to detection of a passive movement. Both absolute error and variable error of threshold to detection of a passive movement were greater in the lateral epicondylitis-diagnosed elbows than in the controls' elbows (lateral epicondylitis, 1.8 degrees vs controls 1.1 degrees, P = .026; lateral epicondylitis, 0.8 degrees vs controls 0.3 degrees, P = .015), and there was a tendency toward a greater absolute error of joint position sense compared with the control elbows (lateral epicondylitis, 8.2 degrees vs controls, 5.6 degrees; P = .078). Absolute error of joint position sense was greater in the elbows than in the knees of the lateral epicondylitis patients, but no group differences were found for knees. Proprioception seems, therefore, to be poorer in elbows with lateral epicondylitis elbows than in the controls' elbows. This needs to be taken into consideration in the management of lateral epicondylitis.

  12. Magnetic resonance imaging in the evaluation of treatment response of lateral epicondylitis of the elbow

    Energy Technology Data Exchange (ETDEWEB)

    Savnik, Anette [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg (Denmark); Department of Radiology, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg (Denmark); Hovmarksvej 39, 2920, Charlottenlund (Denmark); Jensen, Bente; Noerregaard, Jesper; Danneskiold-Samsoee, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg (Denmark); Egund, Niels [Department of Radiology, Aarhus University Hospital, 8000, Aarhus C (Denmark)

    2004-06-01

    The purpose of this study was to investigate the treatment response in lateral epicondylitis (tennis elbow) by MRI. Magnetic resonance imaging was obtained in 30 patients with clinical symptoms of lateral epicondylitis of the elbow using T1-, T2- and T2-weighted fat-saturated (FS) sequences. The patients were randomised to either i.m. corticosteroid injection (n=16) or immobilisation in a wrist splint (n=14). Magnetic resonance imaging of the elbow was performed on a 1.5-T MR system at baseline and after 6 weeks. The extensor carpi radialis (ECRB) tendon, the radial collateral ligament, lateral humerus epicondyle at tendon insertion site, joint fluid and signal intensity changes within brachio-radialis and anconeus muscles were evaluated on the MR unit's workstation before and after 6 weeks of treatment. The MRI was performed once in 22 healthy controls for comparison and all images evaluated by an investigator blinded to the clinical status of the subjects. The MR images showed thickening with separation of the ECRB tendon from the radial collateral ligament and abnormal signal change in 25 of the 30 patients on the T1-weighted sequences at inclusion. The signal intensity of the ECRB tendon was increased in 24 of the 30 patients with lateral epicondylitis of the elbow on the T2-weighted FS sequences. (orig.)

  13. Grip strength measurements at two different wrist extension positions in chronic lateral epicondylitis-comparison of involved vs. uninvolved side in athletes and non athletes: a case-control study

    Directory of Open Access Journals (Sweden)

    Bhargava Arti S

    2010-09-01

    Full Text Available Abstract Background Lateral epicondylitis is a common sports injury of the elbow caused due to altered muscle activation during repetitive wrist extension in many athletic and non-athletic endeavours. The amount of muscle activity and timing of contraction eventually is directly dependent upon joint position during the activity. The purpose of our study was to compare the grip strength in athletes with lateral epicondylalgia in two different wrist extension positions and compare them between involved and uninvolved sides of athletes and non-athletes. Methods An assessor-blinded case-control study of eight athletes and twenty-two non-athletes was done. The grip strength was measured using JAMAR® hand dynamometer in kilograms-force at 15 degrees (slightly extended and 35 degrees (moderately extended wrist extension positions (maintained by wrist splints on both involved and uninvolved sides of athletes and non-athletes with unilateral lateral epicondylitis of atleast 3 months duration. Their pain was to be elicited with local tenderness and two of three tests being positive- Cozen's, Mill's manoeuvre, resisted middle finger extension tests. For comparisons of grip strength, Wilcoxon signed rank test was used for within-group comparison (between 15 and 35 degrees wrist extension positions and Mann-Whitney U test was used for between-group (athletes vs. non-athletes comparisons at 95% confidence interval and were done using SPSS 11.5 for Windows. Results Statistically significant greater grip strength was found in 15 degrees (27.75 ± 4.2 kgms in athletes; 16.45 ± 4.2 kgms in non-athletes wrist extension than at 35 degrees (25.25 ± 3.53 kgm in athletes and 14.18 ± 3.53 kgm in non-athletes. The athletes had greater grip strength than non-athletes in each of test positions (11.3 kgm at 15 degrees and 11.07 kgm at 35 degrees measured. There was also a significant difference between involved and uninvolved sides' grip strength at both wrist

  14. The effect of autologous platelet rich plasma in treatment lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    İsmail Ağır

    2011-03-01

    Full Text Available Lateral epicondylitis (tennis elbow is the most commonly diagnosed cause of lateral elbow pain. The aim of this study was to compare the effect of single dose corticosteroid and autologous platelet rich plasma (PRP injection in the treatment of tennis elbow.Materials and methods: The 15 elbow of 15 patients (6 male and 9 female was included in the study, who applied to our clinic with lateral elbow pain and diagnosed as lateral epicondylitis. A single dose of 0,5 ml Bethametasone and 0,5 ml Prilocaine mixture was applied to first group and single dose 1 ml autologous PRP was locally applied to the second group.Results: In the early follow-ups the results of corticosteroid group were better than latter follow-ups, however in PRP group the results were worst in early follow-ups but better results were obtained in later follow-ups according to Verhaar scoring system.Conclusion: According to our results, the beneficial effects of PRP injection in lateral epicondylitis increases over time but further studies with more patients and longer follow up durations should done in order to more clarified this subject.

  15. Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis

    NARCIS (Netherlands)

    Smidt, N; van der Windt, DA; Assendelft, WJ; Mourits, AJ; Deville, WL; de Winter, AF; Bouter, LM

    2002-01-01

    Objective: To evaluate the interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis in primary care. Design: Two physiotherapists assessed independently, and in randomized order, the severity of compl

  16. Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis.

    NARCIS (Netherlands)

    Smidt, N.; Windt, A. van der; Assendelft, W.J.; Mourits, A.J.; Devillé, W.L.; Winter, F. de; Bouter, L.M.

    2002-01-01

    Objective: To evaluate the interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis in primary care. Design: Two physiotherapists assessed independently, and in randomized order, the severity of compl

  17. EFFECTIVENESS OF MULLIGAN MOBILISATION WITH MOVEMENT COMPARED TO SUPERVISED EXERCISE PROGRAM IN SUBJECTS WITH LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    Hafizur Rahman

    2016-04-01

    Full Text Available Background and Purpose: Lateral epicondylitis commonly referred to as lateral elbow Tendinopathy or tennis elbow is one of the most common lesions of the arm. Men and women are equally affected. There are many treatment options available for tennis elbow; an exercise program is used as the first treatment option. Mulligan has proposed the use of mobilization with movement for lateral epicondylitis. The main Purpose of the study is to compare the effects of mulligan mobilization with movement and supervised exercise program in subjects with lateral epicondylitis. Materials and Methods: 60 Subjects fulfilled the inclusive criteria and were randomly assigned into two groups. Group A were given Mobilization with movement and Group B performed Supervised Exercise Program. Both groups performed three sessions per week for the duration of 4 weeks. After the treatment, subjects were evaluated for their pain profile using visual analogue scale, and grip strength by Hand grip dynamometer. Results: Paired t-test analysis is used within group and Independent t-test is used for between group comparisons. At the end of 4 weeks Mulligan mobilisation with movement group showed significant improvement in VAS and hand grip strength scores than the supervised exercise program group (P<0.000. Conclusion: It is concluded that both techniques showed improvements in hand grip strength and VAS. The group that performed mulligan mobilisation with movement showed significantly greater improvement in reduction of pain and increase in hand grip strength than the supervised exercise program.

  18. A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis

    OpenAIRE

    2016-01-01

    Background Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. Objectives To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients ...

  19. EFFICACY OF PHONOPHORESIS AND IONTOPHORESIS OF NAPROXEN IN THE TREATMENT OF LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    Shyam D.Ganvir

    2012-08-01

    Full Text Available The aim of study see the efficacy of iontophoresis, phonophoresis and to compare their effects in the treatment of lateral epicondylitis, it was Randomized controlled trial at Padmashree Dr.Vithalrao Vikhe Patil Foundations, medical hospital,Physiotherapy OPD,AHMEDNAGAR (M.S This study was carried out with 31 patients who had lateral epicondylitis and randomized into two groups. Group A and Group B, Naproxen was applied to the group A using Phonophoresis (19 patients-23 extremities and to the group B using iontophoresis(12 patients – 14 extremities.Both groups were treated by other conventional physiotherapy in the form -cryotherapy, strengthening and stretching exercises. it outcomes was Pain scores (at rest, during motion, with pressure, weight lifting.Grip strength and Nirschl- Petterone Grading System were evaluated before and after treatment. Results: Pain scores decreased, grip strength and Nirsch- Petterone Grading System statistically significantly increased in both groups after treatment (p0.05.Conclusion: The results suggest that iontophoresis and phonophoresis of naproxen are equally effective electrotherapy methods in the treatment of lateral epicondylitis.

  20. Anatomy of the lateral antebrachial cutaneous nerve in relation to the lateral epicondyle and cephalic vein.

    Science.gov (United States)

    Wongkerdsook, Wachara; Agthong, Sithiporn; Amarase, Chavarin; Yotnuengnit, Pattarapol; Huanmanop, Thanasil; Chentanez, Vilai

    2011-01-01

    The lateral antebrachial cutaneous nerve (LACN) is the terminal sensory branch of the musculocutaneous nerve supplying the lateral aspect of forearm. Because of its close proximity to the biceps brachii tendon (BBT), the lateral epicondyle (LE), and the cephalic vein (CV), surgery and venipuncture in the cubital fossa can injure the LACN. Measurement data regarding the relative anatomy of LACN are scarce. We, therefore, dissected 96 upper extremities from 26 males and 22 females to expose the LACN in the cubital fossa and forearm. The LACN consistently emerged from the lateral margin of BBT. It then pierced the deep fascia distal to the interepicondylar line (IEL) in 84.4% with mean distances of 1.8 ± 1.1 and 1.2 ± 0.9 cm (male and female, respectively). At the level of IEL, the LACN in all cases was medial to the LE (5.9 ± 1.1 cm male and 5.2 ± 0.9 cm female). Two types of branching were observed: single trunk (78.1%) and bifurcation (21.9%). Asymmetry in the branching pattern was observed in 6 males and 1 female. Concerning the relationship to the CV, the LACN ran medially within 1 cm at the level of IEL in 78.7%. Moreover, in 10 specimens, the LACN was directly beneath the CV. In the forearm, the LACN tends to course medial to the CV. Significant differences in the measurement data between genders but not sides were found in some parameters. These data are important for avoiding LACN injury and locating the LACN during relevant medical procedures.

  1. Natural course in tennis elbow--lateral epicondylitis after all?

    Science.gov (United States)

    Zeisig, Eva

    2012-12-01

    Tennis elbow is a common and difficult-to-treat condition largely because of lack of evidence. The natural history is unknown, but the condition is described as self-limiting. The objective of this case report is to describe the natural course of two control participants (pain free), who later developed tennis elbow, patient history, clinical findings, and ultrasound and colour Doppler examination before, during and after a period of tennis elbow.

  2. CLINICAL ASSESSMENT OF FUNCTIONAL OUTCOME IN LATERAL EPICONDYLITIS MANAGED BY LOCAL INFILTRATION OF AUTOLOGOUS BLOOD

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    Dr. Ajay Bharti

    2010-01-01

    Full Text Available Lateral epicondylitis is a well known elbow disorder known to affect a variety of population. Though the disorder is expected to affect a lot of sports personnel, the incidence is not uncommon in persons of household activities. The management comprises of conservative to operative with a dilemma of what to be done in most of the affected population. A large number of interventions have been tried to delineate the best modality but none of them proved to be conclusive. The aim of the present study was to prove the efficacy of cheapest possible interventional modality autologous blood for treatment of Lateral Epicondylitis. Twenty five patients of Tennis elbow were included in this study who have attended the OPD of GSVM Medical College and associated LLR Hospital, Kanpur from November 2007 to April 2008 and fulfilled inclusion and exclusion criteria. 78% were females, mostly housewives involved in regular household activities. All the patients were infiltrated autologous blood with local anaesthetic infiltration. Patients were deprived of regular activities for 3 weeks after infiltration. Follow up was done at weekly interval for 2 weeks and then at 6th week and 12th week. Assessment was done using Visual Analogue Scale ( VAS and Verhaar et al scoring system. Total follow up period was 3 months. We observed that the mean VAS score improved from preinfiltrative 6.40±1.22 to 0.48±1.53 with p value being < .001. 64% patients showed excellent results and 32% showed good results as per Verhaar et al scoring system on 12 weeks follow up. One patient did not respond to this procedure and showed poor result as per Verhaar et al score. Therefore, autologous blood infiltration is a safe and effective modality in treatment of Lateral Epicondylitis.

  3. Evidence-Based Approach to Treating Lateral Epicondylitis Using the Occupational Adaptation Model.

    Science.gov (United States)

    Bachman, Stephanie

    2016-01-01

    The occupational therapy Centennial Vision reinforces the importance of informing consumers about the benefit of occupational therapy and continuing to advocate for the unique client-centered role of occupational therapy. Occupational therapy practitioners working in hand therapy have traditionally found it difficult to combine the biomechanical foundations of hand therapy with the fundamental client-centered tenets of occupational therapy. Embracing our historical roots will become more important as health care evolves and third-party payers continue to scrutinize the need for the profession of occupational therapy. This article outlines a client-centered approach for hand therapists for the treatment of lateral epicondylitis using the Occupational Adaptation Model.

  4. Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial

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    Evandro Pereira Palacio

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the effects of platelet-rich plasma (PRP infiltration in patients with lateral epicondylitis of the elbow, through analysis of the Disabilities of the Arm, Shoulder and Hand (DASH and Patient-Rated Tennis Elbow Evaluation (PRTEE questionnaires. METHODS: Sixty patients with lateral epicondylitis of the elbow were prospectively randomized and evaluated after receiving infiltration of three milliliters of PRP, or 0.5% neocaine, or dexamethasone. For the scoring process, the patients were asked to fill out the DASH and PRTEE questionnaires on three occasions: on the day of infiltration and 90 and 180 days afterwards. RESULTS: Around 81.7% of the patients who underwent the treatment presented some improvement of the symptoms. The statistical tests showed that there was evidence that the cure rate was unrelated to the substance applied (p = 0.62. There was also intersection between the confidence intervals of each group, thus demonstrating that the proportions of patients whose symptoms improved were similar in all the groups. CONCLUSION: At a significance level of 5%, there was no evidence that one treatment was more effective than another, when assessed using the DASH and PRTEE questionnaires.

  5. The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis

    NARCIS (Netherlands)

    van de Streek, M.D.; van der Schans, C.P.; de Greef, M.H.G.; Postema, K.

    2004-01-01

    The aim of the present study was to compare the effect of a new prefabricated Thamert forearm/hand splint with the effect of a simple elbow band as a treatment for lateral epicondylitis. Forty-three (43) patients that met the inclusion criteria were randomly assigned to the elbow band group and the

  6. Motor unit potential morphology differences in individuals with non-specific arm pain and lateral epicondylitis

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    McLean Linda

    2008-12-01

    Full Text Available Abstract Background The pathophysiology of non-specific arm pain (NSAP is unclear and the diagnosis is made by excluding other specific upper limb pathologies, such as lateral epicondylitis or cervical radiculopathy. The purpose of this study was to determine: (i if the quantitative parameters related to motor unit potential morphology and/or motor unit firing patterns derived from electromyographic (EMG signals detected from an affected muscle of patients with NSAP are different from those detected in the same muscle of individuals with lateral epicondylitis (LE and/or control subjects and (ii if the quantitative EMG parameters suggest that the underlying pathophysiology in NSAP is either myopathic or neuropathic in nature. Methods Sixteen subjects with NSAP, 11 subjects with LE, eight subjects deemed to be at-risk for developing a repetitive strain injury, and 37 control subjects participated. A quantitative electromyography evaluation was completed using decomposition-based quantitative electromyography (DQEMG. Needle- and surface-detected EMG signals were collected during low-level isometric contractions of the extensor carpi radialis brevis (ECRB muscle. DQEMG was used to extract needle-detected motor unit potential trains (MUPTs, and needle-detected motor unit potential (MUP and surface detected motor unit potential (SMUP morphology and motor unit (MU firing rates were compared among the four groups using one-way analysis of variance (ANOVA. Post hoc analyses were performed using Tukey's pairwise comparisons. Results Significant group differences were found for all MUP variables and for MU firing rate (p p p p p Conclusion The size-related parameters suggest that the NSAP group had significantly smaller MUPs and SMUPs than the control and LE subjects. Smaller MUPs and SMUPs may be indicative of muscle fiber atrophy and/or loss. A prospective study is needed to confirm any causal relationship between smaller MUPs and SMUPs and NSAP as found

  7. Evaluation of patients submitted to the arthroscopic treatment of the lateral epicondylitis refractory to the conservative treatment

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    Fabio Alexandre Martynetz

    2013-12-01

    Full Text Available Objective: to evaluate the results of the arthroscopic treatment of the lateral epicondylitis. Methods: we evaluated 14 patients (15 elbows submitted to the arthroscopic treatment of the lateral epicondylitis refractory to the conservative treatment, which was realized for a minimum period of 18 months. Beyond the demographic data collection, patients were evaluated according to the arthroscopic classification of Baker et al., the Disabilities of the Arm, Shoulder, and Hand (DASH questionnaire and the Mayo Elbow Performance Score (MEPS. The patients' ages ranged between 23 and 56 years (average 46 years (eight males and six females. Of the 15 elbows, 12 were the dominant and one patient had bilateral lesion. The follow-up after surgery was minimum 24 months and maximum 72 months (average 41 months. Results: we found, according to the arthroscopic classification of Baker et al., two patients with type I lesions, nine with type II lesions and three with type III lesions. We found the following complications: one patient with altered sensitivity in the region of the lateral portal, one with a deficit of ten degrees in length, one with synovial plica and one with synovitis in the lateral compartment. Our score on the DASH questionnaire was minimum of 32 points and maximum of 120 points (average 57 points and the scale of MEPS had a minimum score of 60 points and a maximum of 100 points (average 90 points. Conclusion: the arthroscopic treatment of the lateral epicondylitis, plus insurance, provides satisfactory results.

  8. Hydro-galvanic and rising - temperature bath therapy for chronic elbow epicondylitis: a comparative study

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    C. Mucha

    2004-02-01

    Full Text Available The efficacy of two different regimens of physiotherapy for epicondylitis was compared. A combination treatment with hydrogalvanic four-cell bath and arm bath with rising temperature, which had showed good effects in treatment of tennis elbow in an earlier observational study (Mucha 1987, was compared with the analgesic interference current treatment often recommended in the literature (Sadil and Sadil 1994, Noteboom et al 1994, Becker and Reuter 1982. For this study, 60 patients with epicondylitis that was resistant to conservative treatment were randomized into two groups for comparison. In group 1, interference currents were administered twice a day for six weeks and group 2 received combination treatment with the hydrogalvanic four-cell bath and rising- temperature arm bath once a day for six weeks. Criteria for inclusion, control and appraisal were laid down prospectively. Several parameters were used, recorded and statistically evaluated as outcome measures.  These were active joint range of movement of the elbow, grip strength, pain provocation with muscle contraction, palpation pain and pain with functional activities.  The results showed a significant superiority of combination treatment over therapy with interference current. It is therefore recommended that hydrogalvanic four-cell bath and arm bath with rising temperature should be carried out before considering surgical treatment for chronic epicondylitis.

  9. EFFECTIVENESS OF MOBILIZATION WITH MOVEMENT OF ELBOW COMPARED WITH MANIPULATION OF WRIST IN PATIENTS OF LATERAL EPICONDYLITIS

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    Namrata Patel

    2013-10-01

    Full Text Available Purpose:To evaluate the effectiveness of mobilization with movement of elbow compared with manipulationof wr ist on pai n, strength and acti viti es of dai l y l i vi ng i n patients of l ateral epi condyl i tis.Methodology:An interventional comparative study was conducted on 30 patients having symptomatic lateralepicondylitis. They were randomly assigned to one of the three groups. Group A (n=10 control group,Group B(n=10 Mobilization with movement group and Group C (n=10 wrist manipulation. All the 3 groups werereceivedconventional treatment of ultrasound, stretching and strengthening of wrist extensors. Baseline measurementsof pain (VAS score, functional status (PRTEE questionnaire and strength (maximal isometric grip strengthwere taken on day 1 and after 10thtreatment session.Results:The data analysis was performed with Graph PadInstat trial version 3 software. All three groups showed improvement in VAS, maximal isometrics gripstrengthand PRTEEquestionnaire. There isstatistically significant difference between groups B (Mobilization withmovement and Group C (Manipulation of wrist for VAS and PRTEEquestionnaire score. But No statisticallysignificant difference is found in maximal isometric grip strength. Mobilization with movement of elbow alongwith conventional therapy showed significant improvement in Pain and functional status as compared to wristmanipulation.Conclusion:It can be concluded that mobilization with movement of elbow along withconventional therapy program is effective in treating chronic lateral epicondylitis

  10. Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis): A Randomized Clinical Trial

    OpenAIRE

    Rajadurai Viswas; Rejeeshkumar Ramachandran; Payal Korde Anantkumar

    2012-01-01

    Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis). Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis). Intervention. Group A ( = 1 0 ) had received supervised exercise program. Group B ( = 1 0 ) was treated with Cyriax physiotherapy. All patients received ...

  11. A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis

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    Saremi

    2016-05-01

    Full Text Available Background Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. Objectives To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients with lateral epicondylitis. Materials and Methods Twelve participants (six men and six women were recruited (mean age = 41 ± 6.7 years and evaluated for pain and grip strength in three sessions. A 48-hour break was taken between each session. The first session was without any orthosis, the second session was with the new modified tennis elbow orthosis, and the third session was with a conventional tennis elbow strap. Results Both counterforce straps were effective. However, significantly more improvement was observed in pain and grip strength after using the newly modified orthosis (P < 0.05. Conclusions The newly designed strap reduces pain more effectively and improves grip strength by causing greater localized pressure on two regions with different force applications (two component vectors versus one.

  12. Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis.

    Science.gov (United States)

    Beyazal, Münevver Serdaroğlu; Devrimsel, Gül

    2015-12-01

    [Purpose] This study aimed to determine and compare the effectiveness of extracorporeal shock wave therapy and local corticosteroid injection in patients with lateral epicondylitis. [Subjects and Methods] Sixty-four patients with lateral epicondylitis were randomly divided into extracorporeal shock wave therapy and steroid injection groups. Patients were evaluated using hand grip strength, visual analog scale, and short-form McGill pain questionnaire at baseline and at 4 and 12 weeks post-treatment. [Results] Both groups showed statistically significant increase in hand grip strength and decreases on the visual analog scale and short form McGill pain questionnaire overtime. There was no statistically significant difference in the percentage of improvement in hand grip strength and on the short-form McGill pain questionnaire between groups at 4 weeks post-treatment, whereas the extracorporeal shock wave therapy group showed better results on the visual analog scale. The percentages of improvements in all 3 parameters were higher in the extracorporeal shock wave therapy group than in the injection group at 12 weeks post-treatment. [Conclusion] Both the extracorporeal shock wave therapy and steroid injection were safe and effective in the treatment of lateral epicondylitis. However, extracorporeal shock wave therapy demonstrated better outcomes than steroid injection at the long-term follow-up.

  13. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison.

    Science.gov (United States)

    Gündüz, Rukiye; Malas, Fevziye Ünsal; Borman, Pınar; Kocaoğlu, Seher; Özçakar, Levent

    2012-05-01

    The aim of this study was to compare--clinically and ultrasonographically--the therapeutic effects of physical therapy modalities (hot pack, ultrasound therapy, and friction massage), local corticosteroid injection, and extracorporeal shock wave treatment (ESWT) in lateral epicondylitis (LE). Fifty-nine elbows of 59 patients with LE were randomized into three treatment groups receiving either physical therapy, a single corticosteroid injection, or ESWT. Visual analogue scale (VAS) was used to assess pain intensity, Jamar hydraulic dynamometer for grip strength, finger dynamometer for pinch strength (before treatment, on the first, third, and sixth months of treatment). All subjects were also evaluated with ultrasonography before and 6 months after treatment. In all groups, VAS scores of the patients were found to decrease significantly on the first, third, and sixth months of treatment. With respect to grip strength evaluations, the increase after treatment was significant only on the first month in group II; on the first and third months in group I; and on the first, third, and sixth months of treatment in group III. Pinch strength and ultrasonographical findings did not change during follow-up in any group. We imply that physical therapy modalities, corticosteroid injection, and ESWT have favorable effects on pain and grip strength in the early period of LE treatment. The increase in grip strength lasts longer with ESWT. On the other hand, ultrasonographic findings do not change in the first six months of these treatment methods.

  14. Outcome of Boyd-McLeod procedure for recalcitrant lateral epicondylitis of elbow.

    Science.gov (United States)

    Reddy, V R M; Satheesan, K S; Bayliss, N

    2011-08-01

    Various surgical procedures including percutaneous and open release and arthroscopic procedures have been described to treat recalcitrant tennis elbow. We present the outcome of Boyd-McLeod surgical procedure for tennis elbow resistant to non-operative treatment in twenty-seven patients (twenty-nine limbs). Boyd McLeod procedure involves excision of the proximal portion of the annular ligament, release of the origin of the extensor muscles, excision of the bursa if present, and excision of the synovial fringe. The average time interval from the onset of symptoms of tennis elbow until surgery was 28 months (range 8-72 months). Of those patients, 91% reported complete relief of symptoms with return to full normal activities including sports. Average post-operative time for return to professional/recreational activity was 5 weeks. One case developed pain secondary to ectopic bone formation after surgery, which settled after excision, and in another there was no pain relief with Boyd McLeod procedure. Two patients had scar tenderness that did not affect the final outcome. We conclude that Boyd-McLeod procedure is an effective treatment option in patients with resistant lateral epicondylitis.

  15. Association of real-time sonoelastography findings with clinical parameters in lateral epicondylitis.

    Science.gov (United States)

    Kocyigit, Figen; Kuyucu, Ersin; Kocyigit, Ali; Herek, Duygu Tuncer; Savkin, Raziye; Aslan, Ummuhan Bas; Karabulut, Nevzat

    2016-01-01

    The objective of this study was to investigate the role of real-time sonoelastography (RTSE) in patients with lateral epicondylitis (LE) and whether it is associated with clinical parameters. Seventeen patients with unilateral LE were enrolled in the study. The healthy elbows of the participants constituted the control group. Using B-mode ultrasound, color Doppler ultrasound, and RTSE, we prospectively examined 34 common extensor tendon elbows of 17 patients. Both color scales and strain ratio were used for evaluating RTSE images. Two radiologists evaluated the RTSE images separately. Elbow pain was scored on a 100-mm visual analog scale (VAS). Symptom duration and the presence of nocturnal pain were questioned. Quick disabilities of arm shoulder and hand (DASH) Questionnaire was applied to assess the pain, function, and disability. Nottingham health profile (NHP) was used to determine and quantify perceived health problems. Both color scales and strain ratios of the affected tendon portions were significantly different from that of healthy tendons (p elbows as a feasible and practical supplementary method with substantial interobserver agreement. RTSE was superior to B-mode ultrasound and color Doppler ultrasound in discriminating tendons with LE. Strain ratio of the medial portion of the tendon is associated moderately with nocturnal pain and symptom duration. No other associations were present between RTSE findings and clinical or functional parameters.

  16. Acupuncture for lateral epicondylitis (tennis elbow): study protocol for a randomized, practitioner-assessor blinded, controlled pilot clinical trial

    Science.gov (United States)

    2013-01-01

    Background Lateral epicondylitis is the most frequent cause of pain around the elbow joint. It causes pain in the region of the elbow joint and results in dysfunction of the elbow and deterioration of the quality of life. The purpose of this study is to compare the effects of ipsilateral acupuncture, contralateral acupuncture and sham acupuncture on lateral epicondylitis. Methods/design Forty-five subjects with lateral epicondylitis will be randomized into three groups: the ipsilateral acupuncture group, contralateral acupuncture group and the sham acupuncture group. The inclusion criteria will be as follows: (1) age between 19 and 65 years with pain due to one-sided lateral epicondylitis that persisted for at least four weeks, (2) with tenderness on pressure limited to regions around the elbow joint, (3) complaining of pain during resistive extension of the middle finger or the wrist, (4) with average pain of NRS 4 or higher during the last one week at a screening visit and (5) voluntarily agree to this study and sign a written consent. Acupuncture treatment will be given 10 times in total for 4 weeks to all groups. Follow up observations will be conducted after the completion of the treatment, 8 weeks and 12 weeks after the random assignment. Ipsilateral acupuncture group and contralateral acupuncture group will receive acupuncture on LI4, TE5, LI10, LI11, LU5, LI12 and two Ashi points. The sham acupuncture group will receive treatment on acupuncture points not related to the lateral epicondylitis using a non-invasive method. The needles will be maintained for 20 minutes. The primary outcome will be differences in the visual analogue scale (VAS) for elbow pain between the groups. The secondary outcome will be differences in patient-rated tennis elbow evaluation (PRTEE), pain-free/maximum grip strength (Dynamometer), pressure pain threshold, clinically relevant improvement, patient global assessment, and the EQ-5D. The data will be analyzed with the paired t

  17. Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis.

    Science.gov (United States)

    Alizadehkhaiyat, Omid; Frostick, Simon P

    2015-12-01

    There is no consensus about the main aetiology of Lateral Epicondylitis (LE) or Tennis Elbow. While electromyographic assessment of alterations in neuromuscular control and activation patterns of forearm muscles has received increasing interest as potential intrinsic factors in non-tennis players, there has been insufficient attention in tennis players. The purpose of present review was to search the literature for the electromyographic studies of forearm muscles in tennis players in order to (1) identify related implications for LE, (2) highlight key technical and methodological shortcomings, and (3) suggest potential pathways for future research. An electronic search of PubMed, Scopus, Web of Science, and Google Scholars (1980 to October 2014) was conducted. Titles, abstracts, and full-text articles were screened to identify "peer-reviewed" studies specifically looking into "electromyographic assessment of forearm muscles" in "tennis players". After screening 104 articles, 13 original articles were considered in the main review involving a total of 216 participants (78% male, 22% female). There were indications of increased wrist extensor activity in all tennis strokes and less experienced single-handed players, however with insufficient evidence to support their relationship with the development of LE. Studies varied widely in study population, sample size, gender, level of tennis skills, electrode type, forearm muscles studied, EMG recording protocol, EMG normalisation method, and reported parameters. As a result, it was not possible to present combined results of existing studies and draw concrete conclusions in terms of clinical implications of findings. There is a need for establishment of specific guidelines and recommendations for EMG assessment of forearm musculature particularly in terms of electrode and muscle selection. Further studies of both healthy controls and tennis players suffering from LE with adequate sample sizes and well-defined demographics

  18. The Potential Risk Factors Relevant to Lateral Epicondylitis by Wrist Coupling Posture.

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    Su-Ya Lee

    Full Text Available The use of awkward wrist postures and unskilled techniques might induce lateral epicondylitis. This study thus investigated the effects of wrist deviation combined with extension and movement velocity on the dynamic performances of the wrist muscles during the coupling posture via a custom-made bi-planar isokinetic dynamometer. Thirty subjects were recruited to perform the isokinetic testing. We measured the muscle strengths and activities for the wrist extensors and flexors during concentric and eccentric contractions at three movement velocities, 30°s-1, 90°s-1, and 180°s-1, combined with three wrist postures, neutral position (NP, radial deviation (RD, and ulnar deviation (UD. The root mean square (RMS of the electromyographic signal in the extensor digitorum communis (EDC, normalized peak torque of extensors, and ratio of normalized peak torque between wrist extensors and flexors, were all greater in the NP than RD and UD in both contractions. The ratio of RMS between EDC and flexor digitorum superficialis (FDS had a significantly greater value in RD than UD during the concentric contraction. The EDC showed significantly higher activity at the fast velocity in both contractions. Nevertheless, a significantly higher RMS of the electromyographic signal between EDC and FDS and the ratio of strength between wrist extensors and flexors were found at slow velocity in both contractions. The wrist deviation combined with extension and movement velocity of the wrist joint should thus be considered as influential factors which might alter the dynamic performances, and may result in further injury of the elbow joint.

  19. The Potential Risk Factors Relevant to Lateral Epicondylitis by Wrist Coupling Posture

    Science.gov (United States)

    Lee, Su-Ya; Chieh, Hsiao-Feng; Lin, Chien-Ju; Jou, I-Ming; Kuo, Li-Chieh; Su, Fong-Chin

    2016-01-01

    The use of awkward wrist postures and unskilled techniques might induce lateral epicondylitis. This study thus investigated the effects of wrist deviation combined with extension and movement velocity on the dynamic performances of the wrist muscles during the coupling posture via a custom-made bi-planar isokinetic dynamometer. Thirty subjects were recruited to perform the isokinetic testing. We measured the muscle strengths and activities for the wrist extensors and flexors during concentric and eccentric contractions at three movement velocities, 30°s-1, 90°s-1, and 180°s-1, combined with three wrist postures, neutral position (NP), radial deviation (RD), and ulnar deviation (UD). The root mean square (RMS) of the electromyographic signal in the extensor digitorum communis (EDC), normalized peak torque of extensors, and ratio of normalized peak torque between wrist extensors and flexors, were all greater in the NP than RD and UD in both contractions. The ratio of RMS between EDC and flexor digitorum superficialis (FDS) had a significantly greater value in RD than UD during the concentric contraction. The EDC showed significantly higher activity at the fast velocity in both contractions. Nevertheless, a significantly higher RMS of the electromyographic signal between EDC and FDS and the ratio of strength between wrist extensors and flexors were found at slow velocity in both contractions. The wrist deviation combined with extension and movement velocity of the wrist joint should thus be considered as influential factors which might alter the dynamic performances, and may result in further injury of the elbow joint. PMID:27171198

  20. Long term effects of high intensity laser therapy in lateral epicondylitis patients.

    Science.gov (United States)

    Akkurt, Ekrem; Kucuksen, Sami; Yılmaz, Halim; Parlak, Selman; Sallı, Ali; Karaca, Gülten

    2016-02-01

    The objective of this study is to investigate short- and long-term effects of high-intensity laser therapy (HILT) in lateral epicondylitis (LE) patients. Thirty patients with LE diagnosis (23 unilateral and 7 bilateral in total 37 elbows) were treated using HILT. LE patients were evaluated before, right after, and 6 months following HILT intervention post-treatment using visual analogue scale for pain (VAS) during activity and resting. Disabilities of the Arm, Shoulder, and Hand (DASH) Score and hand grip strength test (HGST) were used. The participants of the present study were also evaluated using Short-Form 36 (SF-36) before and 6 months after the treatment. Out of the 30 patients, 8 were male and 22 female with a mean age of 47.2 ± 9.7. The activity and resting VAS, DASH, and HGST scores revealed statistically significant improvement (p = 0.001) following treatment. Whereas VAS activity, DASH, and HGST scores increased after treatment until post-treatment 6 months significantly (p = 0.001), VAS resting scores remained stable (p = 0.476). A statistically significant improvement was also evident in the physical and mental components of SF-36 scores following treatment until post-treatment 6 months compared to pre-treatment scores (p = 0.001). In conclusion, the results of the present study suggest that HILT is a reliable, safe, and effective treatment option in LE patients in the short and long term considering pain, functional status, and quality of life.

  1. Radiofrequency Microtenotomy for Elbow Epicondylitis: Midterm Results.

    Science.gov (United States)

    Tasto, James P; Richmond, John M; Cummings, Jeffrey R; Hardesty, Renee; Amiel, David

    2016-01-01

    We conducted a prospective, nonrandomized, single-center clinical study to evaluate the safety and midterm effectiveness of microtenotomy using a radiofrequency probe to treat chronic tendinosis of the elbow. All patients had failed conservative treatment for 6 months. The radiofrequency-based microtenotomy was performed using the Topaz Microdebrider (ArthroCare). Patients were followed annually for up to 9 years postoperatively. Pain status was documented using a visual analog scale self-reported measure. Eighty consecutive patients with tendinosis of the elbow were enrolled; 69 patients were treated for lateral epicondylitis and 11 for medial epicondylitis. The duration of follow-up ranged from 6 months to 9 years (mean, 2.5 years). Ninety-one percent of the patients reported a successful outcome. Within the lateral epicondylitis group, the preoperative visual analog scale improved from 6.9 to 1.3 postoperatively and demonstrated an 81% improvement (P ≤ .01). For the medial epicondylitis patients, the preoperative visual analog scale improved from 6.1 to 1.3 after surgery, a 79% improvement (P ≤ .01). No complications were reported. Radiofrequency-based microtenotomy is a safe and effective procedure for elbow epicondylitis. The results are durable with successful outcomes observed at 9 years after surgery.

  2. Effects of corticosteroid on the expressions of neuropeptide and cytokine mRNA and on tenocyte viability in lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Han Soo

    2012-10-01

    Full Text Available Abstract Background The purpose of this study was to determine the reaction mechanism of corticosteroid by analyzing the expression patterns of neuropeptides (substance P (SP, calcitonin gene related peptide (CGRP and of cytokines (interleukin (IL-1α, tumor growth factor (TGF-β after corticosteroid treatment in lateral epicondylitis. In addition, we also investigated whether corticosteroid influenced tenocyte viability. Methods The corticosteroid triamcinolone acetonide (TAA was applied to cultured tenocytes of lateral epicondylitis, and the changes in the mRNA expressions of neuropeptides and cytokines and tenocyte viabilities were analyzed at seven time points. Quantitative real-time polymerase chain reaction and an MTT assay were used. Results The expression of SP mRNA was maximally inhibited by TAA at 24 hours but recovered at 72 hours, and the expressions of CGRP mRNA and IL-1α mRNA were inhibited at 24 and 3 hours, respectively. The expression of TGF-β mRNA was not significant. Tenocyte viability was significantly reduced by TAA at 24 hours. Conclusions We postulate that the reaction mechanism predominantly responsible for symptomatic relief after a corticosteroid injection involves the inhibitions of neuropeptides and cytokines, such as, CGRP and IL-1α. However the tenocyte viability was compromised by a corticosteroid.

  3. COMPARITIVE STUDY OF LOCAL STEROID INJECTION VERSUS AUTOLOGOUS BLOOD INJECTION THERAPY FOR THE MANAGEMENT OF LATERAL EPICONDYLITI S

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    Partap

    2015-03-01

    Full Text Available OBJECTIVES : Local corticosteroid infiltration is a common practice of treatment for lateral epicondylitis. In recent studies no statistically significant or clinically relevant results in favour of corticosteroid injections were found. The injection of autologous blood has been reported to be effective for both intermediate and long - term outcomes. It is hypothesized that blood contains growth factors, which induce the healing cascade. METHODS : A total of 50 patients were included in this prospective randomized study. Patients were divided in 2 groups of 25 patients each. Group I received 2 ml local corticosteroid +1 ml 2% lignocaine, Group II received 2 ml autologous blood drawn from ipsilateral upper limb vein +1 ml 2% lignocaine, and at the lateral epicondyle. Outcome was measured using a pain score (VAS . Follow - up was continued for tota l of six months. RESULTS : The corticosteroid injection group showed a statistically significant decrease in pain compared with autologous blood injection group at six weeks follow up. At final six - month follow - up, autologous blood injection group showed st atistically significant decrease in pain compared with corticosteroid injection group. CONCLUSIONS : Autologous blood injection is efficient compared with corticosteroid injection, with less side - effects and minimum recurrence rate in long term.

  4. Surgical treatment of refractory lateral epicondylitis%顽固性肱骨外上髁炎的外科治疗

    Institute of Scientific and Technical Information of China (English)

    张新涛; 张文涛

    2011-01-01

    Objective To evaluate the clinical efficacy of surgical treatment for refractory lateral epicondylitis. Methods The modified Nirschl procedure was performed under local anesthesia in 21 patients with refractory lateral epicondylitis from January,2007 to December, 2009 in our hospital. A visual analog scale(VAS) scoring was used to evaluate the degree of pain pre - and post - treatment. Elbow function was evaluated with Nirschl & Pettrone grading system. Results Twenty - one patients underwent open surgical treatment for chronic refractory lateral epicondylitis. The average follow - up was 23.6 months. The preoperative VAS scores of pain were an average of 6.21 at rest,7.10 at daily activities,and 8.76 at sports or occupational activities. After surgery, the VAS scores were improved significantly: 0.83 at rest, 1.46 at daily activities, and 2.22 at sports or occupational activities. According to the grading systern by Nirschl & Pettrone,the elbow function was excellent in 13 cases,good in 7 cases,and fair in one case. Twenty patients ( 95.2% ) achieved satisfactory results. One patient developed subcutaneous cystic mass( n = 1 )postoperatively due to the leakage of joint fluid,which was removed under local anesthesia.Conclusion The modified Nirschl procedure is effective for refractory lateral epicondylitis.%目的 探讨顽固性肱骨外上髁炎的手术治疗效果.方法 2007年1月至2009年12月,我科采用局部麻醉下Nirschl改良手术治疗顽固性肱骨外上髁炎21例,术后通过VAS疼痛评分和Nirschl & Pettrone分级评估患肘疼痛和功能改善情况.结果 21例患者平均随访时间23.6个月.VAS疼痛评分术前休息时为6.21,日常活动时7.10,体育活动时8.76;术后休息时为0.83,日常活动时1.46,体育活动时2.22.术前、术后两者比较差异均有统计学意义.术后Nirschl & Pettrone肘关节功能分级优13例,良7例,中1例,优良率95.2%.1例患者术后出现肘关节囊壁破裂后关节滑液积聚

  5. The effect of oscillating-energy manual therapy on lateral epicondylitis: a randomized, placebo-control, double-blinded study.

    Science.gov (United States)

    Nourbakhsh, Mohammad Reza; Fearon, Frank J

    2008-01-01

    Symptoms of lateral epicondylitis (LE) are attributed to degenerative changes and inflammatory reactions in the common extensor tendon induced by microscopic tears in the tissue after repetitive or overload functions of the wrist and hand extensor muscles. Conventional treatments, provided on the premise of inflammatory basis of LE, have shown 39-80% failure rate. An alternative approach suggests that symptoms of LE could be due to active tender points developed in the origin of hand and wrist extensor muscles after overuse or repetitive movements. Oscillating-energy Manual Therapy (OEMT), also known as V-spread, is a craniosacral manual technique that has been clinically used for treating tender points over the suture lines in the skull. Considering symptoms of LE may result from active tender points, the purpose of this study was to investigate the effect of OEMT on pain, grip strength, and functional abilities of subjects with chronic LE. Twenty-three subjects with chronic LE (>3mo) between ages of 24 and 72 years participated in this study. Before their participation, all subjects were screened to rule out cervical and other pathologies that could possibly contribute to their lateral elbow pain. Subjects who met the inclusion criteria were randomized into treatment and placebo treatment groups by a second (treating) therapist. Subjects were blinded to their group assignment. Subjects in the treatment group received OEMT for six sessions. During each treatment session, first a tender point was located through palpation. After proper hand placement, the therapist focused the direction of the oscillating energy on the localized tender point. Subjects in the placebo group underwent the same procedure, but the direction of the oscillating energy was directed to an area above or below the tender points, not covering the affected area. Jamar Dynamometer, Patient Specific Functional Scale (PSFS), and Numeric Rating Scale (NRS) were used to measure grip strength

  6. Epicondylitis in the athlete's elbow.

    Science.gov (United States)

    Van Hofwegen, Christopher; Baker, Champ L; Baker, Champ L

    2010-10-01

    Epicondylitis is a diagnostic term that describes a pattern of pain and tenderness localized to the medial or lateral epicondyles of the distal humerus. The pathoanatomy, clinical presentation, and treatment of these disorders is described. Nonoperative treatment, operative techniques, postoperative care, and the results of treatment are discussed.

  7. MR imaging of patients with lateral epicondylitis of the elbow: is the common extensor tendon an isolated lesion?

    Directory of Open Access Journals (Sweden)

    Liang Qi

    Full Text Available OBJECTIVE: To investigate whether an injury of the common extensor tendon (CET is associated with other abnormalities in the elbow joint and find the potential relationships between these imaging features by using a high-resolution magnetic resonance imaging (MRI. METHODS: Twenty-three patients were examined with 3.0 T MR. Two reviewers were recruited for MR images evaluation. Image features were recorded in terms of (1 the injury degree of CET; (2 associated injuries in the elbow joint. Spearman's rank correlation analysis was performed to analyze the relationships between the injury degree of CET and associated abnormalities of the elbow joint, correlations were considered significant at p<0.05. RESULTS: Total 24 elbows in 23 patients were included. Various degrees of injuries were found in total 24 CETs (10 mild, 7 moderate and 7 severe. Associated abnormalities were detected in accompaniments of the elbow joints including ligaments, tendons, saccussynovialis and muscles. A significantly positive correlation (r = 0.877,p<0.01 was found in injuries of CET and lateral ulnar collateral ligament (LUCL. CONCLUSION: Injury of the CET is not an isolated lesion for lateral picondylitis, which is mostly accompanied with other abnormalities, of which the LUCL injury is the most commonly seen in lateral epicondylitis, and there is a positive correlation between the injury degree in CET and LUCL.

  8. A Case Study of 20 Patients with Lateral Epicondylitis of the Elbow by Using Hwachim (Burning Acupuncture Therapy and Sweet Bee Venom Pharmacopuncture

    Directory of Open Access Journals (Sweden)

    Seho Jung

    2014-12-01

    Full Text Available Objectives: This study was performed to estimate the effectiveness of burning acupuncture therapy (Hwachim and sweet bee venom pharmacopuncture (S-BV pharmacopuncture in treating lateral epicondylitis of elbow. Methods: We selected 33 patients at first, but 13 patients were excluded due to unclear medical records. Finally, a total of 20 patients who had received treatment from January 2012 to December 2013 were included in this study; all 20 patients had undergone Hwachim for the treatment of lateral epicondylitis of elbow, and 19 of the 20 had been treated with S-BV pharmacopuncture (Korea Pharmacopuncture Institute, KPI and transcutaneous electrical nerve stimulation (TENS as an ancillary treatment method. The degrees of pain of the 20 patients were evaluated by using the visual analogue scale (VAS score at their first and final visits. The Wilcoxon signed rank test and the Kruskal-Wallis test were used to compare the VAS scores statistically. Results: The VAS score had decreased significantly from 10.00 ± 0.00 to 4.00 ± 2.47 (P = 0.000 by the end of the treatment. No significant changes were observed based on the number of treatments (P = 0.246, the age of the patients (P = 0.810, the duration of the illness (P = 0.705, and the location of the lesion (P = 0.076. Conclusion: This study suggests Hwachim and S-BV pharmacopuncture are very effective for treating lateral epicondylitis of the elbow.

  9. Role of extracorporeal shockwave therapy and injectable corticosteroids in the treatment of lateral epicondylitis: a comparative study of 100 patients

    Directory of Open Access Journals (Sweden)

    Yogesh Sharma

    2016-09-01

    Results: The mean VAS in both groups reduced from 8.47 and 8.53 to 2.51 and 1.67 respectively at the end of the follow up (p <0.001 .The mean PRTEE score in Group A reduced from 80.59 to 26.53 (p<0.001 and Group B from 82.76 to 13.59 (p<0.05. In Group A (ESWT, the average reduction In PRTEE Score at the end of follow up was 54.06 and Group B (steroids was 69.16. The difference was found to be statistically significant (p<0.001 favouring steroid injections. Conclusions: Both ESWT and steroid injections were found to be effective in producing symptomatic pain relief and improving the functional disability in the management of lateral epicondylitis. The comparison of both modalities showed a statistically significant improvement in pain and functional disability in favour of steroids at a short duration of follow up i.e., 03 weeks, 06 weeks and 06 months. [Int J Res Med Sci 2016; 4(9.000: 4055-4060

  10. Avaliação dos resultados do tratamento artroscópico da epicondilite lateral Evaluation of the results of arthroscopic treatment of the lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados dos pacientes com epicondilite lateral tratados cirurgicamente pela técnica artroscópica. MÉTODOS: Vinte pacientes foram operados pela técnica artroscópica. A idade variou de 19 a 54 anos (média de 41 anos e oito meses, sendo 12 (60% pacientes do sexo feminino e oito (40%, do masculino. O seguimento mínimo foi de 12 meses e o máximo, de 48 meses, sendo a média de 20 meses. Todos os casos eram refratários ao tratamento conservador (repouso e fisioterapia, com tempo de tratamento clínico prévio variando entre seis e 136 meses. Para a avaliação dos resultados utilizamos os critérios da Associação Médica Americana (AMA, modificados por Bruce. RESULTADOS: Obtivemos 13 (65% resultados excelentes e sete (13% regulares, com apenas uma complicação (distrofia simpático-reflexa. Este foi o único caso que referiu não estar satisfeito. CONCLUSÃO: O tratamento cirúrgico pela técnica artroscópica da epicondilite lateral do cotovelo representa uma boa opção para 65% dos casos.OBJECTIVE: To evaluate the results in patients with lateral epicondylitis surgically treated by the arthroscopy technique. METHODS: Twenty patients were submitted to surgery by the arthroscopic technique. Age ranged from 19 to 54 years (average 41 years and eight months. Twelve (60% of the patients were female and eight (40% male. The minimum follow-up period was 12 months and the maximum period, 48 months, with an average of 20 months. All the cases were refractory to conservative treatment (rest and physiotherapy, with previous clinical treatment times varying ranging from six to 136 months. For the evaluation of the results, we used the criteria of the American Medical Association (AMA, modified by Bruce. RESULTS: We obtained 13 (65% excellent results and seven (13% regular results, with just one complication (reflex sympathetic dystrophy. This was the only patient who reported dissatisfaction. CONCLUSION: Surgical treatment

  11. [Treatment of epicondylitis - a current review].

    Science.gov (United States)

    Schleicher, I; Szalay, G; Kordelle, J

    2010-12-01

    Lateral epicondylitis or tennis elbow is a common injury, which affects not only people who play tennis but occurs with many different activities. It reflects overuse of the extensor muscles of the forearm. There are some other pathologies which have to be separated from epicondylitis. The choice of different treatments is hard to overlook and there are only a few good clinical trials which support one treatment option by means of evidence based medicine. During the acute phase topical NSAIR, steroid injections, ultrasound and acupuncture are helpful. There is no consensus about the effectiveness of physiotherapy, orthoses, laser, electrotherapy or botulinumtoxininjections. During the chronic phase none of the different treatment modalities is effective according to criterias of evidence based medicine. By now, it has not been proven whether patients profit during that time of physiotherapy, orthoses, extracorporeal shock wave therapy or an operation. Whether orthobiological treatment options may play a role in the future is presently uncertain.

  12. The prevalence of humeral epicondylitis: a survey in general practice

    OpenAIRE

    1986-01-01

    The characteristics of all patients with humeral epicondylitis who presented over a two-year period in a group practice were examined to clarify the epidemiological features of this condition. In all 77 patients were seen. There was no observed difference in incidence between the sexes, lateral epicondylitis being more common than medial in both sexes. Medial epicondylitis is more common in the community than is generally recognized. Epicondylitis is a relapsing condition with a strong bias t...

  13. Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Rajadurai Viswas

    2012-01-01

    Full Text Available Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis. Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis. Intervention. Group A (=10 had received supervised exercise program. Group B (=10 was treated with Cyriax physiotherapy. All patients received three treatment sessions per week for four weeks (12 treatment sessions. Outcome measures. Pain was evaluated using a visual analogue scale (VAS, and functional status was evaluated by completion of the Tennis Elbow Function Scale (TEFS which were recorded at base line and at the end of fourth week. Results. Both the supervised exercise program and Cyriax physiotherapy were found to be significantly effective in reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in greater improvement in comparison to those who received Cyriax physiotherapy. Conclusion. The results of this clinical trial demonstrate that the supervised exercise program may be the first treatment choice for therapist in managing tennis elbow.

  14. Changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis caused by frequency of physical therapy: a randomized controlled trial.

    Science.gov (United States)

    Lee, Soyoung; Ko, Youngjun; Lee, Wanhee

    2014-07-01

    [Purpose] The purpose of this study was to investigate the changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis and to suggest the appropriate treatment frequency and period. [Subjects] The subjects were divided into three: 2 days per week group (n=12), 3 days per week group (n=15), and 6 days per week group (n=13). [Methods] All groups received conventional physical therapy for 40 minutes and therapeutic exercises for 20 minutes per session during 6 weeks. The outcome measurements were the visual analogue scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE), and grip strength. [Results] The results of this study were as follows: at 3 weeks, there were no significant differences in VAS and PRTEE in the 3 groups, but at 6 weeks, 6 days per week group significantly decreased these two outcomes. Grip strength was significantly increased in 3 and 6 days per week groups at 6 weeks. [Conclusion] In conclusion, physical therapy is needed 3 days per week for 3 weeks in patients with acute lateral epicondylitis. After 3 weeks, 6 days per week is the most effective treatment frequency.

  15. Physiotherapy alone or in combination with corticosteroid injection for acute lateral epicondylitis in general practice: A protocol for a randomised, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Holmedal Øystein

    2009-12-01

    Full Text Available Abstract Background Lateral epicondylitis is a painful condition responsible for loss of function and sick leave for long periods of time. In many countries, the treatment guidelines recommend a wait-and-see policy, reflecting that no conclusions on the best treatment can be drawn from the available research, published studies and meta-analyses. Methods/Design Randomized double blind controlled clinical trial in a primary care setting. While earlier trials have either compared corticosteroid injections to physical therapy or to naproxen orally, we will compare the clinical effect of physiotherapy alone or physiotherapy combined with corticosteroid injection in the initial treatment of acute tennis elbow. Patients seeing their general practitioner with lateral elbow pain of recent onset will be randomised to one of three interventions: 1: physiotherapy, corticosteroid injection and naproxen or 2: physiotherapy, placebo injection and naproxen or 3: wait and see treatment with naproxen alone. Treatment and assessments are done by two different doctors, and the contents of the injection is unknown to both the treating doctor and patient. The primary outcome measure is the patient's evaluation of improvement after 6, 12, 26 and 52 weeks. Secondary outcome measures are pain, function and severity of main complaint, pain-free grip strength, maximal grip strength, pressure-pain threshold, the patient's satisfaction with the treatment and duration of sick leave. Conclusion This article describes a randomized, double blind, controlled clinical trial with a one year follow up to investigate the effects of adding steroid injections to physiotherapy in acute lateral epicondylitis. Trial Registration ClinicalTrials.gov Identifier: NCT00826462

  16. Ultrasonographic assessment of tendon thickness, Doppler activity and bony spurs of the elbow in patients with lateral epicondylitis and healthy subjects

    DEFF Research Database (Denmark)

    Krogh, T P; Fredberg, U; Christensen, Robin

    2013-01-01

    PURPOSE: Tennis elbow, also known as lateral epicondylitis (LE), is a common disorder often assessed by ultrasound. The aim of this study was to evaluate the ultrasonographic outcomes and methods used in LE research and clinical practice. MATERIALS AND METHODS: This study was designed as an intra......- and interobserver reliability and agreement study. Ultrasonographic examination of the common extensor tendon of the elbow was performed. The intraobserver study examined tendon thickness twice in 20 right elbows from 20 healthy individuals at an interval of 7 to 12 days. The interobserver study examined tendon...... thickness, color Doppler activity, and bony spurs in 18 right elbows in 9 healthy individuals and 9 patients with LE. Two trained rheumatologists performed the interobserver examinations with the same scanner on the same day. The main outcomes were intra- and interclass correlation (ICC) and agreement...

  17. 冰球运动员肱骨外上髁炎的防治%Treatment and Precaution on the Ice Hockey Players' Humeral Lateral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    高文岳; 宋克宁

    2011-01-01

    The incidence of ice hockey players'athletic injuries is high because it's not only a fierce confrontational event with heavy intensity, fast speed, high difficulty and continual body contact, but also an athletic event with high requirement of muscle strength and flexility. Humeral lateral epieondylitis is one of the ice hockey players'most common athletic injuries, which is related with their frequent swinging the stick to hit the puck in playing. Wrong or delayed treatment and precaution will badly influence their athletic life and even their future daily living. By analyzing its pathogeny and pathology, the paper indicates the ice hockey players' common symptoms physical sign and diagnosis of humeral lateral epicondylitis. It many - sidedly puts forward and demonstrates the treatment and precaution against the players'humeral lateral epicondylitis.%冰球运动是一项强度大、速度快、难度高并且身体接触频繁的激烈对抗性体育运动,也是一项对肌肉力量素质和柔韧性素质要求很高的运动项目,运动损伤的发生率较高。肱骨外上髁炎在冰球运动员群体中是最常见的运动损伤之一,主要是运动员经常挥拍击球有关,如预防和治疗不正确、不及时,不仅会严重影响运动员的运动寿命,甚至影响今后的日常生活。分析和总结了冰球运动员肱骨外上髁炎发生的病因病理,指出了冰球运动员肱骨外上髁炎的常见症状、体征和诊断要点,从多方面提出和论证了冰球运动员肱骨外上髁炎的治疗和预防措施。

  18. Eccentric Strengthening for Chronic Lateral Epicondylosis

    OpenAIRE

    Wen, Dennis Y.; Schultz, Brian J.; Schaal, Bob; Graham, Scott T.; Kim, Byung Sung

    2011-01-01

    Background: Effective treatments for chronic lateral epicondylosis have not been studied adequately. Eccentric overload exercises have been used with success for other chronic tendinopathy, mainly Achilles and patellar. Hypothesis/Purpose: To compare a wrist extensor eccentric strengthening exercise program with a wrist extensor stretching/modality program for the treatment of chronic lateral epicondylosis. The authors hypothesized that the eccentric strengthening program would produce more f...

  19. Application of MRI in Comprehensive Evaluation of Lateral Epicondylitis of the Elbow%运用MRI对肱骨外上髁炎的综合性评价

    Institute of Scientific and Technical Information of China (English)

    祁良; 李锋; 艾飞; 王德杭; 吴飞云; 施海彬; 王仁法

    2013-01-01

    目的 探讨肱骨外上髁炎MRI的综合表现.方法 对经临床诊断的23例肱骨外上髁炎患者共24个肘关节分别行MRI检查,按伸肌总腱损伤程度分为轻、中和重度,观察患者是否合并其他损伤,包括桡侧尺副韧带损伤,桡侧副韧带损伤,内侧副韧带损伤,伸肌损伤、骨质损伤、关节腔积液、肱二头肌腱损伤等.将韧带的损伤分为轻、中和重度三级.对伸肌总腱和桡侧尺副韧带的损伤程度作Spearman等级相关分析,P<0.05认为有显著相关.结果 伸肌总腱轻度损伤10例,中度7例,重度7例.合并桡侧尺副韧带损伤22例(轻度9例,中度6例,重度7例),桡侧副韧带损伤8例,内侧副韧带损伤3例,伸肌损伤7例,骨质损伤5例,关节腔积液6例,肱二头肌腱损伤1例,肘肌损伤7例.伸肌总腱与桡侧尺副韧带的损伤程度呈正相关(r,=0.852,P<0.01).结论 肱骨外上髁炎并非单一的伸肌总腱病变,多合并其他改变,并且随着伸肌总腱损伤的加重,桡侧尺副韧带损伤也加重,对诊疗具有重要的指导作用.%Objective To evaluate comprehensive MRI findings of lateral epicondylitis of elbow.Methods 23 cases of clinical diagnosed lateral epicondylitis including 24 elbows underwent MRI examination.The injury of the common extensor tendon was graded as mild,moderate or severe,and associated injuries were observed,such as lateral ulnar collateral ligament,radial collateral ligament,medial collateral ligament,the common extensor muscle,bone,joint effusion,biceps tendon.The injury of the ligament was graded as mild,moderate and severe too.Spearman's rank correlative analysis was performed to compare the injury of the common extensor tendon with that of lateral ulnar collateral ligament,correlations were considered significant at P < 0.05.Results Mild injury of common extensor tendon were detected in 10 elbows,7 elbows with moderate injury,and 7 with severe injury.22 elbows were associated with injury of

  20. 肱骨外上髁炎痛点封闭治疗220例护理观察%Local corticosteroid injection for lateral humeral epicondylitis: Observation of 220 cases

    Institute of Scientific and Technical Information of China (English)

    吴俊; 徐建达; 胡素琴; 程秀红

    2011-01-01

    目的 肱骨外上髁炎是肘部软组织损伤常见的疾病,治疗上多以保守治疗为主,且方法多样,文中旨在观察肱骨外上髁炎痛点封闭治疗的临床疗效及护理指导.方法 从2009年12月至2010年3月期间对220例肱骨外上髁炎病例进行局部痛点封闭注射醋酸泼尼松,观察临床疗效.结果 96%患者获得回访并取得了满意疗效,优良率为96.0%,半年后复发者4例,1年后复发者2例,复发率为3%.结论 局部痛点封闭治疗肱骨外上髁炎疗效确切,可作为保守治疗肱骨外上髁炎的首选方法.%Objective Lateral humeral epicondylitis is a common disease of soft tissue injuries of the elbow, and generally treated by corticosteroid injection. The authors investigated the clinical effectiveness of local corticosteroid injection in the treatment of lateral humeral epicondylitis. Methods A total of 220 patients with lateral humeral epicondylitis were injected with prednisone acetate deep into the myofascial tissue of the tender spot of the lateral humeral epicondyle, and the clinical effectiveness was observed. Results Satisfactory results were achieved in 201 of the patients, with an excellence rate of 96.0%. Occurrence was found in 4 cases 6 months later and in 2 cases 12 months later, with an occurrence rate of 3.0%. Conclusion Local corticosteroid injection is a pre ferable option for the treatment of lateral humeral epicondylitis.

  1. The Prevalence of Medial Epicondylitis Among Patients With C6 and C7 Radiculopathy

    OpenAIRE

    2010-01-01

    Background: Medial epicondylitis, or golfer’s/pitcher’s elbow, develops as a result of medial stress overload on the flexor muscles at the elbow and presents as pain at the medial epicondyle. Cervical radiculopathy has been associated with lateral epicondylitis, but few associations between the cervical spine and medial epicondylitis have been made. Researchers propose that there is an association, suggesting that the weakness and imbalance in the elbow flexor and extensor muscles from C6 and...

  2. A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Tahririan

    2014-01-01

    Full Text Available Background: Lateral epicondylitis is a common problem affecting 1-3% of the population. There has been much debate about the best treatment modality for this condition. There is, however, no conclusive evidence in support of any of the proposed treatment modalities. In this trial, we have studied the effect of corticosteroid injection (with or without splinting with normal saline injection (with or without splinting. Materials and Methods: In this double-blind, randomized clinical trial, individuals were randomly assigned to either of four treatment groups and received either 40 mg depomedrol injection alone, 40 mg depomedrol injection with splinting, normal saline injection alone, or normal saline injection with splinting. They were evaluated using the visual analog scale (VAS at weeks 2, 4 and 24 and with the Oxford elbow scale (OES at 24 weeks. Results: A total of 79 patients were participated in the study. The corticosteroid injection groups had better pain relief as measured by VAS at 2 and 4 weeks compared with the two saline injection groups. Mean VAS difference at week 0 versus week 2 was 4.5 ± 0.9 and 2.8 ± 0.6 in corticosteroid injection groups and saline injection groups respectively (P < 0.01 but at 24 weeks, there was only moderate benefit reported for the group which received steroid injection and splinting (P < 0.01 compared to the saline injection groups. The saline injection groups reported better improvement in OES scores (20.1 ± 3.7 at the end of the trial compared corticosteroid injection groups (16.1 ± 2.9 (P < 0.05. Conclusion: Our results indicate that despite the clear pain reduction benefit associated with steroid injection in short term, this benefit in comparison with normal saline injection fades by the 24 th week of follow-up.

  3. Treatment of refractory lateral epicondylitis with modified Nirschl surgical technique%改良Nirschl术式治疗顽固性肱骨外上髁炎

    Institute of Scientific and Technical Information of China (English)

    张川; 张作君; 王俊颀; 牛素玲; 昌中孝; 赵明; 杨林平; 许海燕; 夏凯

    2013-01-01

    目的:探讨改良Nirschl术式治疗顽固性肱骨外上髁炎的临床疗效.方法:2009年3月至2011年1月,共收治顽固性单纯肱骨外上髁炎21例(21肘),男8例,女13例;年龄25~59岁,平均(48.3±13.4)岁;优势侧16例,非优势侧5例.发病时间8~33个月,平均(17.1±7.7)个月,患者均接受过多种非手术治疗.采用小切口下桡侧腕短伸肌腱起点清理术,即改良Nirschl术式进行治疗,病变涉及指总伸肌腱者予以指总伸肌腱病变部分切除.术后切口部位冰敷2d,石膏托行肘关节制动1周后开始肘部力量和活动度锻炼,腕关节制动2周后行手部和腕部活动度和力量锻炼及正常日常活动.术后随访记录患者休息疼痛情况、手部握力和患者满意度,根据Verhaar网球肘疗效评分评价恢复情况.结果:21例失访4例,17例术后获得随访,时间13~22个月,平均16.3个月.根据Verhaar网球肘疗效评价,结果仇15例,良2例,无肘关节不稳定等并发症出现.结论:单纯顽固性肱骨外上髁炎可通过行改良Nirschl术式取得良好疗效,其关键在于对并发疾病的排除和准确诊断,以及术中病变组织准确切除.%To investigate the clinical effects of modified Nirschl surgical technique in treating refractory lateral epicondylitis. Methods:From March 2009 to January 2011,21 patients (21 elbows) with refractory lateral epicondylitis were treated in our hospital. There were 8 males and 13 females,ranged in age from 25 to 59 years with an average of (48.3± 13.4) years and the duration time from 8 to 33 months with an average of (17.1 ±7.7) months;affected position in dominant sides of 16 cases and non-dominant sides of 5 cases. The patients had already received multiple non-operative treatments. Modified Nirschl surgical technique was performed, and operative origination from origin of musculus extensor carpi radialis brevis to discard process with small incision, the process place of extensor digitorum

  4. Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial

    OpenAIRE

    Raeissadat, Seyed Ahmad; Rayegani, Seyed Mansoor; Hassanabadi, Hossein; Rahimi, Rosa; Sedighipour, Leyla; Rostami, Khalil

    2014-01-01

    Background Lateral humeral epicondylitis, or ‘tennis elbow’, is a common condition with a variety of treatment options. Platelet-rich plasma (PRP) and Autologous Whole Blood (AWB) represent new therapeutic options for chronic tendinopathies including tennis elbow. The aim of the present study was to compare the long term effects of PRP versus autologous whole blood local injection in patients with chronic tennis elbow. Methods Seventy six patients with chronic lateral humeral epicondylitis wi...

  5. Eccentric Strengthening for Chronic Lateral Epicondylosis

    Science.gov (United States)

    Wen, Dennis Y.; Schultz, Brian J.; Schaal, Bob; Graham, Scott T.; Kim, Byung Sung

    2011-01-01

    Background: Effective treatments for chronic lateral epicondylosis have not been studied adequately. Eccentric overload exercises have been used with success for other chronic tendinopathy, mainly Achilles and patellar. Hypothesis/Purpose: To compare a wrist extensor eccentric strengthening exercise program with a wrist extensor stretching/modality program for the treatment of chronic lateral epicondylosis. The authors hypothesized that the eccentric strengthening program would produce more favorable results than a stretching/modality program. Study Design: Prospective randomized controlled trial. Methods: Twenty-eight adults with lateral epicondylosis of greater than 4 weeks’ duration were randomized to an eccentric strengthening group or a stretching group. Exercises were taught by a physical therapist, and participants performed most of the exercises on their own at home. Pain scores with visual analog scale from 0 to 100 were obtained at baseline and then at 4, 8, 12, 16, and 20 weeks after the start of the exercise program. Results: Both groups improved their pain scores from baseline to the 4-week time point, followed by nonsignificant further decreases in pain scores thereafter. No statistically significant differences were found between the eccentric strengthening group and stretching groups at any follow-up time point. Conclusions: Despite previous reports documenting favorable results with eccentric exercises for other tendinopathy, the authors were unable to show any statistical advantage to eccentric exercises for lateral epicondylosis during these periods compared with local modalities and stretching exercises. PMID:23016049

  6. Extracorporeal shock-wave therapy for chronic lateral tennis elbow--prediction of outcome by imaging.

    Science.gov (United States)

    Maier, M; Steinborn, M; Schmitz, C; Stäbler, A; Köhler, S; Veihelmann, A; Pfahler, M; Refior, H J

    2001-07-01

    Today the clinical use of extracorporeal shockwave application (ESWA) for the treatment of lateral tennis elbow is hampered by the lack of results from randomized controlled trials and of predictive parameters of clinical outcome. The present prospective study aimed to provide the latter by means of magnetic resonance imaging (MRI). Twenty-three female and 19 male patients with unilateral chronic tennis elbow of the dominant site were clinically examined before and after repetitive low-energy ESWA. MRI was performed before ESWA to evaluate signal intensity changes or contrast enhancement of the common extensor tendon and the lateral epicondyle. After ESWA (mean follow-up period 18.6 months for all patients), clinical evaluation showed a significantly better mean clinical performance after ESWA than before treatment. Interestingly, male patients showed a significantly better mean clinical performance after ESWA than female patients, and male and female patients differed significantly in the signal intensity of the common extension tendon cross-section and tendon thickening on MRI. For female patients, MRI scans could be applied for predicting a positive clinical outcome of ESWA. This study reports the first indication of predictability of positive clinical outcome of the treatment of chronic lateral tennis elbow by ESWA using imaging prior to treatment. This may serve as an important step towards overcoming the therapeutic nihilism with respect to the non-operative management of this condition recently in the literature.

  7. 中医综合疗法治疗肱骨外上髁炎33例临床观察%Clinical Observation of Lateral Epicondylitis with TCM Comprehensive Therapy:33 Cases

    Institute of Scientific and Technical Information of China (English)

    杜海

    2015-01-01

    目的:观察运用理筋推拿、中药熏洗和运动练功综合治疗肱骨外上髁炎的疗效。方法:将63例肱骨外上髁炎患者随机分成治疗组和对照组,对照组予以局部封闭注射治疗;治疗组运用推拿理筋、中药熏洗及运动练功综合治疗,观察两组疗效、VAS评分及复发率。结果:治疗组总有效率为90.9%,对照组为70%,治疗组的复发率低于对照组,治疗1年后治疗组VAS评分低于对照组,两组差异均有统计学意义(P<0.05)。结论:运用理筋推拿、中药熏洗和运动练功综合疗法治疗肱骨外上髁炎具有疗效优势。%Objective Explore the effect using Manipulation,Herbal Fumigation and Kinesitherapy to treat Lateral Epicondylitis. Methods 63 cases of Lateral Epicondylitis were randomly divided into treatment group and control group:control group were given block therapy,treatment group were given Manipulation,Herbal Fumigation and Kinesitherapy .Results The total effective rate of treatment group was higher than that of the control group,the recurrence rate of treatment group was lower than the control group,the VAS score of treatment group was lower than that of the control group After 1 years.Conclusion The advantage of curative effect using Manipulation,Herbal Fumigation and Kinesitherapy to treat Lateral epicondylitis.

  8. 3.0 T MR imaging manifestation in lateral epicondylitis: correlation with pathological characters%肱骨外上髁炎的3.0T磁共振表现及病理对照分析

    Institute of Scientific and Technical Information of China (English)

    梁建晓; 吕海莲

    2011-01-01

    Objective:To analyze the 3. 0 T MRI appearance of lateral epicondylitis and to investigate the value in the diagnosis of lareral epicondylitis. Age-related changes of the common extensor tendon in asymptomatic persons. Methods:Analyse MR findings of 34 patients with clinical symptoms of tennis elbow and the elbows of 20 healthy volunteers and the symptom-free contralateral elbow of 22 of the 34 patients were studied as controls. Results: In the symptomatic elbows, the common extensor origin (CEO) showed signs of edcma in 34 , thickening in 25 , and partial tears in 11 , and complete tears in 3. 34 patients had unilateral symptoms, 27 in the right arm and 7 in the left arm, 15 patients were surgically treated after the MRI examination. Conclusion:The imagines of 3. 0 T MRI have high diagnosis value in lateral epicondylitis.%目的:分析肱骨外上髁炎的3.0T 磁共振表现,探讨磁共振对肱骨外上髁炎的诊断价值以及肱骨外上髁炎发生率与年龄的相关性.方法:收集临床拟诊肱骨外上髁炎患者34例(侧),和20例(侧)健康志愿者及肱骨外上髁炎患者对侧无症状的肘关节22(侧),回顾性分析、对比其磁共振表现.结果:34例患者MRI均表现为伸肌总腱的异常,主要位于近肱骨附着处.伸肌总腱增厚、信号异常25例,伸肌总腱完全撕裂3例,部分撕裂11例.其中伸肌总腱的病变发生于左侧7例,右侧27例.15例经外科手术证实,与磁共振表现相符.结论:3.0TMRI对肱骨外上髁炎的诊断有较高的价值.肱骨外上髁炎发生率与年龄呈正相关性.

  9. 肱骨上髁炎的磁共振诊断价值%Humeral epicondylitis of diagnostic value of MRI

    Institute of Scientific and Technical Information of China (English)

    姜庆军; 邱中华; 郁冰冰; 杨晓; 孙钢

    2011-01-01

    目的:评价磁共振成像(MRD在肱骨内、外上髁炎的诊断价值.方法:回顾分析12例肱骨内,外上髁炎病变患者的MRI图像.部分患者与关节手术对照.结果:12例患者中,1例同时患有内、外上髁炎;余11例中,内上髁炎1例,外上髁炎10例;10例外上髁炎显示伸肌总腱增粗,其内不规则高信号,伴或不伴周围程度水肿,其中2例可见肱骨外上髁局部信号异常,1例伴外侧副韧带部分撕裂;2例内上髁炎显示屈肌总腱增粗,伴有信号增高,肱骨内上髁未见明显异常.结论:MRI能显示肌腱的急慢性损伤,显示骨髓水肿,同时,MRI有助于正确诊断和了解较为复杂的肘关节损伤.%Objective: To evaluate MRI in diagnosis for humeral epicondylitis. Methods: Analyzing the MR images of 12patients who suffered epicondylitis retrospectively. The analyzing results were compared with those of operation or arthroscopy. Results: Among these patients , one patient was confirmed medial humeral epicondylitis and lateral humeral epicondylitis simultaneously, ten patients were confirmed lateral epicondylitis. one patient was confirmed medial epicondylitis. The tendons origin at the lateral or medial epicondyles thickened and showed increased signal intensity on all pulse sequence.One patient suffered from the lateral epicondylitis with the lateral ulnar collateral ligament partial teared. Conclusion : MRI can show the acute and chronic injuries of tendons and the edema of the marrow. Meanwhile, MRI is helpful to evaluate the complex elbow injuries.

  10. TREATMENT OF 62 CASES OF EXTERNAL HUMERAL EPICONDYLITIS WITH STILETTO NEEDLE

    Institute of Scientific and Technical Information of China (English)

    JIA Jian-xin; WEN Zhi-hua

    2006-01-01

    @@ External humeral epicondylitis, also known as brachioradial bursitis, popularly called "tennis elbow" refers to the acute or chronic myofascitis, the injury of the common extensor tendon of the humeral epicondyle. The authors have recently treated 62 cases of the disease by means of stiletto needle, the therapeutic effect of the treatment is so satisfactory, following is the report of the treatment.

  11. Diagnostic value of Color Doppler ultrasonography in lateral epicondylitis%彩色多普勒超声对肱骨外上髁炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    许华宁; 殷立平; 杨益虎; 徐大华; 周正国; 强也

    2014-01-01

    目的:利用彩色多普勒超声检查(CDUS)观察肱骨外上髁炎(LE)患者肘关节外上髁的超声表现,评价CDUS对LE 的诊断价值。方法对27例临床诊断为LE患者的27个患侧肘关节和18例对照者25个正常肘关节行超声检查,观察肱骨外上髁伸肌总腱的厚度、内部回声、有无钙化、撕裂以及内部血流情况,肱骨外上髁骨质是否光整、有无毛糙,并进行对比分析。结果对照组伸肌总腱平均厚度约(0.40±0.06)cm,LE 组伸肌总腱平均厚度约(0.56±0.13)cm,较对照组明显增厚,差异有统计学意义(t=-5.43,P<0.01)。病变伸肌总腱回声减低,内部可有钙化或撕裂,彩色血流信号较对照组明显增多。肱骨外上髁骨皮质回声毛糙、不光整。结论 CDUS对肱骨外上髁炎具有一定的诊断价值,在临床应用中可作为诊断肱骨外上髁炎的首选检查方法。%Objective By observing the sonographic features of elbow in lateral epicondylitis (LE) with color doppler ultrasonography (CDUS), evaluate the diagnostic value of CDUS in LE. Methods Twenty-seven affected elbows of 27 patients with clinically diagnosed LE and 25 bilateral elbows of 18 normal controls were examined by ultrasound, to obtaining the thickness, internal echo, having calcification and tear or not, and color flow image of extensor tendon. The bone of humeral epicondyle was whether smooth or rough. The results of two group was compared. Results The thickness of extensor tendon was (0.40±0.06) cm in control group and (0.56±0.13) cm in LE group, which was significantly thicker than control group (t=-5.43, P<0.01), and having significantly statistical significance. Internal echo of lesion extensor tendon was hypoechoic, in which, perhaps had calcification or tear. Color doppler flow signal was significantly increasing than control group. The bone of humeral epicondyle was rough or not smooth. Conclusion CDUS has certain

  12. A preliminary study of mobilization with movement in the treatment of lateral epicondylitis%动态关节松动术治疗肱骨外上髁炎的初步研究

    Institute of Scientific and Technical Information of China (English)

    张瑾; 张顺喜; 王新亮; 鞠洪斌; 邓卫兵; 刘月萍; 王东山; 华学锋

    2012-01-01

    Objective: To investigate the short-tenn effect of mobilization with movement (MWM) on patients with lateral epicondylitis. Method: Twenty-seven subjects with lateral epicondylitis were enrolled and divided into MWM group (15 cases) and control group (12 cases). The MWM group were treated with single MWM, while the control group were treated with ultrashort wave ( USW) and single ultrasonic wave management Pain-free grip strength (PFG) and maximum grip strength ( MGS) were measured before and after a single intervention. The visual analogue scales ( VAS) of suffering limbs before and after treatments were also recorded. Result: In the MWM group, the PFG affected /MGS unaffected after MWM was much higher than before MWM (0. 80 ±0. 18 vs. 0. 55 ±0. 20, P <0. 05) , and also much higher than the traditional physiotherapy treatment group (0. 80 ± 0. 18 vs. 0. 58 ±0. 18, P <0. 05 ). The VAS of MWM group was much lower than of the traditional physiotherapy treatment group (3.25 ±1.09 vs. 4.29 ±0.61, P<0.05). Conclusion: MWM is effective in reducing pain, increasing active range of motion and promoting strength for patients with lateral epicondylalgia.%目的:初步探讨动态关节松动术( MWM)治疗肱骨外上髁炎的短期疗效.方法:将27例肱骨外上髁炎患者随机分为MWM组(15例)和对照组(12例).MWM组予单次MWM治疗,对照组予传统物理治疗——单次超短波和超声波治疗.检测两组治疗前后的患侧无痛握力及健、患侧最大握力,取其比值(无痛握力患侧/最大握力健补、最大握力患侧/最大握力健侧)作为参数进行比较.并比较两组治疗前后患肢的视觉模拟评分(VAS).结果:MWM组患者治疗后的无痛握力患侧/最大握力健侧较治疗前显著提高(0.80±0.18对比0.55±0.20,P<0.05),也明显高于治疗后的对照组(0.80 +0.18对比0.58±0.18,P<0.05).MWM组治疗后VAS明显低于对照组(3.25±1.09对比4.29±0.61,P<0.05).结论:MWM可快速缓解肱骨外

  13. Diagnostic guidlines for occupational epicondylitis

    Directory of Open Access Journals (Sweden)

    Patrycja Krawczyk-Szulc

    2015-07-01

    Full Text Available Making final decisions on the occupational etiology of musculoskeletal diseases is often difficult and problematic at every stage of the diagnostic procedure. Taking into account the need to facilitate decision-making about the causal relationship between the diagnosed disease entity and the working conditions guidelines for the recognition of work-related musculoskeletal diseases have been developed. This paper presents the guidelines for the diagnosis of occupational etiology of humeral epicondylitis, one of the most common occupational disease of the musculoskeletal system in Poland. The developed guidelines have been based on the literature data concerning occupational risk factors of humeral epicondylitis, workload classification, including repetitive movements, awkward postures, and force. Some criteria applied in ergonomic evaluation methods were also included. The presented diagnostic guidelines define approximate benchmarks for stating (after excluding non-occupational etiology that the identified humeral epicondylitis, is related to the way of working. Crucial work factors that should be analyzed include an operating time of movements overloading tendons connecting to the epicondyle, repetition and force used to perform occupational activities. The developed guidelines are aimed to facilitate occupational physicians diagnostic and certification procedures in case of humeral epicondylitis and determination whether there is a likelihood of its occupational etiology. Med Pr 2015;66(3:443–450

  14. [Diagnostic guidlines for occupational epicondylitis].

    Science.gov (United States)

    Krawczyk-Szulc, Patrycja; Wągrowska-Koski, Ewa; Puzder, Anna; Markowski, Przemysław; Walusiak-Skorupa, Jolanta

    2015-01-01

    Making final decisions on the occupational etiology of musculoskeletal diseases is often difficult and problematic at every stage of the diagnostic procedure. Taking into account the need to facilitate decision-making about the causal relationship between the diagnosed disease entity and the working conditions guidelines for the recognition of work-related musculoskeletal diseases have been developed. This paper presents the guidelines for the diagnosis of occupational etiology of humeral epicondylitis, one of the most common occupational disease of the musculoskeletal system in Poland. The developed guidelines have been based on the literature data concerning occupational risk factors of humeral epicondylitis, workload classification, including repetitive movements, awkward postures, and force. Some criteria applied in ergonomic evaluation methods were also included. The presented diagnostic guidelines define approximate benchmarks for stating (after excluding non-occupational etiology) that the identified humeral epicondylitis, is related to the way of working. Crucial work factors that should be analyzed include an operating time of movements overloading tendons connecting to the epicondyle, repetition and force used to perform occupational activities. The developed guidelines are aimed to facilitate occupational physicians diagnostic and certification procedures in case of humeral epicondylitis and determination whether there is a likelihood of its occupational etiology.

  15. Efficacy of eccentric exercise combined with extracorporeal shock wave therapy on lateral epicondylitis%离心收缩训练联合体外冲击波治疗肱骨外上髁炎的疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈建新; 刘光华; 林瑜玮; 吴一鸣; 刘邦忠

    2016-01-01

    Objective: To compare clinical efficacy of three different treatments , eccentric exercise (EE ) , extracorporeal shock wave therapy (ESWT ) ,and EE combined with ESWT on lateral epicondylitis (LE) .Methods:Sixty subjects with LE were selected and randomly assigned to EE group (n=20) ,ESWT group (n=20) and EE combined with ESWT group (n=20) .All of the subjects were evaluated through the visual analogue scale (VAS) and hand-grip strength test at baseline and 2 weeks after the end of treatment respectively .All data were analyzed by SPSS 17 .0 .Results:The VAS scores dramatically decreased from baseline to 2 weeks after the end of treatment in all three groups (P<0 .05);however ,there were no significant differences in VAS scores between any two groups 2 weeks after the end of treatment .As to hand-grip strength , there was significant increase from baseline to 2 weeks after the end of treatment in all three groups (P<0 .05);moreover ,the hand-grip strength of EE combined with ESWT group was significantly higher than that of EE group (P<0 .05) and ESWT group (P<0 .05) at 2 weeks after the end of treatment ;however ,no significant difference of the hand-grip strength emerged between EE group and ESWT group at the same time point .The overall response rate of EE combined with ESWT group was 100% ,which was significantly higher than that of EE group (64 .70% ,P<0 .05) and ESWT group (68 .42% ,P<0 .05);no statistically significant difference of overall response rate was found between EE group and ESWT group .Conclusions:EE and ESWT were both effective and showed similar efficacy in the treatment of LE .In addition ,the combination therapy of EE and ESWT was better than either single therapy .%目的:比较离心收缩训练(eccentric exercise ,EE)、体外冲击波疗法(extracorporeal shock wave therapy ,ESWT)及EE联合ESWT对肱骨外上髁炎(lateral epicondylitis ,LE)的疗效。方法:选择60例LE受试者,随机分为EE

  16. A randomized comparison of open and arthroscopic Nirschl debridement for refractory lateral epicondylitis%Nirschl手术治疗顽固性网球肘:切开与关节镜手术比较

    Institute of Scientific and Technical Information of China (English)

    闫辉; 崔国庆; 刘玉雷; 肖健; 杨渝平; 敖英芳

    2009-01-01

    Objective To compare open and arthroscopie methods for treatment of recalcitrant lateral epicondylitis. Methods A prospective trial of 26 patients (28 elbows) with recalcitrant lateral epieondylitis were treated between May 2006 and September 2008. The mean duration of conservative care was 23. 0 months (4-60 months). The mean follow-up was 17.4 months (4-32 months). The patients were randomized divided into two groups, 13 elbows with an open Nirschl procedure and 15 with an arthroscopic Nirschl procedure. All patients had pre-and post-operative assessment using VAS (visual analog scale) scores, Mayo 12 points elbow scores, time of return to work or sports, satisfaction, and so on. Results There were no significant differences in VAS scores at rest and activities of daily living, time of return to work or sports and satisfaction between the two groups. But there was a statistically significant difference in VAS scores at work and sports and Mayo 12 points elbow scores between the two groups. 100% of the patients had excellent or good results in the open group and 93. 3% in arthroscopic group. There were no severe complications in this series. Conclusions Both open and arthroscopic Nirschl procedures are valid and reliable treatments for patients with refractory lateral epieondylitis. The patients in the open group have a better function in the return-to work and sports postoperatively than the arthroscopic group.%目的 比较切开和关节镜手术治疗顽固性网球肘的临床疗效.方法 2006年5月至2008年9月连续收治顽固性网球肘患者26例(28例肘),手术时患者平均年龄45岁(32~62岁),保守治疗时间为23个月(4~60个月).手术方式以Nirschl术为原则,按照随机表随机分为切开组(13例13肘)和关节镜组(13例15肘).采用VAS疼痛评分、Mayo功能评分、肘关节综合评分、重返工作和运动时间、满意度等评价患者术后效果.结果 26例患者均获随访,随访时间4~32个月,平均17.4

  17. 肱骨外上髁炎临床表现与伸肌总腱损伤程度的相关性研究%A correlative study of the clinical manifestation of lateral epicondylitis and the severity of injury of the common extensor tendon of the elbow joint

    Institute of Scientific and Technical Information of China (English)

    祁良; 李锋; 艾飞; 王德杭; 夏黎明; 胡道予; 王仁法

    2012-01-01

    目的:探讨肱骨外上髁炎临床表现与伸肌总腱损伤程度的相关性.方法:对经临床确诊的23例肱骨外上髁炎患者共24个肘关节行MRI常规扫描,采用疼痛视觉模拟评分法(VAS)将肱骨外上髁炎疼痛程度分为轻、中和重度.分析MRI图像,将伸肌总腱损伤分为轻、中和重度.对肱骨外上髁炎患者的VAS疼痛等级和伸肌总腱损伤程度进行Spearman等级相关分析.结果:24个肘关节中,根据VAS评分轻度疼痛关节8个,中度10个,重度6个;MRI图像分析和统计显示伸肌总腱轻度损伤10个,中度7个,重度7个.肱骨外上髁炎VAS疼痛等级与伸肌总腱损伤程度呈正相关(rs =0.784,P<0.01).结论:MRI是诊断肱骨外上髁炎的重要辅助检查手段;随着肱骨外上炎疼痛等级增加,伸肌总腱损伤程度也明显增加,对患者诊疗具有重要的指导作用.%Objective: To study the correlation between the clinical manifestation of lateral epicondylitis of humerus and the severity of injury degree of common extensor tendon of the elbow. Methods;23 clinical diagnosed lateral epicondylitis patients including 24 elbows underwent MRI examination. The pain of lateral epicondylitis was graded as mild, moderate or ing to trie V.A-O criterion. 1 ne injury ol trie common extensor tendon was graded as mild,moderate or severe based on evaluation of MRI images. Spearman's rank correlation analysis was performed to compare VAS grade of pain with the injury of the common extensor tendon,and statistical correlations were considered significant at P<0.05. Results: Ac cording to VAS criterion, 24 elbows included 8 with mild pain, 10 with moderate, and 6 with sever pain. Basing on MRI image analysis,10 elbows with mild injury of common extensor tendon,/ with moderate injury,and 7 with sever injury were detected. Positive correlation were found between VAS grade of pain and injury of the common extensor tendon ( rs= 0.784,P<0. 01). Conclusion:MRI is an important

  18. The ultrastructural needle knife treatment of near the lateral epicondyle of humerus pain in 90 cases%超微针刀治疗肱骨外上髁附近疼痛90例疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡超伟; 张华林

    2014-01-01

    目的:观察超微针刀治疗肱骨外上髁附近疼痛的疗效。方法:2005-2011年收治肱骨外上髁处疼痛患者90例,用自制的超微针刀对其病变肌肉的起点或止点加以松解,观察其疗效。结果:本组病例经1~3次治疗后,1次痊愈42例(47%),2次痊愈31例(34%),3次痊愈16例(18%);1例好转(1%),后经5次治疗而痊愈;无效0例。结论:超微针刀治疗肱骨外上髁附近疼痛疗效显著。%Objective:To observe the curative effect of ultrastructural needle knife in the treatment of the pain of outside humerus epicondyle.Methods:90 cases of the pain of outside humerus epicondyle were selected from 2005 to 2011.The author treat it with a homemade ultrastructural needle knife on the starting point of the lesion muscles or check point release.Observe its curative effect. Results:After treatment for 1 ~ 3 times,42 cases (47%) were once recovered; 31 cases (34%) were 2 times to heal; 16 cases (18%) were 3 times to heal.1 case (1% ) was improved, who recovered after 5 times of treatment.None had no effect.Conclusion:The curative effect of ultrastructural needle knife therapy in the treatment of outside humerus epicondyle pain is remarkable.

  19. Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures.

    Science.gov (United States)

    Rineer, Craig A; Ruch, David S

    2009-03-01

    Lateral and medial epicondylitis are common causes of elbow pain in the general population, with the lateral variety being more common than the medial by a ratio reportedly ranging from 4:1 to 7:1. Initially thought to be an inflammatory condition, epicondylitis has ultimately been shown to result from tendinous microtearing followed by an incomplete reparative response. Numerous nonoperative and operative treatment options have been employed in the treatment of epicondylitis, without the emergence of a single, consistent, universally accepted treatment protocol. Tendon ruptures about the elbow are much less frequent, but result in more significant disability and loss of function. Distal biceps tendon ruptures typically occur in middle-aged males as a result of an event that causes a sudden, eccentric contraction of the biceps. Triceps tendon ruptures are exceedingly rare but usually have a similar etiology with a forceful eccentric contraction of the triceps that causes avulsion of the tendon from the olecranon. The diagnosis of these injuries is not always readily made. Complete ruptures of the biceps or triceps tendons have traditionally been treated surgically with good results. With regard to biceps ruptures, there continues to be debate about the best surgical approach, as well as the best method of fixation of tendon to bone. This article is not meant to be an exhaustive review of the broad topics of elbow tendinopathy and tendon ruptures, but rather is a review of recently published information on the topics that will assist the clinician in diagnosis and management of these conditions.

  20. Evidence-based soft tissue rheumatology: epicondylitis and hand stenosing tendinopathy.

    Science.gov (United States)

    Alvarez-Nemegyei, Jose; Canoso, Juan J

    2004-02-01

    Lateral and medial epicondylitis represent overuse tendinopathies of wrist extensor and wrist flexor muscles, respectively. In lateral epicondylitis, a short-term therapeutic efficacy of glucocorticoid injection and limited evidence on the efficacy of acupuncture has been shown. De Quervain tendinopathy is caused by tendinous impingement by a thickened retinaculum. There is limited evidence on the efficacy of glucocorticoid injection in this condition.Trigger finger usually results from tendon entrapment beneath a thickened A1 flexor pulley. An association with hand tool use and diabetes has been shown in this condition, and there is evidence on the therapeutic efficacy of glucocorticoid injection. No other therapeutic modality has shown efficacy or has been assessed in a placebo-controlled clinical trial in these conditions.It can be concluded that epicondylitis and stenosing tendinopathy are readily diagnosed, and most patients recover with current therapies. However, still unsolved issues preclude a purely evidence-based approach to these entities.

  1. Early life obesity and chronic kidney disease in later life.

    Science.gov (United States)

    Yim, Hyung Eun; Yoo, Kee Hwan

    2015-08-01

    The prevalence of chronic kidney disease (CKD) has increased considerably with a parallel rise in the prevalence of obesity. It is now recognized that early life nutrition has life-long effects on the susceptibility of an individual to develop obesity, diabetes, cardiovascular disease and CKD. The kidney can be programmed by a number of intrauterine and neonatal insults. Low birth weight (LBW) is one of the most identifiable markers of a suboptimal prenatal environment, and the important intrarenal factors sensitive to programming events include decreased nephron number and altered control of the renin-angiotensin system (RAS). LBW complicated by accelerated catch-up growth is associated with an increased risk of obesity, hypertension and CKD in later life. High birth weight and exposure to maternal diabetes or obesity can enhance the risk for developing CKD in later life. Rapid postnatal growth per se may also contribute to the subsequent development of obesity and CKD regardless of birth weight and prenatal nutrition. Although the mechanisms of renal risks due to early life nutritional programming remain largely unknown, experimental and clinical studies suggest the burdening role of early life obesity in longstanding cardiovascular and renal diseases.

  2. [Extracorporeal shock wave therapy--an alternative concept for the treatment of epicondylitis of the humerus and radius?].

    Science.gov (United States)

    Richter, D; Ekkernkamp, A; Muhr, G

    1995-06-01

    In a prospective study, 16 patients with chronic, painful epicondylitis humeri radialis were treated with extracorporal high-energy shock waves. A complaint-free period of 3 months was achieved in 13 patients. In 2 of them complete release from pain was achieved for more than 3 months. We conclude that release from the symptoms is achieved by local hyperemia in the area of tendinitis. In contrast to the encouraging observations of other authors, our results suggest that a critical view of extracorporal shock waves for the treatment of chronic epicondylitis radialis of the elbow is reasonable.

  3. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    Science.gov (United States)

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  4. The lateral synovial recess of the knee: anatomy and role in chronic Iliotibial band friction syndrome.

    Science.gov (United States)

    Nemeth, W C; Sanders, B L

    1996-10-01

    The tissue deep to the iliotibial band (ITB) and its relationship to the lateral knee joint capsule was studied anatomically and the histopathology of this tissue in chronic iliotibial band friction syndrome (ITBFS) was examined. Findings show that the tissue under the ITB consists of a synovium that is a lateral extension and invagination of the actual knee joint capsule and is not a separate bursa as described in the literature. Additionally, in cases of chronic ITBFS seen in young elite athletes, synovial tissue taken from this lateral synovial recess reveals histological evidence of inflammation and hyperplasia that suggests its involvement in the pathological process.

  5. Alterations in the Contra lateral Ear in Chronic Otitis Media

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Damghani

    2013-03-01

    Full Text Available Introduction: Chronic otitis media (COM, a persistent and durable inflammation and infection of the middle ear, is a common disorder. Alterations in the contralateral ear in sufferers have been observed in recent years. Because only a few studies have been reported in this area, we performed this study in order to assess alterations in the contralateral ear of patients with COM.   Materials and Methods: Cross-sectional and descriptive methods were used in 100 patients with COM who were selected for surgical treatment and admitted to hospital. An information form was completed for all patients including demographic data, medical history of otoscopy and paraclinical examinations such as pure tone audiometry (PTA, tympanometry, Schuller radiography, and high resolution computed tomography (HRCT. All data were processed using SPSS (version 18 software and descriptive statistical tests.   Results: According to otoscopy, PTA, tympanometry and graphical analysis, 60% of patients experienced disorders of the contralateral ear. Otoscopy analysis showed 54% of patients had a disorder of the contralateral ear, with the most common disorder being perforation of the ear drum. PTA showed a 48% incidence of contralateral ear problems (85% conductive hearing impairment; 12.5% sensorineural hearing impairment; 1.2% mixed. A total of 73.2% of patients with conductive hearing loss had a problem across all frequencies, while half of the patients with sensorineural hearing impairment had problems at frequencies greater than 1000 Hz. According to tympanometry, 38% of patients had problem in the contralateral ear. HRCT and Schuller graphical analyses indicated 31.5% and 36% occurrence of contralateral ear disorders, respectively.   Conclusion:  More than 50% of patients with COM in one ear have a chance of also presenting with the disease in the other ear. Outcomes of this study and previous studies have shown that COM should not be perceived as a disease limited

  6. A Clinical Study of Bee Venom Acupuncture Therapy on External Epicondylitis

    Directory of Open Access Journals (Sweden)

    Kyung-Tae Kim

    2006-06-01

    Full Text Available Objective : This study was to evaluate the effectiveness of Bee Venom acupuncture therapy on external epicondylitis. Methods : We divided chronic arthritis of ankle patient into 2 groups; one group combined bee venom acupuncture therapy and acupuncture therapy, another group was only acupuncture therapy. To estimate the effectiveness of treatment that applied for two groups, we used visual analog scale(VAS. We compared the VAS score of two groups statistically. Results : 1. As a result of evaluation by using visual analog scale(VAS, treatment score at final was marked more higher than score before treatment on each groups. 2. treatment at final, acupuncture and bee venom acupuncture therapy group had significant result on visual analog scale(VAS compared with acupuncture therapy group. Conclusion : Bee Venom acupuncture therapy can be used with acupuncture therapy for highly effective treatment for external epicondylitis.

  7. Health behaviour changes and onset of chronic health problems in later life

    Directory of Open Access Journals (Sweden)

    Marijke Veenstra

    2012-11-01

    Full Text Available Objectives: To assess five-year changes in health behaviours in later life and associations with onset of chronic health problems. The results may inform policy and interventions to promote healthy life years in ageing populations.Methods: Data are derived from the Norwegian study on Life-course, Ageing and Generation (NorLAG, a five-year (2002-2007 panel survey comprising a nation wide community sample. The present analyses include a sample of 1,019 respondents aged 60 years and older. Five-year changes in smoking, alcohol use, physical exercise and Body Mass Index (BMI are assessed according to prevalent and incident chronic health problems. Multivariate logistic analyses of “healthy” behavioural changes are conducted.Results: A total of 453 respondents (45% reported at least one chronic condition and 13% (N=133 reported onset of chronic conditions in the course of the past five years. Over a five-year period, there was an overall reduction in smoking rates and a decrease in regular physical activity. Alcohol consumption in older people slightly increased over time, but the incidence of chronic health problems tended to reduce alcohol intake. Older persons experiencing chronic health problems were less likely to initiate physical activity.Conclusions: The results provide limited support for the assumption that the onset of a chronic health condition triggers improved health behaviours. This suggests that the health care system could do more in targeting a potential “window of opportunity” for individuals to adopt new healthy behaviours in later life.

  8. HISTOLOGICAL EFFECTS OF CHRONIC CONSUMPTION OF NUTMEG ON THE LATERAL GENICULATE BODY OF ADULT WISTAR RATS.

    Directory of Open Access Journals (Sweden)

    J.O. Adjene

    2010-01-01

    Full Text Available The effects of chronic consumption of nutmeg commonly used as a spice in various dishes, as components of teas and soft drinks or mixed in milk and alcohol on the lateral geniculate body of adult wistar rats was studied.The rats of both sexes, with average weight of 200g were randomly assigned into treatment and control groups. The rats in the treatment group (n=8 received 2g of nutmeg thoroughly mixed with the feeds on a daily basis for thirty-two days. The control group (n=8 received equal amount of feeds daily without nutmeg added for thirty-two days. The growers mash feeds was obtained from Edo Feeds and Flour Mill Limited, Ewu, Edo State, Nigeria and the rats were given water liberally. The rats were sacrificed on the thirty-three day of the experiment. The lateral geniculate body was carefully dissected out and quickly fixed in 10% formal saline for histological study.The findings indicate that rats in the treated group showed some cellular degenerative changes like sparse cellular population, pyknotic nuclei with some microcystic changes, edema and vacuolations in the stroma of the treated lateral geniculate body as compared to that of the control group.Chronic consumption of nutmeg may therefore have an adverse effect on the visual sensibilities by affecting the microanatomy of the lateral geniculate body of adult wistar rats. It is recommended for further studies aimed at corroborating these observations.

  9. THE METHOD OF SURGICAL TREATMENT OF HUMERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    S. B. Korolev

    2011-01-01

    Full Text Available Method of treatment of epicondylitis of humeral bone is descripted. This metod is proposited to use if conservative therapy was not effective. Experience of use this method show excellent results.

  10. Lateral collateral ligament reconstruction for chronic varus instability of the hallux interphalangeal joint.

    Science.gov (United States)

    Cho, Jaeho

    2014-01-01

    Chronic varus instability of the hallux interphalangeal joint is a rare injury, and only a few reports of this injury have been published. In some studies, this injury has been related to taekwondo. Taekwondo is an essential martial art in the Korean military. We have described a case of varus instability of the hallux interphalangeal joint in a professional soldier who had practiced taekwondo for 5 years and the surgical outcome after reconstruction of the lateral collateral ligament with the fourth toe extensor tendon.

  11. Seventy Cases of External Humeral Epicondylitis Treated by Local Blocking and Massotherapy

    Institute of Scientific and Technical Information of China (English)

    王兴峰

    2001-01-01

    @@External humeral epicondylitis or tennis elbow, is a commonly encountered disease in orthopaedics and traumatology. The curative effect is not satisfactory as far as its treatment by western and traditional Chinese medicine is concerned, which has a long course of treatment and a high recurrent rate. 70 cases of external humeral epicondylitis were treated by massotherapy after local blocking from August 1995 to October 1997 at this hospital with satisfactory therapeutic effects. Clinical Data Of the 70 cases in this series treated by massotherapy after local blocking, 30 were males and 40 females, ranging in age from 19 to 65 years. 55 cases were 30 to 50 years old, 20 had the left elbow affected and 50 the right elbow. 7 cases had a history of trauma, 50 a history of chronic strain, and 13 the cause unknown. The shortest duration of disease was 15 days and the longest 24 months. Among 50 cases in the control group treated by massotherapy, 20 cases were males and 30 females, ranging in age from 16 to 58 years. 40 cases were 30 to 50 years old. 15 cases were affected on the left elbow and 35 on the right elbow. 6 cases had a history of trauma, 32 a history of chronic strain, and 12 the cause unknown. The shortest duration of diseases was 7 days and the longest 22 months.

  12. Comparison of botox and lateral internal sphincterotomy treatment outcomes in chronic anal fissures

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    Tolga Dinç

    2014-03-01

    Full Text Available Objective: Both botox and lateral internal sfinkterotomi are treatment technics used in chronic anal fissure; provide the relaxation of anal sphincter and as a result of this, healing occurs. Aim of this study is to compare efficacy of botox and LIS treatment in chronic anal fissure and discussing with the literature. Methods: 60 of 66 patients who has chronic anal fissure, that we reached, treated but not healed with medical therapy, appealed to the Dr. Sami Ulus Hospital included the study. Gender, age, fissure localization, complaints (pain, bleeding, itching, constipation, complaint length, recurrences after treatment, continence conditions and complications of patients were registered. Results: Sixty patients were enrolled the study. Of the 60 patients; 38(63.3% were male and 22 (27.7% were female. Mean age of all patients was 35.93 ± 11.45 (21 -60. Pain was the common complaint of the all patients. 10 (32.3% recurrence were detected in botox treatment group (Group-I, only 1 (3.4% recurrence was in LIS group (Group-II. There was no complication as an incontinence in group-I but 3 cases with incontinence (10.39% were obtained in group-II. In the evaluation of these 3 cases by Cleveland Clinic Continence Scoring System, 2 cases classified as gas incontinence and 1 case as moderate fecal incontinence. Conclusion: Although botulinum toxin injection seen as an alternative treatment method with low complication rates such as incontinence, high recurrence is an important shortcoming of this technic. LIS performed by experienced surgeons remained the most popular treatment modality with low complication rates and great deal of healing success.

  13. Botulinum toxin injection versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ulusoy Nefise B

    2004-03-01

    Full Text Available Abstract Background Although lateral internal sphincterotomy is the gold-standard treatment for chronic anal fissure, intrasphincteric injection of botulinum toxin seems to be a reliable new option. The aim of this non-randomized study is to compare the effect of lateral internal sphincterotomy and botulinum toxin injection treatments on the outcome and reduction of anal sphincter pressures in patients with chronic anal fissure. Methods Patients with chronic anal fissure were treated with either botulinum toxin injection or lateral internal sphincterotomy by their own choice. Maximal resting pressure and maximal squeeze pressure measurements were performed before and 2 weeks after treatments by anal manometry. Patients were followed for fissure relapse during 14 months. Results Twenty-one consecutive outpatients with posterior chronic anal fissure were enrolled. Eleven patients underwent surgery and ten patients received botulinum toxin injection treatment. Before the treatment, anal pressures were found to be similar in both groups. After the treatment, the maximal resting pressures were reduced from 104 ± 22 mmHg to 86 ± 15 mmHg in the surgery group (p 0.05 in the surgery group, and from 117 ± 62 mmHg to 76 ± 34 (p 0.05. There were no relapses during the 14 months of follow up. Conclusion Lateral internal sphincterotomy and botulinum toxin injection treatments both seem to be equally effective in the treatment of chronic anal fissure.

  14. Treatment of chronic lateral ankle instability: a modified broström technique using three suture anchors

    Directory of Open Access Journals (Sweden)

    Busconi Brian D

    2009-12-01

    Full Text Available Abstract Ankle sprains are very common injuries seen in the athletic and young population. Majority of patients will improve with a course of rest and physical therapy. However, with conservative management about twenty percent of all patients will go on to develop chronic lateral ankle instability. This manuscript describes our detailed surgical technique of a modification to the original Broström procedure using three suture anchors to anatomically reconstruct the lateral ankle ligaments to treat high demand patients who have developed chronic lateral ankle instability. The rationale for this modification along with patient selection and workup are discussed. Both the functional outcomes at the two year follow up along with the complications and the detailed postoperative rehabilitation protocol for the high demand athletes are also presented. This modified Broström procedure is shown in both illustrative format and intra-operative photos.

  15. Acutely calcified hematoma mimicking a displaced medial epicondyle fracture

    Directory of Open Access Journals (Sweden)

    Majed Addie

    2009-01-01

    Full Text Available We present an interesting and unusual case of an acutely calcified pin-site infection hematoma mimicking a displaced cartilaginous medial epicondyle, in a child with a Gartland type III fracture. The treatment of such pathology could be confusing and may interfere with the correct clinical decision-making process. To our knowledge, this is the first presentation of such a case.

  16. PROGRESSION ON TREATMENT OF HUMERAL EPICONDYLITIS WITH ACUPUNCTURE AND MOXIBUSTION

    Institute of Scientific and Technical Information of China (English)

    DAI Mei-you

    2006-01-01

    In recent years, the measures on treatment of humeral epicondylitis with acupuncture and moxibustion were increased daily and a certain progression had been achieved. It had been synthesized in the paper various therapies of acupuncture and moxibustion in treatment of the disease, named filiform needling technique, special needling, warm needling and comprehensive therapy, as well as therapeutic evaluations and mechanisms. Additionally, the problems and shortcomings existed at present had been proposed in the paper.

  17. Distribution of Arsenic, Manganese, and Selenium in the Human Brain in Chronic Renal Insufficiency, Parkinsons Disease and Amyotrophic Lateral Sclerosis

    DEFF Research Database (Denmark)

    Larsen, N. A.; Pakkenberg, H.; Damsgaard, Else;

    1981-01-01

    The concentrations of arsenic, manganese and selenium/g wet tissue weight were determined in samples from 24 areas of the human brain from 3 patients with chronic renal insufficiency, 2 with Parkinson's disease and 1 with amyotrophic lateral sclerosis. The concentrations of the 3 elements were...... determined for each sample by neutron activation analysis with radiochemical separation. Overall arsenic concentrations were about 2.5 times higher in patients with chronic renal failure than in controls, and lower than normal in the patients with Parkinson's disease and amyotrophic lateral sclerosis....... There were no obvious differences in the overall concentrations of manganese and selenium from one group to another. Even multivariate data analysis by the SIMCA method failed to reveal any significant difference in the distribution pattern of manganese and selenium in Parkinson's disease compared to normal...

  18. Molecular basis of chronic stress-induced hippocampal lateral asymmetry in rats and impact on learning and memory.

    Science.gov (United States)

    Spasojevic, N; Jovanovic, P; Dronjak, Sladjana

    2013-12-01

    Neurochemical lateralization has been demonstrated in the rat brain suggesting that such lateralization might contribute to behavior. Thus, the aim of the present study was to examine neurochemical asymmetry in the hippocampus, molecular basis of neurochemical lateralization and its impact on spatial learning and memory. Changes in noradrenaline content, tyrosine hydroxylase (TH) were studied in the right and left hippocampus of naive control and chronically isolated rats, by applying TaqMan RT-PCR and Western blot analysis. Hippocampal-based spatial learning and memory were evaluated using the Barnes maze. In control rats an asymmetrical right-left distribution of noradrenaline content and gene expression of catecholamine synthesizing enzyme was found. Chronic psychosocial stress further emphasized asymmetry. Isolation stress reduced noradrenaline content only in the right hippocampus. No changes were observed in gene expression and protein levels of TH in the right hippocampus, whereas expression of catecholamine synthesizing enzyme was elevated in the left hippocampus. Reduced noradrenaline content in the right hippocampus did not cause impairment in spatial learning and memory. Our findings suggest that chronic psychosocial stress reduces noradrenaline stores in the right hippocampus which may be caused by molecular asymmetry, but it does not affect spatial learning and memory.

  19. Clinical observation of 72 cases ofsmall needle knife combined withcupping treating external humeral epicondylitis%小针刀结合拔火罐治疗肱骨外上髁炎72例疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘宇翔; 唐华谋

    2014-01-01

    目的:探讨治疗肱骨外上髁炎的有效方法。方法:72例肱骨外上髁炎的患者按照所患疾病给予小针刀联合拔火罐治疗。结果:41例症状完全或基本消除,23例好转,8例无效,总有效率为88.9%。结论:肱骨外上髁炎大多慢性劳损致肱骨外上髁处形成急、慢性炎症等引起,采用小针刀联合拔火罐治疗效果显著。%To explore effective ways of humeral epicondylitis treatment.Methods:72 cases of humeral epicondylitis of patients given a smal knife combined cupping therapy according to the ilness.Results:41 cases symptoms completely or substantialy eliminated, 23 cases improved, 8 cases ineffective, the total effective rate was 88.9%. Conclusion:humeral epicondylitis mostly caused by chronic fatigue epicondyle of the humerus formed acute and chronic inflammation caused by using a smal knife cupping therapy combined effect is remarkable.

  20. Fifty Cases of External Humeral Epicondylitis Treated by Moxibustion and Point-injection

    Institute of Scientific and Technical Information of China (English)

    宋理萍

    2004-01-01

    Objective: To observe the therapeutic effects of moxibustion and point-injection on external humeral epicondylitis. Method: The disease is treated with the combined method of moxibustion and effect. The total effective rate was 96%. Conclusion: The combined method of moxibustion and point-injection is a cure indicated for external humeral epicondylitis.

  1. [Autopsy case of a patient with Charcot-Marie-Tooth disease type 1A and suspected chronic inflammatory demyelinating polyradiculoneuropathy, which was later diagnosed as amyotrophic lateral sclerosis].

    Science.gov (United States)

    Higuchi, Yujiro; Sakiyama, Yusuke; Nishihira, Yasushi; Endo, Kazuhiro; Suwazono, Shugo; Suehara, Masahito

    2012-01-01

    We report an autopsy case of a 74-year-old man with late onset Charcot-Marie-Tooth disease type 1A (CMT1A) diagnosed by genetic screening, later associated with amyotrophic lateral sclerosis (ALS). At the age of 70 years, the patient was admitted to our hospital because of progressive weakness and dysesthesia in the right upper limb. In the early stages of the illness, he was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and transient improvement was achieved with intravenous immunoglobulin. However, the symptoms progressively worsened and became refractory. Gene analysis revealed PMP22 gene duplication, which confirmed CMT1A. On sural nerve biopsy, severe demyelinating neuropathy and abundant onion-bulb formations with endoneurial infiltration of inflammatory cells were observed. Thereafter, pseudo-bulbar palsy and respiratory muscle weakness developed insidiously and progressed rapidly along with muscle weakness in the limbs and trunk. The patient died about four years after the onset of this disease. Postmortem examination showed moderate neuronal cell loss, Bunina bodies, and TDP-43-positive inclusions in the anterior horn cells. The spinal cord revealed axonal loss and extensive macrophage permeation in the corticospinal tracts. On the basis of these findings, the final neuropathological diagnosis was ALS. This is the first report of an autopsy case of CMT1A complicated with ALS. We here discuss the significant clinical and neuropathological findings of this case.

  2. Effects of six weeks of chronic ethanol administration on the behavioral outcome of rats after lateral fluid percussion brain injury.

    Science.gov (United States)

    Zhang, L; Maki, A; Dhillon, H S; Barron, S; Clerici, W J; Hicks, R; Kraemer, P J; Butcher, J; Prasad, R M

    1999-03-01

    This study examined the effects of 6 weeks of chronic ethanol administration on the behavioral outcome in rats after lateral fluid percussion (FP) brain injury. Rats were given either an ethanol liquid diet (ethanol diet-groups) or a pair-fed isocaloric sucrose control diet (control diet groups) for 6 weeks. After 6 weeks, the ethanol diet was discontinued for the ethanol diet rats and they were then given the control sucrose diet for 2 days. During those 2 days, the rats were trained to perform a beam-walking task and subjected to either lateral FP brain injury of low to moderate severity (1.8 atm) or to sham operation. In both the control diet and the ethanol diet groups, lateral FP brain injury caused beam-walking impairment on days 1 and 2 and spatial learning disability on days 7 and 8 after brain injury. There were no significant differences in beam-walking performance and spatial learning disability between brain injured animals from the control and ethanol diet groups. However, a trend towards greater behavioral deficits was observed in brain injured animals in the ethanol diet group. Histologic analysis of both diet groups after behavioral assessment revealed comparable ipsilateral cortical damage and observable CA3 neuronal loss in the ipsilateral hippocampus. These results only suggest that chronic ethanol administration, longer than six weeks of administration, may worsen behavioral outcome following lateral FP brain injury. For more significant behavioral and/or morphological change to occur, we would suggest that the duration of chronic ethanol administration must be increased.

  3. Chronic anal fissures: Open lateral internal sphincterotomy result; a case series study

    Directory of Open Access Journals (Sweden)

    Abdulwahid M. Salih

    2017-03-01

    Conclusion: lateral sphincterotomy for internal anal sphincter, along, is the procedure of choice for management of CAF because it is effective and it can cure the disease in nearly all patients with good patient satisfaction.

  4. Clinical Outcomes After Suture Anchor Repair of Recalcitrant Medial Epicondylitis.

    Science.gov (United States)

    Grawe, Brian M; Fabricant, Peter D; Chin, Christopher S; Allen, Answorth A; DePalma, Brian J; Dines, David M; Altchek, David W; Dines, Joshua S

    2016-01-01

    This study evaluated clinical and patient-reported outcomes and return to sport after surgical treatment of medial epicondylitis with suture anchor fixation. Consecutive patients were evaluated after undergoing debridement and suture anchor repair of the flexor-pronator mass for the treatment of medial epicondylitis. Demographic variables, a short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, Oxford Elbow Score (OES), and 10-point pain and satisfaction scales were collected. Ability and time to return to sport after surgery were evaluated, and the relationship between predictor variables and both elbow function and return to sport was investigated. Median age at the time of surgery was 55 years (range, 29-65 years), with median follow-up of 40 months (range, 12-67 months). Median QuickDASH score and OES at final follow-up were 2.3 (range, 0-38.6) and 45 (range, 22-48), respectively. Most patients returned to premorbid sporting activities at a median of 4.5 months (range, 2.5-12 months), whereas 4 patients (14%) reported significant limitations at final follow-up. Older age at the time of surgery was predictive of better QuickDASH score and OES (P=.05 and P=.02, respectively). Patients who underwent surgery after a shorter duration of symptoms had better outcomes, but the difference did not reach statistical significance (QuickDASH, P=.09; OES, P=.10). Surgical treatment of recalcitrant medial epicondylitis with suture anchor fixation offers good pain relief and patient satisfaction, with little residual disability. Older age at the time of surgery predicts a better outcome.

  5. Selection, optimization, and compensation: strategies to maintain, maximize, and generate resources in later life in the face of chronic illnesses.

    Science.gov (United States)

    Rozario, Philip A; Kidahashi, Miwako; DeRienzis, Daniel R

    2011-02-01

    This qualitative study of 45 older adults examines how they allocate their resources in the face of chronic health conditions. Participants were recruited from 2 senior centers and interviewed about their repertoire of activities, any changes in those activities in later life, and meanings they ascribed to those changes. The Selection, Optimization, and Compensation model guided our analysis and interpretation of participants' responses. The findings demonstrate the complexity of participants' responses to age-related changes, particularly in how they adapted and negotiated both their perception and life goals when faced with changing social landscapes. We discuss some implications and nuances of our findings.

  6. Medial Epicondyle Fractures in the Pediatric Overhead Athlete.

    Science.gov (United States)

    Cruz, Aristides I; Steere, Joshua T; Lawrence, J Todd R

    2016-06-01

    The medial epicondyle serves as the proximal attachment of the medial ulnar collateral ligament and the origin of the flexor pronator musculature and as such it is responsible for resisting the main static and dynamic restraints to valgus force at the elbow. Fractures through the physis in the developing elbow are common and treatment remains controversial. Biomechanical modeling predicts that anterior should be the direction of greatest displacement. Anatomic considerations predict that anterior displacement should have the greatest effect on elbow stability and range of motion making the ulnar collateral ligament too loose in flexion and too tight in extension and potentially leading to valgus laxity in flexion and a block to full extension. In the elite overhead athlete, where elbow stability is critical both for sports performance and the long-term health of the elbow, assessment of anterior displacement is thus theoretically an important consideration. Standard radiographic views cannot adequately assess anterior displacement. Specialized radiographs and 3-dimensional modalities such as computerized tomography and magnetic resonance imaging can adequately assess anterior displacement and in the overhead athlete can sometimes aid in the decision-making process. Here, we present a review of the current literature and the rationale for a treatment algorithm for medial epicondyle fractures in the skeletally immature overhead athlete.

  7. Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral Risks and consequences of using the transportal technique in reconstructing the anterior cruciate ligament: relationships between the femoral tunnel, lateral superior genicular artery and lateral epicondyle of the femoral condyle

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2012-10-01

    Full Text Available OBJETIVO: Definir zona de segurança para evitar possíveis complicações vasculares e ligamentares durante a reconstrução do ligamento cruzado anterior. MÉTODOS: Reconstrução artroscópica com uso de técnica transportal e transtibial em joelhos de cadáver foi realizada seguida de dissecção e mensuração da distância entre o túnel femoral e a inserção proximal do ligamento colateral lateral e o túnel femoral e a artéria genicular lateral superior. RESULTADOS: A mensuração das distâncias analisadas mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da inserção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. CONCLUSÃO: Percebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento colateral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecrose do côndilo femoral lateral e ligamentização do enxerto.OBJECTIVE: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. METHODS: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. RESULTS: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. CONCLUSION: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and

  8. Analgesic effect of extracorporeal shock wave therapy versus ultrasound therapy in chronic tennis elbow.

    Science.gov (United States)

    Lizis, Paweł

    2015-08-01

    [Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue scale during grip strength evaluation, palpation of the lateral epicondyle, Thomsen test, and chair test. Resting pain was also recorded. The scores were recorded and compared within and between groups pre-treatment, immediately post-treatment, and 3 months post-treatment. [Results] Intra- and intergroup comparisons immediately and 3 months post-treatment showed extracorporeal shock wave therapy decreased pain to a significantly greater extent than ultrasound therapy. [Conclusion] Extracorporeal shock wave therapy can significantly reduce pain in patients with chronic tennis elbow.

  9. Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.

    Science.gov (United States)

    Gerdesmeyer, Ludger; Mittermayr, Rainer; Fuerst, Martin; Al Muderis, Munjed; Thiele, Richard; Saxena, Amol; Gollwitzer, Hans

    2015-12-01

    Chronic Achilles tendinopathy has been described as the most common overuse injury in sports medicine. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. After failed conservative therapy, invasive treatment may be considered. Extracorporeal shock wave therapy (ESWT) has been successfully used in soft-tissue pathologies like lateral epicondylitis, plantar fasciitis, tendinopathy of the shoulder and also in bone and skin disorders. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is still lacking. In plantar fasciitis as well as in calcific shoulder tendinopathy shock wave therapy is recently the best evaluated treatment option. This article analysis the evidence based literature of ESWT in chronic Achilles tendinopathy. Recently published data have shown the efficacy of focused and radial extracorporeal shock wave therapy.

  10. Three months of chronic ethanol administration and the behavioral outcome of rats after lateral fluid percussion brain injury.

    Science.gov (United States)

    Masse, J; Billings, B; Dhillon, H S; Mace, D; Hicks, R; Barron, S; Kraemer, P J; Dendle, P; Prasad, R M

    2000-05-01

    This study examined the effects of 3 months of chronic ethanol administration (CEAn) on the behavioral outcome in rats after lateral fluid percussion (FP) brain injury. Rats were given either an ethanol liquid diet (ethanol diet groups) or a pair-fed isocaloric sucrose control diet (control diet groups) for 3 months. Then, rats from both diet groups were subjected to either lateral FP brain injury of moderate severity (1.8 atm) or to sham operation. Postinjury behavioral measurements revealed that brain injury caused significant spatial learning disability in both diet groups. There were no significant differences in spatial learning ability in the sham or brain-injured animals between the control and ethanol diets. However, a trend towards cognitive impairment in the sham animals and a trend towards reduced deficits in the brain-injured animals were observed in the ethanol diet group. Histologic analysis of injured animals from both diet groups revealed similar extents of ipsilateral cortical and hippocampal CA3 damage. These results, in general, suggest that 3 months of CEAn does not significantly alter the behavioral and morphologic outcome of experimental brain injury.

  11. Fracture of an unossified humeral medial epicondyle: use of magnetic resonance imaging for diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Katsuhisa; Miyamoto, Nao [Nishinomiya Municipal Central Hospital, Department of Orthopaedic Surgery, Nishinomiya (Japan)

    2016-10-15

    Fracture of the humeral medial epicondyle is a relatively common injury in children. Surgery is a good option for treatment, but correct diagnosis is important. Most fractures occur after the ossification of the medial epicondylar apophysis. If a fracture occurs before the ossification of the medial epicondyle, it is undetectable by radiographs. Here we report a case of an unossified medial epicondyle fracture of the humerus. A 9-year-old boy had persistent pain in the medial side of the right elbow after a fall. Despite his pain, he could move his injured elbow with a range from 60 to 90 . Radiographs and computed tomography showed neither fracture nor dislocation in the injured elbow, and soft tissue swelling was the only finding. Neither the trochlea nor the medial epicondyle was ossified. Magnetic resonance imaging showed that the medial epicondyle was separated from the medial metaphysis and displaced. This clear finding led us to surgical fixation. Under general anesthesia, valgus stress showed gross instability of the injured elbow. Two years after the operation, he had no complaints and could play sports with the same range of motion as the left elbow. It is important to keep in mind that medial epicondylar fractures may be hidden in a normal radiograph before the ossification of the medial epicondylar apophysis. (orig.)

  12. The posterolateral plica: a cause of refractory lateral elbow pain.

    Science.gov (United States)

    Ruch, David S; Papadonikolakis, Anastasios; Campolattaro, Robert M

    2006-01-01

    Lateral epicondylitis is one of the most common upper extremity pain syndromes. We report the results of patients in whom conservative treatment was unsuccessful and who were finally treated arthroscopically for symptomatic plicae. Ten patients (mean age, 40 years [range, 18-60 years]) who were misdiagnosed as having lateral epicondylitis were included in this study. Examination revealed the site of maximal tenderness to be posterior to the lateral epicondyle and centered at the posterior radiocapitellar joint. Preoperatively, all patients received conservative treatment (physical therapy or corticosteroid injections [or both]). The mean follow-up was 25 months (range, 6-68 months). The mean score on the Disabilities of the Arm, Shoulder and Hand questionnaire was 9 (range, 0-37). Preoperatively, 7 patients had full elbow range of motion; however, in 3 patients, there was a loss of extension at the elbow ranging from 7 degrees to 20 degrees preoperatively. The range of elbow motion was full in all patients postoperatively. No patient demonstrated posterolateral pain after the operation. Synovial plicae of the elbow may be the cause of lateral elbow pain in patients with vague clinical symptoms. Arthroscopic management may provide a successful treatment option for such patients.

  13. Effectiveness of extracorporeal shock wave therapy for tennis elbow (lateral epicondylitis).

    Science.gov (United States)

    Stasinopoulos, D; Johnson, M I

    2005-03-01

    Randomised controlled trials were reviewed to evaluate the evidence of the effectiveness of extracorporeal shock wave therapy in the management of tennis elbow. Seven relevant trials were found, which had satisfactory methodology but conflicting results. Further research with well designed randomised control trials is needed to establish the absolute and relative effectiveness of this intervention for tennis elbow.

  14. Three-phase scintigraphy in epicondylitis of the lateral lower humerus

    Energy Technology Data Exchange (ETDEWEB)

    Koppers, B.; Riel, K.

    1982-08-01

    Ten patients with tennis elbow were examined by three-phase scintigraphy, using sup(99m)Tc-MDP. In agreement with the histological findings of H. Schneider (14), there was no uptake during the perfusion and soft tissue phase. In the phase, there was focal bone uptake in one patient only.

  15. Physical and psychosocial risk factors for lateral epicondylitis: a population based case-referent study

    DEFF Research Database (Denmark)

    Haahr, J. P.; Andersen, JH

    2003-01-01

    : Manual job tasks were associated with tennis elbow (odds ratio (OR) 3.1, 95% confidence interval (CI) 1.9 to 5.1). The self reported physical risk factors "posture" and "forceful work" were related to tennis elbow. Among women, work involving performing repeated movements of the arms was related.......3 to 4.6). CONCLUSION: Results indicate that being a new case of tennis elbow is associated with non-neutral postures of hands and arms, use of heavy hand held tools, and high physical strain measured as a combination of forceful work, non-neutral posture of hands and arms, and repetition. Furthermore......, tennis elbow among women was associated with low social support at work. The results for precision demanding movements and for vibration were less consistent...

  16. Osteosynthesis of medial humeral epicondyle fractures in children. 8-year follow-up of 33 cases

    DEFF Research Database (Denmark)

    Duun, P S; Ravn, Pernille; Hansen, L B;

    1994-01-01

    33 children with a mean age of 12 (7-15) years had open reduction and osteosynthesis for a displaced fracture of the medial humeral epicondyle. 8 (2-15) years after the operation a clinical and radiographic examination was performed. 22/33 had a prominent scar. No patients had symptoms from...

  17. An extensive posterior approach of the elbow with osteotomy of the medial epicondyle

    NARCIS (Netherlands)

    Vos, de M.J.; Wagener, M.L.; Verdonschot, N.J.J.; Eygendaal, D.

    2014-01-01

    Background This study describes a posterior approach to the elbow for placement of a total elbow prosthesis. Methods Release of the medial collateral ligament is achieved by performing an osteotomy of the medial epicondyle. This allows anatomic refixation of the origin of the medial collateral liga

  18. An extensive posterior approach of the elbow with osteotomy of the medial epicondyle

    NARCIS (Netherlands)

    Vos, M.J. de; Wagener, M.L.; Verdonschot, N.J.J.; Eygendaal, D.

    2014-01-01

    BACKGROUND: This study describes a posterior approach to the elbow for placement of a total elbow prosthesis. METHODS: Release of the medial collateral ligament is achieved by performing an osteotomy of the medial epicondyle. This allows anatomic refixation of the origin of the medial collateral lig

  19. Treatment of the external epicondylitis of the humerus with a magnetic field

    Science.gov (United States)

    Degen, I. L.

    1974-01-01

    The therapeutic effect of a constant and varying magnetic field on epicondylitis of the humerus is studied on ninety patients. Good results are obtained from the treatment (recovery of 80%, considerable improvement in 14.5%). The method is recommended for clinical application.

  20. Chronic corticosterone exposure persistently elevates the expression of memory-related genes in the lateral amygdala and enhances the consolidation of a Pavlovian fear memory.

    Science.gov (United States)

    Monsey, Melissa S; Boyle, Lara M; Zhang, Melinda L; Nguyen, Caroline P; Kronman, Hope G; Ota, Kristie T; Duman, Ronald S; Taylor, Jane R; Schafe, Glenn E

    2014-01-01

    Chronic exposure to stress has been widely implicated in the development of anxiety disorders, yet relatively little is known about the long-term effects of chronic stress on amygdala-dependent memory formation. Here, we examined the effects of a history of chronic exposure to the stress-associated adrenal steroid corticosterone (CORT) on the consolidation of a fear memory and the expression of memory-related immediate early genes (IEGs) in the lateral nucleus of the amygdala (LA). Rats received chronic exposure to CORT (50 μg/ml) in their drinking water for 2 weeks and were then titrated off the CORT for an additional 6 days followed by a 2 week 'wash-out' period consisting of access to plain water. Rats were then either sacrificed to examine the expression of memory-related IEG expression in the LA or given auditory Pavlovian fear conditioning. We show that chronic exposure to CORT leads to a persistent elevation in the expression of the IEGs Arc/Arg3.1 and Egr-1 in the LA. Further, we show that rats with a history of chronic CORT exposure exhibit enhanced consolidation of a fear memory; short-term memory (STM) is not affected, while long-term memory (LTM) is significantly enhanced. Treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine following the chronic CORT exposure period was observed to effectively reverse both the persistent CORT-related increases in memory-related IEG expression in the LA and the CORT-related enhancement in fear memory consolidation. Our findings suggest that chronic exposure to CORT can regulate memory-related IEG expression and fear memory consolidation processes in the LA in a long-lasting manner and that treatment with fluoxetine can reverse these effects.

  1. Chronic corticosterone exposure persistently elevates the expression of memory-related genes in the lateral amygdala and enhances the consolidation of a Pavlovian fear memory.

    Directory of Open Access Journals (Sweden)

    Melissa S Monsey

    Full Text Available Chronic exposure to stress has been widely implicated in the development of anxiety disorders, yet relatively little is known about the long-term effects of chronic stress on amygdala-dependent memory formation. Here, we examined the effects of a history of chronic exposure to the stress-associated adrenal steroid corticosterone (CORT on the consolidation of a fear memory and the expression of memory-related immediate early genes (IEGs in the lateral nucleus of the amygdala (LA. Rats received chronic exposure to CORT (50 μg/ml in their drinking water for 2 weeks and were then titrated off the CORT for an additional 6 days followed by a 2 week 'wash-out' period consisting of access to plain water. Rats were then either sacrificed to examine the expression of memory-related IEG expression in the LA or given auditory Pavlovian fear conditioning. We show that chronic exposure to CORT leads to a persistent elevation in the expression of the IEGs Arc/Arg3.1 and Egr-1 in the LA. Further, we show that rats with a history of chronic CORT exposure exhibit enhanced consolidation of a fear memory; short-term memory (STM is not affected, while long-term memory (LTM is significantly enhanced. Treatment with the selective serotonin reuptake inhibitor (SSRI fluoxetine following the chronic CORT exposure period was observed to effectively reverse both the persistent CORT-related increases in memory-related IEG expression in the LA and the CORT-related enhancement in fear memory consolidation. Our findings suggest that chronic exposure to CORT can regulate memory-related IEG expression and fear memory consolidation processes in the LA in a long-lasting manner and that treatment with fluoxetine can reverse these effects.

  2. Surgical treatment of acute and chronic anterior and posterior cruciate ligament and lateral side injuries of the knee.

    Science.gov (United States)

    Levy, Bruce A; Boyd, Joel L; Stuart, Michael J

    2011-06-01

    Combined anterior cruciate ligament, posterior cruciate ligament, and lateral-sided injuries of the knee most often occurs secondary to a forced varus moment or after knee dislocation. Management controversies include the optimal timing of surgery, operative techniques, and postoperative rehabilitation. Recent systematic literature reviews have demonstrated higher rates of failure with repair of the lateral and posterolateral corner structures, as opposed to reconstruction. However, the ideal ligament reconstruction techniques remain unclear. This chapter will review the combined anterior cruciate ligament/posterior cruciate ligament/lateral-sided injury pattern, including the physical examination findings, imaging, timing of surgery, graft selection, operative techniques, and postoperative rehabilitation protocols.

  3. Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

    NARCIS (Netherlands)

    T. Schepers (Tim); L.M.M. Vogels (Lucas); E.M.M. van Lieshout (Esther)

    2011-01-01

    textabstractPurpose: In the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of pa

  4. EFFECT OF ECCENTRIC EXERCISE PROGRAMME ON PAIN AND GRIP STRENGTH FOR SUBJECTS WITH MEDIAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    Mishra Prashant Akhilesh

    2014-04-01

    Full Text Available Background and Objective: Therapeutic eccentric exercise may provide both a structural and functional benefit during tendinopathy rehabilitation. The objective is to find the effect of eccentric exercises on improvement of pain and grip strength for subjects with Medial Epicondylitis. Method: Pre to post test experimental study design randomized thirty subjects with medial epicondylitis, 15 each into Group A and Group B. Group B subjects were treated with conventional therapy and Eccentric exercises. Group A subjects were treated with conventional therapy. Results: When means of post intervention were compared using Independent ‘t’ between groups there was no statistically significant difference in improvements obtained in VAS scores and grip strength. There was a statistically significant change in means of VAS score and Grip strength when means were analyzed by using Paired‘t’ test and Wilcoxon signed rank test within the groups with positive percentage of change. Conclusion: It is concluded that four weeks of Eccentric Exercise Programme combined with conventional therapy shown significant effect on improving pain and Grip strength, however the improvement obtained has no difference when compared with control conventional treatment for Subjects with Medial Epicondylitis.

  5. Three years later: report on the state of well-being of patients with chronic tinnitus who underwent modified tinnitus retraining therapy.

    Science.gov (United States)

    Seydel, Claudia; Haupt, Heidemarie; Szczepek, Agnieszka J; Hartmann, Anne; Rose, Matthias; Mazurek, Birgit

    2015-01-01

    Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT.

  6. Epstein-Barr virus antibodies in serum and cerebrospinal fluid from multiple sclerosis, chronic inflammatory demyelinating polyradiculoneuropathy and amyotrophic lateral sclerosis.

    Science.gov (United States)

    Nociti, V; Frisullo, G; Marti, A; Luigetti, M; Iorio, R; Patanella, A K; Bianco, A; Tonali, P A; Grillo, R L; Sabatelli, M; Batocchi, A P

    2010-08-25

    Elevated anti-Epstein-Barr virus (EBV) antibody levels are present in serum of Multiple sclerosis (MS) patients but literature lacks of studies comparing anti-EBV antibody levels between MS and other neurological diseases. We evaluate anti-VCA IgG and IgM, anti-EBNA1 IgG, anti-Cytomegalovirus IgG and IgM titres in serum and cerebrospinal fluid (CSF) of 267 MS, 50 Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) and 88 Amyotrophic Lateral Sclerosis (ALS) patients. We found increased titres of anti-EBV-IgG in serum and CSF of MS subjects as compared to CIDP and ALS patients thus providing additional evidence for a possible involvement of EBV in MS.

  7. Late diagnosis of lateral meningocele syndrome in a 55-year-old woman with symptoms of joint instability and chronic musculoskeletal pain.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Ritelli, Marco; Brancati, Francesco; De Bernardo, Carmelilia; Colombi, Marina; Grammatico, Paola

    2014-02-01

    Lateral meningocele syndrome (LMS) is a rare hereditary connective tissue disorder characterized by pan-spinal meningoceles, specific facial dysmorphism, skeletal and soft tissue abnormalities, and hypotonia and/or muscle weakness. LMS has been observed in eleven patients with two instances of vertical transmission, and seven sporadic cases with an age at diagnosis ranging from 25 months to 33 years. We report on a further observation of LMS in a 55-year-old woman presenting with a long history of joint instability, chronic musculoskeletal pain, and iatrogenic bladder and anorectal dysfunction due to irreversible nerve damage after surgical excision of a meningeal cyst. Her clinical characteristics are compared with those of previously reported patients, as well as two further cases originally diagnosed with Hajdu-Cheney and Ehlers-Danlos syndromes, but displaying typical features of LMS.

  8. Lateral sided snapping elbow caused by a meniscus: two case reports and literature review.

    Science.gov (United States)

    Kang, Shin-Taek; Kim, Tae-Ho

    2010-06-01

    Lateral sided snapping elbow is an unusual condition, and it is apt to be misdiagnosed as lateral epicondylitis. The causes of lateral sided snapping elbow have been attributed to intraarticular loose bodies, instability, synovial plicae and torn annular ligament. We report our experiences for treating lateral sided snapping elbow caused by a meniscus in the radio-humeral joint. In the present cases, the cause of snapping was detected using double contrast arthrogram under fluoroscopic control, and histology revealed that it was a meniscus. Complete removal of the meniscus allowed immediate relief of the symptom, and there was no recurrence in both cases.

  9. Effects of Linear-Polarized Near-Infrared Light Irradiation on Chronic Pain

    Directory of Open Access Journals (Sweden)

    Dong Huang

    2012-01-01

    Full Text Available In order to study the efficacy of linear-polarized near-infrared light irradiation (LPNIR on relieving chronic pain in conjunction with nerve block (NB or local block (LB, a 3-week prospective, randomized, double-blind, controlled study was conducted to evaluate the pre- and post-therapy pain intensity. Visual analogue scales (VASs were measured in all patients before and 6 months after therapy visiting the pain clinic during the period of August 2007 to January 2008. A total of 52 patients with either shoulder periarthritis or myofascial pain syndrome or lateral epicondylitis were randomly assigned into two groups by drawing lots. Patients in Group I were treated with NB or LB plus LPNIR; Group II patients, for their part, were treated with the same procedures as in Group I, but not using LPNIR. In both groups, the pain intensity (VAS score decreased significantly immediately after therapy as compared to therapy. There was a significant difference between the test and control groups immediately after therapy (P<0.05, while no effect 6 months later. No side effects were observed. It is concluded that LPNIR is an effective and safe modality to treat various chronic pains, which has synergic effects with NB or LB.

  10. Neglected fracture of the medial humeral epicondyle that was entrapped into the elbow joint: a case report.

    Science.gov (United States)

    Potenza, Vito; Farsetti, Pasquale; Caterini, Roberto; Bisicchia, Salvatore; De Luna, Vincenzo; Ippolito, Ernesto

    2010-11-01

    The objective of this paper is to report clinical and radiographic long-term results of a neglected fracture of the medial humeral epicondyle, which was entrapped into the elbow joint. At follow-up, 48 years after the trauma, the patient complained of occasional discomfort around the elbow, but the joint had a normal range of motion and good stability. Radiographs showed that the epicondylar fragment was fused to the medial border of the olecranon. The authors conclude that an old fracture of the medial humeral epicondyle, presenting a fusion of the fragment to the olecranon with normal range of motion and without pain, may be managed expectantly.

  11. Laterality, frequency and replication of rTMS treatment for chronic tinnitus: pilot studies and a review of maintenance treatment

    Science.gov (United States)

    Mennemeier, M.; Munn, T.; Allensworth, M.; Lenow, J.K.; Brown, G.; Allen, S.; Dornhoffer, J.; Williams, D.K.

    2012-01-01

    This manuscript reports on findings of three open label, pilot studies and it reviews studies using rTMS as a maintenance treatment for any disorder. The first pilot study examined whether a patient’s original treatment response to 1 Hz rTMS over temporal cortex could be replicated by stimulating a homologous region of the opposite hemisphere. The second study examined whether a patient’s response to 1Hz rTMS could be replicated by applying 10 Hz rTMS over the same treatment site. The third study applied a 3-day course of maintenance rTMS, either at 1 or 10 Hz, when subjects indicated that the benefit of their last course of treatment was waning. Patients with bilateral subjective tinnitus of at least 6 months duration were recruited from a prior, sham controlled study with treatment crossover that applied 1Hz rTMS over temporal cortex. Both treatment responders and non-responders were recruited. Results indicated, first, that the original treatment response, both positive and negative, is replicated after stimulating a homologous region of the opposite hemisphere; second, patients respond similarly to 1 and 10 Hz stimulation of the same treatment site (an exception was one patient who initially failed 1 Hz stimulation but responded positively to 10 Hz stimulation); and, third, maintenance rTMS had a sustained and additive benefit for tinnitus among treatment responders. Conclusions are that rTMS-induced effects on tinnitus are neither hemisphere specific nor frequency dependent; although, different frequencies of rTMS may have greater potency for a given subject. Maintenance treatment is a well tolerated approach with demonstrated feasibility for managing chronic tinnitus in persons who respond positively to an initial course of treatment. PMID:22486989

  12. Lateral Knee Pain after Outside-in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using the TightRope RT

    Science.gov (United States)

    Kuribayashi, So; Nakayama, Shuichi; Nakazato, Keisuke; Fukubayashi, Toru; Okinaga, Shuji

    2016-01-01

    The anterior cruciate ligament (ACL) TightRope RT (TR) was recently introduced as a novel cortical suspension device for ACL reconstruction. It has an adjustable graft loop that gives the surgeon some advantages during ACL reconstruction. We report three patients who required removal of the TR after an outside-in anatomical ACL reconstruction because of lateral knee pain. We assumed that the knee pain was associated with friction between the TR button of the posterolateral bundle and iliotibial band (ITB). Placing the TR button close to the lateral epicondyle and tissue interposition between the TR button and lateral femoral cortex may be potential risk factors for ITB irritation. Therefore, we recommend not placing the TR button close to the top of the lateral epicondyle and reducing the tissue interposition between the TR button and lateral femoral cortex as much as possible. PMID:26955618

  13. [External stability of the elbow after surgical treatment of epicondylitis. Presentation of a case].

    Science.gov (United States)

    Llop-Corbacho, A; Romero-Ruiz, J; Denia-Alarcón, N

    2014-01-01

    Elbow instability is a difficult to diagnose condition in certain cases, and could lead to some problems that limit daily functioning, such as joint blocks, bumps, projections, muscle weakness, and persistent pain. A case is presented of a patient with a clinical picture of epicondylitis, with a previous history of a fall on the affected arm. As there was no improvement after performing conventional non-aggressive treatment, surgery was performed on the affected tendon. The outcome of this was persistent pain and clinical instability of the elbow that ended up requiring surgery to reconstruct the ligament over the external complex. In follow-up 6 months after the operation, the clinical instability had disappeared, but there was still external discomfort and a 30° extension deficit. When faced with a picture of epicondylitis with a previous injury that does not respond to conventional therapies, it is important to take into account the possibility of an underlying elbow instability, ruling this out with a correct physical examination and, where necessary, with the appropriate complementary tests.

  14. 局部阻滞疗法并激光治疗肱骨外上髁炎%Local blocking combined with laser onexternal humeral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    刘崇丽; 李昭杨

    2003-01-01

    @@ BACKGROUND: External epicondylitis of distal humerus is often caused by overwork of wrist which pathological change are hyperemia, edema, exudation and adhesion of local tissue, laceration, calcification, aseptic necrosis of extensor tendon, or local synovitis, burstis.

  15. Efficacy of tennis elbow (epicondylitis humeri radialis) treatment in CBR "Praxis".

    Science.gov (United States)

    Pecar, Dzemal; Avdić, Dijana

    2009-02-01

    Tennis elbow (Epicondylitis humeri radialis) is the most frequent reason that patients with elbow pain report to a physician. The exact cause of elbow pain is still unclear. However, it is certainly causally connected with connective intersection between forearm muscle and bone in the elbow region. In this paper, we analyzed patients that, over the period of 15 years, reported to "Praxis" clinic for elbow pain treatment (Epicondylitis humeri radialis). Of the total number of 228 patients, 126 were male, 101 female while one patient was younger than 14. Initial analysis established that average overall health condition grade was 2,87 at the onset of treatment. Following the treatment completion that grade was 4,48. Of the total number of 223 patients who were treated by combined method of manipulation and local corticosteroid instillation, eight patients received physical therapy as well. Thus, surgical treatment was not necessary in any patient. The patients' treatment included: 1. Application of manipulative methods in order to reestablish mobility in the "blocked" radio-humeral and the upper radio-ulnar joints. 2. Local instillation of corticosteroid depot in order to control inflammation (enthesitis) and thus, eliminate pain and establish physiological conditions for functioning of joint and local structures. Unlike conservative method which includes initial immobilization due to irritation and inflammation development prevention with concomitant analgesic and antirheumatic therapy, initial application of manipulation with reinstatement of joint mobility instead of immobilization with subsequent instillation of steroid preparations achieves functional restitution and fast reinstatement of full working ability, as a rule.

  16. EFFECTIVENESS OF MOBILIZATION WITH MOVEMENT OF ELBOW COMPARED WITH MANIPULATION OF WRIST IN PATIENTS OF LATERAL EPICONDYLITIS

    OpenAIRE

    Namrata Patel

    2013-01-01

    Purpose:To evaluate the effectiveness of mobilization with movement of elbow compared with manipulationof wr ist on pai n, strength and acti viti es of dai l y l i vi ng i n patients of l ateral epi condyl i tis.Methodology:An interventional comparative study was conducted on 30 patients having symptomatic lateralepicondylitis. They were randomly assigned to one of the three groups. Group A (n=10) control group,Group B(n=10) Mobilization with movement group and Group C (n=10) wrist manipulati...

  17. Effects of extracorporeal shock wave therapy on functional and strength recovery of handgrip in patients affected by epicondylitis.

    Science.gov (United States)

    Notarnicola, Angela; Quagliarella, Livio; Sasanelli, Nicola; Maccagnano, Giuseppe; Fracella, Maria Rosaria; Forcignanò, Maria Immacolata; Moretti, Biagio

    2014-12-01

    Extracorporeal shock wave therapy (ESWT) is effective in the treatment of tendinopathy. We designed a prospective observational clinical study to assess the correlation between clinical and functional measures and recovery of strength after ESWT for epicondylitis. We analyzed 26 patients. We measured progressive improvement in visual analogue scale values (p 0.05). We found no correlation between degree of clinical function and muscle deficit during follow-up. After ESWT, there was a tendency toward a decrease in grip strength, especially in the dominant limb. This could be related to the effects of ESWT, which reduces spasticity in painful hypertonic muscles. These data may be useful in defining the expectations for function during ESWT for epicondylitis, particularly for elite athletes.

  18. The impact of poverty, chronic illnesses, and health insurance status on out-of-pocket health care expenditures in later life.

    Science.gov (United States)

    Kim, Jinhyun; Richardson, Virginia

    2014-10-01

    This study aims to examine poverty, chronic illnesses, health insurance, and health care expenditures, within the context of a political economy of aging perspective. Subsamples of 1,773 older adults from the Medical Expenditure Panel Survey were selected for analyses. The results showed that chronic illnesses influenced out-of-pocket health care costs. Older persons with more than one health insurance spent less on out-of-pocket health care costs. The results have implications for health care social workers concerned with the growing costs of chronic illnesses, implementing integrated care, and advocating for extending public health insurance coverage especially for our most impoverished older adults.

  19. Lateral Concepts

    Directory of Open Access Journals (Sweden)

    Christopher Gad

    2016-06-01

    Full Text Available This essay discusses the complex relation between the knowledges and practices of the researcher and his/her informants in terms of lateral concepts. The starting point is that it is not the prerogative of the (STS scholar to conceptualize the world; all our “informants” do it too. This creates the possibility of enriching our own conceptual repertoires by letting them be inflected by the concepts of those we study. In a broad sense, the lateral means that there is a many-to-many relation between domains of knowledge and practice. However, each specific case of the lateral is necessarily immanent to a particular empirical setting and form of inquiry. In this sense lateral concepts are radically empirical since it locates concepts within the field. To clarify the meaning and stakes of lateral concepts, we first make a contrast between lateral anthropology and Latour’s notion of infra-reflexivity. We end with a brief illustration and discussion of how lateral conceptualization can re-orient STS modes of inquiry, and why this matters.

  20. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

    OpenAIRE

    Lui, Tun Hing

    2016-01-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conse...

  1. Corticosteroïdinjecties, fysiotherapie of een afwachtend beleid voor patiënten met een epicondylitis lateralis? Een gerandomiseerd onderzoek in de eerste lijn.

    NARCIS (Netherlands)

    Smidt, N.; Windt, D. van der; Assendelft, P.; Devillé, W.; Bouter, L.

    2004-01-01

    Doel: Vergelijking van de effecten van corticosteroïdinjecties, fysiotherapie en een afwachtend beleid voor een epicondylitis lateralis. Methoden: Patiëntenselectie vond plaats in 65 deelnemende huisartsenpraktijken. De belangrijkste insluitcriteria waren: minimaal 6 weken pijn aan de laterale zijde

  2. OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE OF CHONGYANG ACUPOINT PLUS MOXIBUSTION FOR TREATMENT OF 30 CASES OF EXTERNAL HUMERAL EPICONDYLITIS

    Institute of Scientific and Technical Information of China (English)

    李万婷; 崔丽琴

    2003-01-01

    In the present paper, the authors stmmnarize their results of 30 cases of external humeral epicondylitis treated with thermal acupuncture of Chongyang (ST 42) and Ashi-points. After 3- 15 sessions of treatment, of the 30cases, 24 (80%) were cured, and the rest 6 (20%) responded with apparent improvement in their symptoms.

  3. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain.

    Science.gov (United States)

    Lui, Tun Hing

    2016-06-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conservative treatment failed. Endoscopic release of the nerve through the dorsal and plantar portals, as well as endoscopic plantar aponeurosis release, is a feasible approach.

  4. Taking Sides: An Integrative Review of the Impact of Laterality and Polarity on Efficacy of Therapeutic Transcranial Direct Current Stimulation for Anomia in Chronic Poststroke Aphasia

    Directory of Open Access Journals (Sweden)

    Margaret Sandars

    2016-01-01

    Full Text Available Anomia is a frequent and persistent symptom of poststroke aphasia, resulting from damage to areas of the brain involved in language production. Cortical neuroplasticity plays a significant role in language recovery following stroke and can be facilitated by behavioral speech and language therapy. Recent research suggests that complementing therapy with neurostimulation techniques may enhance functional gains, even amongst those with chronic aphasia. The current review focuses on the use of transcranial Direct Current Stimulation (tDCS as an adjunct to naming therapy for individuals with chronic poststroke aphasia. Our survey of the literature indicates that combining therapy with anodal (excitatory stimulation to the left hemisphere and/or cathodal (inhibitory stimulation to the right hemisphere can increase both naming accuracy and speed when compared to the effects of therapy alone. However, the benefits of tDCS as a complement to therapy have not been yet systematically investigated with respect to site and polarity of stimulation. Recommendations for future research to help determine optimal protocols for combined therapy and tDCS are outlined.

  5. Taking Sides: An Integrative Review of the Impact of Laterality and Polarity on Efficacy of Therapeutic Transcranial Direct Current Stimulation for Anomia in Chronic Poststroke Aphasia.

    Science.gov (United States)

    Sandars, Margaret; Cloutman, Lauren; Woollams, Anna M

    2016-01-01

    Anomia is a frequent and persistent symptom of poststroke aphasia, resulting from damage to areas of the brain involved in language production. Cortical neuroplasticity plays a significant role in language recovery following stroke and can be facilitated by behavioral speech and language therapy. Recent research suggests that complementing therapy with neurostimulation techniques may enhance functional gains, even amongst those with chronic aphasia. The current review focuses on the use of transcranial Direct Current Stimulation (tDCS) as an adjunct to naming therapy for individuals with chronic poststroke aphasia. Our survey of the literature indicates that combining therapy with anodal (excitatory) stimulation to the left hemisphere and/or cathodal (inhibitory) stimulation to the right hemisphere can increase both naming accuracy and speed when compared to the effects of therapy alone. However, the benefits of tDCS as a complement to therapy have not been yet systematically investigated with respect to site and polarity of stimulation. Recommendations for future research to help determine optimal protocols for combined therapy and tDCS are outlined.

  6. 肱骨内上髁炎手术治疗的疗效分析%Therapeutic effect analysis of surgical treatment of medial epicondylitis

    Institute of Scientific and Technical Information of China (English)

    潘土; 孙鲁源; 柴益民

    2015-01-01

    Objective To observe the clinical outcomes of surgical treatment of medial epicondylitis and to investigate the surgical technique. Methods From January 2011 to February 2013, 24 patients with medial epicondylitis underwent open surgery, who all had a poor response to conservative treatment. The degenerated tissues at the starting points of pronator teres tendons were resected. The preoperative and postoperative Harris Hip Scores 2 ( HHS2 ) and Mayo scores were compared, which were reported by the patients themselves with pain in the elbow, and the surgical outcomes were evaluated based on the statistical analysis. Results All the 24 patients were followed up for an average period of 13.7 months ( range:8-23 months ). The HHS2 were 73.2±6.4 points, 93.0±4.7 points, 92.5±5.0 points and 94.5±5.1 points preoperatively and at the 1st, 2nd and 6th month postoperatively. The Mayo scores were 72.8±5.8 points, 83.2±6.3 points, 87.9±4.9 points and 91.7±6.0 points preoperatively and at the 1st, 2nd and 6th month postoperatively. The HSS2 and Mayo scores showed the apparent improvement of the subjective sensation and the elbow function after the surgery. Good long-term outcomes were noticed in 19 of the 24 patients ( 79.2%). Two patients ( 8.3%) had mild chronic pain on the medial side of the elbow. Three patients ( 12.5%) had secondary procedures because of ulnar neuritis, whose neurological symptoms were improved postoperatively. Conclusions The outcomes of open surgery are reliable in the treatment of refractory medial epicondylitis. Prophylactic neurolysis and anterior transposition of the ulnar nerve are recommended in the patients with combined ulnar neuritis.%目的:观察肱骨内上髁炎手术治疗的临床效果,并探讨手术技巧。方法自2011年1月至2013年2月,我科对24例保守治疗效果欠佳的肱骨内上髁炎患者行开放手术治疗,切除旋前屈肌群肌腱起始处的退变组织。对比患者术前、术后的

  7. Lateral Mixing

    Science.gov (United States)

    2012-11-08

    being made on their analysis. A process we became very curious about was the separation of tendrils of warm salty water from the north wall figure 7...structure, and to remove the effect of internal waves by mapping this structure onto isopycnals. This has been very successful in elucidating lateral...we passed through the same water on multiple passes, and that changes in the horizontal structure of the water mas should be readily apparent from

  8. Lateral Elbow Tendinopathy

    Science.gov (United States)

    Bhabra, Gev; Wang, Allan; Ebert, Jay R.; Edwards, Peter; Zheng, Monica; Zheng, Ming H.

    2016-01-01

    Lateral elbow tendinopathy, commonly known as tennis elbow, is a condition that can cause significant functional impairment in working-age patients. The term tendinopathy is used to describe chronic overuse tendon disorders encompassing a group of pathologies, a spectrum of disease. This review details the pathophysiology of tendinopathy and tendon healing as an introduction for a system grading the severity of tendinopathy, with each of the 4 grades displaying distinct histopathological features. Currently, there are a large number of nonoperative treatments available for lateral elbow tendinopathy, with little guidance as to when and how to use them. In fact, an appraisal of the clinical trials, systematic reviews, and meta-analyses studying these treatment modalities reveals that no single treatment reliably achieves outstanding results. This may be due in part to the majority of clinical studies to date including all patients with chronic tendinopathy rather than attempting to categorize patients according to the severity of disease. We relate the pathophysiology of the different grades of tendinopathy to the basic science principles that underpin the mechanisms of action of the nonoperative treatments available to propose a treatment algorithm guiding the management of lateral elbow tendinopathy depending on severity. We believe that this system will be useful both in clinical practice and for the future investigation of the efficacy of treatments. PMID:27833925

  9. FIFTY-THREE CASES OF EXTERNAL HUMERAL EPICONDYLITIS TREATED WITH WARM ACUPUNCTURE AND TRIPLE PUNCTURE%温针齐刺治疗肱骨外上髁炎53例

    Institute of Scientific and Technical Information of China (English)

    张斌渊

    2007-01-01

    @@ The author has treated external humeral epicondylitis with triple puncture recorded in Miraculous Pivot: Official Needles (), combined with warm acupuncture and won good therapeutic effects, following is the report.

  10. MEDIAL EPICONDYLE FRACTURE OF THE HUMERUS WITH ULNAR NERVE PALSY OF AN 11-MONTH-OLD INFANT:CASE REPORT

    Institute of Scientific and Technical Information of China (English)

    张楷乐; 张自明; 张菁

    2013-01-01

    <正>To our knowledge,there is no report concerning medial epicondyle fracture of the humerus for infants,the clinical course and treatment outcome of an 11 -month-old boy with such fracture with ulnar nerve palsy was described in this article.Ulnar nerve detection and scar tissue release were performed.The bony fragment was anatomically reduced and fixed with an anchor.The above-elbow wellpadded anterior plastic splint was used postoperatively for 4 weeks.After removing the splint,the motion of hand had no obvious improvement accompanied with claw hand deformity,and nerve transplantation was suggested to the patient’s parent.We would like to remind clinicians of encountering the clinical manifestations to be vigilant for any possibilities.

  11. 体外冲击波治疗肱骨外上髁炎的疗效观察%Observating of the curative effects of extra-corporeal shock wave therapy on external hu-meral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    吴长青; 华英

    2015-01-01

    AIM: To investigate the curative effect of extracor⁃poreal shock wave therapy on lateral epicondylitis. METHODS:A total of 56 cases with lateral epicondylitis admitted to our hospi⁃tal from January 2013 to June 2014 were selected and randomly divided into observation group and control group. Thirty patients in observation group received extracorporeal shock wave therapy, while 26 cases in control group received corticosteroid injection. Complications were recorded; visual analogue scale ( VAS ) and disabilities of arm, shoulder, and hand ( DASH) was used to e⁃valuate the effect, before the treatment, after 6⁃week treatment, and after three⁃month treatment. RESULTS:All the patients had full follow⁃ups. Local swelling and subcutaneous blood stasis ap⁃peared in six patients, and symptoms relieved after treatment. All patients had VAS ( lifting a 5KG dumbbell) and DASH assess⁃ment for three times, with the VAS score being 7. 6 ± 1. 3 before the treatment, 3. 2 ± 0. 7 6 weeks after treatment, and 2. 1 ± 0. 3 three months after treatment in observation group, and those num⁃bers being 7. 5 ± 1. 2, 3. 1 ± 0. 6, and 1. 9 ± 0. 4 in control group. There was no statistical difference between the two groups (P>0. 05). The DASH score were 16. 1 ± 1. 5, 10. 2 ± 1. 1, and 6. 1 ± 0. 6 in observation group, while 15. 8 ± 1. 4, 9. 8 ± 0. 9, and 5. 9 ± 0. 5 in control group. There was no statistical difference between the two groups (P>0. 05). There was, how⁃ever, statistically significant difference between pre⁃treatment score and post⁃treatment score (P <0. 05). CONCLUSION:Curative effects of extracorporeal shock wave therapy on lateral epicondylitis are prominent, which is the same to corticosteroid injection. It can markedly improve the symptoms of external hu⁃meral epicondylitis and is worthy of further promotion in the clini⁃cal practice.%目的:观察体外冲击波治疗肱骨外上髁炎的疗效.方法:选择2013⁃01/2014⁃06

  12. Treating external humeral epicondylitis with fire acupuncture need%毫火针治疗肱骨外上髁炎38例

    Institute of Scientific and Technical Information of China (English)

    高艳红

    2013-01-01

      目的:探讨毫火针治疗肱骨外上髁炎的临床效果。方法:38例肱骨外上髁患者采取毫火针治疗。留针30min,隔日1次,5次为1个疗程。结果:24例治愈,占64%;12例好转,占13%;2例无效,占5%。总有效率为95%。结论:此法操作简便,起效快,易于掌握,治愈率高,值得临床推广。%Objective:To investigate the clinical effect of fire acupuncture need on treating external humeral epicondylitis. Methods:38 cases of external humeral epicondylitis were treated by fire acupuncture need. Results:24 cases were cured, occupying 64%, 12 cases were improved, occupying 13%, 2 cases were invalid, occupying 5%. The total effective rate was 95%. Conclusion:Fire acupuncture need treatment was effective and safe on treating external humeral epicondylitis, worthy a wide clinical application.

  13. A non-randomized clinical control trial of Harrison mirror image methods for correcting trunk list (lateral translations of the thoracic cage) in patients with chronic low back pain.

    Science.gov (United States)

    Harrison, Deed E; Cailliet, Rene; Betz, Joseph W; Harrison, Donald D; Colloca, Christopher J; Haas, Jason W; Janik, Tadeusz J; Holland, Burt

    2005-03-01

    Spinal trunk list is a common occurrence in clinical practice, but few conservative methods of spinal rehabilitation have been reported. This study is a non-randomized clinical control trial of 63 consecutive retrospective subjects undergoing spinal rehabilitation and 23 prospective volunteer controls. All subjects presented with lateral thoracic-cage-translation posture (trunk list) and chronic low back pain. Initial and follow-up numerical pain rating scales (NRS) and AP lumbar radiographs were obtained after a mean of 11.5 weeks of care (average of 36 visits) for the treatment group and after a mean of 37.5 weeks for the control group. The radiographs were digitized and analyzed for a horizontal displacement of T12 from the second sacral tubercle, verticality of the lumbar spine at the sacral base, and any dextro/levo angle at mid-lumbar spine. Treatment subjects received the Harrison mirror image postural correction methods, which included an opposite trunk-list exercise and a new method of opposite trunk-list traction. Control subjects did not receive spinal rehabilitation therapy, but rather self-managed their back pain. For the treatment group, there were statistically significant improvements (approximately 50%) in all radiographic measurements and a decrease in pain intensity (NRS: 3.0 to 0.8). For the control group, no significant radiographic and NRS differences were found, except in trunk-list displacement of T12 to S1, worsened by 2.4 mm. Mirror image (opposite posture) postural corrective exercises and a new method of trunk-list traction resulted in 50% reduction in trunk list and were associated with nearly resolved pain intensity in this patient population. The findings warrant further study in the conservative treatment of chronic low back pain and spinal disorders.

  14. Estudo anatômico do ligamento patelofemoral lateral em joelho de cadáveres Anatomical study of the lateral patellofemoral ligament in cadaver knees

    Directory of Open Access Journals (Sweden)

    Marcelo Schmidt Navarro

    2008-07-01

    fresh cadavers by means of anatomical dissections. The dissections were standardized and the data were noted down and forwarded to statistical analysis. RESULTS: The LPFL presented a mean 16.05 mm width (standard deviation of 2.48, 42.10 mm length (standard deviation of 8.84. The femoral insertion was found at the lateral femoral epicondyle and with a fan-like expansion of the fibers, predominantly in the posterior region proximal to the lateral epicondyle. In the patella, the insertion found was in the upper-lateral region (in the middle of the upper third of the coronal plan, also with expanded fibers, but less intensely so. In the sagittal plan, the ligament was located in the posterior half of the border of the patella. The LPFL was isolated in the second lateral retinacular layer, the deep transverse retinaculum. CONCLUSION: The LPFL is located in the deep transverse retinacular layer with the presence of a fan-like expansion of its fibers both in the femoral and in the patellar insertions. The insertion is more posterior and proximal at the femoral epicondyle and in the posterior half of the patellar border (sagittal plan and in the upper-lateral aspect.

  15. Open lateral internal anal sphincterotomy under local anesthesia as the gold standard in the treatment of chronic anal fissures: A prospective clinical and manometric study Esfinterotomía lateral interna abierta con anestesia local como gold standard en el tratamiento de la fisura anal crónica: Estudio prospectivo clínico y manométrico a largo plazo

    Directory of Open Access Journals (Sweden)

    A. Sánchez Romero

    2004-12-01

    Full Text Available Background: chronic anal fissure is one of the most frequent proctological disorders in Western populations. Open lateral internal sphincterotomy is one of the therapeutic options accepted as the treatment of choice for chronic anal fissure, since it reduces the hypertonia of the internal anal sphincter (the main etiopathogenic mechanism of fissures, decreases anal pain, and allows the fissure to heal. Material and methods: we carried out a prospective study of 120 patients operated on for chronic anal fissure with open sphincterotomy under local anesthesia at our Proctology Outpatient Unit from 1998 to 2001. No preoperative studies, bowel preparation, or antibiotic prophylaxis were carried out. All patients were followed up after 1 week, 2 months, 6 months, and 1 year, and underwent an anal manometry before and after surgery. Results: early complications: 3 hematoma-ecchymosis of the wound (2.5%, 3 self-limited hemorrhage events (2.5%. No hemorrhoidal thrombosis, fistulas, or perianal abscesses occurred. Fissures recurred in nine patients (7.5% within one year. The initial rate of incontinence of 7.5% at two months dropped down to 5% at six months. The mean resting pressure (MRP in incontinent patients was lower than in continent patients (55±7 mmHg versus 80.7 ± 21 mmHg. The difference in mean squeeze pressure (MSP between incontinent patients and continent patients was not statistically significant. Conclusions: open sphincterotomy under local anesthesia has a long-term rate of healing and a morbidity rate similar to other techniques. It may therefore be considered an effective treatment for chronic anal fissure.Introducción: la fisura anal crónica sigue siendo uno de los problemas proctológicos más frecuentes e incapacitantes en la población occidental actual. La esfinterotomía lateral interna abierta es una de las opciones terapéuticas descritas y aceptadas como tratamiento de elección de la fisura anal crónica, ya que reduce la

  16. 带线锚钉结合改良Brostr(o)m法修复慢性踝关节外侧不稳%Suture anchors in treatment of chronic lateral ankle instability using modified Brostr(o)m technique

    Institute of Scientific and Technical Information of China (English)

    陈刚; 陈封明; 任鹏; 李兵兵; 陈立; 周阳

    2012-01-01

    Objective To discuss the application of suture anchors in the treatment of chronic lateral ankle instability using the modified Brostr(o)m technique.Methods From May 2009 to May 2011,we admitted 16 patients with ankle sprain of degree Ⅲ who had had little improvement after conservative treatment for more than 6 months and deteriorated into chronic lateral ankle instability.They were 7 men and 9 women,aged from 19 to 31 years (average,23.6 years).They all had mild swelling,pain and instability at the lateral ankle.We treated them with suture anchors using the modified Brostr(o)m technique.The pre-and post-operative ankle functions were evaluated by American Orthopaedic Foot and Ankle Society(AOFAS) scores.The patients' subjective feeling after operation was evaluated by the Good grading system.Results The patients were followed up for 6 to 24 months (average,16 months).The AOFAS ankle and hindfoot score improved significantly from preoperative 65.00 ± 6.65 points to postoperative 92.06 ± 3.13 points,the talar antedisplacement from preoperative 11.38 ±2.23 mm to postoperative 3.19 ± 1.1 mm,and the talar tilt angle from preoperative 13.44° ± 2.25° to postoperative 4.69° ± 1.35° (P < 0.05).By the Good grading system for postoperative symptoms,there were 8 cases of grade Ⅰ,6 cases of grade Ⅱ,2 cases of grade Ⅲ and no case of grade Ⅳ,giving a good to excellent rate of 87.5%.Conclusion Suture anchors and modified Brostr(o)m technique is a reasonable and effective surgical method for the treatment of chronic lateral ankle instability.%目的 探讨带线锚钉结合改良Brostr(o)m法修复慢性踝关节外侧不稳的方法和疗效.方法 对2009年5月至2011年5月间收治16例慢性踝关节不稳患者进行回顾性分析,其中男7例,女9例;年龄19 ~31岁,平均23.6岁;均有踝关节外侧轻度肿胀、疼痛、不稳感,均为6个月以上的陈旧性损伤,而且经过3~6个月康复训练无改善,反复扭伤.均采用

  17. Anwendung der extrakorporalen Stoßwellentherapie bei kalzifizierender Periathropathia humeroscapularis, Fersensporn und Epicondylitis humeri - Erfahrungsbericht aus dem Wilhelminenspital

    Directory of Open Access Journals (Sweden)

    Feyertag J

    2004-01-01

    Full Text Available Die Stoßwellentherapie wird bei verschiedenen Indikationen, die unter konservativen Therapien schwer zu schwer zu behandeln sind, eingesetzt. Dazu zählen die kalzifizierenden Schultererkrankungen (Tendinitis calcarea, Epicondylitis humeri (EHR und die plantare Fasciitis mit/ohne plantarem Fersensporn (FSP. Berichtet werden die Ergebnisse von 147 Patienten (102 Frauen/45 Männer, mittleres Alter betrug 57,8 Jahre, die mittels einer einmaligen extrakorporalen Stoßwellentherapie (ESWT (Tend. calc. 82 %, FSP 11 % oder EHR 7 % mittels eines HMT-ReflecTron therapiert wurden. Verabreicht wurden im Mittel 1.800 Stoßwellen. Untersucht wurde die subjektive Verbesserung der Schmerzen anhand einer visuellen Analogskala vor und 6 Wochen nach der Therapie bei allen Patienten. Bei Patienten mit Tendinitis calcarea wurde auch eine Verbesserung der Funktion sowie Veränderungen der Kalzifizierungen untersucht. Bei allen Patienten konnte eine statistisch signifikante Verbesserung der Schmerzen sowie des Bewegungsumfanges beobachtet werden (p 0,0001. Röntgenaufnahmen ergaben eine partielle Verkleinerung der Kalkdepots bei ca. 80 % der Patienten. Aufgrund der geringen Zahl der Patienten fand sich für die EHR keine signifikante Verbesserung der Schmerzsymptomatik. Eine einmalige ESWT kann zu einer deutlichen Verbesserung der Schmerzsymptomatik und zu einer Verbesserung des Bewegungsumfanges führen. Bei 80 % der Patienten mit einer Tendinitis calcarea findet sich weiter eine partielle Verkleinerung der Kalkdepots 6 Wochen nach Therapie.

  18. 药艾灸配合中药内服治疗肱骨外上髁炎1则%Treating 1 case of humeral epicondylitis in the medicine moxa acupuncture combined with TCM oral medicine

    Institute of Scientific and Technical Information of China (English)

    赵崇智

    2013-01-01

    Humeral epicondylitis, also known as tennis elbow, is a common and frequently disease of clinical orthopedics. The writer summarized one representative case of humeral epicondylitis treating with the medicine moxa acupuncture combined with TCM oral medicine, the results showed that the TCM oral medicine was effective in treating humeral epicondylitis, worthy of a wide application.%  肱骨外上髁炎又称网球肘,是骨伤科临床常见病和多发病。笔者将1例采用药艾灸配合中药内服治疗肱骨外上髁炎的典型病例进行了总结。结果表明,药艾灸配合中药内服治疗肱骨外上髁炎疗效好,值得临床推广使用。

  19. Sex determination using discriminant analysis of the medial and lateral condyles of the femur in Koreans.

    Science.gov (United States)

    Kim, Deog-Im; Kwak, Dai-Soon; Han, Seung-Ho

    2013-12-10

    The proximal and distal parts of the femur show the differences between the sexes. Head diameter and the breadth of the epicondyle of the femur are known to distinguish males from females. The proximal end of the femur is studied to determine sex using discriminant analysis but; its distal end is not done. This study aims to develop an equation specific to Koreans by using the medial and lateral condyles of the femur, and to demonstrate the usefulness of equations for specific population groups. We used three-dimensional images from 202 Korean femurs. Twelve variables were measured with a computer program after the femurs were in alignment. Eleven variables showed a statistically significant difference between the sexes (Psex determination in situations where the skull and pelvis are missing and part of the femur is available. The study also demonstrates the need for different equations for different population groups.

  20. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain

    Science.gov (United States)

    Hauser, Ross A.; Lackner, Johanna B.; Steilen-Matias, Danielle; Harris, David K.

    2016-01-01

    OBJECTIVE The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. DATA SOURCES Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. STUDY SELECTION Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. DATA EXTRACTION Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. DATA SYNTHESIS Fourteen RCTs, 1 case–control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood–Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive

  1. Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: a randomized clinical trial.

    Science.gov (United States)

    Nagrale, Amit V; Herd, Christopher R; Ganvir, Shyam; Ramteke, Gopichand

    2009-01-01

    Cyriax and Cyriax advocated the use of deep transverse friction massage in combination with Mill's manipulation in treating lateral epicondylalgia. Evidence comparing this approach with other physical therapies is lacking. The purpose of this randomized clinical trial was to compare the effectiveness of deep transverse friction massage with Mill's manipulation versus phonophoresis with supervised exercise in managing lateral epicondylalgia. Sixty patients age 30-60, presenting with the teno-periosteal variety of lateral epicondylalgia with symptom duration greater than one month, were randomized into two groups. The control group received phonophoresis with diclofenac gel over the area of the lateral epicondyle for 5 minutes combined with supervised exercise. The experimental group received 10 minutes of deep transverse friction massage followed by a single application of Mill's manipulation. Both groups received treatment 3 times per week for 4 weeks. Outcomes of interest included pain via visual analog scale (VAS), pain-free grip strength, and functional status measured with the Tennis Elbow Function Scale. Data were analyzed using a one-way ANOVA. Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (pCyriax physiotherapy is a superior treatment approach compared to phonophoresis and exercise in managing lateral epicondylalgia.

  2. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  3. Deep transverse friction massage for treating lateral elbow or lateral knee tendinitis.

    Science.gov (United States)

    Loew, Laurianne M; Brosseau, Lucie; Tugwell, Peter; Wells, George A; Welch, Vivian; Shea, Beverley; Poitras, Stephane; De Angelis, Gino; Rahman, Prinon

    2014-11-08

    Background Deep transverse friction massage, one of several physical therapy interventions suggested for the management of tendinitis pain, was first demonstrated in the 1930s by Dr James Cyriax, a renowned orthopedic surgeon in England. Its goal is to prevent abnormal fibrous adhesions and abnormal scarring. This is an update of a Cochrane review first published in 2001.Objectives To assess the benefits and harms of deep transverse friction massage for treating lateral elbow or lateral knee tendinitis.Search methods We searched the following electronic databases: the specialized central registry of the Cochrane Field of Physical and Related Therapies,the Cochrane Central Register of Controlled Trials (CENTRAL),MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinicaltrials.gov, and the Physiotherapy Evidence Database (PEDro), up until July 2014. The reference lists of these trials were consulted for additional studies.Selection criteria All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing deep transverse friction massage with control or other active interventions for study participants with two eligible types of tendinitis (ie, extensor carpi radialis tendinitis (lateral elbow tendinitis, tennis elbow or lateral epicondylitis or lateralis epicondylitis humeri) and iliotibial band friction syndrome (lateral knee tendinitis)) were selected. Only studies published in English and French languages were included.Data collection and analysis Two review authors independently assessed the studies on the basis of inclusion and exclusion criteria. Results of individual trials were extracted from the included study using extraction forms prepared by two independent review authors before the review was begun.Data were cross-checked by a third review author. Risk of bias of the included studies was assessed using the "Risk of bias"tool of The Cochrane Collaboration. A pooled analysis was performed using

  4. 奇正青鹏膏外敷配合推拿手法治疗30例肱骨外上髁炎临床疗效观察%Efficacy of QI ZHENG QING Peng Plaster and Massage Manipulation in Treating 30 Patients with Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    刘红艳

    2013-01-01

    目的观察奇正青鹏膏配合推拿手法治疗肱骨外上髁炎治疗效果。方法将30例36肘随机分为两组,治疗组15例18肘,取2g左右青鹏膏涂于外侧髁压痛点区域,点按曲池、手三里、合谷,然后自肱骨外侧髁沿桡侧腕伸肌和指总伸肌腱走向反复推揉弹拨3min,放松肌肉直至药剂透皮吸收(不粘手为准),每天早晚2次治疗4w。对照组15例18肘,选用醋酸曲安奈德针20mg溶于2%利多卡因2.5ml,注射点选择外上髁前下方痛点周围区域,1次/w,共4w。4w后评定VAS评分及疗效。结果两组治疗结果经统计学检验P<0.05,治疗组疗效优于对照组,VAS评分降低更多,有显著性差异。结论奇正青鹏膏剂外敷配合推拿手法治疗肱骨外上髁炎方法简单,疗效显著,不良作用小,患者依从性好,值得临床推广使用。%Objective To observe the ef ect of QI ZHENG Qing Peng paste and massage manipulation treatment of humeral epicondylitis. Methods 30 patients (36 elbows) with humeral epicondylitis were randomized into two groups,15 patients (18 elbows) treated with QI ZHENG Qing Peng paste and massage manipulation, take 2 grams Qing Peng cream applied to the region of the lateral condyle of tender points, tap Qu CHI, SHOU SANLI, Hegu, Ashi xue,then from the lateral humeral condyle along the radial side of the wrist extensor and refers to the total extensor tendon towards repeated push, rub, fingerstyle and toggle for 3 minutes, relax the muscles until the pharmaceutical transdermal absorption (sticky prevail),twice a day (morning and evening) , for four weeks. 15 patients (18 elbows)in the control group,treated with triamcinolone acetonide needle 20mg dissolved in 2% lidocaine 2.5ml external condyle pain points below the area around the injection point selection, once a week for 4 weeks. The dif erence between VAS score and ef icacy were for statistical analysis after 4 weeks. Results Compared with control

  5. 针灸治疗肱骨外上髁炎文献质量评价%Literature Quality Evaluation for Acupuncture Treatment of External Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    王一先; 陈少宗

    2012-01-01

    Objective : To research quality evaluation of literature of acupuncture and moxihustion in the treatment of external humeral epicondylitis. Methods : The retrieval of Chinese Academic Journal Full-text Database ( CNKI ) was made, retrieval time deadline was November of 2010. All related literatures of acupuncture and moxibustion in the treatment of external humeral epicondylitis with randomized controlled trials were selected in accordance with the inclusion criteria lor clinical trials, evaluating the method. Results : The randomized controlled trials accounted for 32%, 21.54% of the documents had eomparsions between groups of statistics, the balance between groups was reliable. 32.31% literature had a clear diagnostic criteria. The correct use of stochastic grouping method accounted lor 2.56%, 17 articles had follow-up record, 2 mentioned blind method, 3 papers mentioned treatment safety and adverse reaction. Conclusion : The limited inlcusion criteria shows acupuncture and moxibustion in the treatment of external humeral epicondylitis superiority still needs more high quality, inner reality of randomized controlled trials.%目的:对针灸治疗肱骨外上髁的试验研究进行文献质量评价.方法:检索中文学术期刊全文数据库(CNKI),检索时间截止至2010年11月.获取所有涉及针灸治疗肱骨外上髁炎的随机对照试验,选择符合纳入标准的临床试验,评价其方法.结果:其中随机对照试验占32%,21.54%的文献进行细间可比性的统计,组间均衡性比较可靠,有明确诊断标准的文献占32.31%,正确运用随机分组方法的文献占2.56%,17篇文献有随访记录,2篇提及盲法,3篇提及治疗安全性及不良反应.结论:目前有限的纳入试验显示,对于针灸治疗肱骨外上髁炎的优越性尚需更多的质量高、内在真实性好的随机对照试验来证实.

  6. Minimally invasive surgery for children with unstable of humerus epicondyle fractures%微创治疗儿童肱骨髁上不稳定骨折

    Institute of Scientific and Technical Information of China (English)

    沈建业; 谭志胜; 郑彩平; 李有生; 梁炳生

    2009-01-01

    目的 探讨以生物学固定及间接复位技术为基础,微创治疗儿童肱骨髁上不稳定骨折的临床疗效.方法 对86例儿童肱骨髁上不稳定骨折采用闭合复位,部分加内侧小切口,然后经皮克氏针交叉固定辅加石膏托外固定进行治疗.结果 术后随访时间为6个月至5年(平均2.5年),骨折全部愈合,平均愈合时间为1.2个月.参照Flum临床功能评定标准评定:优78例,良6例,可2例;优良率为98%.结论 以微创为原则闭合复位,经皮交叉克氏针内固定治疗儿童肱骨髁上不稳定骨折,该方法 符合生物学固定的观点,创伤小,并发症少,恢复快,疗效满意.%Objective To explore the clinical trestment outcomes d minimally invasive surgery for children with unstable humerus epicondyle fractures using biological internal fixation arid indirect reduction. Methods This series involved 86 children with unstable humerus epicondyle fractures. They were treated with close reduction and percutaneous Kirschner wire cross fixation assisted with small incisions on the medial side. Immobilization was supplemented with a plaster cast. Results Postoperative follow up ranged from 6 months to 5 years (average 2.5 years). All fractures healed. The average time of fracture healing was 1.2 month. According to Flum clinical functional assessment standard, 78 cases had excellent results, 6 cases good and 2 cases fair. The gcod-excellent rate was 98%. Conclusion Minimally invasive surgery for children with unstable humerus epicondyle fractures including close reduction and percutaneous fixation by cross K-wires. It obeys biomechanical laws, causes minimal trauma and few complications, achieves rapid recovery and leads to satisfactory treatment outcome.

  7. The Investigation on Traditional Chinese Medicine Treatment of External Humeral Epicondylitis%肱骨外上髁炎的中医治疗探析

    Institute of Scientific and Technical Information of China (English)

    李春光

    2015-01-01

    Objective The Traditional Chinese medicine treatment of external humeral epicondylitis is to be investigated. Methods Choose 42 patients of external humeral epicondylitis who are treated in hospital from September 2013 to October 2014 and cure them with traditional Chinese medicine treatment, including both internal and external traditional Chinese medicine treatment as wel as non-drug therapy. And then observe the treatment efficiency. Results With the treatment of acupuncture,massage,external application as wel as oral-taking of traditional Chinese medicine,al of 42 patients’ il ness symptoms have been relieved; thus,such a treatment approach is quite effective and it has statistic value(P<0.05).Conclusion Traditional Chinese medicine treatment is conducive to eliminating spasm of joints and its surround tissue,in addition,it is effective to cure inflammation and restore the stress and tension balance of elbow,therefore,the traditional Chinese medicine treatment of external humeral epicondylitis is quite worthy to be clinical y promoted and applied.%目的:探讨肱骨外上髁炎的中医治疗探析。方法选取2013年9月~2014年10月我院接诊的42例肱骨外上髁炎患者,全部采用中医治疗方法,包括中药内治、中药外治以及非药物疗法,观察患者的治疗效果。结果42例患者经过中医针灸、推拿、中药外敷、中药内服等治疗后症状缓解,治疗效果显著,有统计学意义(P<0.05)。结论中医治疗肱骨外上髁炎能够解除关节与周围组织的痉挛,消除炎症,恢复肘关节的应力和张力平衡。

  8. Primary Lateral Sclerosis

    Science.gov (United States)

    ... mistaken for amyotrophic lateral sclerosis (ALS) or spastic paraplegia. Most neurologists follow an affected individual's clinical course ... mistaken for amyotrophic lateral sclerosis (ALS) or spastic paraplegia. Most neurologists follow an affected individual's clinical course ...

  9. Cross-cultural adaptation and determination of the reliability and validity of PRTEE-S (Patientskattad Utvärdering av Tennisarmbåge, a questionnaire for patients with lateral epicondylalgia, in a Swedish population

    Directory of Open Access Journals (Sweden)

    Baigi Amir

    2008-06-01

    Full Text Available Abstract Background In Sweden, as well as in Scandinavia, there is no easy way to evaluate patients' difficulties when they suffer from lateral epicondylitis/epicondylalgia. However, there is a Canadian questionnaire, in English, that could make the evaluation of a patient's pain and functional loss both quick and inexpensive. Therefore, the aim of this study was to translate and cross-culturally adapt the questionnaire "Patient-rated Tennis Elbow Evaluation" into Swedish (PRTEE-S; "Patientskattad Utvärdering av Tennisarmbåge", and to evaluate the reliability and validity of the test. Methods The Patient-rated Tennis Elbow Evaluation was cross-culturally adapted for the Swedish language according to well-established guidelines. Fifty-four patients with unilateral epicondylitis/epicondylalgia were assessed using the PRTEE-S (Patientskattad Utvärdering av Tennisarmbåge, the Disabilities of Arm, Shoulder, and Hand questionnaire, and the Roles & Maudsley score to establish the validity and reliability of the PRTEE-S. Reliability was determined via calculation of the intra-class correlation coefficient (ICC the internal consistency was assessed by Cronbach's alpha, and validity was calculated using Spearman's correlation coefficient. Results The test-retest reliability, using the PRTEE-S (Patientskattad Utvärdering av Tennisarmbåge intraclass correlation coefficient, was 0.95 and the internal consistency was 0.94. The PRTEE-S correlated well with the Disabilities of the Arm, Shoulder, and Hand questionnaire (r = 0.88 and the Roles & Maudsley score (r = 0.78. Conclusion The PRTEE-S (Patientskattad Utvärdering av Tennisarmbåge represents a reliable and valid instrument to evaluate the subjective outcome in Swedish speaking patients with lateral epicondylitis/epicondylalgia, and can be used in both research and clinical settings.

  10. EFFECT OF KINESIO TAPING VERSUS ATHLETIC TAPING ON PAIN AND MUSCLE PERFORMANCE IN LATERAL EPICONDYLALGIA

    Directory of Open Access Journals (Sweden)

    Rashi Goel

    2015-02-01

    Full Text Available Lateral epicondylalgia is a degenerative musculoskeletal pain state characterised by pain over the lateral humeral epicondyle resulting in absenteeism from work and daily living activities. It is most prevalent in jobs requiring repetitive manual activities of the upper extremity. Literature describes different treatment options for lateral Epicondylalgia but there is no consensus about the most efficacious intervention strategy. Taping (athletic/kinesio has been used successfully in various musculoskeletal conditions with successful results. To date, no study has investigated the effect of kinesio taping in lateral epicondylalgia. The purpose of the study was to investigate and compare the effects of kinesio taping and athletic taping on pain and muscle performance in patients with lateral epicondylalgia. 16 patients (9 males, 7 females within age group of 18 – 50 years participated in the study. It was a cross over design. VAS, digital al goniometer and Jamar Dynamometer were used to quantify pain, pressure pain threshold and pain free grip strength. These were evaluated pre taping, immediately after taping and after 30 minutes of each taping application selected randomly for two consecutive days. Repeated measures ANOVA and percentage change were used to examine differences in outcome measures. Bonferroni correction was applied to correct for repeated testing. The results showed significant pain reduction and increase in grip strength after both the taping techniques but no statistically significant differences for any outcome measure between the two taping techniques (p>0.05. Also the immediate pain reduction was more after athletic taping (21% than kinesio taping (10% that corresponded to the immediate increase in pain free grip strength more after athletic taping (14.5% than kinesio taping (9.7%. 30 minutes later both the outcome measures gave similar percentage changes . The present study concludes with the recommendation of both

  11. Medial epicondylitis - golfer's elbow

    Science.gov (United States)

    ... Saunders; 2009:chap 19. Schmidt MJ, Adams SL. Tendinopathy and bursitis. In: Marx JA, Hockberger RS, Walls ... Health Topics Elbow Injuries and Disorders Sports Injuries Tendinitis Browse the Encyclopedia A.D.A.M., Inc. ...

  12. Relationship between renal histology and later graft outcome.

    Science.gov (United States)

    Isoniemi, H; Ahonen, J; Eklund, B; Häyry, P; Höckerstedt, K; Krogerus, L; Salmela, K; Taskinen, E

    1994-01-01

    We have created the chronic allograft damage index (CADI), which quantifies the early histopathological changes in renal allografts. In this study we showed that the CADI at 2 years after renal transplantation predicted the graft outcome 4 years later and that the CADI identified the risk group that proceeded to chronic rejection during subsequent years.

  13. Language lateralization in schizophrenia

    NARCIS (Netherlands)

    Sommer, I.E.C.

    2004-01-01

    Schizophrenia is a severe chronic psychiatric illness that affects approximately 1-2% of the populations worldwide. Schizophrenia is characterized by episodes of psychosis, in which patients experience hallucinations (false perceptions) and delusions (false beliefs). Apart from the psychotic episode

  14. Amyotrophic Lateral Sclerosis (ALS)

    Science.gov (United States)

    ... ALS Neurons' broken machinery piles up in ALS Esclerosis Lateral Amiotrófica Dormant viral genes may awaken to ... Dementia Information Page Multifocal Motor Neuropathy Information Page Multiple Sclerosis Information Page Muscular Dystrophy Information Page Myasthenia ...

  15. Amyotrophic lateral sclerosis (ALS)

    Science.gov (United States)

    Lou Gehrig disease; ALS; Upper and lower motor neuron disease; Motor neuron disease ... 98. Shaw PJ. Amyotrophic lateral sclerosis and other motor neuron diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  16. Laterally loaded masonry

    DEFF Research Database (Denmark)

    Raun Gottfredsen, F.

    In this thesis results from experiments on mortar joints and masonry as well as methods of calculation of strength and deformation of laterally loaded masonry are presented. The strength and deformation capacity of mortar joints have been determined from experiments involving a constant compressive...... stress and increasing shear. The results show a transition to pure friction as the cohesion is gradually destroyed. An interface model of a mortar joint that can take into account this aspect has been developed. Laterally loaded masonry panels have also been tested and it is found to be characteristic...

  17. Lateral Thinking of Prospective Teachers

    Science.gov (United States)

    Lawrence, A. S. Arul; Xavier, S. Amaladoss

    2013-01-01

    Edward de Bono who invented the term "lateral thinking" in 1967 is the pioneer of lateral thinking. Lateral thinking is concerned with the generation of new ideas. Liberation from old ideas and the stimulation of new ones are twin aspects of lateral thinking. Lateral thinking is a creative skills from which all people can benefit…

  18. 可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折%Absorbable thread tension with the needle was merged cross ifxed treat children chronic humerus lateral condyle fracture

    Institute of Scientific and Technical Information of China (English)

    江政晃; 余舒鹏

    2016-01-01

    目的:探讨可吸收线张力带合并克氏针治疗儿童陈旧性肱骨外髁骨折的治疗效果及儿童肱骨外髁骨折治疗的注意事项和经验。方法回顾性研究2014年1月至2016年1月江西中医药大学附属医院收治的18例陈旧性肱骨外髁骨折患儿临床资料,均采用可吸收线张力带合并克氏针交叉固定治疗,术后定期随访患儿骨折愈合情况。结果18例患儿均获得随访。骨折愈合时间4~12周,平均6周。无术后感染、神经损伤、肱骨小头缺血坏死、骨不连等并发症。肘关节活动根据 hardacre的疗效标评估,优16例(88.9%),良2例(11.1%)。结论可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折获得较为满意的治疗效果;肱骨外髁骨折骨折的处理第一要务就是在于早期的诊断,及时正确的治疗,防止陈旧性肱骨外髁骨折的产生,而对于陈旧性肱骨外髁骨折的早期手术治疗却能够使得肘关节的外观和功能得到有效的纠正。%Objective to explore the absorbable thread tension with the needle was merged the curative effect of treating children chronic humerus lateral condyle fracture and children humerus condyle fracture treatment considerations and experience.Methods retrospective study between January 2014 and January 2014 in jiangxi university of traditional Chinese medicine affiliated hospital of 18 cases of pulmonary humerus lateral condyle fracture with clinical data, adopts absorbable thread tension with the needle was merged cross fixed treatment, postoperative follow-up on a regular basis with fracture healing.Results 18 cases were follow-up. Fracture healing time 4 ~ 12 weeks, 6 weeks on average. No postoperative infection, nerve injury, capitellum complications such as ischemic necrosis, bone nonunion. Elbow movement according to the curative effect of hardacre standard evaluation, optimal 16 cases (88.9%), good in 2 cases (11

  19. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... Chronic myelogenous leukemia is grouped into phases: Chronic Accelerated Blast crisis The chronic phase can last for ...

  20. Onset dominance in lateralization.

    Science.gov (United States)

    Freyman, R L; Zurek, P M; Balakrishnan, U; Chiang, Y C

    1997-03-01

    Saberi and Perrott [Acustica 81, 272-275 (1995)] found that the in-head lateralization of a relatively long-duration pulse train could be controlled by the interaural delay of the single pulse pair that occurs at onset. The present study examined this further, using an acoustic pointer measure of lateralization, with stimulus manipulations designed to determine conditions under which lateralization was consistent with the interaural onset delay. The present stimuli were wideband pulse trains, noise-burst trains, and inharmonic complexes, 250 ms in duration, chosen for the ease with which interaural delays and correlations of select temporal segments of the stimulus could be manipulated. The stimulus factors studied were the periodicity of the ongoing part of the signal as well as the multiplicity and ambiguity of interaural delays. The results, in general, showed that the interaural onset delay controlled lateralization when the steady state binaural cues were relatively weak, either because the spectral components were only sparsely distributed across frequency or because the interaural time delays were ambiguous. Onset dominance can be disrupted by sudden stimulus changes within the train, and several examples of such changes are described. Individual subjects showed strong left-right asymmetries in onset effectiveness. The results have implications for understanding how onset and ongoing interaural delay cues contribute to the location estimates formed by the binaural auditory system.

  1. 本体感觉反射手法治疗肱骨外上髁炎41例%Clinical Study of Proprioceptive Sensibility Reflexotherapy Treating External Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    农文恒; 罗汉华; 张雪; 谢仁明

    2012-01-01

    目的:观察人体本体感觉反射疗法对肱骨外上髁炎的治疗效果.方法:对41例肱骨外上髁炎患者,实施人体本体感觉反射整复手法1个疗程,采用视觉模拟疼痛量表(VAS)及压力测痛仪(kg/cm2)压痛情况分别于治疗前和治疗后予以评定,治疗前、后分值比较采用配对t检验.结果:41例病人症状体征均得到不同程度的改善,治疗前、后差异有统计学意义(P<0.01).结论:人体本体感觉反射无损伤手法整复术是一种治疗肱骨外上髁炎的有效方法.%Objective: To study the clinical effect on external humeral epicondylitis with proprioceptive sensibility rgflexolhera-py. Methods:41 patients with external humeral epicondylitis were treated with proprioceptive sensibility reflexotherapy for 5 days. The clinical effect was evaluated by visual analog score simulation (VAS) and instrument for measuring pain (kg/cm ) before and after treatment. The statistical analysis of the score before and after treatment was made by matching t test. Results:The clinical symptoms of 41 patients were improved compared with pre - treatment, there were statistically significant differences before and after treatment (P <0. 01). Conclusion: Proprioceptive sensibility reflexotherapy is an effective therapy on treating external humeral epicondylitis.

  2. Massage Cooperated with High Potential Therapeutic Apparatus in Treatment of 65 Cases of External Humeral Epicondylitis%推拿配合高电位治疗仪治疗肱骨外上髁炎65例

    Institute of Scientific and Technical Information of China (English)

    夏振君; 李旭华

    2013-01-01

    Objective:To discuss the efficacy of massage cooperated with high potential thera-peutic apparatus in treatment of external humeral epicondylitis. Methods:65 patients with external humeral epicondylitis were treated by technique of rolling manipulation, kneading method, grasping manipulation, single-finger meditation pushing therapy, flipping and poking, pronation-traction and high potential therapeutic apparatus. The efficacy was observed. Results: 48 cases were excellent, 14 cases were good, 2 cases were middle, 1 case was bad. The total effective rate was 98.5%. Con-clusion:Massage cooperated with high potential therapeutic apparatus in treatment of external hu-meral epicondylitis has marked effect, and it is worthy of popularization and application.%  目的:探讨中医推拿配合高电位治疗仪治疗肱骨外上髁炎的疗效.方法:65例确诊为肱骨外上髁炎的患者,运用滚、揉、拿、一指禅、弹拨、旋前牵拉等手法配合高电位治疗仪治疗后统计疗效.结果:临床疗效优48例,良14例,中2例,差1例,总有效率98.5%.结论:中医推拿配合高电位治疗仪治疗肱骨外上髁炎效果显著,值得推广应用.

  3. Clinical observation of 80 cases of needle knife type in the treatment of external humeral epicondylitis%针刀分型治疗肱骨外上髁炎80例临床观察

    Institute of Scientific and Technical Information of China (English)

    张敬珍

    2015-01-01

    Objective:To observe the clinical effect of needle knife type in the treatment of external humeral epicondylitis. Methods:80 patients with external humeral epicondylitis were selected from March 2012 to February 2014.They were given needle knife type treatment.The effects were observed.Results:42 cases were cured after one time treatment,and 27 cases were cured after two times treatment.The cure rate was 87.5%,and the effective rate was 100%.Conclusion:The needle knife type in the treatment of external humeral epicondylitis has the effect of releasing soft tissue,reduction,decompression,releasing conglutination,and it helps to build new blood circulation.%目的:观察针刀分型治疗肱骨外上髁炎的临床疗效。方法:2012年3月-2014年2月收治肱骨外上髁炎患者80例,采用针刀分型治疗,观察疗效。结果:1次治疗后痊愈42例,2次治疗痊愈27例,治愈率87.5%,有效率达100%。结论:针刀分型在肱骨外上髁炎患者中具有松解软组织,减张、减压、松解粘连的作用,有利于重新建立新的血液循环。

  4. A COMPARATIVE STUDY OF OUTCOMES OF PERCUTANEOUS CROSSED VS LATERAL DIVERGENT PINNING IN THE TREATMENT OF DISPLACED (GRADE - 3 SUPRACONDYLAR FRACTURES OF HUMERUS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Nirav Patel

    2015-02-01

    Full Text Available INTRODUCTION: Displaced supracondylar fractures of humerus are one of the most common fractures in paediatric age group with preferred treatment being close reduction with percutaneous k - wire fixation. This study compares whether lateral pin construct alone can provide same stability like medial and lateral pin fixation, and prevent iatrogenic ulnar nerve injury. MATERIAL & METHODS: This is a prospective comparative randomized controlled trial. A total of 60 patients of displaced supracondylar fracture aged between 3 - 12 years with fresh fracture, without any compound injury or communition were enrolled for the study and randomly divided into two groups, A and B. For each group of 30 patients, they were assigned treatment of crossed pinning and lateral pinning respectively and outcome was evaluated on basis of pain, motion, stability and function according to Mayo’s elbow score and follow - up was maintained for a period of 45 days and test for statistical significance were applied. RESULTS: After assessing 30 patients in each group we found out that mean mayo score was 98 in cross pinning group and 96.83 in lateral pinning group. This difference is statistically not significant. (p value - 0.502. CONCLUSION: In our study we conclude that, Lateral pinning is an equally good treatment choice in these fractures and especially for grossly swollen elbows in which medial epicondyle is barely palpable with increased risk of ulnar nerve injury during placement of medial pin. Both the methods offer consistently satisfactory functional and cosmetic results

  5. The influence of intensive electro-acupuncture on external humeral epicondylitis%强化电针刺治疗肱骨外上髁炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨和平; 李易; 舒相平; 易陆; 梁莹

    2013-01-01

    Objective: To investigate the clinical effects of intensive electro-acupuncture at tenderness point and electro-acupuncture at acupoints in the treatment of external humeral epicondylitis. To find a treatment prescription on external humeral epicondylitis,that is simple, safe, pragmatic and applied to rural area.Methods: The parallel single blind randomized control clinical trial was administered 80 patients with external humeral epicondylitis were divided into two groups by random. Among these patients, therapeutic group(40) was treated with intensive electro-acupuncture at tenderness point, the control group(40) was treated with electro-acupuncture at acupoints, 5 times of treatment was a course.Results: The clinical observing showed that in therapeutic group intensive electro-acupuncture at tenderness point could improve the degrees of pain, compared to the control group, the difference was significant(P<0.01).Conclusion: intensive electro-acupuncture at tenderness point can effectively alleviate pain surffered from external humeral epicondylitis.and that is simple, safe, pragmatic and applied to rural area.%目的对比分析压痛点强化电针刺与常规腧穴电针治疗肱骨外上髁炎的临床疗效,以期探索一种适用于乡村的简便、安全、实用的治疗方案。方法 采用平行单盲随机对照研究,将80例肱骨外上髁炎患者随机分为治疗组和对照组各40例,其中治疗组给予强化电针刺治疗,对照组给予常规腧穴电针治疗,两组均治疗5次。结果 治疗组患者疼痛程度明显改善,与对照组比较差异具有显著性(P<0.01)。结论 强化电针刺治疗肱骨外上髁炎疗效显著且简单、安全、实用,适于在乡村推广。

  6. 微创小切口等离子射频成形术治疗顽固性肱骨外上髁炎%Application of minimally invasive radiofrequency angioplasty for the treatment of humeral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    孙海宁; 于秀淳; 付志厚; 惠文鹏

    2011-01-01

    Objective To evaluate the clinical efficacy of minimally invasive radiofrequency angioplasty in treating the humeral epicondylitis.Methods From July 2005 to October 2010, 39 patients (12 males and 27 females) with refractory humeral epicondylitis were admitted in the hospital.Of the 39 patients, 18 were with epicondylitis on the left side and 21 were on the right side.A 2-3cm incision was obtained under the minimally invasive surgery.RF formed after punching the tendon with special tendon RF segment.Results All patients were followed up for 26 months on average (range; 10 to 48 months).35 cases were cured, 2 cases demonstrated excellent efficacy and 2 cases good efficacy.No surgery-related complication happened.Conclusions Minimal invasive radiofrequency angioplasty has characteristics of small lesion and easy operation in treating the refractory humeral epicondylitis with confirmed efficacy and no impact on the integrity and physical strength of the tendon.It can also promote the physical recovery of the tendon.It is an effective, reliable and new method in treating this disease at present.%目的评价微创手术等离子射频成形术治疗顽固性肱骨外上髁炎的临床效果.方法自2005年7月至2010年10月收治39例顽固性肱骨外上髁炎,男12例,女27例,左侧18例,右侧21例,行微创小切口手术治疗,切口长约2~3cm,肌腱专用射频刀头行肌腱打孔,射频成形.结果所有病例均得到随访,时间10-48个月,平均26个月,治愈35例,显效2例,有效2例,无手术相关并发症发生.结论小切口等离子射频成形术治疗顽固性肱骨外上髁炎创伤小,操作简单,不影响肌腱的完整性和生理强度,并且可促进肌腱的生理性恢复,疗效确切,是目前治疗该疾病的一种微创、疗效可靠的新方法.

  7. [Lateral lumbar disk herniation].

    Science.gov (United States)

    Deburge, A; Barre, E; Guigui, P

    A retrospective study of 41 lateral discal hernias observed between 1984 and 1991 were studied among the 1080 discal hernias treated during this period. CT scan, performed in all cases, distinguished several different types of hernia: foramen hernias (26), extraforamen hernias (12), mixed forms (5) associated with canal component (11). Thirteen disco scans were required. Nucleolysis was performed in 24 patients (58%) and surgical treatment was the first intention choice in 17 (41%). Outcome, evaluated with a function score developed in the unit were good in the 17 surgery cases (100%). In the nucleolysis patients results were good or excellent in 13, average in 4, and poor in 7. Five of the nucleolysis failures were later operated leading to good results in 3, average in 1 and no change in 1. Indications for surgery are more frequent in this type of discal hernia and results in our surgical series were better than those for chemonucleolysis.

  8. Lateral Attitude Change.

    Science.gov (United States)

    Glaser, Tina; Dickel, Nina; Liersch, Benjamin; Rees, Jonas; Süssenbach, Philipp; Bohner, Gerd

    2015-08-01

    The authors propose a framework distinguishing two types of lateral attitude change (LAC): (a) generalization effects, where attitude change toward a focal object transfers to related objects, and (b) displacement effects, where only related attitudes change but the focal attitude does not change. They bring together examples of LAC from various domains of research, outline the conditions and underlying processes of each type of LAC, and develop a theoretical framework that enables researchers to study LAC more systematically in the future. Compared with established theories of attitude change, the LAC framework focuses on lateral instead of focal attitude change and encompasses both generalization and displacement. Novel predictions and designs for studying LAC are presented.

  9. The lateral angle revisited

    DEFF Research Database (Denmark)

    Morgan, Jeannie; Lynnerup, Niels; Hoppa, R.D.

    2013-01-01

    measurements taken from computed tomography (CT) scans. Previous reports have observed that the lateral angle size in females is significantly larger than in males. The method was applied to an independent series of 77 postmortem CT scans (42 males, 35 females) to validate its accuracy and reliability...... method appears to be of minimal practical use in forensic anthropology and archeology. © 2013 American Academy of Forensic Sciences....

  10. Lateral Control”

    DEFF Research Database (Denmark)

    Rasmussen, Hanne Nina; Veierskov, Bjarke; Hansen-Møller, Jens;

    2010-01-01

    pattern changes followed from destipitation, but few from decapitation. Growth reactions suggest that resource allocation to main branch buds inhibits leader growth in normal trees, a kind of “lateral control.” Auxin and ABA content in buds and stems was largely unaffected by treatments. Data suggest...... that subapical leader tissues beneath the apical bud group are a primary source of cytokinin regulation. Keywords ABA - Apical control - Auxin - Bud development - Cytokinin - Plant architecture...

  11. Treating 37 cases of xternal humeral epicondylitis with float-needling therapy%浮针疗法治疗肱骨外上髁炎37例

    Institute of Scientific and Technical Information of China (English)

    蒋湘萍

    2013-01-01

    Objective: To investigate the clinical effect of float-needling therapy. Methods: 72 patients were randomly divided into two groups. 37 cases were given the float-needling therapy, while the other 35 cases were given the electro-acupuncture therapy. Results:The total effective rate in the float-needling therapy group was 94.6%, significantly higher than that in the electro-acupuncture therapy group 74.3% (P<0.05). Conclusion: Float-needling therapy was effective on treating xternal humeral epicondylitis.%  目的:观察浮针疗法治疗肱骨外上髁炎的临床疗效.方法:将72例肱骨外上髁炎患者分为浮针组37例,电针组35例.浮针组:给予浮针疗法,3次/d,3次为1个疗程.电针组:给予常规针刺,1次/d,6次为1个疗程.结果:浮针治疗组总有效率94.6%,电针对照组74.3%,差异均有统计学意义(P<0.05),治疗组明显优于对照组.结论:浮针疗法治疗肱骨外上髁炎具有较好临床疗效.

  12. 带线锚钉在11例慢性踝关节外侧不稳韧带重建中的应用%With wire anchors application in the ligament reconstruction of 11 pa-tients with chronic lateral ankle instability

    Institute of Scientific and Technical Information of China (English)

    王波; 武亚娟; 侯勇

    2014-01-01

    Objective To investigate the value of with wire anchors in the treatment of cable anchors with chronic lat-eral ankle instability. Methods Selected 11 patients with chronic lateral ankle instability from January 2009 to Decem-ber 2012,7 males and 4 females,average age were(24.8±6.5) years,all implemented with wire anchors surgery to anatomi-cal reconstruction lateral ligaments,follow-up of 3 to 12 months postoperative,used a modified American Orthopaedic Foot and Ankle Society(AOFAS) scale to evaluate ankle function. Results Modified AOFAS ankle score excellent in 6 cases,good in 3 cases, fine in 1 case, poor in 1 case,good rate was 81.82%.AOFAS ankle scores were higher than preoperative after 3 months (P<0.05 or P<0.01); postoperative talar tilt angle,talar shift distance,ankle medial joint space was less than before(P<0.01). Conclusion With wire anchors application in the anatomical reconstruction of lat-eral ankle ligaments,the ligaments can restore the stability of the ankle, joint function recovered well, worthy of pro-motion apply.%目的:探讨带线锚钉在慢性踝关节外侧不稳治疗中的应用价值。方法选取2009年1月~2013年12月收治的慢性踝关节外侧不稳定患者11例,男7例,女4例;平均年龄(24.8±6.5)岁;均实施带线锚钉手术解剖重建外侧韧带,术后随访3~12个月,采用改良美国足踝骨科协会(AOFAS)足踝评分评价踝关节功能。结果改良AOFAS足踝评分优6例,良3例,可1例,差1例,优良率为81.82%。术后3个月改良AOFAS足踝评分均高于术前(P<0.05或P<0.01);术后距骨倾斜角度、距骨移位距离、踝关节内侧间隙均小于术前(P<0.01)。结论带线锚钉解剖重建踝关节外侧韧带能恢复韧带稳定性,踝关节功能恢复良好,值得临床推广适用。

  13. The lateral line microcosmos.

    Science.gov (United States)

    Ghysen, Alain; Dambly-Chaudière, Christine

    2007-09-01

    The lateral-line system is a simple sensory system comprising a number of discrete sense organs, the neuromasts, distributed over the body of fish and amphibians in species-specific patterns. Its development involves fundamental biological processes such as long-range cell migration, planar cell polarity, regeneration, and post-embryonic remodeling. These aspects have been extensively studied in amphibians by experimental embryologists, but it is only recently that the genetic bases of this development have been explored in zebrafish. This review discusses progress made over the past few years in this field.

  14. Creativity in later life.

    Science.gov (United States)

    Price, K A; Tinker, A M

    2014-08-01

    The ageing population presents significant challenges for the provision of social and health services. Strategies are needed to enable older people to cope within a society ill prepared for the impacts of these demographic changes. The ability to be creative may be one such strategy. This review outlines the relevant literature and examines current public health policy related to creativity in old age with the aim of highlighting some important issues. As well as looking at the benefits and negative aspects of creative activity in later life they are considered in the context of the theory of "successful ageing". Creative activity plays an important role in the lives of older people promoting social interaction, providing cognitive stimulation and giving a sense of self-worth. Furthermore, it is shown to be useful as a tool in the multi-disciplinary treatment of health problems common in later life such as depression and dementia. There are a number of initiatives to encourage older people to participate in creative activities such as arts-based projects which may range from visual arts to dance to music to intergenerational initiatives. However, participation shows geographical variation and often the responsibility of provision falls to voluntary organisations. Overall, the literature presented suggests that creative activity could be a useful tool for individuals and society. However, further research is needed to establish the key factors which contribute to patterns of improved health and well-being, as well as to explore ways to improve access to services.

  15. Brainmining emotive lateral solutions

    Directory of Open Access Journals (Sweden)

    Theodore Scaltsas

    2016-07-01

    Full Text Available BrainMining is a theory of creative thinking that shows how we should exploit the mind’s spontaneous natural disposition to use old solutions to address new problems – our Anchoring Cognitive Bias. BrainMining develops a simple and straightforward method to transform recalcitrant problems into types of problems which we have solved before, and then apply an old type of solution to them. The transformation makes the thinking lateral by matching up disparate types of problem and solution. It emphasises the role of emotive judgements that the agent makes, when she discerns whether a change of the values or the emotions and feelings in a situation, which would expand the space of solutions available for the problem at hand, would be acceptable or appropriate in the situation. A lateral solution for an intractable problem is thus spontaneously brainmined from the agent’s old solutions, to solve a transformed version of the intractable problem, possibly involving changes in the value system or the emotional profile of the situation, which the agent judges, emotively, will be acceptable, and even appropriate in the circumstances.

  16. Lateral Lumbar Interbody Fusion

    Science.gov (United States)

    Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-01-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  17. Long-term Effect of Wrist Extensor Energy on Humeral Epicondylitis%腕伸肌能量技术对肱骨外上髁炎疗效的远期观察①

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To explore the effect of wrist extensor energy on humeral epicondylitis. Methods 48 humeral epicondylitis pa-tients were divided into muscular energy group and block therapy group with 24 cases in each group. The muscular energy group was treat-ed with muscle energy technique, and the other group received block therapy. They were assessed with Visual Analogue Scale (VAS) and muscle strength. They were followed up 3 months, 6 months and 1 year after discharge. Results The score of VAS was lower in the block therapy group than in the muscular energy group (P0.05);6 months after discharge, the muscular energy group (75.0%) was better than the block therapy group (46.1%) (P0.05);6个月随访,肌肉能量组(75.0%)与封闭治疗组(46.1%)有显著性差异(P<0.01);1年随访,肌肉能量组(54.2%)与封闭治疗组(16.7%)有显著性差异(P<0.01)。结论封闭治疗对肱骨外上髁炎短期阵痛疗效较肌肉能量技术好,但肌肉能量技术对于长期疗效维持好于单纯的封闭治疗。

  18. Clinical Observation of Massage and Herbal Packets Treating External Humerus Epicondylitis%按摩配合中药封包治疗肱骨外上髁炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    罗卫泉; 杨兴杜

    2013-01-01

      目的:观察按摩配合中药封包治疗肱骨外上髁炎的疗效。方法:将90例患者随机分为治疗组和对照组,治疗组予按摩加中药封包治疗,对照组予常规口服药物(非甾体抗炎药)加电脑中频治疗仪治疗。结果:治疗组总有效率100.0%,高于对照组的84.4%(P<0.05)。结论:按摩配合中药封包治疗肱骨外上髁炎疗效显著。%Objective:To observe the curative effects of massage combined with herbal packets treating humerus epicondylitis. Methods:90 patients were randomly divided into treatment group and control group, treatment group was treated with massage and herbal packets, and control group re-ceived therapy of routine oral drugs (non-steroidal anti-inflammatory drugs) and computer intermediate frequency. Results:The total effective rate of treatment group was 100%, higher than that of control group by 84.4%(P<0.05). Conclusion:The curative effects of massage and herbal packets treating external humerus epicondylitis are significant.

  19. 放血疗法治疗顽固性肱骨外上髁炎15例%Treating 15 cases of refractory external humeral epicondylitis with blood-letting therapy

    Institute of Scientific and Technical Information of China (English)

    王文娟

    2013-01-01

    Objective: To investigate the clinical effect of blood-letting therapy on refractory external humeral epicondylitis. Methods:15 patients were given routine treatment and blood-letting therapy as well. Results:9 cases were cured, occupying 60%, 5 cases were significantly effective, occupying 33% and 1 case was effective, occupying 7%, with the total effective rate 100%. Conclusion:Blood-letting therapy was significantly effective on refractory external humeral epicondylitis.%  目的:探讨放血疗法对顽固性肱骨外上髁炎的治疗效果。方法:15例患者在基础治疗的基础上,给予放血疗法。结果:9例痊愈,占60%;5例显效,占33%;1例有效,占7%。结论:放血疗法是治疗顽固性肱骨外上髁炎比较理想的方法。

  20. 针刀结合封闭治疗复发性肱骨外上髁炎疗效观察%Efficacy observation on treating radiohumeral epicondylitis by needle knife therapy combined with local blocking treatment

    Institute of Scientific and Technical Information of China (English)

    谷松

    2013-01-01

    Objective: To investigate the clinical effect of local blocking on treating recrudescent radiohumeral epicondylitis. Methods: To treated the ache place by needle knife and inject with Lidocaine and Prednisolone. Results: 63 cases were cured, with the curative rate 82.9%, 10 cases were improved, with the effective rate 13.2%, and 3 cases were ineffective, with the total effective rate 96.1%. Conclusion:Needle knife therapy combined with local blocking achieved notable effect on radiohumeral epicondylitis.%  肱骨外上髁炎,以肘关节外侧疼痛,用力握拳,提重物及前臂作旋前伸肘动作时加重,局部有多处压痛。临床多采用局部封闭、口服非甾体类抗炎药、针灸或物理治疗,短期疗效尚可,但易复发,且对于复发性肱骨外上髁炎疗效甚微。笔者观察针刀结合局部封闭方法治疗易复发的肱骨外上髁炎76例,疗效较为满意,现报道如下。

  1. Chronic cholecystitis

    Science.gov (United States)

    Cholecystitis - chronic ... Most of the time, chronic cholecystitis is caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder. These ...

  2. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  3. Chronic Pain

    Science.gov (United States)

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis ...

  4. Analysis of Therapeutic Effect of the Treatment of Cannulated Screws on Displaced Medial Humeral Epicondyle Fractures%空心螺钉治疗移位肱骨内上髁骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    朱仲伦; 谢德; 谭鸿; 高博

    2015-01-01

    Objective To explore the effect and clinic value of appplying cannulated screws on medial humeral epicon-dyle fractures. Methods From August 2005 to March 2012,15 consecutive patients(male 13,female 2;right elbow 11,left elbow 4;mean age 16 years;range 11 to 23 years) suffered from medial epicondylar fractures were treated with cannulated screws in open reduction and internal fixation(ORIF). All patients had medial humeral epicondyle fractures with displacement >1cm or had epi-condyle fractures accompanying elbow dislocations and with entrapment of the fragments in the elbow joint after manipulative reduc-tion of elbow dislocation. Of the 15 patients, 7 complicated with elbow dislocation and 1 had ulnar nerve disfunction syndrome. The duration time between the injury and operation ranged from 3 to 6 days. All the patients were followed up and evaluated. The outcome was evaluated by bone union and elbow function. Results All cases were followed up for 13-24 months with an average of 15 months. All the incisions were healed primarily and there were neither failures of the implantation divices nor early physeal growth cessations. All patients had union of the medial epicondyle with the mean healing time of 10 weeks and there were no avas-cular necroses ( AVN) of bone. According to Mayo Elbow Performance Score ( MEPS) for the function of elbow joint, among these 14 cases was excellent, 1 was good. Conclusion ORIF with cannulated screws is an ideal surgical method for treatment of medial humeral epicondyle fractures with larger than 1cm of displacement or with fragment being entrapped in the joint.%目的 探讨空心螺钉治疗肱骨内上髁骨折的临床疗效及应用价值. 方法 回顾性分析我院收治的采用空心螺钉治疗的15例肱骨内上髁骨折患者资料. 所有患者均骨折块移位大于1cm或伴有肘关节脱位并且复位后骨折块嵌顿在关节间隙中,即Ⅱ度~Ⅳ度肱骨内上髁骨折. 其中男13例,女2例;右侧11

  5. Chronic prostatitis

    OpenAIRE

    Le, Brian; Schaeffer, Anthony J.

    2011-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  6. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  7. Epicondilite lateral do cotovelo

    OpenAIRE

    Cohen,Marcio; Motta Filho,Geraldo da Rocha

    2012-01-01

    A epicondilite lateral, também conhecida como cotovelo do tenista, é uma condição comum que acomete de 1 a 3% da população. O termo epicondilite sugere inflamação, embora a análise histológica tecidual não demonstre um processo inflamatório. A estrutura acometida com mais frequência é a origem do tendão extensor radial curto do carpo e o mecanismo de lesão está associado à sua sobrecarga. O tratamento incruento é o de escolha e inclui: repouso, fisioterapia, infiltração com cortisona ou plasm...

  8. Vitiligo Lateral Lower Lip

    Directory of Open Access Journals (Sweden)

    Sahoo Antaryami

    2002-01-01

    Full Text Available Vitiligo characteristically affecting the lateral lower lip (LLL is a common presentation in South Orissa. This type of lesion has rarely been described in literature. One hundred eighteen such cases were studied during the period from October 1999 to September, 2000. LLL vitiligo constituted 16.39% of all vitiligo patients. Both sexes were affected equally. The peak age of onset was in the 2nd decade, mean duration of illness 21.46 months. Fifty six patients had unilateral lesion (38 on the left and 18 on the right. Among the 62 patients having bilateral lesions, the onset was more frequent on the left (38 than either the right (8 or both sides together (16. All the patients were right handed. Association with local factors like infection, trauma, cheilitis, FDE etc were associated in 38.98% of cases, but systemic or autoimmune diseases were not associated. Positive family history was found in 22% of cases.

  9. Lateral conduction infrared photodetector

    Science.gov (United States)

    Kim, Jin K.; Carroll, Malcolm S.

    2011-09-20

    A photodetector for detecting infrared light in a wavelength range of 3-25 .mu.m is disclosed. The photodetector has a mesa structure formed from semiconductor layers which include a type-II superlattice formed of alternating layers of InAs and In.sub.xGa.sub.1-xSb with 0.ltoreq.x.ltoreq.0.5. Impurity doped regions are formed on sidewalls of the mesa structure to provide for a lateral conduction of photo-generated carriers which can provide an increased carrier mobility and a reduced surface recombination. An optional bias electrode can be used in the photodetector to control and vary a cut-off wavelength or a depletion width therein. The photodetector can be formed as a single-color or multi-color device, and can also be used to form a focal plane array which is compatible with conventional read-out integrated circuits.

  10. Insulin-like growth factor system in amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Wilczak, N; de Keyser, J; Cianfarani, S; Clemmons, DR; Savage, MO

    2005-01-01

    Insulin-like growth factor-I (IGF-I) is a neurotrophic factor with insulin-like metabolic activities, and possesses potential clinical applications, particularly in neurodegenerative disorders. Amyotrophic lateral sclerosis (ALS) is a chronic progressive devastating disorder of the central nervous s

  11. Lateral Thinking and Technology Education.

    Science.gov (United States)

    Waks, Shlomo

    1997-01-01

    Presents an analysis of technology education and its relevance to lateral thinking. Discusses prospects for utilizing technology education as a platform and a contextual domain for nurturing lateral thinking. Argues that technology education is an appropriate environment for developing complementary incorporation of vertical and lateral thinking.…

  12. [Lateral lumbar disk hernia].

    Science.gov (United States)

    Monod, A; Desmoineaux, P; Deburge, A

    1990-01-01

    Lateral lumbar disc herniations (L.D.H.) develop in the foramen, and compress the nerve root against the overlying vertebral pedicle. In our study of L.D.H. from the clinical, radiographical, and therapeutical aspects, we reviewed 23 cases selected from the 590 patients treated for discal herniation from 1984 to 1987. The frequency of L.D.H. in this series was 3.8 per cent. The clinical pattern brings out some suggestive signs of L.D.H. (frequency of cruralgia, a seldom very positive Lasegue's test, the paucity of spinal signs, non impulsive pain). Saccoradiculography and discography rarely evidenced the L.D.H.. The T.D.M. was the investigation of choice on condition that it was correctly used. When the image was doubtful, disco-CT confirmation should be proceeded too. This latter method of investigation enabled the possibility of sequestration to be explored. 14 patients were treated by chemonucleolysis, with 9 successful outcomes. The 5 failures were cases where chemonucleolysis should not have been indicated, mainly due to associated osseous stenosis. 9 patients underwent immediate surgery with good results in each case.

  13. 2种糊剂对慢性根尖炎患牙侧副根管封闭性的效果比较%Comparative effects of two root canal sealers on lateral accessory canals obturation of teeth with chronic periapical periodontitis

    Institute of Scientific and Technical Information of China (English)

    周颖蕊; 王津惠; 李歆

    2015-01-01

    Objective To observe the short-term clinical effect of two root canal sealers on lateral accessory canals obturation of teeth with chronic periapical periodontitis. Method A total of 54 teeth with periapical periodontitis and lateral accessory canals were randomly divided into two groups of 27 teeth:AH-plus group and Septodont group. After coronal cavity preparation , debridement and root canal preparation by step-back technique, the root canals were filled using continuous-wave condensation technique with AH-plus paste (AH-plus group) and Endomethasone ivory (Septodont group). The percentage of lateral accessory canals fillings, the success rate of root canal treatment and infection control after 1 year were compared between the two groups. Result The percentage of lateral accessory canals fillings of AH-plus group and Septodont group was respectively 62.96%and 37.04%, and there was significant difference between them(P<0.05). The success rate of root canal treatment and infection control of AH-plus group and Septodont group were respectively 88.89%vs 66.67%, and 96.30%vs 74.07%, and there were significant differences between them(P<0.05). Conclusion AH-plus paste was proved to have better sealing effects than Endomethasone ivory.%目的:观察2种根管充填糊剂充填慢性根尖炎侧副根管的治疗效果。方法:选择术后X线片显示有侧副根管的慢性根尖炎病例54例,随机分为AH-plus组和赛普敦组,每组27例。开髓、揭顶、去除牙本质肩领,应用逐步后退法进行根管预备,氢氧化钙糊剂根管封药消毒,分别选用AH-plus糊剂和赛普敦(SEPTODONT)美松根管充填糊剂,热牙胶连续波垂直加压充填技术进行根管充填。比较根尖1/3侧副根管充填率、治疗一年后根管治疗成功率和感染控制率。结果:AH-plus组根尖1/3侧副根管充填率为62.96%,根管治疗成功率为88.89%,感染控制率为96.30%,分别高于赛普敦组的37.04%、66

  14. [Chronic inflammatory bowel diseases in cats].

    Science.gov (United States)

    Ghermai, A K

    1989-01-01

    The aetiology of chronic idiopathic intestinal inflammation is unknown. It is characterized by a diffuse infiltration with inflammatory cells into the intestinal mucosa and sometimes submucosa. Cats with chronic intermittent vomiting and diarrhoea, later on accompanied by anorexia and weight loss, are presented. Definitive diagnosis can be obtained by intestinal biopsy only. An immune pathogenesis is suspected, which is supported by the fact, that chronic inflammatory bowel disease responds to steroid therapy.

  15. Diamond heteroepitaxial lateral overgrowth

    Science.gov (United States)

    Tang, Yung-Hsiu

    This dissertation describes improvements in the growth of single crystal diamond by microwave plasma-assisted chemical vapor deposition (CVD). Heteroepitaxial (001) diamond was grown on 1 cm. 2 a-plane sapphiresubstrates using an epitaxial (001) Ir thin-film as a buffer layer. Low-energy ion bombardment of the Ir layer, a process known as bias-enhanced nucleation, is a key step in achieving a high density of diamond nuclei. Bias conditions were optimized to form uniformly-high nucleation densities across the substrates, which led to well-coalesced diamond thin films after short growth times. Epitaxial lateral overgrowth (ELO) was used as a means of decreasing diamond internal stress by impeding the propagation of threading dislocations into the growing material. Its use in diamond growth requires adaptation to the aggressive chemical and thermal environment of the hydrogen plasma in a CVD reactor. Three ELO variants were developed. The most successful utilized a gold (Au) mask prepared by vacuum evaporation onto the surface of a thin heteroepitaxial diamond layer. The Au mask pattern, a series of parallel stripes on the micrometer scale, was produced by standard lift-off photolithography. When diamond overgrows the mask, dislocations are largely confined to the substrate. Differing degrees of confinement were studied by varying the stripe geometry and orientation. Significant improvement in diamond quality was found in the overgrown regions, as evidenced by reduction of the Raman scattering linewidth. The Au layer was found to remain intact during diamond overgrowth and did not chemically bond with the diamond surface. Besides impeding the propagation of threading dislocations, it was discovered that the thermally-induced stress in the CVD diamond was significantly reduced as a result of the ductile Au layer. Cracking and delamination of the diamond from the substrate was mostly eliminated. When diamond was grown to thicknesses above 0.1 mm it was found that

  16. 弹拨过伸手法治疗肱骨外上髁炎临床研究%Clinical Research in Plucking Hyperextension Manipulations Treating External Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    邝仰东; 张喜

    2014-01-01

    Objective:To investigate the effect of plucking hyperextension manipulations treating external humeral epicondylitis. Methods:36 cases of external humeral epicondylitis were randomly divided into observation group and control group with each of 18 cases, observation group was treat-ed with plucking hyperextension manipulations, control group with traditional method, the effect and VAS integral of two groups were compared. Re-sults:The total effective rate of treatment group was 93.3%, significantly higher than that of control group by 78%(P<0.05);VAS integral of treat-ment group after treatment of 7 days was significantly better than that of control group and that before treatment (P<0.01);VAS integral of control group after treatment of 14 days was significantly better than that after treatment of 7 days (P<0.05), but VAS integral of treatment group was better than that of control group (P<0.05). Conclusion:Effect of plucking hyperextension manipulations treating external humeral epicondylitis is signifi-cant, which can obviously reduce the pain degree of patients.%目的:探讨弹拨过伸手法治疗肱骨外上髁炎的效果。方法:36例肱骨外上髁炎患者随机分为观察组与对照组各18例,观察组采用弹拨过伸手法治疗,对照组采用传统手法,比较两组疗效及VAS积分。结果:治疗组总有效率为93.3%,显著高于对照组的78.0%(P<0.05);治疗7天后治疗组VAS积分显著优于治疗前及对照组(P<0.01);治疗14天对照组VAS积分显著优于治疗7天后(P<0.05),但治疗组VAS积分明显优于对照组(P<0.05)。结论:弹拨过伸手法治疗肱骨外上髁炎效果显著,能明显减轻患者疼痛程度。

  17. The effective analysis of closing part medicine combined with massage in treating lateral epicondylitis%局部药物封闭配合推拿治疗肱骨外上髁炎疗效分析

    Institute of Scientific and Technical Information of China (English)

    张龙; 林强

    2011-01-01

    为了研究中医推拿手法配合药物治疗肱骨外上髁炎的疗效,通过对患者的资料进行分析,采用局部药物封闭配合推拿疗法用于肱骨外上髁炎的临床疗效优于单用推拿疗法。

  18. Acupuncture and Chinese traditional manipulation treat the humerus lateral epicondyle ingluvitis 96 example%动态下推灸治疗肱骨外上髁炎96例

    Institute of Scientific and Technical Information of China (English)

    谷建华; 孙国栋

    2006-01-01

    肱骨外上髁炎又称网球肘,肱桡滑囊炎,是一种影响前臂旋转和伸腕功能的慢性劳损性疾病。本组用动态下推灸法治疗96例,取得较好疗效,总结报告如下:

  19. LATERAL SURVIVAL: AN OT ACCOUNT

    Directory of Open Access Journals (Sweden)

    Moira Yip

    2004-12-01

    Full Text Available When laterals are the targets of phonological processes, laterality may or may not survive. In a fixed feature geometry, [lateral] should be lost if its superordinate node is eliminated by either the spreading of a neighbouring node, or by coda neutralization. So if [lateral] is under Coronal (Blevins 1994, it should be lost under Place assimilation, and if [lateral] is under Sonorant Voicing (Rice & Avery 1991 it should be lost by rules that spread voicing. Yet in some languages lateral survives such spreading intact. Facts like these argue against a universal attachment of [lateral] under either Coronal or Sonorant Voicing, and in favour of an account in terms of markedness constraints on feature-co-occurrence (Padgett 2000. The core of an OT account is that IFIDENTLAT is ranked above whatever causes neutralization, such as SHARE-F or *CODAF. laterality will survive. If these rankings are reversed, we derive languages in which laterality is lost. The other significant factor is markedness. High-ranked feature co-occurrence constraints like *LATDORSAL can block spreading from affecting laterals at all.

  20. Amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Leigh P Nigel

    2009-02-01

    Full Text Available Abstract Amyotrophic lateral sclerosis (ALS is a neurodegenerative disease characterised by progressive muscular paralysis reflecting degeneration of motor neurones in the primary motor cortex, corticospinal tracts, brainstem and spinal cord. Incidence (average 1.89 per 100,000/year and prevalence (average 5.2 per100,000 are relatively uniform in Western countries, although foci of higher frequency occur in the Western Pacific. The mean age of onset for sporadic ALS is about 60 years. Overall, there is a slight male prevalence (M:F ratio~1.5:1. Approximately two thirds of patients with typical ALS have a spinal form of the disease (limb onset and present with symptoms related to focal muscle weakness and wasting, where the symptoms may start either distally or proximally in the upper and lower limbs. Gradually, spasticity may develop in the weakened atrophic limbs, affecting manual dexterity and gait. Patients with bulbar onset ALS usually present with dysarthria and dysphagia for solid or liquids, and limbs symptoms can develop almost simultaneously with bulbar symptoms, and in the vast majority of cases will occur within 1–2 years. Paralysis is progressive and leads to death due to respiratory failure within 2–3 years for bulbar onset cases and 3–5 years for limb onset ALS cases. Most ALS cases are sporadic but 5–10% of cases are familial, and of these 20% have a mutation of the SOD1 gene and about 2–5% have mutations of the TARDBP (TDP-43 gene. Two percent of apparently sporadic patients have SOD1 mutations, and TARDBP mutations also occur in sporadic cases. The diagnosis is based on clinical history, examination, electromyography, and exclusion of 'ALS-mimics' (e.g. cervical spondylotic myelopathies, multifocal motor neuropathy, Kennedy's disease by appropriate investigations. The pathological hallmarks comprise loss of motor neurones with intraneuronal ubiquitin-immunoreactive inclusions in upper motor neurones and TDP-43

  1. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  2. [Chronicity, chronicization, systematization of delusions].

    Science.gov (United States)

    Trapet, P; Fernandez, C; Galtier, M C; Gisselmann, A

    1984-05-01

    Chronicity in psychopathology is indicative of a term, a decay. Chronicization only leads the way to this term. Here, chronicization is taken literally as an inscription in the time course of delusions. The mechanism of systematization seems to be a central mark in the approach to chronic delusions. It is not an alienation or an irreversible closing but an attempted accommodation with reality in the life of psychotic subjects, irrespective of the delusional structure. The role of therapy and drug treatment as a follow-up may in that case assume another meaning.

  3. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Froeling, Fieke EM

    2008-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas owing to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects 3–9 people in 100,000; 70% of cases are alcohol-induced.

  4. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  5. Observe the clinical effect of two different treatment methods for external humeral epicondylitis%观察两种不同治法对肱骨外上髁炎的临床疗效

    Institute of Scientific and Technical Information of China (English)

    蔡万德

    2015-01-01

    目的:探讨局部封闭配合推拿手法与单纯局部封闭治疗肱骨外上髁炎的临床效果。方法:将106例肱骨外上髁炎患者随机分成对照组和治疗组,对照组采用单纯局部封闭法治疗,治疗组采用局部封闭配合推拿手法治疗,比较两组的疗效。结果:治疗组有效率94.34%,明显高于对照组的71.70%(P<0.05)。结论:局部封闭配合推拿手法疗效明显优于单纯局部封闭治疗。%Objective:To explore the clinical effect of partial closure combined with massage and simple partial closure treatment for external humeral epicondylitis.Methods:106 patients with external humeral epicondylitis were randomly divided into the control group and the treatment group,the control group was treated with simple partial closure,the treatment group was treated with partial closure combined with massage,we compared the efficacy of the two groups.Results:In the treatment group,the effective rate of 94.34% was significantly higher than 71.70% of the control group(P<0.05).Conclusion:The clinical effect of partial closure combined with massage was better than simple partial closure.

  6. Clinical Observation on Surgery for 50 Patients with Facture of Medial Epicondyle of Humerus%肱骨内上髁骨折手术治疗50例临床观察

    Institute of Scientific and Technical Information of China (English)

    王永宏

    2013-01-01

    Objective: To explore the techniques and clinical effects of the surgery for the facture of medial epicondyle of humerus. Method: All 50 patients were cut from the inside of the elbow and received internal fixation with draw point or screw. Result: All the patients were followed up, the patients' affected arms were recovered very well and no one was complicated with bone non-union, myositis ossificans, wound infection and the symptoms of cubital nerve, there were two patients with poor flexion-extension function since the children feared the pain and exercised late. Conclusion: If the patients are proved with fracture of medial epicondyle of humerus clearly, especially the ones with positive results in valgus stress test, they should receive open reduction surgery.%目的:探讨肱骨内上髁骨折手术治疗技巧和疗效.方法:50例肱骨内上髁骨折患者均选择肘内侧切口,切开复位钢针或螺钉内固定术.结果:本组50例患者随访复查,患肢功能恢复良好,无1例发生骨不连,骨化性肌炎,针眼感染及尺神经症状.2例因怕疼痛活动较迟,致屈伸功能欠佳.结论:肱骨内上髁骨折如诊断明确,特别是外翻应力试验阳性者,宜切开复位手术治疗.

  7. Research on Humeral Epicondylitis of Massage and Rehabilitation of Resistance Exercise%肱骨外上髁炎的推拿与抗阻运动康复研究

    Institute of Scientific and Technical Information of China (English)

    陈香仙; 朱国萍

    2011-01-01

    Objective:To investigate the humeral epicondylitis in primary and secondary diagnosis and differential diagnosis,use manipulation and resistance exercise treatment of humeral epicondylitis,find the best practices and exercise rehabilitation methods.Method%目的:探讨肱骨外上髁炎原发性与继发性的诊断与鉴别诊断,运用推拿手法与抗阻运动治疗肱骨外上髁炎,寻找最佳手法与运动康复方法。方法:肱骨外上髁炎患者22例,为期3 d一次共10次的推拿手法治疗。2 d一次共25次抗阻运动康复训练。分别在实验结束和结束后的3个月时统计治疗结果。结果:22例肱骨外上髁炎患者,有原发性肱骨外上髁炎4例、继发性6例、继发并原发性12例。实验结束时,痊愈15例占68.18%、显效4例占18.18%、有效3例占13.63%、mills征检查21人阴性占95.45%。3个月时,痊愈17例占

  8. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Poulsen, Frantz Rom; Bergholt, Bo

    2017-01-01

    OBJECTIVE Bilateral chronic subdural hematoma (bCSDH) is a common neurosurgical condition frequently associated with the need for retreatment. The reason for the high rate of retreatment has not been thoroughly investigated. Thus, the authors focused on determining which independent predictors...... are associated with the retreatment of bCSDH with a focus on surgical laterality. METHODS In a national database of CSDHs (Danish Chronic Subdural Hematoma Study) the authors retrospectively identified all bCSDHs treated in the 4 Danish neurosurgical departments over the 3-year period from 2010 to 2012....... Univariate and multivariate analyses were performed to determine the relationship between retreatment of bCSDH and clinical, radiological, and surgical variables. RESULTS Two hundred ninety-one patients with bCSDH were identified, and 264 of them underwent unilateral (136 patients) or bilateral (128 patients...

  9. A Pascalian lateral drift sensor

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, H., E-mail: hendrik.jansen@desy.de

    2016-09-21

    A novel concept of a layer-wise produced semiconductor sensor for precise particle tracking is proposed herein. In contrast to common semiconductor sensors, local regions with increased doping concentration deep in the bulk termed charge guides increase the lateral drift of free charges on their way to the read-out electrode. This lateral drift enables charge sharing independent of the incident position of the traversing particle. With a regular grid of charge guides the lateral charge distribution resembles a normalised Pascal's triangle for particles that are stopped in depths lower than the depth of the first layer of the charge guides. For minimum ionising particles a sum of binomial distributions describes the lateral charge distribution. This concept decouples the achievable sensor resolution from the pitch size as the characteristic length is replaced by the lateral distance of the charge guides.

  10. A Pascalian lateral drift sensor

    Science.gov (United States)

    Jansen, H.

    2016-09-01

    A novel concept of a layer-wise produced semiconductor sensor for precise particle tracking is proposed herein. In contrast to common semiconductor sensors, local regions with increased doping concentration deep in the bulk termed charge guides increase the lateral drift of free charges on their way to the read-out electrode. This lateral drift enables charge sharing independent of the incident position of the traversing particle. With a regular grid of charge guides the lateral charge distribution resembles a normalised Pascal's triangle for particles that are stopped in depths lower than the depth of the first layer of the charge guides. For minimum ionising particles a sum of binomial distributions describes the lateral charge distribution. This concept decouples the achievable sensor resolution from the pitch size as the characteristic length is replaced by the lateral distance of the charge guides.

  11. Ear infection - chronic

    Science.gov (United States)

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... up. When this happens, infection can occur. A chronic ear infection develops when fluid or an infection ...

  12. Lateral inhibition during nociceptive processing

    DEFF Research Database (Denmark)

    Quevedo, Alexandre S.; Mørch, Carsten Dahl; Andersen, Ole Kæseler

    2017-01-01

    of skin. Thus, the stimulation of the skin region between the endpoints of the lines appears to produce inhibition. These findings indicate that lateral inhibition limits spatial summation of pain and is an intrinsic component of nociceptive information processing. Disruption of such lateral inhibition......Spatial summation of pain is the increase of perceived intensity that occurs as the stimulated area increases. Spatial summation of pain is sub-additive in that increasing the stimulus area produces a disproportionately small increase in the perceived intensity of pain. A possible explanation...... for sub-additive summation may be that convergent excitatory information is modulated by lateral inhibition. To test the hypothesis that lateral inhibition may limit spatial summation of pain, we delivered different patterns of noxious thermal stimuli to the abdomens of 15 subjects using a computer...

  13. Lateral gene transfer, rearrangement, reconciliation

    NARCIS (Netherlands)

    Patterson, M.D.; Szollosi, G.; Daubin, V.; Tannier, E.

    2013-01-01

    Background. Models of ancestral gene order reconstruction have progressively integrated different evolutionary patterns and processes such as unequal gene content, gene duplications, and implicitly sequence evolution via reconciled gene trees. These models have so far ignored lateral gene transfer,

  14. Cerebral Laterality and Verbal Processes

    Science.gov (United States)

    Sherman, Jay L.; And Others

    1976-01-01

    Research suggests that we process information by way of two distinct and functionally separate coding systems. Their location, somewhat dependent on cerebral laterality, varies in right- and left-handed persons. Tests this dual coding model. (Editor/RK)

  15. Lateral Asymmetries in Human Evolution

    OpenAIRE

    John L. Bradshaw; Nettleton, Norman C.

    1989-01-01

    Lateral asymmetries are not confined to humans. Palaeozoic trilobites and calcichordates are now known to have been asymmetrical; song control in passerines is vested in the left cerebral hemisphere; learning which is lateralized to the left forebrain of chicks includes imprinting, visual discrimination learning and auditory habituation, while responses to novelty, attack and copulation are activated by the right; in rats the right hemisphere is involved in emotional behavior and spatial disc...

  16. 小针刀加穴位注射治疗肱骨外上髁炎88例临床观察%Clinical Observation of 88 Cases about Treating External Humeral Epicondylitis by Point Injection with a Needle Knife

    Institute of Scientific and Technical Information of China (English)

    金晓平

    2012-01-01

    [目的]观察小针刀加曲安奈德穴位注射治疗肱骨外上髁炎的效果.[方法]小针刀加曲安奈德穴位注射对88例门诊肱骨外上髁炎患者进行治疗.[结果]痊愈54.54%,显效34.1%,好转11.36%,总有效率99.73%.[结论1针药结合的方法对肱骨外上髁炎周围软组织损伤小、疼痛较轻.真正体现中医传统治疗的特色,尤其适用于基层.%[Objective] To observe the effect of treating external humeral epicondylitis by tnamcinolone acetonide point injection with a needle knife. [Method] To treat 88 outpatients for external humeral epicondylitis by tnamcinolone acetonide point injection with a needle knife. [Result] The recovery rate was 54.54%, significant effects 34.1%, improvement 11.36%, and total effective rate 99.73%. [Conclusion] The method of combining needles and medicine does little harm to the soft tissues around external humeral epicondylitis as well as alleviates pain. It reflects the characteristics of the Chinese traditional treatment, especially suitable for the basic level.

  17. Prematurity, smallness-for-gestational age and later hospital admissions

    DEFF Research Database (Denmark)

    Á Rogvi, Rasmus; Forman, Julie Lyng; Greisen, Gorm

    2015-01-01

    significantly different from unity for people born premature or SGA. After correcting for multiple testing, 250 remained significant. The diagnoses covered diseases in most organ systems, including cardiovascular, endocrinological, infectious, neurological/neurosurgical, obstetric, orthopedic, psychiatric, lung...... & urological diseases, and occurred throughout childhood and early adulthood. Novel findings included increased risks for delayed puberty, neurofibromatosis type 1 and ileus and decreased risks of mononucleosis, peritonsillar abscesses, chronic hypothyroidism and several types of fractures and contusions later...

  18. Hippocampal Theta Dysfunction after Lateral Fluid Percussion Injury

    OpenAIRE

    2010-01-01

    Chronic memory deficits are a major cause of morbidity following traumatic brain injury (TBI). In the rat, the hippocampal theta rhythm is a well-studied correlate of memory function. This study sought to investigate disturbances in hippocampal theta rhythm following lateral fluid percussion injury in the rat. A total of 13 control rats and 12 TBI rats were used. Electrodes were implanted in bilateral hippocampi and an electroencephalogram (EEG) was recorded while the rats explored a new envi...

  19. [Chronic hepatitis].

    Science.gov (United States)

    Figueroa Barrios, R

    1995-01-01

    Medical literature about chronic hepatitis is reviewed. This unresolving disease caused by viruses, drugs or unknown factors may progress to in cirrhosis and hepatocarcinoma. A classification based on liver biopsy histology into chronic persistent and chronic active types has been largely abandoned and emphasis is placed on recognizing the etiology of the various types. One is associated with continuing hepatitis B virus infection; another is related to chronic hepatitis C virus infection and the third is termed autoinmune, because of the association with positive serum autoantibodies. A fourth type with similar clinical functional and morphologic features is found with some drug reactions. Long term corticoesteroid therapy is usually successful in autoinmune type. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C with interpheron alfa is employed, controlling symptoms and abnormal biochemistry and the progression to cirrhosis and liver cancer in 30 to 40% patients. Alternative therapies or combinations with interpheron are being evaluated waiting for final results.

  20. Optineurin and amyotrophic lateral sclerosis.

    Science.gov (United States)

    Maruyama, Hirofumi; Kawakami, Hideshi

    2013-07-01

    Amyotrophic lateral sclerosis is a devastating disease, and thus it is important to identify the causative gene and resolve the mechanism of the disease. We identified optineurin as a causative gene for amyotrophic lateral sclerosis. We found three types of mutations: a homozygous deletion of exon 5, a homozygous Q398X nonsense mutation and a heterozygous E478G missense mutation within its ubiquitin-binding domain. Optineurin negatively regulates the tumor necrosis factor-α-induced activation of nuclear factor kappa B. Nonsense and missense mutations abolished this function. Mutations related to amyotrophic lateral sclerosis also negated the inhibition of interferon regulatory factor-3. The missense mutation showed a cyotoplasmic distribution different from that of the wild type. There are no specific clinical symptoms related to optineurin. However, severe brain atrophy was detected in patients with homozygous deletion. Neuropathologically, an E478G patient showed transactive response DNA-binding protein of 43 kDa-positive neuronal intracytoplasmic inclusions in the spinal and medullary motor neurons. Furthermore, Golgi fragmentation was identified in 73% of this patient's anterior horn cells. In addition, optineurin is colocalized with fused in sarcoma in the basophilic inclusions of amyotrophic lateral sclerosis with fused in sarcoma mutations, and in basophilic inclusion body disease. These findings strongly suggest that optineurin is involved in the pathogenesis of amyotrophic lateral sclerosis.

  1. Clinical research on treatment of external humeral epicondylitis by indomethacin cataplasm%吲哚美辛巴布膏治疗肱骨外上髁炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    王德忠

    2013-01-01

    Objective To observe the curative effect and safety of indomethacin cataplasm in the treatment of external humeral epicondylitis. Methods Seventy eight patients with external humeral epicondylitis were randomly divided into 2 groups with 39 ones in each group. Experiment group were treated by local application of indomethacin cataplasm once a day for consecutive 8 days. Control group orally took 75 mg diclofenac sodium once a day for consecutive 8 days. Comparison was made in the pain degree, the onset time for pain release,the comprehensive improvement degree of clinical pain,drug side effects,and patients'satisfactory rate before and after the treatment between the two groups. Results Thirty eight patients in each group finished the study. The onset of analgesia in the experiment group was quicker than that in the control group( 79.4 ±26.7 )min vs( 94. 5 ±38.3 )min( P 0.05 ),but in the experiment group the side effects occurred locally, and in the control group those occurred generally. The satisfactory rate of the patients in the experiment group was higher than that in the control group( 65. 8% vs 39. 5% ,P <0. 05 ). Conclusion Indomethacin cataplasm is an excellent choice for the treatment of external humeral epicondylitis with good efficacy,low incidence of side effects,and high satisfactory rate of patients.%目的 观察吲哚美辛巴布膏对肱骨外上髁炎的疗效及安全性.方法 78例肱骨外上髁炎患者随机分成2组,每组39例.试验组采用吲哚美辛巴布膏局部外贴治疗,1次/d,持续8 d;对照组口服双氯芬酸钠75 mg,1次/d,持续8 d.比较两组治疗前后的疼痛程度、疼痛缓解起效时间、临床疼痛综合改善度、药物副作用以及患者的满意度.结果 每组各38例患者完成观察.试验组起效快于对照组(79.4±26.7)min vs(94.5±38.3)min(P<0.05);试验组疼痛评分在治疗结束时(2.1±0.5 vs 2.3±0.7)及结束后2 w(2.0±0.4 vs 2.4±0.6)明显低于对照组(P<0.05);试验组

  2. Diclofenac Patch for Treatment of Mild to Moderate Tendonitis or Bursitis

    Science.gov (United States)

    2008-08-05

    Rotator Cuff Tendonitis; Bicipital Tendonitis; Subdeltoid Bursitis of the Shoulder; Subacromial Bursitis of the Shoulder; Medial Epicondylitis of the Elbow; Lateral Epicondylitis of the Elbow; DeQuervain's Tenosynovitis of the Wrist

  3. Golf Injuries to the Hand, Wrist, or Elbow

    Science.gov (United States)

    ... left hand for a right handed player). Medial Epicondylitis , also known as “golfer’s elbow,” is a painful ... on the outer aspect of the elbow (Lateral Epicondylitis) is more common. Hamate bone fractures occur when ...

  4. Chronic gastritis.

    Science.gov (United States)

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-06-01

    Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understanding of the bizarre epidemiology and course of the disease. A life-long and aggressive inflammation in gastritis results in destruction (atrophic gastritis) of stomach mucosa with time (years and decades). The progressive worsening of atrophic gastritis results subsequently in dysfunctions of stomach mucosa. Atrophic gastritis will finally end up in a permanently acid-free stomach in the most extreme cases. Severe atrophic gastritis and acid-free stomach are the highest independent risk conditions for gastric cancer known so far. In addition to the risks of malignancy and peptic ulcer, acid-free stomach and severe forms of atrophic gastritis may associate with failures in absorption of essential vitamins, like vitamin B12, micronutrients (like iron, calcium, magnesium and zinc), diet and medicines.

  5. Chronic Bronchitis

    Science.gov (United States)

    ... breathing. You may also have other tests. Chronic bronchitis is a long-term condition that keeps coming back or never goes away completely. If you smoke, it is important to quit. Treatment can help with your symptoms. It often includes ...

  6. Prevention Of Chronic Renal Diseases

    Directory of Open Access Journals (Sweden)

    Fejzi Alushi

    2011-10-01

    Full Text Available It is easier to prevent a disease than to cure it. This postulate is a foundation stone of the contemporary medicine, furthermore its mission. The Chronic Kidney Diseases (CKD, amongst them the Chronic Pyelonephrites (CP and the mass kidney reduction  take an important  place in human pathologies in general, and in particular in renal ones. The Chronic Pyelonephrites  are chronic renal pathologies, which on one side are of various causes and on the other side are multi systemic. At the same time they tend, earlier or later, depending on their course, to bring the patient towards the Chronic Kidney Insufficiency  in stage of uremia, consequently in need of substitution therapies e.g. dialysis, peritoneum dialysis or transplant. It is worthy to emphasize that from the prevention and correct cure of CP make profit the patients, the family, the state and in the last analyses  the entire society, because in that way the budget expense destined for the fore going substitution cures, dialysis, peritoneum dialysis or transplant, is considerably  reduced. The same should be mentioned  in relation to the CP and the mass kidney reduction, speaking about our country, which are still at the first place as the very cause of Chronic Kidney  Insufficiencies (CRI, later on advancing toward uremia and terminal uremia along with its grave consequences. In general  the very foundation of the CP is on  the  infections of urinary roads, in particular on the complicated ones, among them it should be mentioned-congenital kidney anomalies, renal calculosis  so much present in our country, and pathologies of segment or vesical-ureteral reflux, and rarely the pathologies of prostate.

  7. Pollute first, clean up later?

    NARCIS (Netherlands)

    Azadi, Hossein; Verheijke, Gijs; Witlox, Frank

    2011-01-01

    There is a growing concern with regard to sustainability in emerging economies like China. The Chinese growth is characterized by a strategy which is known as "pollute first, clean up later". Here we show that based on this strategy, the pollution alarm can often be postponed by a tremendous economi

  8. Later Zhou Sejong's Cultural Policy

    Institute of Scientific and Technical Information of China (English)

    PAN Qing

    2015-01-01

    Sejong wanted to stabilize the control. He paid attention to strengthen cultural enlightenment and implement cultural policy from educating people, choosing capable person, repairing history, limiting Buddhism, respecting Confucianism and other aspects. The wind of literature rise gradually. It is conducive to research the developmental trajectory of Later Zhou Dynasty.

  9. Chronic Pancreatitis in Children

    Science.gov (United States)

    ... Information > Children/Pediatric > Chronic Pancreatitis in Children test Chronic Pancreatitis in Children What symptoms would my child ... pancreatitis will develop diabetes in adolescence. Who gets chronic pancreatitis? Those at risk for chronic pancreatitis are ...

  10. Chronic Beryllium Disease

    Science.gov (United States)

    ... Science Education & Training Home Conditions Chronic Beryllium Disease Chronic Beryllium Disease Make an Appointment Find a Doctor ... MD, MSPH, FCCP (February 01, 2016) What is chronic beryllium disease (CBD)? Chronic beryllium disease (CBD) is ...

  11. Chronic motor tic disorder

    Science.gov (United States)

    Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

  12. Chronic Pelvic Pain

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  13. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  14. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, C.B.; Skaf, A.; Campos, J.; Stump, X.; Resnick, D. [Dept. of Radiology, University of California, San Diego (United States); Roger, B. [Service de Radiologie Polyvalente, Groupe Hospitalier Pitie-Salpetriere, Paris (France)

    2001-12-01

    Objective: To demonstrate the MR imaging findings that occur between the posterior inferolateral patellar tendon and the lateral femoral condyle in patients with chronic anterior and or lateral knee pain. Patients and design: A retrospective review of the MR images in 42 patients who presented with chronic anterior or lateral knee pain was performed by two musculoskeletal radiologists. In 15 patients, post-contrast images were available. Results: Sagittal and axial imaging planes best demonstrated the patellar tendon and its relationship with the lateral femoral condyle. In 40 patients, there was obliteration of the fat planes and abnormal signal intensity in the lateral soft tissues of the inferior patellofemoral joint. Enhancement after administration of gadolinium was noted in all cases in which contrast was administered. Eighteen patients showed cystic changes in the soft tissues adjacent to the lateral femoral condyle in addition to fat plane obliteration. In two patients, only cystic changes were noted in the lateral soft tissues. Abnormal patellar alignment was noted in 37 patients. Patellar tendon pathology was seen in nine patients. Conclusion: In evaluating anterior knee symptoms, MR imaging allows identification of changes that may be related to patellar tendon-lateral femoral condyle friction syndrome and that should be distinguished from other causes of anterior or lateral knee pain. (orig.)

  15. Craving creativity in later life

    DEFF Research Database (Denmark)

    Fristrup, Tine

    2013-01-01

    but it also raises questions as to what constitutes a ‘good’ and ‘active’ life in all societies. The conflicting aspect of the discursive battlefield on active ageing constitutes a fight for authority: Who has the ‘right’ to define the meaning of being ‘active’ and how can ‘activity’ be identified? ‘Active......’ is to be understood according to the interpretations available in different knowledge perspectives in order to discipline the future knowledge production of ageing and control the processes of subjectification in later life as the disciplining of ‘Population Ageing’: Becoming a subject to active ageing. Dominant...... discourses on ‘active ageing’ are challenged by the focus of museums and archives on using heritage and participatory arts as an arena to performAGE in later life by craving creativity as a notion of age and opportunity....

  16. Mozart's chronic subdural hematoma.

    Science.gov (United States)

    Drake, M E

    1993-11-01

    No commemoration of the bicentennial of Mozart's death would be complete without some consideration of that premature yet predictable demise. Mozart's premonitions of death are well known and apparently played a role in the composition of the K.626 Requiem and perhaps other works. His death has traditionally been ascribed to infectious causes, chiefly rheumatic fever or post-streptococcal glomerulonephritis, exacerbated by intemperance and chronic penury. Pathology has been difficult because of his supposed burial in a pauper's grave, the location and contents of which were later supposedly lost. Mozart's burial place in St. Mark's Cemetery in Vienna was known and, in the parlance of the day, "reorganized" a decade later, as the occupants of plots were disinterred to make room for the more recently decreased. A skull believed to the Mozart's was saved by the successor of the gravedigger who had supervised Mozart's burial, and then passed into the collections of the anatomist Josef Hyrtl, the municipality of Salzburg, and the Mozarteum museum (Salzburg). Forensic reconstruction of soft tissues related to this skull reveals substantial concordance with Mozart's portraits. The skull suggests premature closure of the metopic suture, which has been suggested on the basis of his physiognomy. A left temporal fracture and concomitant erosions raise the question of chronic subdural hematoma, which would be consistent with several falls in 1789 and 1790 and could have caused the weakness, headaches, and fainting he experienced in 1790 and 1791. Aggressive bloodletting to treat suspected rheumatic fever could have decompensated such a lesion to produce his death on December 5, 1791.

  17. Laterally Loaded Piles in Clay

    DEFF Research Database (Denmark)

    Christensen, Helle; Niewald, Gitte

    1992-01-01

    The ultimate lateral resistance of a pile element moved horizontally can be analyzed by the theory of plasticity. At a certain depth the movements around the pile are purely horizontal and upper bound solutions can be estimated theoretically under undrained circumstances. Model tests...... in the laboratory show ultimate resistances close to the estimated limits and p - y curves close to curves based on test results from full-scale piles. Rough and smooth piles with circular and square cross sections are investigated....

  18. Molecular Profiling of the Lateral Habenula in a Rat Model of Depression

    DEFF Research Database (Denmark)

    Christensen, Trine; Bouzinova, Elena; Wiborg, Ove

    2013-01-01

    habenula of rats subjected to chronic mild stress (mild stressors exchanged twice a day for 8 weeks). Some rats received antidepressant treatment during fifth to eights week of CMS. The lateral habenula gene expression profile was studied through the gene ontology and signal pathway analyses using......Objective. This study systematically investigated the effect of chronic mild stress and response to antidepressant treatment in the lateral habenula at the whole genome level. Methods. Rat whole genome expression chips (Affymetrix) were used to detect gene expression regulations in the lateral...... bioinformatics. Real-time quantitative polymerase chain reaction (RT-PCR) was used to verify the microarray results and determine the expression of the Fcrla, Eif3k, Sec3l1, Ubr5, Abca8a, Ankrd49, Cyp2j10, Frs3, Syn2, and Znf503 genes in the lateral habenula tissue. Results. In particular we found that stress...

  19. Direct lateral maneuvers in hawkmoths

    Directory of Open Access Journals (Sweden)

    Jeremy S. M. Greeter

    2016-01-01

    Full Text Available We used videography to investigate direct lateral maneuvers, i.e. ‘sideslips’, of the hawkmoth Manduca sexta. M. sexta sideslip by rolling their entire body and wings to reorient their net force vector. During sideslip they increase net aerodynamic force by flapping with greater amplitude, (in both wing elevation and sweep, allowing them to continue to support body weight while rolled. To execute the roll maneuver we observed in sideslips, they use an asymmetric wing stroke; increasing the pitch of the roll-contralateral wing pair, while decreasing that of the roll-ipsilateral pair. They also increase the wing sweep amplitude of, and decrease the elevation amplitude of, the contralateral wing pair relative to the ipsilateral pair. The roll maneuver unfolds in a stairstep manner, with orientation changing more during downstroke than upstroke. This is due to smaller upstroke wing pitch angle asymmetries as well as increased upstroke flapping counter-torque from left-right differences in global reference frame wing velocity about the moth's roll axis. Rolls are also opposed by stabilizing aerodynamic moments from lateral motion, such that rightward roll velocity will be opposed by rightward motion. Computational modeling using blade-element approaches confirm the plausibility of a causal linkage between the previously mentioned wing kinematics and roll/sideslip. Model results also predict high degrees of axial and lateral damping. On the time scale of whole and half wing strokes, left-right wing pair asymmetries directly relate to the first, but not second, derivative of roll. Collectively, these results strongly support a roll-based sideslip with a high degree of roll damping in M. sexta.

  20. Diagnosis of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Rowland, L P

    1998-10-01

    This review of the differential diagnosis of amyotrophic lateral sclerosis focuses on two themes. The first is practical, how to establish the diagnosis based primarily on clinical findings buttressed by electrodiagnosis. The main considerations are multifocal motor neuropathy and cervical spondylotic myelopathy. The second theme is the relationship of motor neuron disease to other conditions, including benign fasciculation (Denny-Brown, Foley syndrome), paraneoplastic syndromes, lymphoproliferative disease, radiation damage, monomelic amyotrophy (Hirayama syndrome), as well as an association with parkinsonism, dementia and multisystem disorders of the central nervous system.

  1. Detecting lateral genetic material transfer

    CERN Document Server

    Calderón, C; Mireles, V; Miramontes, P

    2012-01-01

    The bioinformatical methods to detect lateral gene transfer events are mainly based on functional coding DNA characteristics. In this paper, we propose the use of DNA traits not depending on protein coding requirements. We introduce several semilocal variables that depend on DNA primary sequence and that reflect thermodynamic as well as physico-chemical magnitudes that are able to tell apart the genome of different organisms. After combining these variables in a neural classificator, we obtain results whose power of resolution go as far as to detect the exchange of genomic material between bacteria that are phylogenetically close.

  2. Lateral Thoracic Maningocele : Anaesthetic Implications

    Directory of Open Access Journals (Sweden)

    Nazeer Ahmed K

    2008-12-01

    Full Text Available Meningomyelocele is a broad term representing herniation of extracranial contents through a congenital defect in the vertebral column. If only cerebrospinal fluid (CSF and meninges herniate, it is termed as a meningocele. A meningoencephalocele is herniation of neural elements along with meninges. Anaesthetic challenges in management of thoracic meningomyelocele include securing the airway with intubation in lateral or supine position, intraoperative prone position with its associated complications and accurate assessment of blood loss and prevention of hypothermia. We report a case of a thoracic meningocele posted for resection and discuss its anaesthetic implications

  3. Strangulated ileostomy evisceration following lateralizing mesh repair of parastomal hernia.

    Science.gov (United States)

    Ramly, E P; Crosslin, T; Orkin, B; Popowich, D

    2016-04-01

    Parastomal hernia formation and ostomy prolapse are relatively common complications of intestinal ostomy construction. Underlay mesh placement with lateralization of the stoma limb appears to be the method of repair with the lowest recurrence rate. Prophylaxis of new stomas with mesh is advocated by many authors. We report the case of an 81-year-old man with chronic steroid-dependent COPD who presented to the emergency department with strangulated small bowel evisceration 9 days following completion abdominal colectomy, and creation of an end ileostomy reinforced with intraperitoneal mesh. This rare complication was related to this patient's risk factors for poor healing including poor nutrition, age, chronic COPD and coughing and steroid dependence with immunosuppression.

  4. Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement

    Directory of Open Access Journals (Sweden)

    Eduardo Araújo Santana Nunes

    2014-01-01

    Full Text Available Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA. We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT and magnetic resonance imaging (MRI revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications.

  5. Clinical observation on the treatment of external humeral epicondylitis in 50 patients with heated Chinese medicine permeating combined with triamcinolone acetonide%中药加温透入结合曲安奈德痛点注射治疗肱骨外上髁炎50例

    Institute of Scientific and Technical Information of China (English)

    时少冰; 王斐然; 吴丽平

    2013-01-01

    Objective To observe the clinical curative effects of heated Chinese medicine permeating with Intermediate Frequency Electric Current combined with triamcinolone acetonide in the treatment of external humeral epicondylitis. Methods 100 cases with external humeral epicondylitis were divided into the experimental group (50 cases) and the control group (50 cases) randomly. The patients in the experimental group were treated with heated Chinese medicine permeating with Intermediate Frequency Electric Current combined with triamcinolone acetonide, and the controls were treated with triamcinolone acetonide only. Results The experimental group had a better improvement in elbow pain and gripping indices than the controls, and the difference was signiifcant. The difference in the excellent rate and the relapse rate between the two groups was signiifcant (P<0.05). Conclusion Heated Chinese medicine permeating with Intermediate Frequency Electric Current combined with triamcinolone acetonide has good efifciency in treating external humeral epicondylitis.%目的探讨中频电加温中药透入结合曲安奈德治疗肱骨外上髁炎的临床疗效。方法将100例肱骨外上髁炎患者随机分为两组,每组50例,治疗组采用中频电加温中药透入结合曲安奈德治疗,对照组仅给予曲安奈德治疗。结果治疗组对肘部疼痛、握力指数的改善均优于对照组(P<0.05);两组优良率和复发率比较差异均有统计学意义(P<0.05)。结论中频电加温中药透入结合曲安奈德治疗肱骨外上髁炎疗效确切。

  6. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    Science.gov (United States)

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients.

  7. 反阿是穴与阿是穴治疗肱骨外上髁炎疗效比较%Comparative study on therapeutic effect of Ashi-points and anti-Ashi-points on external humeral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    王欣

    2011-01-01

    目的:观察反阿是穴与阿是穴治疗肱骨外上髁炎的临床疗效差异.方法:将68例患者随机分为反阿是穴组和阿是穴组,每组34例.反阿是穴组在按压后使局部疼痛缓解或消失处选取穴,阿是穴组在痛点取穴,并于周边围刺三针.隔天治疗1次,10次为一疗程,均治疗2个疗程,分别在疗程结束后当天、第7天、第30天、第6个月及1年后观察疗效.结果:治疗后当天反阿是穴组有效率为100.0%(34/34),阿是穴组有效率73.5%(25/34),两组比较差异有统计学意义(P<0.01),第7天和第30天反阿是穴组有效率分别是94.1%(32/34)、91.2%(31/34),优于阿是穴组的70.6%(24/34)、67.6%(23/34)(均P<0.01),第6个月和1年后反阿是穴组有效率分别为73.5%(25/34)、52.9%(18/34),阿是穴组有效率分别为64.7%(22/34)、61.8%(21/34),组间差异无统计学意义(均P>0.05).结论:反阿是穴治疗肱骨外上髁炎具有明显的近期效应,反阿是穴与阿是穴具有相似的远期疗效.%Objective To compare the clinical efficacy between Ashi-points and anti-As/iz-points for external humeral epicondylitis. Methods Sixty-eight cases were randomly devided into an anti-As/ti-points group( group A) and an As/ii-points group(group B), 34 cases in each group. In the group A, anti-Asfti-points(points of pain relief or disappearance after local press) were selected for acupunctures in the group B, Ashi-points (pain spots) were selected for acupuncture and surrounded needling therapy was added . Once other day, 10 treatments made one session, altogether 2 courses. The clinical effects were observed at the ending day, the 7 th day, the 30 th day, the 6 th months and one year after treatment. Results The effective rates at the ending day, the 7 th day, the 30 th day after treatment in the group A were 100. 0% (34/34), 94.1% (32/34) and 91. 2% (31/34) , which were superior to those of 73. 5% (25/34), 70. 6% (24/34), 67. 6% (23/34) respectively

  8. Relativism in Feyerabend's later writings.

    Science.gov (United States)

    Kusch, Martin

    2016-06-01

    This paper reconstructs, and distinguishes between, Feyerabend's different forms of relativism in his later writings. Science in a Free Society remains close to familiar forms of relativism, while, at the same time, developing an original but under-argued form of political relativism, and rejecting "conversion" models of cultural exchange. Farewell to Reason moves away from common renderings of relativism, and develops a range of different new forms. Central here are links between relativism, skepticism and infallibilism. In the last six years of his life, Feyerabend often criticizes a peculiar radical form of relativism that arguably no-one has ever proposed or defended. In the same context, Feyerabend sketches an "ontological" form of relativism. It combines "Kantian humility", metaphysical pluralism and constructivism.

  9. Chronic inflammatory demyelinating polyneuropathy

    Science.gov (United States)

    Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory polyneuropathy; Guillain-Barré - CIDP ... Health care providers also consider CIDP as the chronic form of Guillain-Barré syndrome. The specific triggers ...

  10. Dealing with chronic cancer

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000933.htm Dealing with chronic cancer To use the sharing features on this ... be controlled for a period of time. Controlling Chronic Cancer When you have a chronic cancer, the ...

  11. 远端取穴结合运动疗法治疗肱骨外上髁炎的临床研究%Observation on Distal Acu-Points Combined with Kinesiotherapy Treating External Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    于杰; 孙忠人; 赵惠; 张杰

    2016-01-01

    目的:评价远端取穴结合运动疗法治疗肱骨外上髁炎的近期及远期疗效。方法:将符合纳入标准的66例肱骨外上髁炎患者按随机信封法为观察组和对照组各33例,观察组采用围刺加远端取穴结合运动疗法,对照组采用围刺加经穴治疗。观察两组治疗前、治疗后1周的肘关节活动度改变、简化麦吉尔疼痛问卷(SF-MPQ)评分、病患网球肘评价(PRTEE)评分变化情况,并分别于治疗后1周、治疗后3个月进行临床疗效评价。结果:两组治疗后肘关节活动度、SF-MPQ问卷评分及PRTEE量表评分与治疗前比较均明显改善,差异有高度统计学意义(P<0.01);观察组治疗后1周的肘关节活动度、SF-MPQ问卷评分及PRTEE量表评分显著优于对照组,差异有统计学意义(P<0.05);观察组治疗后1周和治疗后3个月的临床疗效均明显优于对照组,差异有统计学意义(P<0.05)。结论:远端取穴结合运动疗法治疗肱骨外上髁炎的近期及远期疗效均显著优于常规针刺疗法;远端取穴结合运动疗法总有效率高、治愈率高。%Objective:To evaluate the short-term and long-term efficacy of distal acu-points combined with ki-nesiotherapy on treating external humeral epicondylitis. Methods:Sixty-six patients with humeral epicondylitis meeting with the inclusion criteria were divided into observation group and control group randomly ,with 33 cases in each group. The observation group was given surrounding acupuncture with the distal acu-points and kinesiotherapy,while the control group was given surrounding acupuncture therapy with conventional points. We compared the elbow joint activities,the scores of short-form McGill pain questionnaire(SF-MPQ),and pa-tient-rated tennis elbow evaluation (PRTEE) scores before the treatment with those 1 week after treatment. Furthermore,the clinical efficacy 1 week after the therapy and that three months

  12. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Harmsen, L; Thomsen, S F; Sylvan Ingebrigtsen, Truls;

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  13. Chronic pain after childhood groin hernia repair

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Kehlet, Henrik

    2007-01-01

    BACKGROUND: In contrast to the well-described 10% risk of chronic pain affecting daily activities after adult groin hernia repair, chronic pain after childhood groin hernia repair has never been investigated. Studies of other childhood surgery before the age of 3 months suggest a risk of increased...... pain responsiveness later in life, but its potential relationship to chronic pain in adult life is unknown. METHODS: This was a nationwide detailed questionnaire study of chronic groin pain in adults having surgery for a groin hernia repair before the age of 5 years (n = 1075). RESULTS: The response...... the age of 3 months (n = 122) did not report groin pain more often or with higher intensity than other patients did. CONCLUSIONS: Groin pain in adult patients operated on for a groin hernia in childhood is uncommon and usually mild and occurs in relation to physical activity. Operation before the age of 3...

  14. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance.

    Science.gov (United States)

    Stensby, J Derek; Baker, Jonathan C; Fox, Michael G

    2016-02-01

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries.

  15. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance

    Energy Technology Data Exchange (ETDEWEB)

    Stensby, J.D. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States); Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Baker, Jonathan C. [Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Fox, Michael G. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States)

    2016-02-15

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. (orig.)

  16. Amyotrophic lateral sclerosis presenting with orthopnea in a patient with COPD and obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    T.L.N. Swamy

    2011-01-01

    Full Text Available Amyotrophic lateral sclerosis (ALS, also known as motor neuron disease (MND is a relentlessly progressive neurological disorder causing peripheral muscular weakness and resultant respiratory failure. In this article, we report a case of ALS with chronic obstructive pulmonary disease (COPD and obstructive sleep apnea (OSA with orthopnea as initial symptoms.

  17. Hemispheric Laterality in Music and Math

    Science.gov (United States)

    Szirony, Gary Michael; Burgin, John S.; Pearson, L. Carolyn

    2008-01-01

    Hemispheric laterality may be a useful concept in teaching, learning, training, and in understanding more about human development. To address this issue, a measure of hemispheric laterality was compared to musical and mathematical ability. The Human Information Processing Survey (HIPS) instrument, designed to measure hemispheric laterality, was…

  18. Chronic urticaria

    Directory of Open Access Journals (Sweden)

    Sandeep Sachdeva

    2011-01-01

    Full Text Available Chronic urticaria (CU is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ′idiopathic′ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

  19. 依托芬那酯凝胶治疗急性肱骨外上髁炎50例疗效观察%To Observe the Etofenamate Gel Curative Effect in the Treatment of 50 Cases of Acute Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    李卫国

    2014-01-01

    目的:观察依托芬那酯凝胶治疗急性肱骨外上髁炎的临床疗效。方法治疗组给予依托芬那酯凝胶涂抹痛处,并轻柔按摩治疗,对照组予奇正消痛贴膏贴于患处。结果治疗组总有效率显著高于对照组,差异有统计学意义(P<0.01)。结论依托芬那酯凝胶对于肱骨外上髁炎急性期具有良好的疗效,值得推广使用。%Objective To observe the clinical therapeutic effect of etofenamate gel in the treatment of acute external humeral epicondylitis. Methods The patients in treatment group were treated with etofenamate gel and massage.The patients in control group were treated with Qizheng-xiaotong plaster. Results The total effective rate in the treatment group was significantly higher than in control group(P<0.01). Conclusion The etofenamate gel is an ideal treatment for acute external humeral epicondylitis and worthy of clinical use.

  20. Lateral violence in the perioperative setting.

    Science.gov (United States)

    Bigony, Lorraine; Lipke, Tammy G; Lundberg, Ashley; McGraw, Carrie A; Pagac, Gretchen L; Rogers, Anne

    2009-04-01

    Lateral violence is disruptive, bullying, intimidating, or unsettling behavior that occurs between nurses in the workplace. The perioperative setting fosters lateral violence because of the inherent stress of performing surgery; high patient acuity; a shortage of experienced personnel; work demands; and the restriction and isolation of the OR, which allows negative behaviors to be concealed more easily. Lateral violence affects nurses' health and well-being and their ability to care for patients. Interventions to reduce lateral violence include empowerment of staff members and zero tolerance for lateral violence.

  1. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B.; Nikolajsen, L.; Kehlet, H.;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies Udgivelsesdato: 2008/3...

  2. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  3. The Later Wittgenstein and the Later Husserl on Language

    Directory of Open Access Journals (Sweden)

    Paul Ricoeur

    2014-07-01

    Full Text Available This article presents an edited version of lectures given by Paul Ricœur at Johns Hopkins University in April 1966. Ricœur offers a comparative analysis of Wittgenstein’s and Husserl’s late works, taking the problem of language as the common ground of investigation for these two central figures of phenomenology and analytic philosophy. Ricœur develops his study in two parts. The first part considers Husserl’s approach to language after the Logical Investigations and concentrates on Formal and Transcendental Logic; leaving a transcendental reflection on language behind it re-examines a phenomenological conception, according to which the sphere of logic is not separable from that of experience. The main focus of the second part is Wittgenstein’s later philosophy as it moved on from the conception of an isomorphic relation between language and the world, as set out in the picture theory in the Tractatus Logico-Philosophicus, to the more pragmatic notion of a language-game in the Philosophical Investigations. In order to get beyond the irrevocable differences between the two philosophies and the unresolved theoretical issues on both sides, Ricœur suggests turning to a semiological paradigm based on the Saussurean distinction between “language” and “speaking.” Keywords: Analytic Philosophy, Husserl, Phenomenology, Semiology, Wittgenstein.Résumé Cet article est une version éditée de conférences données par Paul Ricœur à la Johns Hopkins University en avril 1966. Ricœur propose une analyse comparée des dernières œuvres de Wittgenstein et Husserl, avec le problème du langage comme sol commun d’investigations pour ces deux figures centrales de la phénoménologie et la philosophie analytique. Cette analyse de Ricœur se joue à travers deux parties. La première partie revient sur l'approche du langage chez Husserl depuis Recherches logiques avec une attention particulière aux développements de Logique formelle et

  4. Molecular profiling of the lateral habenula in a rat model of depression.

    Directory of Open Access Journals (Sweden)

    Trine Christensen

    Full Text Available OBJECTIVE: This study systematically investigated the effect of chronic mild stress and response to antidepressant treatment in the lateral habenula at the whole genome level. METHODS: Rat whole genome expression chips (Affymetrix were used to detect gene expression regulations in the lateral habenula of rats subjected to chronic mild stress (mild stressors exchanged twice a day for 8 weeks. Some rats received antidepressant treatment during fifth to eights week of CMS. The lateral habenula gene expression profile was studied through the gene ontology and signal pathway analyses using bioinformatics. Real-time quantitative polymerase chain reaction (RT-PCR was used to verify the microarray results and determine the expression of the Fcrla, Eif3k, Sec3l1, Ubr5, Abca8a, Ankrd49, Cyp2j10, Frs3, Syn2, and Znf503 genes in the lateral habenula tissue. RESULTS: In particular we found that stress and antidepressant treatment affected intracellular cascades like growth factor receptor signaling, G-protein-coupled receptor signaling, and Wnt signaling - processes involved in the neuroplastic changes observed during the progression of depression and antidepressant treatment. CONCLUSION: The present study suggests an important role of the lateral habenula in the development of depression-like conditions and correlates to previous studies demonstrating a significant role of the lateral habenula in depressive-like conditions and antidepressant treatment.

  5. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

    There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss.

  6. Vehicle lateral dynamics stabilization using active suspension

    Directory of Open Access Journals (Sweden)

    Drobný V.

    2008-12-01

    Full Text Available The paper deals with the investigation of active nonlinear suspension control in order to stabilize the lateral vehicle motion in similar way as systems like ESP do. The lateral stabilization of vehicle based on braking forces can be alternatively provided by the different setting of suspension forces. The basis of this control is the nonlinear property of the tyres. The vehicle has at least four wheels and it gives one or more redundant vertical forces that can be used for the different distribution of vertical suspension forces in such a way that resulting lateral and/or longitudinal forces create the required correction moment for lateral dynamic vehicle stabilization.

  7. Lateral human-structure interaction on footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór; Georgakis, Christos; Ricciardelli, Francesco

    2010-01-01

    In recent years, several high-profile footbridges have suffered from unexpected excessive pedestrian-induced lateral vibrations. There is a commonly accepted view that the synchronisation of pedestrians to the lateral movement of a structure is necessary for the onset of a form of instability which....... The tests reveal that synchronisation is not a pre-condition for the development of large amplitude lateral vibrations on footbridges, as walking frequencies and phase angles remain largely unaffected by lateral motion at most frequencies and amplitudes. Instead, large amplitude vibrations are the result...

  8. Comparison of cAMP with other radioprotectors against chronic damage to the rat parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    Conger, A.D.; Sodicoff, M.; Samel, A.

    1985-04-01

    Radiation damage to the parotid gland is protectable by cAMP during the first week after irradiation (acute phase), though appreciable recovery occurred later with or without such protection. Further damage developed later (chronic phase, 60-90 days), and cAMP was still protective against this damage with a dose modification factor of 1.86 for gland weight. A summary of the protective factors, acute and chronic, for WR-2721, isoproterenol, and cAMP is included. Chronic damage is about 1.5 times as great as acute, and protection against acute and chronic damage is about equal for all three compounds.

  9. Vannevar Bush: Fifty Years Later

    Science.gov (United States)

    Lagowski, J. J.

    1995-12-01

    It is ironic that the 50th anniversary year of Vannevar Bush's Report to President Truman entitled "Science the Endless Frontier", which put into motion the eminently successful current system of education of scientists in this country occurs at a time when serious questions are being asked about the usefulness of that very system. Bush viewed his proposal to establish a national research foundation (later to be called the National Science Foundation) as a "social compact." Judgment of scientific merit would be delegated to expert peers in return for scientific progress, which would ultimately benefit the nation in terms of scientific needs--military security, economic productivity, and enhanced quality of life. Bush wanted the funding of basic research intertwined with training, and preferred to use universities for this purpose rather than industrial or national labs. Bush viewed college and university scientists as teachers and investigators. He believed university-based research would uniquely encourage and engage the next generation of scientists as no other institutional arrangement could. Bush did not trust industry's commitment to basic research, an instinct that proved prophetic. The academic reserve of scientists (PhD's in training and postdoctoral students) that existed before World War II, and upon which the United States could draw for its needs, which were primarily associated with defense efforts, was probably one of the defining factors in Bush's suggested strategy. Currently, that reserve of talent has gotten so large that it is the obvious throttle in the pipeline slowing the continued development of the university research enterprise. Since 1977, the rate at which we have trained new scientists exceeds an average of 4% annually. Since 1987, the "science work force"--PhD's--has grown at three times the rate of the general labor supply. Temporary positions for postdoctoral scientists have grown even faster (over 5% per year since 1989). To compound

  10. 放散状与聚焦状冲击波治疗肱骨内上髁炎的疗效比较%Effect of radial and focused extracorporeal shock waves in the treatment of humeral internal epicondylitis

    Institute of Scientific and Technical Information of China (English)

    张隆浩; 黄广林; 满立波

    2013-01-01

    目的 探讨放散状与聚焦状冲击波治疗肱骨内上髁炎的疗效及安全性.方法 35例肱骨内上髁炎患者随机被分为放散状冲击波治疗组(放散组)和聚焦状冲击波治疗组(聚焦组),分别为20例和15例.放散组患者治疗频率为10 Hz,治疗探头15 mm,治疗压力l~2 bar,冲击剂量2000/次,手持压力低-中.聚焦组患者治疗电压7~8 kV,冲击频率60次/min,冲击剂量1200次.所有患者均治疗3次,治疗间隔为7d,治疗部位为肱骨内上髁部.治疗前,末次治疗4周后和12周后采用视觉模拟评级(VAS)法评估患者治疗前后疼痛强度.结果 两组患者治疗前VAS评分相近,放散组VAS评分(6.53±2.40),聚焦组VAS评分(7.19±1.98);末次治疗4周后及12周后,VAS评分均显著低于治疗前,差异有统计学意义(P<0.05);末次治疗4周后放散组VAS评分(3.47±1.93)显著低于聚焦组VAS评分(4.89 ±0.12),两组之间差异有统计学意义(P<0.05);在12周时放散组VAS评分2.05±1.11,聚焦组VAS评分2.22±0.42,两组比较之间差异无明显意义(P>0.05).结论 放散状冲击波治疗肱骨内上髁炎显效快,但是远期疗效与聚焦状冲击波治疗无明显差异.%Objective To compare the effect of the radial and focused extracorporeal shock waves in the treatment of humeral internal epicondylitis.Methods Thirty-five patients were included in the study,20 received radial extracorporeal shock waves therapy (RSWT) and the others received focused extracorporeal shock waves therapy (FSWT).RSWT group impulses applied with the 15 mm applicator at frequency of 10 Hz,with 2 000 impulses per session,air pressure of the device set at 1-2 bar.FSWT group impulses applied at frequency of 1 Hz,with 1 200 impulses per session,the treatment voltage set at 7-8 kV.Each patient received 3 sessions of treatment with 7 days apart.Visual analog scale (VAS) score was used to evaluate the extent of pain before the therapy and 4 or 12 weeks after the last

  11. Herniographic appearance of the lateral inguinal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kesek, P.

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do.

  12. Naphthyl azomesogens with lateral chloro groups†

    Indian Academy of Sciences (India)

    A K Prajapati; H M Pandya; N L Bonde

    2004-06-01

    A homologous series of azomesogens, 2"-[4-(4'--alkoxybenzoyloxy)-2-chlorophenylazo] naphthalenes, with lateral chloro groups was synthesised. All the homologues synthesized exhibit enantiotropic nematic mesophase. The mesomorphic properties of the present series are compared with other structurally related series to evaluate the effect of lateral chloro group and its position on mesomorphism.

  13. Lateral interception II : Predicting hand movements

    NARCIS (Netherlands)

    Michaels, CF; Jacobs, DM; Bongers, RM

    2006-01-01

    D. M. Jacobs and C. F. Michaels (2006) concluded that aspects of hand movements in lateral catching were predicted by the ratio of lateral optical velocity to expansion velocity. Their conclusions were based partly on a modified version of the required velocity model of catching (C. E. Peper, R. J.

  14. Plasticity and function of cerebral lateralization

    NARCIS (Netherlands)

    Lust, J.M.

    2011-01-01

    Lateralization refers to the division of labour between the hemispheres. The studies presented in this thesis addressed the developmental plasticity and function of cerebral lateralization. The access to an unique dataset of prenatal testosterone (pT) levels and the use of fTCD to measure individual

  15. Sensor data fusion for lateral safe applications

    NARCIS (Netherlands)

    Amditis, A; Floudas, N.; Polychronopoulos, A.; Bank, D.; Broek, B. van den; Oechsle, F.

    2006-01-01

    This paper describes the algorithms that are being developed for the perception layer of the PReVENT subproject LATERAL SAFE. These algorithms aim at achieving a reliable representation of the objects and their kinematics, present at the lateral and rear field of the ego-vehicle. The work presented

  16. Introduction to Single Piles under Lateral Loading

    DEFF Research Database (Denmark)

    Augustesen, Anders; Ibsen, Lars Bo

    The purpose of this chapter is to give a short introduction to single piles subjected to lateral loading. First, the observed behaviour of laterally loaded piles is described, i.e. the effects of loading conditions, installation procedure, pile type etc. on pile behaviour are presented (section 1...

  17. Pseudomelanosis duodeni associated with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Marcia Henriques de Magalh(a)es Costa; Maria da Gloria Fernandes Pegado; Cleber Vargas; Maria Elizabeth C Castro; Kalil Madi; Tiago Nunes; Cyrla Zaltman

    2012-01-01

    Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain,nausea,melena and progressive reduction of hemoglobin index.Gastroduodenal endoscopy revealed erosions in the esophagus and stomach,with no active bleeding at the moment.In addition,the duodenal mucosa presented marked signs of melanosis; later confirmed by histopathological study.Even though PD is usually regarded as a benign condition,its pathogenesis and clinical significance is yet to be defined.

  18. Heterotopic ossification in chronic fibrosing otitis externa

    Science.gov (United States)

    Maughan, Elizabeth F.; Bhutta, Mahmood F.; Lavy, Jeremy

    2015-01-01

    Acquired external auditory canal atresia is a rare complication of chronic inflammatory otitis, and is generally fibrous or soft tissue in nature. Here, we present the first reported case of heterotopic ossification within chronic fibrosing otitis externa in a 25-year-old male patient with a childhood history of granular myringitis and failed tympanoplasty. A calcified mass was demonstrated adjacent to the tympanic membrane on CT imaging, and surgical exploration revealed a cohesive bar of bone traversing the medial external auditory canal. Drill canaloplasty and split-thickness skin graft coverage of the lateral tympanic membrane resulted in an improvement in the pure tone average from 79 to 55 dB. As the treatment for chronic fibrosing otitis externa involves the surgical widening of the external auditory canal, we alert surgeons to the possibility of cohesive bone formation as a potential cause of navigational confusion and inadvertent over- or under-drilling of the canal stenosis. PMID:26429555

  19. Antiglomerular basement membrane antibody-crescentic glomerulonephritis complicating chronic bronchiectasis.

    Science.gov (United States)

    Enríquez, R; Cabezuelo, J B; Sirvent, A E; Andrada, E; Amorós, F; Orti, C

    2001-04-01

    A 68-year-old woman with chronic bronchiectasis presented with haematuria and severe oligoanuric renal failure with no other serious systemic manifestation. Antiglomerular basement membrane (anti-GBM) antibodies and anti-myeloperoxidase antibodies were positive. Renal biopsy revealed anti-GBM crescentic glomerulonephritis. A conservative approach was followed and the patient is stable on chronic haemodialysis 6 months later. To the authors' knowledge, there has only been one previous report of anti-GBM disease complicating bronchiectasis.

  20. Chronic Kidney Diseases

    Science.gov (United States)

    ... Room? What Happens in the Operating Room? Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  1. Diet - chronic kidney disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002442.htm Diet - chronic kidney disease To use the sharing features on this page, ... make changes to your diet when you have chronic kidney disease. These changes may include limiting fluids, eating a ...

  2. Chronic granulomatous disease

    Science.gov (United States)

    CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... In chronic granulomatous disease (CGD), immune system cells called phagocytes are unable to kill some types of bacteria and ...

  3. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; von Linstow, Marie-Louise; Nepper-Christensen, Steen;

    2005-01-01

    To investigate if chronic mucus hypersecretion (CMH) can be used as a marker of asthma in young adults.......To investigate if chronic mucus hypersecretion (CMH) can be used as a marker of asthma in young adults....

  4. Chronic tophaceous gout

    Directory of Open Access Journals (Sweden)

    Thappa D

    1993-01-01

    Full Text Available A rare case of chronic tophaceous gout, in a 27-year-old female on diuretics for chronic congestive cardiac failure with characteristic histopathological and radiological changes is reported.

  5. Chronic Pancreatitis in Children

    Science.gov (United States)

    ... maintaining good health. Can chronic pancreatitis give my child cancer? If your child has chronic pancreatitis, he or she will be at an increased risk of developing pancreatic cancer compared to the general population. The degree of ...

  6. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... Goals Ending Chronic Homelessness Share This: Ending Chronic Homelessness Last updated on January 19, 2017 We can ... the USICH newsletter. We know how to end homelessness. Let's do it, together. Sign up for our ...

  7. Current Therapy of Drugs in Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Lu, Haiyan; Le, Wei Dong; Xie, Ya-Ying; Wang, Xiao-Ping

    2016-01-01

    Amyotrophic lateral sclerosis (ALS), commonly termed as motor neuron disease (MND) in UK, is a chronically lethal disorder among the neurodegenerative diseases, meanwhile. ALS is basically irreversible and progressive deterioration of upper and lower motor neurons in the motor cortex, brain stem and medulla spinalis. Riluzole, used for the treatment of ALS, was demonstrated to slightly delay the initiation of respiratory dysfunction and extend the median survival of patients by a few months. In this study, the key biochemical defects were discussed, such as: mutant Cu/Zn superoxide dismutase, mitochondrial protectants, and anti-excitotoxic/ anti-oxidative / antiinflammatory/ anti-apoptotic agents, so the related drug candidates that have been studied in ALS models would possibly be further used in ALS patients.

  8. Abnormalities of cortical inhibitory neurons in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Enterzari-Taher, M; Eisen, A; Stewart, H; Nakajima, M

    1997-01-01

    We have used peristimulus time histograms to study how paired, transcranial magnetic stimulation alters the firing of single motor units and the magnitude of unitary excitatory postsynaptic potentials (EPSPs) recorded from the extensor digitorum communis muscle. With stimulus intensity at threshold and an interstimulus interval of 30 ms, normal subjects (n = 20) demonstrated marked inhibition with a mean test/conditioning EPSP ratio of 13.8% (range 0-51%) and in 7 subjects the ratio was 0 (100% inhibition). In amyotrophic lateral sclerosis (ALS) the ratio was 133% (range 64-267%), P monomelic amyotrophy. We speculate that the marked loss of inhibition seen in all patients with ALS, which may be unique to this disorder, reflects loss of inhibitory modulation of the corticomotoneuron and could result in their chronic excitatory drive and eventual demise.

  9. Iliotibial band syndrome: evaluation and management.

    Science.gov (United States)

    Strauss, Eric J; Kim, Suezie; Calcei, Jacob G; Park, Daniel

    2011-12-01

    Iliotibial band syndrome is a common overuse injury typically seen in runners, cyclists, and military recruits. Affected patients report lateral knee pain associated with repetitive motion activities. The diagnosis is usually made based on a characteristic history and physical examination, with imaging studies reserved for cases of recalcitrant disease to rule out other pathologic entities. Several etiologies have been proposed for iliotibial band syndrome, including friction of the iliotibial band against the lateral femoral epicondyle, compression of the fat and connective tissue deep to the iliotibial band, and chronic inflammation of the iliotibial band bursa. The mainstay of treatment is nonsurgical; however, in persistent or chronic cases, surgical management is indicated.

  10. Influence of Kinesitherapy on Gait in Patients with Ischemic Stroke in the Chronic Period

    Directory of Open Access Journals (Sweden)

    Danche Vasileva

    2015-10-01

    CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as exercise program at home, which significantly improved gait cadence and speed of movement in patients with ischemic stroke in the chronic period and is with a supportive prolonged exposure.

  11. Model to Design Drip Hose Lateral Line

    Science.gov (United States)

    Ludwig, Rafael; Cury Saad, João Carlos

    2014-05-01

    Introduction The design criterion for non-pressure compensating drip hose is normally to have 10% of flow variation (Δq) in the lateral line, corresponding to 20% of head pressure variation (ΔH). Longer lateral lines in drip irrigation systems using conventional drippers provide cost reduction, but it is necessary to obtain to the uniformity of irrigation [1]. The use of Δq higher levels can provide longer lateral lines. [4] proposes the use of a 30% Δq and he found that this value resulted in distribution uniformity over 80%. [1] considered it is possible to extend the lateral line length using two emitters spacing in different section. He assumed that the spacing changing point would be at 40% of the total length, because this is approximately the location of the average flow according with [2]. [3] found that, for practical purposes, the average pressure is located at 40% of the length of the lateral line and that until this point it has already consumed 75% of total pressure head loss (hf ). In this case, the challenge for designers is getting longer lateral lines with high values of uniformity. Objective The objective of this study was to develop a model to design longer lateral lines using non-pressure compensating drip hose. Using the developed model, the hypotheses to be evaluated were: a) the use of two different spacing between emitters in the same lateral line allows longer length; b) it is possible to get longer lateral lines using high values of pressure variation in the lateral lines since the distribution uniformity stays below allowable limits. Methodology A computer program was developed in Delphi® based on the model developed and it is able to design lateral lines in level using non-pressure compensating drip hose. The input data are: desired distribution uniformity (DU); initial and final pressure in the lateral line; coefficients of relationship between emitter discharge and pressure head; hose internal diameter; pipe cross-sectional area

  12. Ultrastructural alterations of choroid plexuses of lateral ventricles of rats (Rattus norvegicus submitted to experimental chronic alcoholism Alterações ultraestruturais dos plexos coróides dos ventrículos laterais de ratos (Rattus norvegicus submetidos a alcoolismo crônico experimental

    Directory of Open Access Journals (Sweden)

    LUÍS FERNANDO TIRAPELLI

    2000-03-01

    Full Text Available Adult male rats (Wistar lineage were alcoholized with sugar cane liquor diluted at 30(0 GL during 300 days and sacrificed every 60 days in 5 stages. Samples of choroid plexuses of lateral ventricles were collected and examined at transmission electronic microscope to detect possible ultrastructural alterations and to raise possible pathological correlations. Gradual changes were observed in these animals during all the experiment: dilatation and enlargement of cisternae of Golgi complex, dilatation of RER, presence of digestive vacuoles and a large amount of pinocytic vesicles as well as vesicles with electronlucent content throughout cytoplasm, as well as an enlargement of intercellular space between basolateral interdigitation of the cells and of the connective tissue. The changes observed in the epithelium and connective tissue of choroid plexuses specially in 240 and 300 days of treatment are presumably due to a disturbance in hydroelectrolitic homeostasis, contributing to several morpho-functional disturbs of central nervous system. No changes were observed in the control group animals.Ratos machos adultos (linhagem Wistar foram alcoolizados com aguardente de cana diluída a 30(0 GL durante 300 dias e sacrificados a cada 60 dias em 5 etapas. Amostras dos plexos coróides dos ventrículos laterais foram coletadas e examinadas ao microscópio eletrônico de transmissão para detectar possíveis alterações ultraestruturais e suas correlações patológicas. Alterações graduais foram observadas nestes animais durante todo o experimento: dilatação e aumento das cisternas de complexo de Golgi, dilatação do retículo endoplasmático rugoso, presença de vacúolos digestivos e grande quantidade de vesículas pinocíticas assim como de vesículas de conteúdo elétron-lúcido por todo o citoplasma, além de aumento do espaço intercelular, entre as interdigitações das células assim como no tecido conjuntivo. As alterações observadas no

  13. Olfactory coding in the honeybee lateral horn.

    Science.gov (United States)

    Roussel, Edith; Carcaud, Julie; Combe, Maud; Giurfa, Martin; Sandoz, Jean-Christophe

    2014-03-03

    Olfactory systems dynamically encode odor information in the nervous system. Insects constitute a well-established model for the study of the neural processes underlying olfactory perception. In insects, odors are detected by sensory neurons located in the antennae, whose axons project to a primary processing center, the antennal lobe. There, the olfactory message is reshaped and further conveyed to higher-order centers, the mushroom bodies and the lateral horn. Previous work has intensively analyzed the principles of olfactory processing in the antennal lobe and in the mushroom bodies. However, how the lateral horn participates in olfactory coding remains comparatively more enigmatic. We studied odor representation at the input to the lateral horn of the honeybee, a social insect that relies on both floral odors for foraging and pheromones for social communication. Using in vivo calcium imaging, we show consistent neural activity in the honeybee lateral horn upon stimulation with both floral volatiles and social pheromones. Recordings reveal odor-specific maps in this brain region as stimulations with the same odorant elicit more similar spatial activity patterns than stimulations with different odorants. Odor-similarity relationships are mostly conserved between antennal lobe and lateral horn, so that odor maps recorded in the lateral horn allow predicting bees' behavioral responses to floral odorants. In addition, a clear segregation of odorants based on pheromone type is found in both structures. The lateral horn thus contains an odor-specific map with distinct representations for the different bee pheromones, a prerequisite for eliciting specific behaviors.

  14. Morpho-functional changes in human tendon tissue

    Directory of Open Access Journals (Sweden)

    I Galliani

    2009-12-01

    Full Text Available Insertion tissue biopsies of right arm common extensor tendons from 11 patients with chronic lateral epicondylitis were processed for light and electron microscopy. The subjects were aged between 38 and 54 years (only one was 25. The specimens showed a variety of structural changes such as biochemical and spatial alteration of collagen, hyaline degeneration, loss of tenocytes, fibrocartilage metaplasia, calcifying processes, neovascularization and vessel wall modifications. Tissue alterations were evident in limited zones of the tendon fibrocartilage in which the surgical resection was generally visible. The areas where the degenerative processes were localized, were restricted and in spatial contiguity with morphologically normal ones. The observed cases presented histological and electron microscopic findings that characterize lateral epicondylitis as a degenerative phenomenon involving all tendon components.

  15. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  16. The National Report--Five Years Later.

    Science.gov (United States)

    Stewart, Bob R.; And Others

    1993-01-01

    Six theme articles assess the impact five years later of the National Academy of Sciences report, "Understanding Agriculture." Topics discussed include strategic planning, agricultural education's mission, teacher education, policy research needs, and agricultural literacy. (SK)

  17. Genetics Home Reference: amyotrophic lateral sclerosis

    Science.gov (United States)

    ... Lattante S, Ciura S, Rouleau GA, Kabashi E. Defining the genetic connection linking amyotrophic lateral sclerosis (ALS) with frontotemporal dementia (FTD). Trends Genet. 2015 May;31(5):263-73. ...

  18. Primary lateral sclerosis mimicking atypical parkinsonism

    DEFF Research Database (Denmark)

    Norlinah, Ibrahim M; Bhatia, Kailash P; Østergaard, Karen;

    2007-01-01

    Primary lateral sclerosis (PLS), the upper motor neurone variant of motor neurone disease, is characterized by progressive spinal or bulbar spasticity with minimal motor weakness. Rarely, PLS may present with clinical features resembling parkinsonism resulting in occasional misdiagnosis as one...

  19. The laterality effect: myth or truth?

    Science.gov (United States)

    Cohen Kadosh, Roi

    2008-03-01

    Tzelgov and colleagues [Tzelgov, J., Meyer, J., and Henik, A. (1992). Automatic and intentional processing of numerical information. Journal of Experimental Psychology: Learning, Memory and Cognition, 18, 166-179.], offered the existence of the laterality effect as a post-hoc explanation for their results. According to this effect, numbers are classified automatically as small/large versus a standard point under autonomous processing of numerical information. However, the genuinity of the laterality effect was never examined, or was confounded with the numerical distance effect. In the current study, I controlled the numerical distance effect and observed that the laterality effect does exist, and affects the processing of automatic numerical information. The current results suggest that the laterality effect should be taken into account when using paradigms that require automatic numerical processing such as Stroop-like or priming tasks.

  20. Coping with Mood Changes Later in Life

    Science.gov (United States)

    ... of Personal Stories Peers Celebrating Art Peers Celebrating Music Be Vocal Support Group Locator DBSA In-Person ... or adjust your medication can prevent more costly interventions later. back to top What can I do ...

  1. Lateral shear interferometry with holo shear lens

    Science.gov (United States)

    Joenathan, C.; Mohanty, R. K.; Sirohi, R. S.

    1984-12-01

    A simple method for obtaining lateral shear using holo shear lenses (HSL) has been discussed. This simple device which produces lateral shears in the orthogonal directions has been used for lens testing. The holo shear lens is placed at or near the focus of the lens to be tested. It has also been shown that HSL can be used in speckle shear interferometry as it performs both the functions of shearing and imaging.

  2. Lateral sacral lipomyelomeningocele : a rare anomaly.

    Directory of Open Access Journals (Sweden)

    Shetty D

    2002-04-01

    Full Text Available Lateral sacral lipomyelomeningocele is a rare spinal developmental anomaly. In the case under report, the fat attached to the neural placode was blending with the gluteal fat externally. The cord was tethered at this level. Multiple bony anomalies and diastematomyelia were associated findings. A case of lateral sacral lipomyelomeningocele with excellent imaging detail provided by the multiplanar magnetic resonance (MR scan is reported.

  3. Brain and behavioural lateralization in invertebrates.

    Directory of Open Access Journals (Sweden)

    Elisa eFrasnelli

    2013-12-01

    Full Text Available Traditionally, only humans were thought to exhibit brain and behavioural asymmetries, but several studies have revealed that most vertebrates are also lateralized. Recently, evidence of left-right asymmetries in invertebrates has begun to emerge, suggesting that lateralization of the nervous system may be a feature of simpler brains as well as more complex ones. Here I present some examples in invertebrates of sensory and motor asymmetries, as well as asymmetries in the nervous system. I illustrate two cases where an asymmetric brain is crucial for the development of some cognitive abilities. The first case is the nematode C. elegans, which has asymmetric odour sensory neurons and taste perception neurons. In this worm left/right asymmetries are responsible for the sensing of a substantial number of salt ions, and lateralized responses to salt allow the worm to discriminate between distinct salt ions. The second case is the fruit fly D. melanogaster, where the presence of asymmetry in a particular structure of the brain is important in the formation or retrieval of long-term memory. Moreover, I distinguish two distinct patterns of lateralization that occur in both vertebrates and invertebrates: individual-level and population-level lateralization. Theoretical models on the evolution of lateralization suggest that the alignment of lateralization at the population level may have evolved as an evolutionary stable strategy in which individually-asymmetrical organisms must coordinate their behaviour with that of other asymmetrical organisms. This implies that lateralization at the population-level is more likely to have evolved in social rather than in solitary species. I evaluate this new hypothesis with specific focus on insects showing different level of sociality. In particular, I present a series of studies on antennal asymmetries in honeybees and other related species of bees, showing how insects may be extremely useful to test evolutionary

  4. C-reactive protein and later preeclampsia

    DEFF Research Database (Denmark)

    Rebelo, Fernanda; Schlüssel, Michael M; Vaz, Juliana S;

    2013-01-01

    This study aims to determine whether high C-reactive protein (CRP) concentration during pregnancy is associated with later preeclampsia and whether weight status (BMI) is a potential modifier of the relation between CRP and preeclampsia.......This study aims to determine whether high C-reactive protein (CRP) concentration during pregnancy is associated with later preeclampsia and whether weight status (BMI) is a potential modifier of the relation between CRP and preeclampsia....

  5. Laterality enhances cognition in Australian parrots.

    Science.gov (United States)

    Magat, Maria; Brown, Culum

    2009-12-01

    Cerebral lateralization refers to the division of information processing in either hemisphere of the brain and is a ubiquitous trait among vertebrates and invertebrates. Given its widespread occurrence, it is likely that cerebral lateralization confers a fitness advantage. It has been hypothesized that this advantage takes the form of enhanced cognitive function, potentially via a dual processing mechanism whereby each hemisphere can be used to process specific types of information without contralateral interference. Here, we examined the influence of lateralization on problem solving by Australian parrots. The first task, a pebble-seed discrimination test, was designed for small parrot species that feed predominately on small seeds, which do not require any significant manipulation with the foot prior to ingestion. The second task, a string-pull problem, was designed for larger bodied species that regularly use their feet to manipulate food objects. In both cases, strongly lateralized individuals (those showing significant foot and eye biases) outperformed less strongly lateralized individuals, and this relationship was substantially stronger in the more demanding task. These results suggest that cerebral lateralization is a ubiquitous trait among Australian parrots and conveys a significant foraging advantage. Our results provide strong support for the enhanced cognitive function hypothesis.

  6. The effect of lateral internal sphincterotomy on resting anal sphincter pressures

    OpenAIRE

    Peker, Kemal; YILMAZ, İsmayil; DEMİRYILMAZ, İsmail; İNAL, Abdullah; Işik, Arda

    2014-01-01

    Anal fissures are one of the most common proctologic disorders. This study aimed to investigate alterations in anal sphincteric resting pressures after lateral internal sphincterotomy, which was performed for chronic anal fissure treatment. Materials and methods: Fifty-six (68.3%) male and 26 (31.7%) female patients were included in this study. Patients complicated with fistula-in-ano, abscess, cancer, inflammatory bowel disease, dermatitis, poor general condition, allergy to any of the stan...

  7. Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation

    Directory of Open Access Journals (Sweden)

    Fuyuki Tateno

    2014-08-01

    Full Text Available It is rare that amyotrophic lateral sclerosis (ALS presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness.

  8. Biofilms in chronic wounds.

    Science.gov (United States)

    James, Garth A; Swogger, Ellen; Wolcott, Randall; Pulcini, Elinor deLancey; Secor, Patrick; Sestrich, Jennifer; Costerton, John W; Stewart, Philip S

    2008-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. It has been speculated that bacteria colonizing chronic wounds exist as highly persistent biofilm communities. This research examined chronic and acute wounds for biofilms and characterized microorganisms inhabiting these wounds. Chronic wound specimens were obtained from 77 subjects and acute wound specimens were obtained from 16 subjects. Culture data were collected using standard clinical techniques. Light and scanning electron microscopy techniques were used to analyze 50 of the chronic wound specimens and the 16 acute wound specimens. Molecular analyses were performed on the remaining 27 chronic wound specimens using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic wound specimens evaluated by microscopy, 30 were characterized as containing biofilm (60%), whereas only one of the 16 acute wound specimens was characterized as containing biofilm (6%). This was a statistically significant difference (p<0.001). Molecular analyses of chronic wound specimens revealed diverse polymicrobial communities and the presence of bacteria, including strictly anaerobic bacteria, not revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds relative to acute wounds observed in this study provides evidence that biofilms may be abundant in chronic wounds.

  9. Managing acute and chronic pancreatitis.

    Science.gov (United States)

    Skipworth, James R A; Shankar, Arjun; Pereira, Stephen P

    2010-10-01

    Pancreatitis may be acute or chronic. Although both can be caused by similar aetiologies, they tend to follow distinct natural histories. Around 80% of acute pancreatitis (AP) diagnoses occur secondary to gallstone disease and alcohol misuse. AP is commonly associated with sudden onset of upper abdominal pain radiating to the back that is usually severe enough to warrant the patient seeking urgent medical attention. Onset of pain may be related to a recent alcohol binge or rich, fatty meal. The patient may appear unwell, be tachycardic and have exquisite tenderness in the upper abdomen. Overall, 10-25% of AP episodes are classified as severe, leading to an associated mortality rate of 7.5%. Disease severity is best predicted from a number of clinical scoring systems which can be applied at diagnosis in association with repeated clinical assessment, measurement of acute inflammatory markers, and CT. All patients with suspected AP should be referred urgently. Chronic pancreatitis (CP) follows continued, repetitive or sustained injury to the pancreas and 70% of diagnoses occur secondary to alcohol abuse. The characteristic presenting feature of CP is insidious progression of chronic, severe, upper abdominal pain, radiating to the back, caused by a combination of progressive pancreatic destruction, inflammation and duct obstruction. Signs and symptoms include weight loss and steatorrhoea and later on diabetes. CP patients may also present with recurrent episodes mimicking AP, both symptomatically and metabolically. Diagnosis of CP should be based on symptom profile, imaging and assessment of exocrine and endocrine pancreatic function. CT should be the first-line imaging investigation.

  10. Language lateralization shifts with learning by adults.

    Science.gov (United States)

    Plante, Elena; Almryde, Kyle; Patterson, Dianne K; Vance, Christopher J; Asbjørnsen, Arve E

    2015-05-01

    For the majority of the population, language is a left-hemisphere lateralized function. During childhood, a pattern of increasing left lateralization for language has been described in brain imaging studies, suggesting that this trait develops. This development could reflect change due to brain maturation or change due to skill acquisition, given that children acquire and refine language skills as they mature. We test the possibility that skill acquisition, independent of age-associated maturation can result in shifts in language lateralization in classic language cortex. We imaged adults exposed to an unfamiliar language during three successive fMRI scans. Participants were then asked to identify specific words embedded in Norwegian sentences. Exposure to these sentences, relative to complex tones, resulted in consistent activation in the left and right superior temporal gyrus. Activation in this region became increasingly left-lateralized with repeated exposure to the unfamiliar language. These results demonstrate that shifts in lateralization can be produced in the short term within a learning context, independent of maturation.

  11. Lateral laryngopharyngeal diverticulum: anatomical and videofluoroscopic study

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Milton Melciades Barbosa [Universidade Federal do Rio de Janeiro ICB/CCS/UFRJ, Laboratorio de Motilidade Digestiva e Imagem, S. F1-008, Departamento de Anatomia, Rio de Janeiro (Brazil); Koch, Hilton Augusto [Universidade Federal do Rio de Janeiro ICB/CCS/UFRJ, Departamento de Radiologia, Rio de Janeiro (Brazil)

    2005-07-01

    The aims were to characterize the anatomical region where the lateral laryngopharyngeal protrusion occurs and to define if this protrusion is a normal or a pathological entity. This protrusion was observed on frontal contrasted radiographs as an addition image on the upper portion of the laryngopharynx. We carried out a plane-by-plane qualitative anatomical study through macroscopic and mesoscopic surgical dissection on 12 pieces and analyzed through a videofluoroscopic method on frontal incidence the pharyngeal phase of the swallowing process of 33 patients who had a lateral laryngopharyngeal protrusion. The anatomical study allowed us to identify the morphological characteristics that configure the high portion of the piriform recess as a weak anatomical point. The videofluoroscopic study allowed us to observe the laryngopharyngeal protrusion and its relation to pharyngeal repletion of the contrast medium. All kinds of the observed protrusions could be classified as ''lateral laryngopharyngeal diverticula.'' The lateral diverticula were more frequent in older people. These lateral protrusions can be found on one or both sides, usually with a small volume, without sex or side prevalence. This formation is probably a sign of a pharyngeal transference difficulty associated with a deficient tissue resistance in the weak anatomical point of the high portion of the piriform recess. (orig.)

  12. Recommendations for Prevention of Physical Training (PT)-Related Injuries: Results of a Systematic Evidence-Based Review by the Joint Services Physical Training Injury Prevention Work Group (JSPTIPWG)

    Science.gov (United States)

    2003-10-01

    the use of forearm or elbow straps to prevent medial or lateral epicondylitis ( elbow tendonitis). Reasons for pursuing this theory and a summary of... epicondyles of the elbow . The expedited review of this intervention revealed that neither of these devices, or anything similar, has been tested in...sustaining lateral or medial epicondylitis or epicondylalgia ( elbow pain). 3. Recommendation. The JSPTIPWG cannot recommend for or against the

  13. Chronic Inflammatory Polyneuropathy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-02-01

    Full Text Available Thirteen children with chronic inflammatory demyelinating polyneuropathy monitored between 1975 and 2005 are reported from Centre hospitalier universitaire Sainte-Justine, Montreal, Canada.

  14. Pedestrian-induced lateral vibrations of footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór; Georgakis, Christos T.; Jönsson, Jeppe

    2012-01-01

    The earliest scientific descriptions of excessive pedestrian-induced lateral vibrations are dated back to the 1970s, but it was not until the beginning of the new millennium that bridge engineers fully comprehended the potential negative effect of pedestrian crowds on long-span footbridges....... Following the unexpected serviceability failures of Paris’ Solférino and London’s Millennium footbridges in 1999 and 2000, a new tract of research was initiated, focused on understanding the phenomenon which has become known as Synchronous Lateral Excitation (SLE). In this paper, a comprehensive review...... of studies related to pedestrian-induced lateral vibrations of footbridges is provided, primarily focusing on studies published within the last decade. Research in this field can generally be split into three categories; (i) fullscale testing of existing bridges subject to crowd loading, (ii) laboratory...

  15. Bucket foundations under lateral cyclic loading

    DEFF Research Database (Denmark)

    Foglia, Aligi

    -competitive in the energy market. This thesis addresses issues concerning monopod bucket foundations in the hope of providing tools and ideas that could be used to optimize the design of this sub-structure. The work is focussed on the behaviour of bucket foundations under lateral cyclic loading. Other related......To enable a prosperous development of offshore wind energy, economically feasible technologies must be developed. The monopod bucket foundation is likely to become a cost-effective sub-structure for offshore wind turbines and has the potential to make offshore wind more cost...... and propaedeutic topics, such as bucket foundations under transient lateral loading and under monotonic lateral loading, are also investigated. All the scientific work is fundamentally based on small-scale experimental tests of bucket foundations in dense water-saturated sand. The most important scientific...

  16. Anisotropic permeability in deterministic lateral displacement arrays

    CERN Document Server

    Vernekar, Rohan; Loutherback, Kevin; Morton, Keith; Inglis, David

    2016-01-01

    We investigate anisotropic permeability of microfluidic deterministic lateral displacement (DLD) arrays. A DLD array can achieve high-resolution bimodal size-based separation of micro-particles, including bioparticles such as cells. Correct operation requires that the fluid flow remains at a fixed angle with respect to the periodic obstacle array. We show via experiments and lattice-Boltzmann simulations that subtle array design features cause anisotropic permeability. The anisotropy, which indicates the array's intrinsic tendency to induce an undesired lateral pressure gradient, can lead to off-axis flows and therefore local changes in the critical separation size. Thus, particle trajectories can become unpredictable and the device useless for the desired separation duty. We show that for circular posts the rotated-square layout, unlike the parallelogram layout, does not suffer from anisotropy and is the preferred geometry. Furthermore, anisotropy becomes severe for arrays with unequal axial and lateral gaps...

  17. EAS thermal neutron lateral and temporal distributions

    CERN Document Server

    Stenkin, Yu V; Petrukhin, A A; Shchegolev, O B; Stepanov, V I; Volchenko, V I; Yashin, I I; Zadeba, E A

    2015-01-01

    A novel type of EAS array (PRISMA-32) has been constructed on the base of NEVOD-DECOR experiment (MEPhI,Moscow) and is now taking data. It consists of 32 specially designed scintillator en-detectors able to measure two main EAS components: hadrons (n) and electrons (e). First results on thermal neutron lateral as well as temporal distributions are presented. Obtained exponential neutron lateral distributions are consistent with that expected for normal hadron production with exponential transverse momentum distribution. As there are no other experimental data on thermal neutron distributions and so, to compare results with other measurements, we additionally obtained electron lateral distribution function (using the same detectors) and compared it with NKG - function. Recorded neutron temporal distributions are very close to that obtained with data of our previous prototypes.

  18. Lateral angle and cranial base sexual dimorphism

    DEFF Research Database (Denmark)

    Duquesnel Mana, Mathilde; Adalian, Pascal; Lynnerup, Niels

    2016-01-01

    SUMMARY: Previous studies have yielded very different results in sex estimation based on measurements of the lateral angle (LA) of the temporal bone. The purpose of this study was to, first, investigate if the bad results obtained by the LA method could be due to the methodology and then, second......, to examine sexual dimorphism in the relationship between the lateral angle and cranial base shape. The lateral angle method was tested using a forensic sample of 102 CT scans of the head with known sex. We measured the angle using two methods: measurements directly on the CT slide, the method usually applied......, and by use of a new method, using a "virtual cast". The cranial base was quantified by placing 12 landmarks in the posterior fossa. Procrustes analysis, principal component analysis, discriminant analysis and cross-validation test were performed. The "cast method" was found to be less accurate than...

  19. Pedestrian-induced lateral forces on footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór; Georgakis, Christos T.; Jönsson, Jeppe

    2011-01-01

    This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration of the unde......This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration...

  20. Pedestrian-induced lateral forces on footbridges

    DEFF Research Database (Denmark)

    Ingolfsson, Einar Thor; Georgakis, Christos T.; Jönsson, Jeppe

    2012-01-01

    This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration of the unde......This paper investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. The vibrations are a consequence of human-structure interaction, in which the forces generated by the pedestrians depend strongly on the vibration...

  1. Reversible transinsular herniation of the lateral ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Holodny, Andrei I. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States); Memorial Sloan Kettering Cancer Center, The Department of Radiology, New York, NY (United States); Gor, Devang M.; Thaver, Hussain; Millian, Brian R. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States)

    2004-11-01

    We present a 7-year-old boy, with a history of neonatal intraventricular hemorrhage, leading to hydrocephalus with multiple shunt revisions. The current presentation of shunt failure and resultant hydrocephalus was complicated by herniation of the trigone of the lateral ventricle into the posterior fossa. Despite the dramatic radiological appearance, this herniation of the lateral ventricle was not accompanied by any additional clinical signs or symptoms other than those usually attributed to hydrocephalus. Following successful shunt revision, the patient returned to his baseline clinically with the trigone reverting back to its normal position. We also present a second companion case. (orig.)

  2. Amyotrophic Lateral Sclerosis: A Historical Perspective.

    Science.gov (United States)

    Katz, Jonathan S; Dimachkie, Mazen M; Barohn, Richard J

    2015-11-01

    This article looks back in time to see where the foundational basis for the understanding of amyotrophic lateral sclerosis originated. This foundation was created primarily in France by Jean-Martin Charcot and his fellow countrymen and disciples, along with key contributions from early clinicians in England and Germany. The early work on amyotrophic lateral sclerosis provides a useful foundation for today's clinicians with respect to tying together genetic and biologic aspects of the disorder that have been discovered over the past few decades.

  3. Dermatomal sensory manifestations in lateral medullary infarction.

    Science.gov (United States)

    Hongo, Hiroki; Tanaka, Yasutaka; Shimada, Yoshiaki; Tanaka, Ryota; Hattori, Nobutaka; Urabe, Takao

    2014-01-01

    A 61-year-old man who experienced a sudden onset of unstable gait followed by nuchal pain was admitted to our department. The neurologic examination revealed right-sided limb ataxia, right partial ptosis, and decreased sensation to 50% of the normal side to pinprick and temperature stimuli on the left side below the level of the T-6 dermatome. A lateral medullary infarction caused by spontaneous vertebral artery dissection was diagnosed by magnetic resonance imaging and computed tomography angiography. In conclusion, lateral medullary infarction is an important entity to consider in the differential diagnosis of dermatomal sensory manifestations.

  4. Tonoplast aquaporins facilitate lateral root emergence

    DEFF Research Database (Denmark)

    Reinhardt, Hagen; Hachez, Charles; Bienert, Manuela Désirée

    2016-01-01

    that, in Arabidopsis (Arabidopsis thaliana), the highly abundant tonoplast AQP isoforms AtTIP1;1, AtTIP1;2, and AtTIP2;1 facilitate the emergence of new lateral root primordia (LRPs). The number of lateral roots was strongly reduced in the triple tip mutant, whereas the single, double, and triple tip...... could be fully rescued by expressing AtTIP2;1 under its native promoter. We conclude that TIP isoforms allow the spatial and temporal fine-tuning of cellular water transport, which is critically required during the highly regulated process of LRP morphogenesis and emergence....

  5. Coronaire hartziekten, steeds later en vaker chronisch

    NARCIS (Netherlands)

    Koopman, Carla; Bots, Michiel L.; Van Dis, Ineke; Vaartjes, Ilonca

    2015-01-01

    Background To identify ageand genderspecific trends in hospital admissions due to acute myocardial infarction, unstable angina and chronic coronary heart disease in the Netherlands between 1998 and 2007. Design Recordlinkage cohort study. Method By linking data from the population register to the na

  6. Coping with Chronic Illness

    Science.gov (United States)

    Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

  7. Chronic Postoperative Roseomonas Endophthalmitis▿

    OpenAIRE

    Chen, Kuan-Jen; Lai, Chi-Chun; Kuo, Ya-Hui; WU, WEI-CHI; CHEN, TUN-LU

    2008-01-01

    We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

  8. Chronic postoperative Roseomonas endophthalmitis.

    Science.gov (United States)

    Chen, Kuan-Jen; Lai, Chi-Chun; Kuo, Ya-Hui; Wu, Wei-Chi; Chen, Tun-Lu

    2009-01-01

    We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

  9. Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall

    OpenAIRE

    Morad, Y.; KOWAL, L.; Scott, A B

    2005-01-01

    Background/aims: Surgical correction of ocular alignment in patients with third cranial nerve paralysis is challenging, as the unopposed lateral rectus muscle often pulls the eye back to exotropia following surgery. The authors present a simple surgical approach to overcome this difficulty. This approach is also applicable to removal of unwanted overactivity of the lateral rectus in Duane syndrome.

  10. Traces of disease in amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Verstraete, E.

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive disease of the motor system involving both upper motor neurons in the brain and lower motor neurons in the spinal cord. Patients suffer from progressive wasting and weakness of limb, bulbar and respiratory muscles. Onset and disease course in ALS

  11. [Upper lateral incisor with 2 canals].

    Science.gov (United States)

    Fabra Campos, H

    1991-01-01

    Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum.

  12. Laterality and Directional Preferences in Preschool Children.

    Science.gov (United States)

    Tan, Lesley E.

    1982-01-01

    Directional preference for horizontal hand movements was investigated in 49 right- and 49 left-handed four-year-olds using three drawing tests. Directionality for more complex perceptual-motor tasks has a different basis than directionality for simple tasks; such directionality is established at a later age but only for the right hand. (Author/CM)

  13. Motorcycle state estimation for lateral dynamics

    NARCIS (Netherlands)

    Teerhuis, A.P.; Jansen, S.T.H.

    2012-01-01

    The motorcycle lean (or roll) angle development is one of the main characteristics of motorcycle lateral dynamics. Control of motorcycle motions requires an accurate assessment of this quantity and for safety applications also the risk of sliding needs to be considered. Direct measurement of the rol

  14. Lateral junction dynamics lead the way out.

    Science.gov (United States)

    Behrndt, Martin; Heisenberg, Carl-Philipp

    2014-02-01

    Epithelial cell layers need to be tightly regulated to maintain their integrity and correct function. Cell integration into epithelial sheets is now shown to depend on the N-WASP-regulated stabilization of cortical F-actin, which generates distinct patterns of apical-lateral contractility at E-cadherin-based cell-cell junctions.

  15. Sweet food preference in amyotrophic lateral sclerosis

    OpenAIRE

    Turner, M; Talbot, K

    2017-01-01

    An elderly female developed anarthria with prominent emotionality over an 18 month period prior to specialist neurological assessment. Although tongue electromyography (EMG) was normal, corticobulbar signs were consistent with amyotrophic lateral sclerosis (ALS), a pattern which in the absence of functional impairment outside of speech and swallowing, is appropriately termed progressive bulbar palsy

  16. Quantifying lateral tissue heterogeneities in hadron therapy.

    Science.gov (United States)

    Pflugfelder, D; Wilkens, J J; Szymanowski, H; Oelfke, U

    2007-04-01

    In radiotherapy with scanned particle beams, tissue heterogeneities lateral to the beam direction are problematic in two ways: they pose a challenge to dose calculation algorithms, and they lead to a high sensitivity to setup errors. In order to quantify and avoid these problems, a heterogeneity number H(i) as a method to quantify lateral tissue heterogeneities of single beam spot i is introduced. To evaluate this new concept, two kinds of potential errors were investigated for single beam spots: First, the dose calculation error has been obtained by comparing the dose distribution computed by a simple pencil beam algorithm to more accurate Monte Carlo simulations. The resulting error is clearly correlated with H(i). Second, the analysis of the sensitivity to setup errors of single beam spots also showed a dependence on H(i). From this data it is concluded that H(i) can be used as a criterion to assess the risks of a compromised delivered dose due to lateral tissue heterogeneities. Furthermore, a method how to incorporate this information into the inverse planning process for intensity modulated proton therapy is presented. By suppressing beam spots with a high value of H(i), the unfavorable impact of lateral tissue heterogeneities can be reduced, leading to treatment plans which are more robust to dose calculation errors of the pencil beam algorithm. Additional possibilities to use the information of H(i) are outlined in the discussion.

  17. Lateral Transpsoas Fusion: Indications and Outcomes

    Directory of Open Access Journals (Sweden)

    Vishal C. Patel

    2012-01-01

    Full Text Available Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common method to achieve fusion. Recent literature on this approach has elucidated its advantage over more traditional anterior and posterior approaches, which include a smaller tissue dissection, potentially lower blood loss, no need for an access surgeon, and a shorter hospital stay. Indications for the procedure have now expanded to include degenerative disc disease, spinal stenosis, degenerative scoliosis, nonunion, trauma, infection, and low-grade spondylolisthesis. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Additional studies are required to further evaluate and monitor the short- and long-term safety, efficacy, outcomes, and complications of lateral transpsoas procedures.

  18. Eye and head turning indicates cerebral lateralization.

    Science.gov (United States)

    Kinsbourne, M

    1972-05-05

    When solving verbal problems, right-handed people usually turn head and eyes to the right, whereas with numerical and spatial problems, these people look up and left. Left-handed people differ in all these respects. The results suggest that the direction in which people look while thinking reflects the lateralization of the underlying cerebral activity.

  19. Lateral pressure profiles in lipid monolayers

    NARCIS (Netherlands)

    Baoukina, Svetlana; Marrink, Siewert J.; Tieleman, D. Peter

    2010-01-01

    We have used molecular dynamics simulations with coarse-grained and atomistic models to study the lateral pressure profiles in lipid monolayers. We first consider simple oil/air and oil/water interfaces, and then proceed to lipid monolayers at air/water and oil/water interfaces. The results are qual

  20. Lateral Eye Movement Behavior in Children.

    Science.gov (United States)

    Reynolds, Cecil R.; Kaufman, Alan S.

    1980-01-01

    The conjugate lateral eye movement phenomenon was investigated for 52 children aged 2 through 10 using both spatial and verbal-analytic questions. The phenomenon was observed in 50 subjects and appeared well-established by age 3 1/2. Some interesting developmental findings and discrepancies with the results of adult studies are noted. (Author/SJL)

  1. Liponeurocytoma of the Left Lateral Ventricle

    Directory of Open Access Journals (Sweden)

    Ahmet BEKAR

    2009-09-01

    Full Text Available Liponeurocytoma has been recognized recently as a distinct clinicopathological entity by the World Health Organization. Although there are few cases described in the literature it has been accepted as a benign lesion. Here we present a 55-year-old woman with a supratentorial intraventricular liponeurocytoma of the left lateral ventricle.

  2. MEPHISTO spectromicroscope reaches 20 nm lateral resolution

    Science.gov (United States)

    De Stasio, Gelsomina; Perfetti, Luca; Gilbert, B.; Fauchoux, O.; Capozi, M.; Perfetti, P.; Margaritondo, G.; Tonner, B. P.

    1999-03-01

    The recently described tests of the synchrotron imaging photoelectron spectromicroscope MEPHISTO (Microscope à Emission de PHotoélectrons par Illumination Synchrotronique de Type Onduleur) were complemented by further resolution improvements and tests, which brought the lateral resolution down to 20 nm. Images and line plot profiles demonstrate such performance.

  3. Service differentiation through selective lateral transshipments

    NARCIS (Netherlands)

    Alvarez, E.M.; Heijden, van der M.C.; Vliegen, I.M.H.; Zijm, W.H.M.

    2014-01-01

    We consider a multi-item spare parts problem with multiple warehouses and two customer classes, where lateral transshipments are used as a differentiation tool. Specifically, premium requests that cannot be met from stock at their preferred warehouse may be satisfied from stock at other warehouses (

  4. iPS Cells 10 Years Later.

    Science.gov (United States)

    2016-09-08

    In 2006, Takahashi and Yamanaka reported the breakthrough discovery of induction of pluripotent stem cells from fibroblasts by a combination of defined factors. Ten years later, Cell editor João Monteiro brings together Shinya Yamanaka and Hans Schöler, one the original reviewers of the landmark study, to revisit the history behind the paper and its long-lasting legacy.

  5. Clinical psychology and amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Francesco Pagnini

    2010-07-01

    Full Text Available Amyotrophic Lateral Sclerosis is a fatal and progressive disease, characterized by progressive muscles weakness, with consequent loss of physical capacities. Psychologists can play an important role in ALS care, by providing clinical activities in every step of the disease, including support and counseling activities directed to patients, their caregivers and to physicians.

  6. [Chronic pancreatitis, acute pancreatitis].

    Science.gov (United States)

    Mabuchi, T; Katada, N; Nishimura, D; Hoshino, H; Shimizu, F; Suzuki, R; Sano, H; Kato, K

    1998-11-01

    MRCP has been recognized as a safe and noninvasive diagnostic method. In the present study we evaluated the usefulness of MRCP in diagnosis of chronic and acute pancreatitis. Two-dimensional fast asymmetric spin-echo (FASE) MRCP was performed in 40 patients with chronic pancreatitis and 13 with acute pancreatitis. In 29 patients (72.5%) with chronic pancreatitis and 9 (66.7%) with acute pancreatitis, main pancreatic duct (MPD) was visualized entirely. MRCP could demonstrate the characteristic findings of chronic pancreatitis such as dilatation and irregularity of MPD in most cases. In acute pancreatitis, MRCP indicated that MPD was normal in diameter, but irregular in configuration compared with that of the control group. MRCP may facilitate the diagnosis of chronic and acute pancreatitis.

  7. The Chronic Responsibility

    DEFF Research Database (Denmark)

    Ravn, Iben M; Frederiksen, Kirsten; Beedholm, Kirsten

    2016-01-01

    This article reports on the results of a Fairclough-inspired critical discourse analysis aiming to clarify how chronically ill patients are presented in contemporary Danish chronic care policies. Drawing on Fairclough’s three-dimensional framework for analyzing discourse, and using Dean’s concepts...... of governmentality as an interpretative lens, we analyzed and explained six policies published by the Danish Health and Medicines Authority between 2005 and 2013. The analysis revealed that discourses within the policy vision of chronic care consider chronically ill patients’ active role, lifestyle, and health...... behavior to be the main factors influencing susceptibility to chronic diseases. We argue that this discursive construction naturalizes a division between people who can actively manage responsible self-care and those who cannot. Such discourses may serve the interests of those patients who are already...

  8. Chronic gastritis - an update.

    Science.gov (United States)

    Varbanova, Mariya; Frauenschläger, Katrin; Malfertheiner, Peter

    2014-12-01

    Helicobacter pylori is the main aetiologic factor for chronic gastritis worldwide. The degree of inflammation and the evolution of this form of chronic gastritis can vary largely depending on bacterial virulence factors, host susceptibility factors and environmental conditions. Autoimmune gastritis is another cause of chronic inflammation in the stomach, which can occur in all age groups. This disease presents typically with vitamin B12 deficiency and pernicious anaemia. The presence of anti-parietal cell antibodies is highly specific for the diagnosis. The role of H. pylori as a trigger for autoimmune gastritis remains uncertain. Other rare conditions for chronic gastritis are chronic inflammatory conditions such as Crohn's disease or on the background of lymphocytic or collagenous gastroenteropathies.

  9. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...... from which he eventually died. The glomerulonephritis was of unknown origin, and a possible relationship between CGD and glomerulonephritis is discussed....

  10. What Is Chronic Myeloid Leukemia?

    Science.gov (United States)

    ... Chronic Myeloid Leukemia (CML) About Chronic Myeloid Leukemia What Is Chronic Myeloid Leukemia? Cancer starts when cells ... their treatment is the same as for adults. What is leukemia? Leukemia is a cancer that starts ...

  11. What Is Chronic Lymphocytic Leukemia?

    Science.gov (United States)

    ... Chronic Lymphocytic Leukemia (CLL) About Chronic Lymphocytic Leukemia What Is Chronic Lymphocytic Leukemia? Cancer starts when cells ... body, including the lymph nodes, liver, and spleen. What is leukemia? Leukemia is a cancer that starts ...

  12. Lateral organic photodetectors for imaging applications

    Science.gov (United States)

    Shafique, Umar; Karim, Karim S.

    2011-03-01

    Organic semiconductor detectors have always been in active research interest of researchers due to its low fabrication cost. Vertical organic detectors have been studied in the past but not much of the works have been done on lateral organic detectors. The lateral design has an advantage over the vertical design that it is easy to fabricate and can be easily integrated with the backplane TFT imager circuit. Integrating an organic photodetectors with TFT imager can improve the over all sensitivity of the imager. However the lateral design limits the fill-factor. Here in our work we propose a new bilayered lateral organic photodetectors with Copper-Phthalocyanine (CUPC) as top and Perylene- Tetracarboxylic Bis- Benzimidazole (PTCBI) as the bottom layer organic material. The bottom organic semiconductor layer work as both, charge transport layer and photon absorption layer. The top and bottom layer provides and heterojunction a potential gradient enough to separate the photo generated excitons in to electrons and holes. The incident photons are absorbed in the two layers active layers giving an exciton. These excitons see a potential barrier at the CUPC-PTCBI heterojunction and separated into holes and electrons. The separated electrons are directed by the external applied electric field and thus give a increase in photocurrent. Lateral organic photodetectors are simple to design and have low dark current. The photo-response of these photo detectors is observed approximately three orders higher in magnitude compare able to its dark response. The dual layer has an advantage of tuning the devices for different absorption wavelengths and were observed more stable comparable to vertical devices.

  13. [Importance of artificial nutrition in the resolution and etiologic diagnosis of severe chronic diarrhea: a propos of a case].

    Science.gov (United States)

    Arrieta, F J; Gómez, F J; Aragón, C; Rueda, A; Balsa, J A; Zamarrón, I; Carrero, C; Botella Carretero, J I; Montalbán, C; Vázquez, C

    2008-01-01

    We present a case of severe chronic diarrhea requiring parenteral nutritional support to both cover the nutritional needs and allow for intestinal rest for later adaptation to enteral nutrition, altogether allowing for the etiologic diagnosis and disease healing.

  14. Measuring acetabular component position on lateral radiographs - ischio-lateral method.

    Science.gov (United States)

    Pulos, Nicholas; Tiberi Iii, John V; Schmalzried, Thomas P

    2011-01-01

    The standard method for the evaluation of arthritis and postoperative assessment of arthroplasty treatment is observation and measurement from plain films, using the flm edge for orientation. A more recent employment of an anatomical landmark, the ischial tuberosity, has come into use as orientation for evaluation and is called the ischio-lateral method. In this study, the use of this method was evaluated as a first report to the literature on acetabular component measurement using a skeletal reference with lateral radiographs. Postoperative radiographs of 52 hips, with at least three true lateral radiographs taken at different time periods, were analyzed. Component position was measured with the historical method (using the flm edge for orientation) and with the new method using the ischio-lateral method. The mean standard deviation (SD) for the historical approach was 3.7° and for the ischio-lateral method, 2.2° (p historical method, 19 (36.5%) hips had a SD greater than ± 4°, compared to six hips (11.5%) with the ischio-lateral method. By using a skeletal reference, the ischio-lateral method provides a more consistent measurement of acetabular component position. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicate that the angle measured with this simple method, which employs no further technology, increased time, or cost, is consistent and reproducible for multiple observers.

  15. 克氏针和拉力螺钉治疗儿童肱骨内上髁骨折疗效比较%Comparison of Kirschner Wire and Lag Screw in the Treatment of Medial Humeral Epicondyle Fracture in Children

    Institute of Scientific and Technical Information of China (English)

    宫伟; 李炳钻; 王建嗣; 钟黎娟; 蔡秀英

    2012-01-01

    目的:比较克氏针和拉力螺钉内固定治疗儿童肱骨内上髁骨折的临床疗效.方法:回顾分析2002年6月-2009年12月手术治疗的儿童肱骨内上髁骨折78例,克氏针组38例,均采用切开复位两枚克氏针内固定,3~4周去石膏托后开始肘关节功能锻炼;拉力螺钉组40例,均采用切开复位1枚拉力螺钉内固定,2周去石膏托后开始肘关节功能锻炼.结果:参照Mayo肘关节功能评分系统,术后3个月对肘关节功能进行评价.克氏针组:优23例,良7例,可6例,差2例,优良率为78.9%;拉力螺钉组:优30例,良8例,可2例,差0例,优良率为95.0%.2组比较差异有统计学意义(P<0.05),拉力螺钉组疗效明显优于克氏针组.结论:切开复位、拉力螺钉内固定结合早期功能锻炼治疗儿童肱骨内上髁骨折,能在较短时间内使患儿肘关节功能得到最大程度的恢复.%Objective: To comprise the clinical effect of Kirschner wire and lag screw internal fixation for treating medial humeral epicondyle fracture in children. Methods:We retrospectively analyzed 78 children with the medial humeral epicondyle fracture who were treated in Quanzhou osteopathy hospital from June 2002 to December 2009. The patients in Kirschner wire group (n=38) were treated by open reduction and two Kirschner wire internal fixation, eibow joint functional exercise should be conducted after 3 to 4 weeks when plaster was removed. The patients in lag screw group (n=40) were treated by open reduction and one lag screw internal fixation, elbow joint functional exercise should be conducted after 2 weeks when plaster was removed. Results: The functional of elbow joint were assessed three months after surgery according to Mayo system. There were 23 cases as excellent, 8 cases as good, 6 cases as fair, and 2 cases as poor in Kirschner wire group. And there were 30 cases as excellent, 8 cases as good, 2 cases as fair, and no cases as poor in lag screw group. The excellent

  16. 体外冲击波与小针刀疗法治疗肱骨内上髁炎疗效比较%Comparative study of extracorporeal shock wave therapy and small-needle-knife therapy in treating medial epicondylitis

    Institute of Scientific and Technical Information of China (English)

    云文科; 葛茂林; 曹磊光; 王剑; 宝音; 白杰; 任喜存

    2015-01-01

    目的:比较体外冲击波疗法及小针刀疗法治疗肱骨内上髁炎的效果。方法肱骨内上髁炎80例被随机分成两组,每组40例,分别行体外冲击波治疗和小针刀治疗,计算并比较两组术前及术后的VAS疼痛评分、HSS肘关节功能评分。结果小针刀及体外冲击波疗法均能明显缓解肱骨内上髁炎患者肘关节的疼痛,两组治疗后VAS评分均低于治疗前,差异有统计学意义(P<0.01);体外冲击波组治疗后VAS评分低于小针刀组治疗后[(1.07±0.66) vs (2.24±0.75)],差异有统计学意义(P<0.01)。两组治疗后HSS评分均高于治疗前,差异有统计学意义(P<0.01);体外冲击波组治疗后HSS评分高于小针刀组治疗后[(92.06±8.07) vs (83.71±7.65)],差异有统计学意义(P<0.01)。结论在治疗肱骨内上髁炎疼痛和恢复功能方面,体外冲击波疗法比小针刀效果更明显。%Objective To discuss and compare the effect of extracorporeal shock wave therapy and small needle knife therapy in the treatment of medial epicondylitis .Methods Eighly patients with medial epicondylitis were divided into two groups randomly ,the extracorporeal shock wave therapy group (ESWT) and the small needle knife therapy group (SNKT).The visual analog scale ( VAS) score, function and overall rating were compared before and after the treatment between the two groups .Results Both therapy relieved pain significantly, the VAS scores in the two groups declined to (2.24 ±0.75) and (1.07 ±0.66)(P<0.01),respectively after treatment.The HSS scores recoverd to (83.71 ±7.65) and (92.06 ±8.07), respectively, the functions of both elbows recovered sig-nificantly(P<0.01) compared with the condition of pre-treatment.The the rapy in ESWT group was more effective than in the SNKT group(P<0.01)in pain and function.Conclusions Both extracorporeal shock wave and the small needle knife therapy can

  17. Chronic hypersensitivity pneumonitis

    Science.gov (United States)

    Pereira, Carlos AC; Gimenez, Andréa; Kuranishi, Lilian; Storrer, Karin

    2016-01-01

    Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary. PMID:27703382

  18. Lateral cephalometric radiograph versus lateral nasopharyngeal radiograph for quantitative evaluation of nasopharyngeal airway space

    Directory of Open Access Journals (Sweden)

    Suelen Cristina da Costa Pereira

    2014-08-01

    Full Text Available OBJECTIVE: This study compared lateral radiographs of the nasopharynx (LN and lateral cephalometric radiographs (LC used to assess nasopharyngeal airway space in children. MATERIAL AND METHODS: One examiner measured the nasopharyngeal space of 15 oral breathing patients aged between 5 and 11 years old by using LN and LC. Both assessments were made twice with a 15-day interval in between. Intergroup comparison was performed with t-tests (P < 0.05. RESULTS: Comparison between LN and LC measurements showed no significant differences. CONCLUSION: Lateral cephalometric radiograph is an acceptable method used to assess nasopharyngeal airway space.

  19. Early Taste Experiences and Later Food Choices

    Directory of Open Access Journals (Sweden)

    Valentina De Cosmi

    2017-02-01

    Full Text Available Background. Nutrition in early life is increasingly considered to be an important factor influencing later health. Food preferences are formed in infancy, are tracked into childhood and beyond, and complementary feeding practices are crucial to prevent obesity later in life. Methods. Through a literature search strategy, we have investigated the role of breastfeeding, of complementary feeding, and the parental and sociocultural factors which contribute to set food preferences early in life. Results. Children are predisposed to prefer high-energy, -sugar, and -salt foods, and in pre-school age to reject new foods (food neophobia. While genetically determined individual differences exist, repeated offering of foods can modify innate preferences. Conclusions. Starting in the prenatal period, a varied exposure through amniotic fluid and repeated experiences with novel flavors during breastfeeding and complementary feeding increase children’s willingness to try new foods within a positive social environment.

  20. Motorcycle state estimation for lateral dynamics

    Science.gov (United States)

    Teerhuis, A. P.; Jansen, S. T. H.

    2012-08-01

    The motorcycle lean (or roll) angle development is one of the main characteristics of motorcycle lateral dynamics. Control of motorcycle motions requires an accurate assessment of this quantity and for safety applications also the risk of sliding needs to be considered. Direct measurement of the roll angle and tyre slip is not available; therefore, a method of model-based estimation is developed to estimate the state of a motorcycle. This paper investigates the feasibility of such a motorcycle state estimator (MCSE). A simplified analytic model of a motorcycle is developed by comparison to an extended multi-body model of the motorcycle, designed in Matlab/SimMechanics. The analytic model is used inside an extended Kalman filter. Experimental results of an instrumented Yamaha FJR1300 motorcycle show that the MCSE is a feasible concept for obtaining signals related to the lateral dynamics of the motorcycle.

  1. Pedestrian-induced lateral vibrations of footbridges

    DEFF Research Database (Denmark)

    Ingólfsson, Einar Thór

    The dissertation investigates the phenomenon of excessive pedestrian-induced lateral vibrations as observed on several high-profile footbridges. In particular, the temporary closures of both Paris’ Solferino Bridge (1999) and the London Millennium Bridge (2000) have led to an understanding...... on the part of engineers and architects of the need to evaluate the potential for footbridge vibrations that can be attributed to pedestrians. Within the scientific community, the closures have also led to the initiation of a new tract of research, focused on the understanding of pedestrian loading, bridge...... is presented, solely focused on pedestrianinduced lateral forces, their effect on footbridges and existing theoretical models of humanstructure interaction. It is shown that different hypotheses exist about the nature of this interaction, many of which are only supported by theoretical modelling and lack...

  2. Customized MFM probes with high lateral resolution

    Directory of Open Access Journals (Sweden)

    Óscar Iglesias-Freire

    2016-07-01

    Full Text Available Magnetic force microscopy (MFM is a widely used technique for magnetic imaging. Besides its advantages such as the high spatial resolution and the easy use in the characterization of relevant applied materials, the main handicaps of the technique are the lack of control over the tip stray field and poor lateral resolution when working under standard conditions. In this work, we present a convenient route to prepare high-performance MFM probes with sub-10 nm (sub-25 nm topographic (magnetic lateral resolution by following an easy and quick low-cost approach. This allows one to not only customize the tip stray field, avoiding tip-induced changes in the sample magnetization, but also to optimize MFM imaging in vacuum (or liquid media by choosing tips mounted on hard (or soft cantilevers, a technology that is currently not available on the market.

  3. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Directory of Open Access Journals (Sweden)

    Angélica Castro Pimentel

    2016-01-01

    Full Text Available Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics.

  4. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Science.gov (United States)

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  5. LATERAL SINUS THROMBOSIS IN OTOLOGY: A REVIEW

    Directory of Open Access Journals (Sweden)

    B Visavanatha

    2010-09-01

    Full Text Available Lateral sinus thrombosis (LST is usually occurs as a complication of middle ear infection .The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days .The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.

  6. Reflection tomography in laterally varying media

    Energy Technology Data Exchange (ETDEWEB)

    Carrion, Phillip M.; Boehm, Gualtiero; Vesnaver, Aldo

    1993-12-31

    In this paper, we will discuss a separate reconstruction of lateral velocity gradients and reflection interfaces using the method of reflection tomography. We will be limited by inversion of traveltimes. As it is known such inversion may suffer from a significant drawback: ambiguity. This ambiguity is referred to as depth/velocity ambiguity which is especially notable in the case of non-vertical angles of propagation. In tomographic experiments this ambiguity is suppressed by finite angular aperture. The next problem is non-uniqueness. It will be shown that the lateral gradients of velocity and the depths to the reflection points can be uniquely recovered from surface seismic data in the reflection tomography experiments. Reflection data inversion is done via an optimization process which can be formulated either in the physical space of seismic velocities or in the dual space of Lagrangian multipliers. We compare both methods and show the advantages of the dual transform. (author). 4 refs., 8 figs

  7. Later Wittgenstein and the Philosophy of Religion

    DEFF Research Database (Denmark)

    Hansen, Stig Børsen

    2010-01-01

    This article sets out by distinguishing Wittgenstein’s own views in the philosophy of religion from a school of thought in the philosophy of religion that relies on later Wittgenstein’s philosophy of language. After a survey of distinguishing features of Wittgenstein’s later philosophy, the third...... section explores Wittgenstein’s treatment of Frazer’s account of magic among primitive peoples. The following section offers an account of Wittgensteinian philosophy of religion, including the use of the notions of a language game and superstition. I conclude by criticizing a very influential argument...... of Wittgenstein’s to the effect that the meaning of words like ‘belief’ and ‘object’ varies from context to context without having any one thing in common....

  8. The management of amyotrophic lateral sclerosis.

    LENUS (Irish Health Repository)

    Phukan, Julie

    2009-02-01

    The terms amyotrophic lateral sclerosis (ALS) or motor neuron disease (MND) refer to a condition characterized by motor system degeneration with relative preservation of other pathways. Although there have been advances in symptomatic treatment, ALS remains an incurable condition. Advances in ALS management prolong survival but simultaneously raise challenging ethical dilemmas for physicians, patients and their families. Here, we review current practice in the management of ALS including pharmacological treatment, nutritional management, respiratory care, and evolving strategies in the management of cognitive impairment.

  9. Lateral force transmission between human tendon fascicles

    DEFF Research Database (Denmark)

    Haraldsson, Bjarki T; Aagaard, Per; Qvortrup, Klaus

    2008-01-01

    Whether adjacent collagen fascicles transmit force in parallel is unknown. The purpose of the present study was to examine the magnitude of lateral force transmission between adjacent collagen fascicles from the human patellar and Achilles tendon. From each sample two adjacent strands of fascicles...... adjacent collagen fascicles in human tendons is small or negligible, suggesting that tendon fascicles largely act as independent structures and that force transmission principally takes place within the individual fascicles....

  10. Tonoplast Aquaporins Facilitate Lateral Root Emergence.

    Science.gov (United States)

    Reinhardt, Hagen; Hachez, Charles; Bienert, Manuela Désirée; Beebo, Azeez; Swarup, Kamal; Voß, Ute; Bouhidel, Karim; Frigerio, Lorenzo; Schjoerring, Jan K; Bennett, Malcolm J; Chaumont, Francois

    2016-03-01

    Aquaporins (AQPs) are water channels allowing fast and passive diffusion of water across cell membranes. It was hypothesized that AQPs contribute to cell elongation processes by allowing water influx across the plasma membrane and the tonoplast to maintain adequate turgor pressure. Here, we report that, in Arabidopsis (Arabidopsis thaliana), the highly abundant tonoplast AQP isoforms AtTIP1;1, AtTIP1;2, and AtTIP2;1 facilitate the emergence of new lateral root primordia (LRPs). The number of lateral roots was strongly reduced in the triple tip mutant, whereas the single, double, and triple tip mutants showed no or minor reduction in growth of the main root. This phenotype was due to the retardation of LRP emergence. Live cell imaging revealed that tight spatiotemporal control of TIP abundance in the tonoplast of the different LRP cells is pivotal to mediating this developmental process. While lateral root emergence is correlated to a reduction of AtTIP1;1 and AtTIP1;2 protein levels in LRPs, expression of AtTIP2;1 is specifically needed in a restricted cell population at the base, then later at the flanks, of developing LRPs. Interestingly, the LRP emergence phenotype of the triple tip mutants could be fully rescued by expressing AtTIP2;1 under its native promoter. We conclude that TIP isoforms allow the spatial and temporal fine-tuning of cellular water transport, which is critically required during the highly regulated process of LRP morphogenesis and emergence.

  11. Lateral Modes in Quantum Cascade Lasers

    Directory of Open Access Journals (Sweden)

    Gregory C. Dente

    2016-03-01

    Full Text Available We will examine the waveguide mode losses in ridge-guided quantum cascade lasers. Our analysis illustrates how the low-loss mode for broad-ridge quantum cascade lasers (QCLs can be a higher-order lateral waveguide mode that maximizes the feedback from the sloped ridge-wall regions. The results are in excellent agreement with the near- and far-field data taken on broad-ridge-guided quantum cascade lasers processed with sloped ridge walls.

  12. Lateral elbow tendinopathy: Evidence of physiotherapy management

    OpenAIRE

    2016-01-01

    Lateral elbow tendinopathy (LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, ext...

  13. Clinical neurorestorative progress in amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Chen L

    2015-08-01

    Full Text Available Lin Chen,1,2,5 Hongyun Huang,3 Haitao Xi,4,5 Gengsheng Mao3 1Medical Center, Tsinghua University, 2Tsinghua University Yuquan Hospital, 3General Hospital of Chinese People's Armed Police Forces, 4Beijing Rehabilitation Hospital of Capital Medical University, 5Beijing Hongtianji Neuroscience Academy, Beijing, People’s Republic of China Abstract: Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease characterized by progressive paralysis and motor neuron death. In addition to symptomatic managements such as ventilation and nutritional support, neurorestorative therapies have demonstrated anti-neurodegenerative potential and may improve quality of life for patients. Currently, clinical neurorestorative strategies include pharmacological management (granulocyte colony stimulating factor, neuromodulatory intervention (repetitive transcranial magnetic and cortical stimulation, cell transplantation (bone marrow stromal cells, olfactory ensheathing cells, granulocyte colony stimulating factor-mobilized peripheral blood stromal cells, hematopoietic stem and progenitor cells, neural stem/progenitor cells, CD133+ cells and CD34+ cells, bioengineering and tissue engineering therapy, and combined neurorehabilitative treatment. In this review, we describe the latest progress in clinical neurorestorative management of amyotrophic lateral sclerosis and discuss the underlying evidence base. Keywords: amyotrophic lateral sclerosis, neurorestorative treatment, cell transplantation, clinical trial

  14. Chronic Fatigue Syndrome

    Science.gov (United States)

    Chronic fatigue syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that ... activities. The main symptom of CFS is severe fatigue that lasts for 6 months or more. You ...

  15. Chronic Kidney Disease

    Science.gov (United States)

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  16. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  17. Chronic Condition Data Warehouse

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Condition Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across...

  18. Zabofloxacin for chronic bronchitis.

    Science.gov (United States)

    Kocsis, B; Szabo, D

    2016-09-01

    Treatment of lower respiratory tract infection poses as an ongoing challenge among respiratory tract diseases. Bacterial infections are causes of acute exacerbations in chronic bronchitis and indications for antibacterial therapy. Several antibiotics were applied to treat bacterial infections in chronic bronchitis, among them fluoroquinolones are considered potent, broad-spectrum agents with excellent tissue penetration. This monograph focuses on zabofloxacin, a novel fluoroquinolone agent recently approved and launched in South Korea, and summarizes the drug's antibacterial efficacy, pharmacokinetic properties and toxicity. Recent advances concerning fluoroquinolones in chronic bronchitis will be discussed, along with a comparison between zabofloxacin and moxifloxacin. Zabofloxacin has proved to be noninferior to moxifloxacin against major community-acquired Gram-positive and Gram-negative respiratory tract pathogens and found to be well tolerated in both oral and parenteral administrations. These features can make it a potential antimicrobial agent in therapy of chronic bronchitis and other lower respiratory tract infections.

  19. Living with Chronic Bronchitis

    Science.gov (United States)

    ... Health Topics » Bronchitis » Living With Chronic Bronchitis Explore Bronchitis What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics ...

  20. Chronic Critical Illness

    Science.gov (United States)

    ... the patient’s situation and on the hospital and city. Do Chronically Critically Ill Patients Regain the Ability ... as the patient. You may feel stress, worry, sadness, or fatigue. Some families worry about financial burdens. ...

  1. Chronic Conditions Dashboard

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Conditions Dashboard presents statistical views of information on the prevalence, utilization and Medicare spending for Medicare beneficiaries with...

  2. Chronic Myeloproliferative Neoplasms Treatment

    Science.gov (United States)

    ... way to treat some chronic myeloproliferative neoplasms. Platelet apheresis Platelet apheresis is a treatment that uses a special machine ... using interferon alfa or pegylated interferon alpha . Platelet apheresis . A clinical trial of a new treatment. Check ...

  3. Chronic penile strangulation

    Directory of Open Access Journals (Sweden)

    Lopes Roberto I

    2003-01-01

    Full Text Available Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

  4. Chronic Illness & Mental Health

    Science.gov (United States)

    ... is present. For More Information Share Chronic Illness & Mental Health Download PDF Download ePub Order a free hardcopy ... For more information, see the National Institute of Mental Health (NIMH) booklet on Depression at http://www.nimh. ...

  5. Chronic obstructive pulmonary disease

    Science.gov (United States)

    ... and oxygen therapy Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic ... PA: Elsevier Saunders; 2016:chap 44. Read More Cor pulmonale Dilated cardiomyopathy Heart failure - overview Lung disease Patient ...

  6. Chronic Kidney Disease (CKD)

    Science.gov (United States)

    ... CKD treated? Kidney-friendly diet for CKD What causes chronic kidney disease (CKD)? Anyone can get CKD. Some people are ... and high blood pressure are the most common causes of CKD. If you have diabetes or high blood pressure, ...

  7. Sleep and Chronic Disease

    Science.gov (United States)

    ... message, please visit this page: About CDC.gov . Sleep About Us About Sleep Key Sleep Disorders Sleep ... Sheets Data & Statistics Projects and Partners Resources Events Sleep and Chronic Disease Recommend on Facebook Tweet Share ...

  8. Chronic Conditions PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Chronic Conditions PUFs are aggregated files in which each record is a profile or cell defined by the characteristics of Medicare beneficiaries. A profile is...

  9. Chronic inflammatory demyelinative polyneuropathy

    DEFF Research Database (Denmark)

    Said, Gérard; Krarup, Christian

    2013-01-01

    Chronic inflammatory demyelinative polyneuropathy (CIDP) is an acquired polyneuropathy presumably of immunological origin. It is characterized by a progressive or a relapsing course with predominant motor deficit. The diagnosis rests on the association of non-length-dependent predominantly motor ...

  10. Chronic dysimmune neuropathies: Beyond chronic demyelinating polyradiculoneuropathy

    Directory of Open Access Journals (Sweden)

    Khadilkar Satish

    2011-01-01

    Full Text Available The spectrum of chronic dysimmune neuropathies has widened well beyond chronic demyelinating polyradiculoneuropathy (CIDP. Pure motor (multifocal motor neuropathy, sensorimotor with asymmetrical involvement (multifocal acquired demylinating sensory and motor neuropathy, exclusively distal sensory (distal acquired demyelinating sensory neuropathy and very proximal sensory (chronic immune sensory polyradiculopathy constitute the variants of CIDP. Correct diagnosis of these entities is of importance in terms of initiation of appropriate therapy as well as prognostication of these patients. The rates of detection of immune-mediated neuropathies with monoclonal cell proliferation (monoclonal gammopathy of unknown significance, multiple myeloma, etc. have been facilitated as better diagnostic tools such as serum immunofixation electrophoresis are being used more often. Immune neuropathies associated with malignancies and systemic vasculitic disorders are being defined further and treated early with better understanding of the disease processes. As this field of dysimmune neuropathies will evolve in the future, some of the curious aspects of the clinical presentations and response patterns to different immunosuppressants or immunomodulators will be further elucidated. This review also discusses representative case studies.

  11. Lateral shear-moraines and lateral marginal-moraines of palaeo-ice streams

    Science.gov (United States)

    Batchelor, C. L.; Dowdeswell, J. A.

    2016-11-01

    An understanding of the nature of sedimentation at ice-stream lateral margins is important in reconstructing the dynamics of former ice sheets and modelling the mechanisms by which sediment is transported beneath contemporary ice streams. Theories of the formation of ice-stream lateral moraines (ISLMs) have hitherto been based on a relatively limited number of terrestrial and marine examples. Here, an inventory of ISLMs is compiled from available studies, together with independent analysis of seismic-reflection and bathymetric datasets. The locations and dimensions of 70 ISLMs, alongside a synthesis of their key architectural and geomorphic characteristics, are presented. Two different types of ISLMs are identified. Type 1 ISLMs are up to 3.5 km wide and 60 m thick. They maintain a constant width, thickness and cross-sectional shape along their length. Type 1 ISLMs are interpreted and referred to as ice-stream lateral shear-moraines that form subglacially in the shear zone between ice streams and slower-flowing regions of an ice sheet. In contrast, Type 2 ISLMs are up to 50 km wide and 300 m thick. They are only identified close to the shelf break in the marine environment. Type 2 ISLMs exhibit an increase in width and thickness along their length and their distal slopes become steeper in a seaward direction. They contain internal dipping reflections that indicate sediment progradation away from the former ice stream. Type 2 ISLMs are interpreted and referred to as ice-stream lateral marginal-moraines that were formed at the lateral boundary between ice streams and seafloor terrain that was free of grounded ice. We suggest that, using bathymetric images and acoustic profiles, it is possible to differentiate between ice-stream lateral shear-moraines and lateral marginal-moraines in the geological record. This distinction is important for understanding the mechanisms of sediment transfer beneath ice streams and for making inferences about the conditions that existed

  12. Tolerance and chronic rejection.

    OpenAIRE

    Womer, K. L.; Lee, R S; Madsen, J. C.; Sayegh, M H

    2001-01-01

    The most common cause of chronic allograft loss is an incompletely understood clinicopathological entity called chronic rejection (CR). Recent reports suggest an improvement in long-term renal allograft survival, although it is not clear from these data whether a true reduction of biopsy-proven CR has occurred. Although newer immunosuppressive medications have greatly reduced the incidence of acute rejection (AR) in the early post-transplantation period, the ideal therapy for both AR and CR w...

  13. Chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008430 Effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease. WANG Haoyan(王浩彦), et al. Dept Respir Dis, Beijing Friendship Hosp, Capital Med Sci Univ, Beijing 100050. Chin J Tuberc Respir Dis 2008;31(6):414-416. Objective To investigate the effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).

  14. Experimental chronic periodontitis morphogenesis

    OpenAIRE

    Schneider S.A.

    2011-01-01

    Morphogenesis of periodontium tissue in a model of chronic periodontitis was studied. Adult Wistar rats wereused in a model; chronic periodontitis was developed through mastication-related loading decrease. Histological assessmentof periodontium tissue was conducted at Days 7, 14, 21 and 30. It was demonstrated that dystrophic tissue changes prevailover the inflammatory one in this particular experimental model. The structural elements of periodontium were involved intothe pathologic process ...

  15. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  16. Molecular characteristics and stages of chronic hepatitis B virus infection

    Institute of Scientific and Technical Information of China (English)

    Ying-Hui Shi; Chang-He Shi

    2009-01-01

    Hepatitis B virus (HBV) is a common viral pathogen that causes a substantial health burden worldwide. Remarkable progress has been made in our understanding of the natural stages of chronic HBV infection. A dynamic balance between viral replication and host immune response is pivotal to the pathogenesis of liver disease. Knowledge of the HBV genome organization and replication cycle can unravel HBV genotypes and molecular variants, which contribute to the heterogeneity in outcome of chronic HBV infection. Most HBV infections are spontaneously resolved in immunocompetent adults, whereas they become chronic in most neonates and infants at a great risk of developing complications such as cirrhosis and hepatocellular carcinoma (HCC). Those with chronic HBV infection may present in one of the four phases of infection: immune tolerance, immune clearance [hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB)], inactive carrier state, and reactivation (HBeAg-negative CHB). Understanding the dynamic nature of chronic HBV infection is crucial in the management of HBV carriers. Long-term monitoring and optimal timing of antiviral therapy for chronic HBV infection help to prevent progression of HBV-related liver disease to its later stage, particularly in patients with higher risk markers of HCC, such as serum DNA concentration, HBeAg status, serum aminotransferase, HBV genotypes, and pre-core or core mutants.

  17. Treatment of Chronic Cough.

    Science.gov (United States)

    Soni, Resha S; Ebersole, Barbara; Jamal, Nausheen

    2017-01-01

    Objective Chronic cough remains a challenging condition, especially in cases where it persists despite comprehensive medical management. For these particular patients, there appears to be an emerging role for behavior modification therapy. We report a series of patients with refractory chronic cough to assess if there is any benefit of adding behavioral therapy to their treatment regimen. Study Design A case series with planned chart review of patients treated for chronic cough. Setting The review was performed with an outpatient electronic health record system at a tertiary care center. Subjects and Methods The charts of all patients treated for chronic cough by a single laryngologist over a 30-month period were analyzed. Patients' response to treatment and rate of cough improvement were assessed for those with refractory chronic cough who underwent behavior modification therapy. Results Thirty-eight patients with chronic cough were initially treated empirically for the most common causes of cough, of which 32% experienced improvement. Nineteen patients who did not significantly improve with medical management underwent behavior modification therapy with a speech-language pathologist. Of these patients, 84% experienced resolution or marked improvement of their symptoms. Conclusion Behavioral therapy may be underutilized in practice and could lead to improvement of otherwise recalcitrant cough.

  18. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  19. Terapia manual en epicondalgia lateral (revisión sistemática Manual therapy in lateral epicondylalgia (systematic review

    Directory of Open Access Journals (Sweden)

    R.A. Aguilera Eguía

    2009-03-01

    rehabilitation is based on clinical experience and on the treatment of the physical limitations found during the clinical examination. The main physical limitation in LE is lack of grip strength due to pain, leading to motor function impairment. Multiple treatments have been proposed in the literature (complementary therapies, physiotherapy, drug treatment, manual therapy, surgery but most are lacking an evidence base to support their use. The aim of the present study was to select the clinical interventions in manual therapy with the highest level of evidence for the treatment of LE. A search was made of Pubmed, Cochcrane, National Guideline Clearinghouse, NHS Guidelines Finder, and CMA infobase for meta-analyses, randomized clinical trials and clinical trials. To evaluate the internal validity of each of the selected studies, the Physiotherapy Evidence Database (PEDro scale was applied and the level of evidence was subsequently classified according to the scale of the Centre for Evidence-Based Medicine in Oxford. One randomized clinical trial and one randomized pilot study met the inclusion and exclusion criteria. There is level 1B evidence with level A recommendation for the use of the lateral glide and wrist manipulation techniques for the treatment of chronic unilateral epicondylalgia.

  20. Cerebrospinal fluid biomarkers of neurodegeneration in chronic neurological diseases.

    Science.gov (United States)

    Tumani, Hayrettin; Teunissen, Charlotte; Süssmuth, Sigurd; Otto, Markus; Ludolph, Albert C; Brettschneider, Johannes

    2008-07-01

    Chronic neurological diseases (CND) like amyotrophic lateral sclerosis (ALS), dementia or multiple sclerosis (MS) share a chronic progressive course of disease that frequently leads to the common pathological pathway of neurodegeneration, including neuroaxonal damage, apoptosis and gliosis. There is an ongoing search for biomarkers that could support early diagnosis of CND and help to identify responders to interventions in therapeutic treatment trials. Cerebrospinal fluid (CSF) is a promising source of biomarkers in CND, since the CSF compartment is in close anatomical contact with the brain interstitial fluid, where biochemical changes related to CND are reflected. We review recent advances in CSF biomarkers research in CND and thereby focus on markers associated with neurodegeneration.

  1. Resolution of chronic severe refractory thrombocytopenia after treatment of hypothyroidism

    Science.gov (United States)

    Bowles, K M; Turner, G E; Wimperis, J Z

    2004-01-01

    The case of a 52 year old woman with chronic severe refractory thrombocytopenia is presented. Over a three year period, her platelet count was persistently less than 20 × 109/litre (normal range, 150–400). She required repeated hospital admission for management of bleeding and received multiple blood transfusions. She was given repeated courses of steroids, immunosuppression, immunoglobulin, and splenectomy, without success, in an attempt to stop the chronic blood loss. Eventually, she was found to be profoundly hypothyroid. On correction of her thyroid deficiency the platelet count returned to the normal range and all bleeding stopped. The platelet count remains in the normal range three years later. PMID:15333667

  2. ANALYSIS AND DESIGN OF A MICROIRRIGATION LATERAL

    Directory of Open Access Journals (Sweden)

    Lakhdar ZELLA

    2006-10-01

    Full Text Available Micro-irrigation systems are methods of applying water, nutrients and chemicals directly to the plant root area at a controllable rate, which allows maximum results and minimum use of water and energy. For these reasons, microirrigation systems are developed in arid countries with insuffi ciency water resources. It has expanded to many countries engaging in modern agricultural practices due to relatively high agricultural outputs and low energy expenses. For micro-irrigation to be profi table, system design’s must be based on precise calculations and rigorous management. The precision with which micro-irrigation lateral and network’s are designed is of fundamental importance to system operation, the uniformity of distribution of water and fertilizer, and the consumption of energy. The computation model presented in this paper is based on equations of mass and energy conservation within an elemental control volume on the lateral. Considering the variation of the out-fl ow regime leads to an algebraic, coupled and non-linear equation system whose resolution is based on the numeric methods to a defective analytic approach. In this work, the control volume method was selected due to its simplicity. A program of computation has been developed for this and applied to a lateral for the fi rst time. Results from this simple model are precise and are similar to those from other validated models. Precision design increase effi ciency of water and fertilizer distribution. This method can be applied to the design of micro-irrigation lateral’s or network’s.

  3. The changing scene of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Robberecht, Wim; Philips, Thomas

    2013-04-01

    Several recent breakthroughs have provided notable insights into the pathogenesis of amyotrophic lateral sclerosis (ALS), with some even shifting our thinking about this neurodegenerative disease and raising the question as to whether this disorder is a proteinopathy, a ribonucleopathy or both. In addition, these breakthroughs have revealed mechanistic links between ALS and frontotemporal dementia, as well as between ALS and other neurodegenerative diseases, such as the cerebellar atrophies, myotonic dystrophy and inclusion body myositis. Here, we summarize the new findings in ALS research, discuss what they have taught us about this disease and examine issues that are still outstanding.

  4. STRAIN ANALYSIS OF LATERAL EXTRUSION PROCESS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    The strain distribution of equal-cross section lateral extrusion(ECSLE) has been simulated by finite element method. Considering the effect of friction and the width of sample, the simulation results are very close to the reality. The simulated results showed that, around the corner of die, the strain is distributed by sharp layers, and the gradient of the layers is very large, which means that the deformation is just plane shear deformation; the larger the width of sample or the smaller the friction, the more uniform the strain distribution is.

  5. Trigemino-abducens synkinesis after lateral orbitotomy.

    Science.gov (United States)

    Park, Kyung-Ah; Oh, Sei Yeul

    2013-01-01

    A 30-year-old man underwent lateral orbitotomy with removal of dermoid cyst in the right orbit. One month after operation, the patient started to experience double vision. He had 25 prism diopters of esotropia in primary gaze with marked limitation of abduction in the right eye. Seven months after the operation, he developed synkinetic movement of the eye when clenching his teeth. He could abduct his right eye while gritting his teeth. This is the fourth reported case of trigemino-abducens synkinesis and the first reported case without brain trauma.

  6. Monopod bucket foundations under cyclic lateral loading

    OpenAIRE

    Foglia, Aligi; Ibsen, Lars Bo

    2014-01-01

    The monopod bucket foundation can be a cost-reducing sub-structure for offshore wind turbines. To avoid problems during the turbine operation, the long-term effect of cyclic loading must be considered in the design of the foundation. In this paper a 1g testing rig is adopted to extend the knowledge on bucket foundations under lateral cyclic loading. The test setup is described in detail and a comprehensive experimental campaign is presented. The foundation is subjected to cyclic overturning m...

  7. Quantifying Disease Progression in Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Simon, Neil G; Turner, Martin R; Vucic, Steve; Al-Chalabi, Ammar; Shefner, Jeremy; Lomen-Hoerth, Catherine; Kiernan, Matthew C

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) exhibits characteristic variability of onset and rate of disease progression, with inherent clinical heterogeneity making disease quantitation difficult. Recent advances in understanding pathogenic mechanisms linked to the development of ALS impose an increasing need to develop strategies to predict and more objectively measure disease progression. This review explores phenotypic and genetic determinants of disease progression in ALS, and examines established and evolving biomarkers that may contribute to robust measurement in longitudinal clinical studies. With targeted neuroprotective strategies on the horizon, developing efficiencies in clinical trial design may facilitate timely entry of novel treatments into the clinic. PMID:25223628

  8. Lateral elbow tendinopathy: Evidence of physiotherapy management

    Science.gov (United States)

    Dimitrios, Stasinopoulos

    2016-01-01

    Lateral elbow tendinopathy (LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation. PMID:27622145

  9. Lateral dynamic features of a railway vehicle

    DEFF Research Database (Denmark)

    Gao, Xue-jun; True, Hans; Li, Ying-hui

    2016-01-01

    The lateral dynamic features of a railway vehicle are investigated using two similar wheel/rail contact models: the Vermeulen-Johnson and the Shen-Hedrick-Elkins models. The symmetric/asymmetric bifurcation behaviour and chaotic motions of the railway vehicle are investigated in great detail...... by varying the speed and using the resultant bifurcation diagram' method. It is found that multiple solution branches exist and they can lead to more steady states in the dynamic behaviour of the railway vehicle. The coexistence of multiple steady states can lead to jumps in the amplitude of oscillations...

  10. Pemphigus vulgaris and amyotrophic lateral sclerosis

    Science.gov (United States)

    Mokhtari, Fatemeh; Matin, Marzieh; Rajati, Fatemeh

    2016-01-01

    Pemphigus vulgaris (PV) is an autoimmune bullous and erosive mucocutaneous disease. Rarely, it occurs in patients with other autoimmune disease. The relation between PV and neurological disorders is unclear and needs to be more studied. Here, we report a case of amyotrophic lateral sclerosis (ALS), followed by dermatologic involvement. Histopathological evidence and direct immunofluorescence are consistent with PV. Systemic corticosteroid and azathioprine were effective in the treatment of mucocutaneous lesions. PV seems to be accidentally associated with ALS. Expression of major histocompatibility complex Class II in autoimmune disease and production of autoantibodies have been proposed to describe the association of PV with ALS. PMID:28163728

  11. Dynamics of laterally confined marine ice sheets

    OpenAIRE

    Kowal, Katarzyna N.; Pegler, Samuel S.; Worster, M. Grae

    2016-01-01

    This is the author accepted manuscript. The final version is available from Cambridge University Press via http://dx.doi.org/10.1017/jfm.2016.37 We present an experimental and theoretical study of the dynamics of laterally confined marine ice sheets in the natural limit in which the long, narrow channel into which they flow is wider than the depth of the ice. A marine ice sheet comprises a grounded ice sheet in contact with bedrock that floats away from the bedrock at a ‘grounding line’ t...

  12. Psychotherapists and the clergy: Fifty years later.

    Science.gov (United States)

    Spiegelman, J M

    1984-03-01

    Jung's two powerful articles on psychotherapy and the clergy, written in 1928 and 1932. are looked at from the vantage point of fifty years later and the author's experience in conducting analysis with many people from both vocations. He notes that relatively few people achieve the kind of integration of the ego that Jung writes about-an essentially religious experience-wherein the center of their existence now gravitates about the Self. Yet Jung's work and views have had a profound effect on spiritually inclined people of all ages. The predictions of Jung's articles, regarding therapy, the dissemination of pyschology to the masses, and other issues are examined.

  13. Chronic methylmercurialism in a horse

    Energy Technology Data Exchange (ETDEWEB)

    Seawright, A.A.; Roberts, M.C.; Costigan, P.

    1978-02-01

    Chronic methylmercurialism was produced in a horse given 10 g methylmercury chloride over 10 weeks. Neurological signs, particularly proprioceptive disturbances, were apparent by the final week of dosing and became more severe thereafter. An exudative dermatitis, a reluctance to move, weight loss, reduced appetite and dullness were among the earlier clinical signs, and renal changes characterized by a steadily increasing BUN and glucosuria were detected later. Pathological lesions were confined to the kidneys and the nervous system. There was mild neuronal degeneration in the cerebral cortex and in the cerebellar cortex, axonal demyelination in the dorsal columns of the spinal cord and extensive degeneration of ganglion cells in the dorsal root ganglia. The blood organic mercury level, which had plateaued in the second month, increased rapidly in the last weeks of dosing with a sharp rise terminally. This pattern was repeated for the much lower inorganic mercury levels except for a terminal decrease. The proportion of inorganic mercury was five times greater in the dorsal root ganglia than elsewhere in the CNS, although total mercury levels were similar. Highest tissue mercury levels were found in the liver and kidneys, over 50% being in the form of inorganic mercury. As dealkylation of the methylmercury appeared to be more efficient in the dorsal root ganglia and the kidneys, inorganic mercury derived therefrom may have been responsible for some of the clinical and pathological features of this intoxication in the horse. 21 references, 6 figures, 2 tables.

  14. Treatment of cubital tunnel syndrome with ulnar nerve anterior submuscular transposition and medial epicondyle muscle group in situ reconstruction via a bone tunnel%尺神经肌下前置肱骨内上髁肌群经骨道原位重建治疗肘管综合征

    Institute of Scientific and Technical Information of China (English)

    张小路; 林其仁

    2014-01-01

    Objective To investigate the clinical effectiveness of treating moderate to severe cubital tunnel syndrome with ulnar nerve decompression,anterior submuscular transposition and medial epicondyle muscle group in situ reconstruction via a bone tunnel.Methods The clinical data of 45 cases of moderate to severe cubital tunnel syndrome diagnosed between January 2005 and October 2012 were analyzed.The ulnar nerve was decompressed and its perfnsion by the superior ulnar collateral artery was observed under the surgical microscope intraoperatively.After ulnar nerve was transposed anteriorly,the detached medial epicondyle muscle group was reconstructed in situ through a bone tuunel under direct view.The size of the new ulnar nerve tunnel and mobility of the ulnar nerve were observed.Postoperative recovery was follow-up including pain,sensation,muscular atrophy recovery,claw hand,grip strength,wrist flexion and forearm pronation.Results All 45 cases were follow-up for 6 to 18 months.Intraoperative microscopic observation showed good ulnar nerve perfusion by the superior ulnar collateral artery.Reattachment of the medial epicondyle muscle group was secure.The newly formed cubital tunnel could allow an 8 mm dilator without tension in elbow full extension position.Ulnar nerve could glide freely upon elbow flexion and extension.According to the cubital tunnel syndrome function evaluation standard suggested by Gu Yudong,the results were graded as excellent in 20 cases,good in 17 cases,and fair in 8 cases.The overall excellent and good rate was 82.22%.Wrist flexion and forearm pronation force recovered to preoperative level in all the patients 3 months after the operation.Conclusion Including superior ulnar collateral artery in the anterior transposition of the ulnar nerve provides good blood supply to the nerve and benefits nerve recovery.In situ reconstruction of the medial epicondyle muscle group through a bone tunnel puts the ulnar nerve anderneath flexor carpi ulnaris and

  15. Arthroscopic anatomical reconstruction of the lateral ankle ligaments: A technical simplification.

    Science.gov (United States)

    Lopes, R; Decante, C; Geffroy, L; Brulefert, K; Noailles, T

    2016-12-01

    Anatomical reconstruction of the lateral ankle ligaments has become a pivotal component of the treatment strategy for chronic ankle instability. The recently described arthroscopic version of this procedure is indispensable to ensure that concomitant lesions are appropriately managed, yet remains technically demanding. Here, we describe a simplified variant involving percutaneous creation of the calcaneal tunnel for the distal attachment of the calcaneo-fibular ligament. The rationale for this technical stratagem was provided by a preliminary cadaver study that demonstrated a correlation between the lateral malleolus and the distal footprint of the calcaneo-fibular ligament. The main objectives are simplification of the operative technique and decreased injury to tissues whose function is crucial to the recovery of proprioception.

  16. An unusual lateral luxation of an upper incisor owing to long-term boxing without protection.

    Science.gov (United States)

    Bechor, Ron; Zadik, Yehuda

    2008-10-01

    This case report describes a lateral luxation of an upper incisor in a 19-year-old non-professional boxer. The tooth displacement gradually worsened over several months because the boxer received repeated blows to the head without using a mouthguard. Being a chronic dental trauma, rather than an acute lateral luxation, this case had several unique features: the labial plate of the alveolar bone was penetrated, the root apex was free in the vestibulum, the tooth was mobile (second degree) and radiographs revealed bone resorption. This case emphasized the need for a mouthguard to be used even with amateur boxing. The dental practitioner should educate his sportsmen-patients of the risk of sport-related dental trauma and the benefit of a mouthguard.

  17. Amyotrophic lateral sclerosis: one or multiple causes?

    Directory of Open Access Journals (Sweden)

    Aline Furtado Bastos

    2011-04-01

    Full Text Available The Amyotrophic lateral sclerosis (ALS is the most common form of motor neuron disease in the adulthood, and it is characterized by rapid and progressive compromise of the upper and lower motor neurons. The majority of the cases of ALS are classified as sporadic and, until now, a specific cause for these cases still is unknown. To present the different hypotheses on the etiology of ALS. It was carried out a search in the databases: Bireme, Scielo and Pubmed, in the period of 1987 to 2011, using the following keywords: Amyotrophic lateral sclerosis, motor neuron disease, etiology, causes and epidemiology and its similar in Portuguese and Spanish. It did not have consensus as regards the etiology of ALS. Researches demonstrates evidences as regards intoxication by heavy metals, environmental and occupational causes, genetic mutations (superoxide dismutase 1, certain viral infections and the accomplishment of vigorous physical activity for the development of the disease. There is still no consensus regarding the involved factors in the etiology of ALS. In this way, new research about these etiologies are necessary, for a better approach of the patients, promoting preventive programs for the disease and improving the quality of life of the patients.

  18. the Analysis of Coupled Lateral Torsional Vibrations

    Directory of Open Access Journals (Sweden)

    Tomasz Szolc

    2000-01-01

    Full Text Available In the paper, dynamic investigations of the rotor shaft systems are performed by means of the discrete-continuous mechanical models. In these models the rotor shaft segments are represented by the rotating cylindrical flexurally and torsionally deformable continuous viscoelastic elements. These elements are mutually connected according to the structure of the real system in the form of a stepped shaft which is suspended on concentrated inertial viscoelastic supports of linear or non-linear characteristics. At appropriate shaft crosssections, by means of massless membranes, there are attached rigid rings representing rotors, disks, gears, flywheels and others. The proposed model enables us to investigate coupled linear or non-linear lateral torsional Vibrations of the rotating systems in steady-state and transient operating conditions. As demonstrative examples, for the steam turbo-compressor under coupled lateral torsional vibrations, the transient response due to a blade falling out from the turbine rotor as well as the steady-state response in the form of parametric resonance caused by residual unbalances are presented.

  19. Chronic prostatitis: Current concepts

    Directory of Open Access Journals (Sweden)

    Ram Vaidyanathan

    2008-01-01

    Full Text Available Purpose: Chronic prostatitis (CP is a common condition. It causes significant suffering to the patients and constitutes a sizeable workload for the urologists. The purpose of this review is to describe the currently accepted concepts regarding the aspects of CP. Materials and Methods: Relevant papers on the epidemiology, etiology, diagnosis, evaluation and management of CP were identified through a search of MEDLINE using text terms "prostatitis", "chronic prostatitis" and "chronic pelvic pain syndrome". The list of articles thus obtained was supplemented by manual search of bibliographies of the identified articles and also by exploring the MEDLINE option "Related Articles". Results: The salient points of the relevant articles on each aspect of CP have been summarized in the form of a non-systematic narrative review. Conclusion: Chronic prostatitis is caused by a variety of infective and non-infective factors and is characterized by a rather long remitting and relapsing clinical course. The diagnosis is based on symptoms comprising pain and nonspecific urinary and/or ejaculatory disturbances and microbiological tests to localize bacteria and/or leucocytes in segmented urinary tract specimens. The contemporary classification was proposed by the National Institutes of Health/National Institute of Diabetes Digestive Kidney Diseases (NIH/NIDDK. National Institutes of Health - Chronic Prostatitis Symptom Index (NIH-CPSI is the patient evaluation tool used extensively in clinical practice and research. Management should be individualized, multimodal and of an appropriate duration.

  20. Autoantibodies in chronic pancreatitis

    DEFF Research Database (Denmark)

    Rumessen, J J; Marner, B; Pedersen, N T

    1985-01-01

    In 60 consecutive patients clinically suspected of having chronic pancreatitis the serum concentration of the immunoglobulins (IgA, IgG, IgM), the IgG- and IgA-type non-organ-specific autoantibodies against nuclear material (ANA), smooth and striated muscle, mitochondria, basal membrane, and reti......In 60 consecutive patients clinically suspected of having chronic pancreatitis the serum concentration of the immunoglobulins (IgA, IgG, IgM), the IgG- and IgA-type non-organ-specific autoantibodies against nuclear material (ANA), smooth and striated muscle, mitochondria, basal membrane......, and reticulin, and the IgG- and IgA-type pancreas-specific antibodies against islet cells, acinus cells, and ductal cells (DA) were estimated blindly. In 23 of the patients chronic pancreatitis was verified, whereas chronic pancreatitis was rejected in 37 patients (control group). IgG and IgA were found...... in significantly higher concentrations in the patients with chronic pancreatitis than in the control group but within the normal range. ANA and DA occurred very frequently in both groups but with no statistical difference. Other autoantibodies only occurred sporadically. The findings of this study do not support...

  1. Management of chronic paronychia

    Directory of Open Access Journals (Sweden)

    Vineet Relhan

    2014-01-01

    Full Text Available Chronic paronychia is an inflammatory disorder of the nail folds of a toe or finger presenting as redness, tenderness, and swelling. It is recalcitrant dermatoses seen commonly in housewives and housemaids. It is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Repeated bouts of inflammation lead to fibrosis of proximal nail fold with poor generation of cuticle, which in turn exposes the nail further to irritants and allergens. Thus, general preventive measures form cornerstone of the therapy. Though previously anti-fungals were the mainstay of therapy, topical steroid creams have been found to be more effective in the treatment of chronic paronychia. In recalcitrant cases, surgical treatment may be resorted to, which includes en bloc excision of the proximal nail fold or an eponychial marsupialization, with or without nail plate removal. Newer therapies and surgical modalities are being employed in the management of chronic paronychia. In this overview, we review recent epidemiological studies, present current thinking on the pathophysiology leading to chronic paronychia, discuss the challenges chronic paronychia presents, and recommend a commonsense approach to management.

  2. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

  3. Chronic erosive seropositive arthritis in a patient with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    L P Ananjeva

    2008-01-01

    Full Text Available Joint syndrome evolution was prospectively followed up in a 49-year-old woman who had serum hepatitis in 1990. When she came to a rheumatologist for the first time in 1999 she complained of occasional joint pain. She did not have joint inflammatory changes at that time but chronic hepatitis С was revealed at the examination. Hepatitis С diagnosis was confirmed by morphological and repeated virological evaluations. During antiviral treatment the pt developed symmetrical polyarthritis involving hand joints. Elevation of cryoglobuline, rheumatoid factor and antinuclear antibodies level was revealed. During the next year polyarthritis recurred and later acquired undulatory course with periods of exacerbation and stabilization. Attempts of treatment with sulfasalazine failed due to transaminase elevation. In 2006 ulnar deviation appeared and rheumatoid factor level remained elevated. MRI showed multiple erosions of carpal bones. Considering features of joint syndrome development joint damage in this pt was regarded as arthritis associated with chronic hepatitis C.

  4. Neglected lateral process of talus fracture presenting as a loose body in tarsal canal

    Institute of Scientific and Technical Information of China (English)

    Kamal Bali; Sharad Prabhakar; Nitesh Gahlot; Mandeep S Dhillon

    2011-01-01

    Lateral process fractures of talus are rare injuries with a potential to cause significant morbidity if rnisdiagnosed.The appropriate management of these fractures is still controversial and only a few reports are available on this subject.We presented a case of a 37-year-old male with neglected fracture on the lateral process of talus which was misdiagnosed at the time of injury.The patient presented to 7 months after misdiagnosis with a chronic ankle pain.Our case is unique in the sense that it is a rare case of neglected fracture on the lateral process of talus which presented as a loose body in sinus tarsi.However,a surgery with an excision of the loose body presented a satisfactory outcome along with 2 years' follow-up.To our knowledge,it ought to be the first case reported in the English literature.Through this case report,we highlight the importance of high index of suspicion for such rare bony injuries while evaluating trauma to the lateral side of ankle and discuss the principles of management of these fractures.

  5. Nuclear TAR DNA-binding protein 43 A new target for amyotrophic lateral sclerosis treatment

    Institute of Scientific and Technical Information of China (English)

    Mei Zheng; Yujie Shi; Dongsheng Fan

    2013-01-01

    Abnormal TAR DNA-binding protein 43 (TDP-43) inclusion bodies can be detected in the degener-ative neurons of amyotrophic lateral sclerosis. In this study, we induced chronic oxidative stress in-jury by applying malonate to cultured mouse cortical motor neurons. In the later stages of the ma-lonate insult, TDP-43 expression reduced in the nuclei and transferred to the cytoplasm. This was accompanied by neuronal death, mimicking the pathological changes in TDP-43 that are seen in patients with amyotrophic lateral sclerosis. Interestingly, in the early stages of the response to ma-lonate treatment, nuclear TDP-43 expression increased, and neurons remained relatively intact, without inclusion bodies or fragmentation. Therefore, we hypothesized that the increase of nuclear TDP-43 expression might be a pro-survival factor against oxidative stress injury. This hypothesis was confirmed by an in vitro transgenic experiment, in which overexpression of wild type mouse TDP-43 in cultured cortical motor neurons significantly reduced malonate-induced neuronal death. Our findings suggest that the loss of function of TDP-43 is an important cause of neuronal dege-neration, and upregulation of nuclear TDP-43 expression might be neuroprotective in amyotrophic lateral sclerosis.

  6. Chronic hypersensitivity pneumonitis

    Directory of Open Access Journals (Sweden)

    Pereira CA

    2016-09-01

    Full Text Available Carlos AC Pereira,1 Andréa Gimenez,2 Lilian Kuranishi,2 Karin Storrer 2 1Interstitial Lung Diseases Program, 2Pulmonology Postgraduate, Federal University of São Paulo, São Paulo, Brazil Abstract: Hypersensitivity pneumonitis (HSP is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary. Keywords: interstitial lung diseases, extrinsic allergic alveolitis, diffuse lung disease, lung immune response, HRCT, farmers lung

  7. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  8. Omalizumab for chronic urticaria

    DEFF Research Database (Denmark)

    Ivyanskiy, Ilya; Sand, Carsten; Thomsen, Simon Francis

    2012-01-01

    urticaria. We present a case series of 19 patients with chronic urticaria treated in a university department with omalizumab and give an overview of the existing literature comprising an additional 59 cases as well as a total of 139 patients enrolled in two randomized controlled trials comparing omalizumab...... with placebo. The collective evidence points to omalizumab as a safe and effective treatment option for patients with chronic urticaria who do not sufficiently respond to standard therapy as recommended by existing guidelines.......Omalizumab is a recombinant humanized monoclonal antibody that blocks the high-affinity Fc receptor of IgE. Omalizumab has been approved for the treatment of moderate to severe asthma; however, there is currently more and more data showing promising results in the management also of chronic...

  9. Antecedent disease and Amyotrophic Lateral Sclerosis: What is protecting whom?

    Directory of Open Access Journals (Sweden)

    Sabrina K Hollinger

    2016-03-01

    Full Text Available Multiple studies have shown that antecedent diseases are less prevalent in Amyotrophic Lateral Sclerosis (ALS patients than the general age-matched population, which suggests possible neuroprotection. Antecedent disease could be protective against ALS or, conversely, the asymptomatic early physiological underpinnings of ALS could be protective against other antecedent disease. Elucidating the impact of antecedent disease on ALS is critical for assessing diagnostic risk factors, prognostic outcomes, and intervention timing. The objective of this study was to examine the relationship between antecedent conditions and ALS onset age and disease duration. Medical history surveys for 1,439 Emory ALS Clinic patients (Atlanta, GA, USA were assessed for antecedent hypertension, hyperlipidemia, diabetes, obesity, asthma, arthritis, chronic obstructive pulmonary disease (COPD, thyroid, kidney, liver, and other non-ALS neurological disease. The ALS onset age and disease duration is compared between the antecedent and non-antecedent populations using Chi square, Kaplan Meier, and ordinal logistic regression. When controlled for confounders, antecedent hypertension (high blood pressure, hyperlipidemia (high cholesterol, arthritis, COPD, thyroid disease and non-ALS neurological disease are found to be statistically associated with a delayed onset age whereas antecedent obesity (body mass index, BMI > 30 was correlated with earlier ALS onset age. With the potential exceptions of liver disease and diabetes (the latter without other common co-morbid conditions, antecedent disease is associated with overall shorter disease duration. The unique potential relationship between antecedent liver disease and longer ALS disease duration warrants further investigation, especially given liver disease was found to be a factor of 4-7 times less prevalent in ALS. Notably, most conditions associated with delayed ALS onset are also associated with shorter disease duration

  10. Centrifuge modelling of lateral displacement of buried pipelines; Modelagem fisica centrifuga de flambagem lateral de dutos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Jose Renato Moreira da Silva de; Almeida, Marcio de Souza Soares de; Marques, Maria Esther Soares; Almeida, Maria Cascao Ferreira de [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE); Costa, Alvaro Maia da [PETROBRAS, Rio de Janeiro, RJ (Brazil). Centro de Pesquisas (CENPES)

    2003-07-01

    This work discusses soil-structure interaction applied to the buckling phenomena of buried pipelines subjected to heated oil flow. A set of physical modelling tests on lateral buckling of pipelines buried on soft clay is presented using COPPE/UFRJ geotechnical centrifuge. A 1:30 pipeline model was moved side ward through a soft clay layer during centrifuge flight, varying the burial depth, in order to simulate the lateral buckling in plane strain condition. The results show different behaviour concerning horizontal and vertical forces measured at pipeline level due to soil reaction. (author)

  11. [Histaminergic angioedema and chronic urticaria].

    Science.gov (United States)

    Hacard, Florence; Nosbaum, Audrey; Bensaid, Benoit; Nicolas, Jean-François; Augey, Frédéric; Goujon, Catherine; Bérard, Frédéric

    2015-01-01

    Most angioedemas are histaminergic and correspond to deep urticarial swelling. Recurrent histaminergic angioedema led to the diagnosis of chronic urticaria, even when there are no superficial associated hives. Chronic urticaria is a benign disease, and autoimmune in 40 % of cases. The occurrence of angioedema in chronic urticaria is not a sign of severity. The occurrence of angioedema in chronic urticaria is associated with a longer duration of urticarial disease. NSAIDs and/or systemic corticotherapy are classic triggers of angioedema in chronic urticaria. In the absence of clinical endpoints, there is no need to make further assessment in chronic urticaria good responders to antihistamines.

  12. Craniosacral Therapy for the Treatment of Chronic Neck Pain

    OpenAIRE

    2016-01-01

    Objectives: With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients. Materials and Methods: A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20)...

  13. Lateral hypothalamic circuits for feeding and reward.

    Science.gov (United States)

    Stuber, Garret D; Wise, Roy A

    2016-02-01

    In experiments conducted over 60 years ago, the lateral hypothalamic area (LHA) was identified as a critical neuroanatomical substrate for motivated behavior. Electrical stimulation of the LHA induces voracious feeding even in well-fed animals. In the absence of food, animals will work tirelessly, often lever-pressing thousands of times per hour, for electrical stimulation at the same site that provokes feeding, drinking and other species-typical motivated behaviors. Here we review the classic findings from electrical stimulation studies and integrate them with more recent work that has used contemporary circuit-based approaches to study the LHA. We identify specific anatomically and molecularly defined LHA elements that integrate diverse information arising from cortical, extended amygdala and basal forebrain networks to ultimately generate a highly specified and invigorated behavioral state conveyed via LHA projections to downstream reward and feeding-specific circuits.

  14. Exchange coupling between laterally adjacent nanomagnets

    Science.gov (United States)

    Dey, H.; Csaba, G.; Bernstein, G. H.; Porod, W.

    2016-09-01

    We experimentally demonstrate exchange-coupling between laterally adjacent nanomagnets. Our results show that two neighboring nanomagnets that are each antiferromagnetically exchange-coupled to a common ferromagnetic bottom layer can be brought into strong ferromagnetic interaction. Simulations show that interlayer exchange coupling effectively promotes ferromagnetic alignment between the two nanomagnets, as opposed to antiferromagnetic alignment due to dipole-coupling. In order to experimentally demonstrate the proposed scheme, we fabricated arrays of pairs of elongated, single-domain nanomagnets. Magnetic force microscopy measurements show that most of the pairs are ferromagnetically ordered. The results are in agreement with micromagnetic simulations. The presented scheme can achieve coupling strengths that are significantly stronger than dipole coupling, potentially enabling far-reaching applications in Nanomagnet Logic, spin-wave devices and three-dimensional storage and computing.

  15. Motoneuron firing in amyotrophic lateral sclerosis (ALS

    Directory of Open Access Journals (Sweden)

    Mamede eDe Carvalho

    2014-09-01

    Full Text Available Amyotrophic lateral sclerosis is an inexorably progressive neurodegenerative disorder involving the classical motor system and the frontal effector brain, causing muscular weakness and atrophy, with variable upper motor neuron signs and often an associated fronto-temporal dementia. The physiological disturbance consequent on the motor system degeneration is beginning to be well understood. In this review we describe aspects of the motor cortical, neuronal and lower motor neuron dysfunction. We show how studies of the changes in the pattern of motor unit firing help delineate the underlying pathophysiological disturbance as the disease progresses. Such studies are beginning to illuminate the underlying disordered pathophysiological processes in the disease, and are important in designing new approaches to therapy and especially for clinical trials.

  16. EAS-BUAP: Lateral Distribution and Performance

    Science.gov (United States)

    Salazar, H.; Martinez, O.; Cotzomi, J.; Moreno, E.; Aguilar, S.; Villaseñor, L.

    2003-07-01

    We describe the operation and performance of the first stage of the EAS-UAP extensive air shower array, as a detector of very high energy cosmic rays (Eo > 1014eV) after one year of operation. The array is located at the Campus of Puebla University, 2200 m above sea level. It consists of 10 liquid scintillator detectors, each with an active surface of 1 m2 and a detector spacing of 20 m in a square grid. One Auger Water Cherenkov detector is also included as part of the array. In this report we discuss the stability, the calibration and lateral distribution function reconstruction capabilities of the detector array. We also present the analysis of the shower size spectrum. In addition, the main characteristics of this array allow us to use it as an educational and training facility.

  17. A comprehensive review of amyotrophic lateral sclerosis

    Science.gov (United States)

    Zarei, Sara; Carr, Karen; Reiley, Luz; Diaz, Kelvin; Guerra, Orleiquis; Altamirano, Pablo Fernandez; Pagani, Wilfredo; Lodin, Daud; Orozco, Gloria; Chinea, Angel

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a late-onset fatal neurodegenerative disease affecting motor neurons with an incidence of about 1/100,000. Most ALS cases are sporadic, but 5–10% of the cases are familial ALS. Both sporadic and familial ALS (FALS) are associated with degeneration of cortical and spinal motor neurons. The etiology of ALS remains unknown. However, mutations of superoxide dismutase 1 have been known as the most common cause of FALS. In this study, we provide a comprehensive review of ALS. We cover all aspects of the disease including epidemiology, comorbidities, environmental risk factor, molecular mechanism, genetic factors, symptoms, diagnostic, treatment, and even the available supplement and management of ALS. This will provide the reader with an advantage of receiving a broad range of information about the disease. PMID:26629397

  18. Large-scale lateral nanowire arrays nanogenerators

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhong L; Xu, Chen; Qin, Yong; Zhu, Guang; Yang, Rusen; Hu, Youfan; Zhang, Yan

    2014-01-07

    In a method of making a generating device, a plurality of spaced apart elongated seen members are deposited onto a surface of a flexible non-conductive substrate. An elongated conductive layer is applied to a top surface and a first side of each seed member, thereby leaving an exposed second side opposite the first side. A plurality of elongated piezoelectric nanostructures is grown laterally from the second side of each seed layer. A second conductive material is deposited onto the substrate adjacent each elongated first conductive layer so as to be soupled the distal end of each of the plurality of elongated piezoelectric nanostructures. The second conductive material is selected so as to form a Schottky barrier between the second conductive material and the distal end of each of the plurality of elongated piezoelectric nanostructures and so as to form an electrical contact with the first conductive layer.

  19. [Amyotrophic lateral sclerosis and respiratory insufficiency].

    Science.gov (United States)

    Siirala, Waltteri; Korpela, Jaana; Vuori, Arno; Saaresranta, Tarja; Olkkola, Klaus T; Aantaa, Riku

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a disease causing degeneration of motor neurons, without any curative treatment. The most common cause of death is respiratory arrest due to atrophy of the respiratory musculature. ALS-associated respiratory insufficiency differs in mechanism from the more common causes of dyspnea, such as diseases of pulmonary or cardiac origin. Recognizing the respiratory insufficiency can be challenging for a clinician. It should be possible to predict the development of respiratory insufficiency in order to avoid leaving the treatment decisions concerning respiratory insufficiency to emergency services. Noninvasive ventilatory support can be used to alleviate the patient's dyspnea. It is actually recommended as the first-line treatment of ALS-associated respiratory insufficiency.

  20. Dysarthria in amyotrophic lateral sclerosis: A review.

    Science.gov (United States)

    Tomik, Barbara; Guiloff, Roberto J

    2010-01-01

    Dysarthria is a motor disorder of speech characterized by abnormalities of the articulation and intelligibility of speech. Phonation and the rate of facial movements may also be affected. Understanding the nature and course of dysarthria in amyotrophic lateral sclerosis (ALS) is important because loss of communication prevents patients from participating in many activities, may lead to social isolation, and reduces the quality of life. The goal of management of dysarthria in ALS patients is to optimize communication effectiveness for as long as possible. The information about dysarthria in ALS is dispersed in physiological, pathological, speech therapy, otorhinolaringological and neurological publications. This review summarizes the current state of knowledge on the clinical features, differential diagnosis, pathophysiology, investigations and management of dysarthria in ALS patients. There is a need to compare the different methods used to assess dysarthria and for controlled clinical trials to assess therapeutic strategies.