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Sample records for musculoskeletal system pathology

  1. Musculoskeletal Pathology.

    PubMed

    Peat, Frances J; Kawcak, Christopher E

    2015-08-01

    The current understanding of pathology as it relates to common diseases of the equine musculoskeletal system is reviewed. Conditions are organized under the fundamental categories of developmental, exercise-induced, infectious, and miscellaneous pathology. The overview of developmental pathology incorporates the new classification system of juvenile osteochondral conditions. Discussion of exercise-induced pathology emphasizes increased understanding of the contribution of cumulative microdamage caused by repetitive cyclic loading. Miscellaneous musculoskeletal pathology focuses on laminitis, which current knowledge indicates should be regarded as a clinical syndrome with a variety of possible distinct mechanisms of structural failure that are outlined in this overview. PMID:26037607

  2. Computed tomography of the musculoskeletal system

    SciTech Connect

    Scott, W.W. Magid, D. Fishman, E.K. )

    1987-01-01

    This book contain 10 chapters. The chapter titles are: Soft Tissue Masses; Primary Bone Tumors; The Role of CT in the Therapeutic Management of Soft Tissue Sarcomas; Assessment of Musculoskeletal Inflammation; Assessment of Musculoskeletal Trauma; The Foot and Ankle; The Shoulder; Measurement of Bone Mineral for Early Detection of Osteoporosis; MRI of the Musculoskeletal System; and Advances in CT Imaging of Musculoskeletal Pathology.

  3. [Formation and structural features of morbidity in miners with professional pathology of the peripheral nervous system and the musculoskeletal system].

    PubMed

    Shpagina, L N

    2014-01-01

    There were studied polypathy rates, their relationship with the professional pathology in Kuzbass miners. There was performed the analysis of an array of more than 2000 patients with occupational pathology and also 1800 records from for the coal miners hospitals for patients with no signs of occupational diseases. The rise in morbidity rate of polypathies was turned out to be associated with a very low proportion (less than 20%) of patients' preventive visits. It is advisable to introduce the financial incentives for doctors share for the rise of the number of healthy individuals in the enterprise, for detection rate of chronic general and occupational diseases at the early stages of the disease and for reducing of incidence of polypathies. PMID:25306698

  4. Musculoskeletal involvement in systemic sclerosis.

    PubMed

    Lóránd, Veronika; Czirják, László; Minier, Tünde

    2014-10-01

    Musculoskeletal (MSK) involvement is a very frequent manifestation of patients with systemic sclerosis (SSc). There are several reports about clinical trials assessing musculoskeletal involvement in SSc. However, only few controlled studies have been conducted. The prevalence of musculoskeletal symptoms, clinical and radiographic findings has been assessed. The most important articular (arthralgia, synovitis, contractures), tendon (tendon friction rubs, tenosynovitis) and muscular manifestations (myalgia, muscle weakness, myositis) should be carefully evaluated during the assessment of SSc patients, because these are not only common, but substantially influence the quality of life and some of them also have predictive value concerning disease activity and severity. PMID:25179276

  5. Postoperative ultrasonography of the musculoskeletal system

    PubMed Central

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-01-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  6. Infrared fiber optic probes for evaluation of musculoskeletal tissue pathology

    NASA Astrophysics Data System (ADS)

    Padalkar, Mugdha; McGoverin, Cushla; Onigbanjo, Quam; Spencer, Richard; Barbash, Scott; Kropf, Eric; Pleshko, Nancy

    2014-03-01

    Musculoskeletal pathology of the knee commonly occurs with aging and as a result of injury. The incidence of anterior cruciate ligament (ACL) injuries continues to increase annually, and may precede the eventual onset of osteoarthritis (OA), a debilitating and prevalent disease characterized by cartilage degeneration. Early detection of OA remains elusive, with current imaging methods lacking adequate sensitivity to detect early pathologic cartilage changes. We used mid- and near- infrared (IR) spectroscopy through arthroscopic-based fiber-optic devices to assess cartilage damage and differentiate tendon from ligament. Mid-IR spectroscopy is characterized by distinct bands and low penetration depth (< 10 μm) and near-IR spectroscopy is characterized by complex overlapping bands and greater penetration depths (< 1 cm). We have found that combined mid- and near-IR analysis greatly extends the information available through either in the analysis of soft tissues, including cartilage, ligaments and tendons. We discuss here basic science studies and the potential for translation to clinical research with novel arthroscopic probes.

  7. Functional imaging of the musculoskeletal system

    PubMed Central

    2015-01-01

    Functional imaging, which provides information of how tissues function rather than structural information, is well established in neuro- and cardiac imaging. Many musculoskeletal structures, such as ligaments, fascia and mineralized bone, have by definition a mainly structural role and clearly don’t have the same functional capacity as the brain, heart, liver or kidney. The main functionally responsive musculoskeletal tissues are the bone marrow, muscle and nerve and, as such, magnetic resonance (MR) functional imaging has primarily addressed these areas. Proton or phosphorus spectroscopy, other fat quantification techniques, perfusion imaging, BOLD imaging, diffusion and diffusion tensor imaging (DTI) are the main functional techniques applied. The application of these techniques in the musculoskeletal system has mainly been research orientated where they have already greatly enhanced our understanding of marrow physiology, muscle physiology and neural function. Going forwards, they will have a greater clinical impact helping to bridge the disconnect often seen between structural appearances and clinical symptoms, allowing a greater understanding of disease processes and earlier recognition of disease, improving prognostic prediction and optimizing the monitoring of treatment effect. PMID:26029633

  8. [A new 2D and 3D imaging approach to musculoskeletal physiology and pathology with low-dose radiation and the standing position: the EOS system].

    PubMed

    Dubousset, Jean; Charpak, Georges; Dorion, Irène; Skalli, Wafa; Lavaste, François; Deguise, Jacques; Kalifa, Gabriel; Ferey, Solène

    2005-02-01

    Close collaboration between multidisciplinary specialists (physicists, biomecanical engineers, medical radiologists and pediatric orthopedic surgeons) has led to the development of a new low-dose radiation device named EOS. EOS has three main advantages: The use of a gaseous X-ray detector, invented by Georges Charpak (Nobel Prizewinner 1992), the dose necessary to obtain a 2D image of the skeletal system has been reduced by 8 to 10 times, while that required to obtain a 3D reconstruction from CT slices has fallen by a factor of 800 to 1000. The accuracy of the 3D reconstruction obtained with EOS is as good as that obtained with CT. The patient is examined in the standing (or seated) position, and is scanned simultaneously from head to feet, both frontally and laterally. This is a major advantage over conventional CT which requires the patient to be placed horizontally. -The 3D reconstructions of each element of the osteo-articular system are as precise as those obtained by conventional CT. EOS is also rapid, taking only 15 to 30 minutes to image the entire spine. PMID:16114859

  9. Motor Cortex Excitability and BDNF Levels in Chronic Musculoskeletal Pain According to Structural Pathology

    PubMed Central

    Caumo, Wolnei; Deitos, Alícia; Carvalho, Sandra; Leite, Jorge; Carvalho, Fabiana; Dussán-Sarria, Jairo Alberto; Lopes Tarragó, Maria da Graça; Souza, Andressa; Torres, Iraci Lucena da Silva; Fregni, Felipe

    2016-01-01

    The central sensitization syndrome (CSS) encompasses disorders with overlapping symptoms in a structural pathology spectrum ranging from persistent nociception [e.g., osteoarthritis (OA)] to an absence of tissue injuries such as the one presented in fibromyalgia (FM) and myofascial pain syndrome (MPS). First, we hypothesized that these syndromes present differences in their cortical excitability parameters assessed by transcranial magnetic stimulation (TMS), namely motor evoked potential (MEP), cortical silent period (CSP), short intracortical inhibition (SICI) and short intracortical facilitation (SICF). Second, considering that the presence of tissue injury could be detected by serum neurotrophins, we hypothesized that the spectrum of structural pathology (i.e., from persistent nociception like in OA, to the absence of tissue injury like in FM and MPS), could be detected by differential efficiency of their descending pain inhibitory system, as assessed by the conditioned pain modulation (CPM) paradigm. Third, we explored whether brain-derived neurotrophic factor (BDNF) had an influence on the relationship between motor cortex excitability and structural pathology. This cross-sectional study pooled baseline data from three randomized clinical trials. We included females (n = 114), aged 19–65 years old with disability by chronic pain syndromes (CPS): FM (n = 19), MPS (n = 54), OA (n = 27) and healthy subjects (n = 14). We assessed the serum BDNF, the motor cortex excitability by parameters the TMS measures and the change on numerical pain scale [NPS (0–10)] during CPM-task. The adjusted mean (SD) on the SICI observed in the absence of tissue injury was 56.36% lower than with persistent nociceptive input [0.31(0.18) vs. 0.55 (0.32)], respectively. The BDNF was inversely correlated with the SICI and with the change on NPS (0–10)during CPM-task. These findings suggest greater disinhibition in the motor cortex and the descending pain inhibitory system in FM and

  10. Motor Cortex Excitability and BDNF Levels in Chronic Musculoskeletal Pain According to Structural Pathology.

    PubMed

    Caumo, Wolnei; Deitos, Alícia; Carvalho, Sandra; Leite, Jorge; Carvalho, Fabiana; Dussán-Sarria, Jairo Alberto; Lopes Tarragó, Maria da Graça; Souza, Andressa; Torres, Iraci Lucena da Silva; Fregni, Felipe

    2016-01-01

    The central sensitization syndrome (CSS) encompasses disorders with overlapping symptoms in a structural pathology spectrum ranging from persistent nociception [e.g., osteoarthritis (OA)] to an absence of tissue injuries such as the one presented in fibromyalgia (FM) and myofascial pain syndrome (MPS). First, we hypothesized that these syndromes present differences in their cortical excitability parameters assessed by transcranial magnetic stimulation (TMS), namely motor evoked potential (MEP), cortical silent period (CSP), short intracortical inhibition (SICI) and short intracortical facilitation (SICF). Second, considering that the presence of tissue injury could be detected by serum neurotrophins, we hypothesized that the spectrum of structural pathology (i.e., from persistent nociception like in OA, to the absence of tissue injury like in FM and MPS), could be detected by differential efficiency of their descending pain inhibitory system, as assessed by the conditioned pain modulation (CPM) paradigm. Third, we explored whether brain-derived neurotrophic factor (BDNF) had an influence on the relationship between motor cortex excitability and structural pathology. This cross-sectional study pooled baseline data from three randomized clinical trials. We included females (n = 114), aged 19-65 years old with disability by chronic pain syndromes (CPS): FM (n = 19), MPS (n = 54), OA (n = 27) and healthy subjects (n = 14). We assessed the serum BDNF, the motor cortex excitability by parameters the TMS measures and the change on numerical pain scale [NPS (0-10)] during CPM-task. The adjusted mean (SD) on the SICI observed in the absence of tissue injury was 56.36% lower than with persistent nociceptive input [0.31(0.18) vs. 0.55 (0.32)], respectively. The BDNF was inversely correlated with the SICI and with the change on NPS (0-10)during CPM-task. These findings suggest greater disinhibition in the motor cortex and the descending pain inhibitory system in FM and MPS

  11. Opioid receptors and their ligands in the musculoskeletal system and relevance for pain control.

    PubMed

    Spetea, Mariana

    2013-01-01

    Interest in opioid drugs like morphine, as the oldest and most potent pain-killing agents known, has been maintained through the years. One of the most frequent chronic pain sensations people experience is associated with pathological conditions of the musculoskeletal system. Chronic musculoskeletal pain is a major health problem, and an adequate management requires understanding of both peripheral and central components, with more attention drawn to the former. Intense experimental and clinical research activities resulted in important knowledge on the mechanisms and functions of the endogenous opioid system located in the periphery. This review describes the occurrence and distribution of endogenous opioids and their receptors in the musculoskeletal system, and their role in pain control in musculoskeletal disorders, such as rheumatoid arthritis and osteoarthritis. Using different techniques, including immunohistochemistry, electron microscopy or radioimmunoassay, expression of enkephalins, dynorphin, β-endorphin, and endomorphins was demonstrated in musculoskeletal tissues of animals and humans. Localization of opioid peptides was found in synovial membrane, periosteum, bone and bone marrow, loose connective tissue, the paratenon and musculotendinous junction of the achilles tendon. Animal and human studies have also demonstrated expression of µ, δ and κ opioid receptor proteins in musculoskeletal tissues using radioligand binding assays, autoradiography, electrophysiology, immunohistochemistry and Western blotting. Opioid receptor gene expression was reported based on polymerase chain reaction and in situ hybridization techniques. Combining morphological and quantitative approaches, important evidence that the musculoskeletal apparatus is equipped with a peripheral opioid system is provided. Demonstration of the occurrence of an endogenous opioid system in bone and joint tissues represents an essential step for defining novel pharmacological strategies to

  12. Pathological mechanism of musculoskeletal manifestations associated with CRPS type II: an animal study.

    PubMed

    Ota, Hideyuki; Arai, Tetsuya; Iwatsuki, Katsuyuki; Urano, Hideki; Kurahashi, Toshikazu; Kato, Shuichi; Yamamoto, Michiro; Hirata, Hitoshi

    2014-10-01

    Patients with complex regional pain syndrome (CRPS) often complain of abnormal sensations beyond the affected body part, but causes of this spread of musculoskeletal manifestations into contiguous areas remain unclear. In addition, immobilization can predispose to the development of CRPS. We examined functional, biochemical, and histological alterations in affected parts, including contiguous zones, using an animal model. Ten-week-old male Wistar rats were assigned to 5 groups: a normal group receiving no treatment, a sham operation group with surgical exploration, an immobilization group with surgical exploration plus internal knee joint immobilization, a surgical neuropathy group prepared by spinal nerve ligation (SNL) of the left L5 nerve root, and a surgical neuropathy+immobilization group with simultaneous SNL and knee joint immobilization. Mechanical allodynia and knee contracture were compared between groups, and tissues were harvested for histological assessments and gene and protein expression analyses. Neither surgical procedures nor immobilization induced detectable mechanical sensitivity. However, the addition of nerve injury resulted in detectable mechanical allodynia, and immobilization not only accelerated hyperalgesia, but also resulted in muscle fibrosis. Nerve growth factor (NGF) and other mediators of neurogenic inflammation were highly expressed not only in denervated muscles, but also in innervated muscles in contiguous areas, suggesting the spread of NGF production beyond the myotome of the injured nerve. Transforming growth factor β was involved in the development of contracture in CRPS. These findings imply that neuroinflammatory components play major roles in the progression and dispersion of both sensory pathologies and pathologies that are exacerbated by immobilization. PMID:25016218

  13. The effect of relaxin on the musculoskeletal system

    PubMed Central

    Dehghan, F; Haerian, B S; Muniandy, S; Yusof, A; Dragoo, J L; Salleh, N

    2014-01-01

    Relaxin is a hormone structurally related to insulin and insulin-like growth factor, which exerts its regulatory effect on the musculoskeletal and other systems through binding to its receptor in various tissues, mediated by different signaling pathways. Relaxin alters the properties of cartilage and tendon by activating collagenase. This hormone is also involved in bone remodeling and healing of injured ligaments and skeletal muscle. In this review, we have summarized the literature on the effect of relaxin in musculoskeletal system to provide a broad perspective for future studies in this field. PMID:24283470

  14. Usefulness of strain elastography of the musculoskeletal system

    PubMed Central

    2016-01-01

    Ultrasound elastography is a widely used technique for assessing the mechanical characteristics of tissues. Although there are several ultrasound elastography techniques, strain elastography (SE) is currently the most widely used technique for visualizing an elastographic map in real time. Among its various indications, SE is especially useful in evaluating the musculoskeletal system. In this article, we review the SE techniques for clinical practice and describe the images produced by these techniques in the context of the musculoskeletal system. SE provides information about tissue stiffness and allows real-time visualization of the image; however, SE cannot completely replace gray-scale, color, or power Doppler ultrasonography. SE can increase diagnostic accuracy and may be useful for the follow-up of benign lesions. PMID:26810195

  15. [Deleterious effects of smoking on the musculoskeletal system].

    PubMed

    Duthon, V B; Ozturk, M; El-Achachi, S; Menetrey, J

    2014-07-16

    Tobacco smoking has important negative effects on the musculoskeletal system: decrease of bone mineral density, increase of the risk of injury, illness, and perioperative complications such as fracture-healing complications and wound complications. Orthopaedic surgeons should inform all patients of the increased risks associated with active smoking in the perioperative period and should encourage them to quit smoking four to eight weeks in advance of the proposed procedure. PMID:25141568

  16. Computed tomography findings of paracoccidiodomycosis in musculoskeletal system

    PubMed Central

    Lima Júnior, Francisco Valtenor Araújo; Savarese, Leonor Garbin; Monsignore, Lucas Moretti; Martinez, Roberto; Nogueira-Barbosa, Marcello Henrique

    2015-01-01

    Objective To evaluate musculoskeletal involvement in paracoccidioidomycosis at computed tomography. Materials and Methods Development of a retrospective study based on a review of radiologic and pathologic reports in the institution database. Patients with histopathologically confirmed musculoskeletal paracoccidioidomycosis and submitted to computed tomography were included in the present study. The imaging findings were consensually described by two radiologists. In order to avoid bias in the analysis, one patient with uncountable bone lesions was excluded from the study. Results A total of seven patients were included in the present study. A total of 18 bone lesions were counted. The study group consisted of 7 patients. A total number of 18 bone lesions were counted. Osteoarticular lesions were the first manifestation of the disease in four patients (57.14%). Bone lesions were multiple in 42.85% of patients. Appendicular and axial skeleton were affected in 85.71% and 42.85% of cases, respectively. Bone involvement was characterized by well-demarcated osteolytic lesions. Marginal osteosclerosis was identified in 72.22% of the lesions, while lamellar periosteal reaction and soft tissue component were present in 5.55% of them. One patient showed multiple small lesions with bone sequestra. Conclusion Paracoccidioidomycosis can be included in the differential diagnosis of either single or multiple osteolytic lesions in young patients even in the absence of a previous diagnosis of pulmonary or visceral paracoccidioidomycosis PMID:25798000

  17. Crucial Role of Vitamin D in the Musculoskeletal System.

    PubMed

    Wintermeyer, Elke; Ihle, Christoph; Ehnert, Sabrina; Stöckle, Ulrich; Ochs, Gunnar; de Zwart, Peter; Flesch, Ingo; Bahrs, Christian; Nussler, Andreas K

    2016-01-01

    Vitamin D is well known to exert multiple functions in bone biology, autoimmune diseases, cell growth, inflammation or neuromuscular and other immune functions. It is a fat-soluble vitamin present in many foods. It can be endogenously produced by ultraviolet rays from sunlight when the skin is exposed to initiate vitamin D synthesis. However, since vitamin D is biologically inert when obtained from sun exposure or diet, it must first be activated in human beings before functioning. The kidney and the liver play here a crucial role by hydroxylation of vitamin D to 25-hydroxyvitamin D in the liver and to 1,25-dihydroxyvitamin D in the kidney. In the past decades, it has been proven that vitamin D deficiency is involved in many diseases. Due to vitamin D's central role in the musculoskeletal system and consequently the strong negative impact on bone health in cases of vitamin D deficiency, our aim was to underline its importance in bone physiology by summarizing recent findings on the correlation of vitamin D status and rickets, osteomalacia, osteopenia, primary and secondary osteoporosis as well as sarcopenia and musculoskeletal pain. While these diseases all positively correlate with a vitamin D deficiency, there is a great controversy regarding the appropriate vitamin D supplementation as both positive and negative effects on bone mineral density, musculoskeletal pain and incidence of falls are reported. PMID:27258303

  18. Crucial Role of Vitamin D in the Musculoskeletal System

    PubMed Central

    Wintermeyer, Elke; Ihle, Christoph; Ehnert, Sabrina; Stöckle, Ulrich; Ochs, Gunnar; de Zwart, Peter; Flesch, Ingo; Bahrs, Christian; Nussler, Andreas K.

    2016-01-01

    Vitamin D is well known to exert multiple functions in bone biology, autoimmune diseases, cell growth, inflammation or neuromuscular and other immune functions. It is a fat-soluble vitamin present in many foods. It can be endogenously produced by ultraviolet rays from sunlight when the skin is exposed to initiate vitamin D synthesis. However, since vitamin D is biologically inert when obtained from sun exposure or diet, it must first be activated in human beings before functioning. The kidney and the liver play here a crucial role by hydroxylation of vitamin D to 25-hydroxyvitamin D in the liver and to 1,25-dihydroxyvitamin D in the kidney. In the past decades, it has been proven that vitamin D deficiency is involved in many diseases. Due to vitamin D’s central role in the musculoskeletal system and consequently the strong negative impact on bone health in cases of vitamin D deficiency, our aim was to underline its importance in bone physiology by summarizing recent findings on the correlation of vitamin D status and rickets, osteomalacia, osteopenia, primary and secondary osteoporosis as well as sarcopenia and musculoskeletal pain. While these diseases all positively correlate with a vitamin D deficiency, there is a great controversy regarding the appropriate vitamin D supplementation as both positive and negative effects on bone mineral density, musculoskeletal pain and incidence of falls are reported. PMID:27258303

  19. The Musculoskeletal System. Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    This instructional modular unit with instructor's guide provides materials on aspects of one of the major systems of the human body--the musculoskeletal system. Its purpose is to introduce the student to the structures and functions of the human musculoskeletal system--and the interrelationships of the two--and to familiarize the student with some…

  20. 3 T magnetic resonance imaging of the musculoskeletal system.

    PubMed

    Guglielmi, G; Biccari, N; Mangano, F; Toffanin, R

    2010-06-01

    The increasing distribution of high-field (3 T) magnetic resonance (MR) systems for clinical use has been accompanied by the need to fully understand the advantages and disadvantages that the increase in signal quality confers. Continuous development of the coils is required to fully express the potential of these systems, especially given the synergy between parallel imaging and the recent multichannel phased-array coils, which are able to improve image quality, spatial resolution and diagnostic accuracy in musculoskeletal imaging. The increase in signal offered by the high field makes possible improved visualisation of bone, cartilage, tendons and ligaments. This advantage, together with increased spatial resolution, is particularly useful when studying joints or some of their components, the evaluation of which has produced suboptimal results in non arthrographic examinations such as the glenoid labrum of the shoulder and the articular cartilage of the knee. Thanks to the greater signal-to-noise ratio and improved spatial resolution, MR imaging at 3 T is able to notably increase diagnostic performance in the musculoskeletal setting, with a consequent improvement in patient treatment and management. PMID:20177987

  1. Impact of joint laxity and hypermobility on the musculoskeletal system.

    PubMed

    Wolf, Jennifer Moriatis; Cameron, Kenneth L; Owens, Brett D

    2011-08-01

    Excessive joint laxity, or hypermobility, is a common finding of clinical importance in the management of musculoskeletal conditions. Hypermobility is common in young patients and in general is associated with an increased incidence of musculoskeletal injury. Hypermobility has been implicated in ankle sprains, anterior cruciate ligament injury, shoulder instability, and osteoarthritis of the hand. Patients with hypermobility and musculoskeletal injuries often seek care for diffuse musculoskeletal pain and injuries with no specific inciting event. Orthopaedic surgeons and other healthcare providers should be aware of the underlying relationship between hypermobility and musculoskeletal injury to avoid unnecessary diagnostic tests and inappropriate management. Prolonged therapy and general conditioning are typically required, with special emphasis on improving strength and proprioception to address symptoms and prevent future injury. Orthopaedic surgeons must recognize the implications of joint mobility syndromes in the management and rehabilitation of several musculoskeletal injuries and orthopaedic disorders. PMID:21807914

  2. Novel Approaches for Treating Musculoskeletal Diseases: Molecular Orthopedics and Systems Medicine

    PubMed Central

    Mashayekhi, Kaveh; O’Brien, Margaret; Zugun-Eloae, Florin; Labusca, Luminita

    2013-01-01

    Molecular medicine uses knowledge about cell structure and function for disease, diagnostics, stage characterisation and treatment. The advent of genomic technologies is considerably leading to developments in the field of molecular medicine. The accumulation of detailed information about gene expression, epigenetic variability, protein transcription and functional modulation is contributing to a new era in medicine. Rapid and early diagnostic procedures, molecular characterisation of degenerative and proliferative diseases and personalized therapies are predicted to lead to advancements in health prevention and treatment of disease. Diagnostic tools and therapies based on local and /or general modulation of cellular processes for traumatic or degenerative musculoskeletal conditions are becoming available. A logical consequence of the information derived from extensive data gathering, systems biology and systemic medicine has lead to significant improvements in understanding biological structure and function in a simultaneous bottom top and integrative, holistic manner. The description of disease mechanism at an intimate, subcellular level has a dual benefit. A thorough understanding of the crosstalk involved in molecular pathways both in the normal and the diseased state are expanding scientific knowledge and simultaneously are enabling design cell-targeted and individualized therapies. This paper presents a brief overview of current molecular based treatments available to the orthopedic surgeon and introduces the concept of systemic medicine from the perspective of musculoskeletal pathology. PMID:23798982

  3. T1ρ MR Imaging of Human Musculoskeletal System

    PubMed Central

    Wang, Ligong; Regatte, Ravinder R.

    2014-01-01

    Magnetic resonance imaging (MRI) offers the direct visualization of human musculoskeletal (MSK) system, especially all diarthrodial tissues including cartilage, bone, menisci, ligaments, tendon, hip, synovium etc. Conventional MR imaging techniques based on T1- and T2-weighted, proton density (PD) contrast are inconclusive in quantifying early biochemically degenerative changes in MSK system in general and articular cartilage in particular. In recent years, quantitative MR parameter mapping techniques have been used to quantify the biochemical changes in articular cartilage with a special emphasis on evaluating joint injury, cartilage degeneration, and soft tissue repair. In this article, we will focus on cartilage biochemical composition, basic principles of T1ρ MR imaging, implementation of T1ρ pulse sequences, biochemical validation, and summarize the potential applications of T1ρ MR imaging technique in MSK diseases including osteoarthritis (OA), anterior cruciate ligament (ACL) injury, and knee joint repair. Finally, we will also review the potential advantages, challenges, and future prospects of T1ρ MR imaging for widespread clinical translation. PMID:24935818

  4. T₁ρ MRI of human musculoskeletal system.

    PubMed

    Wang, Ligong; Regatte, Ravinder R

    2015-03-01

    Magnetic resonance imaging (MRI) offers the direct visualization of the human musculoskeletal (MSK) system, especially all diarthrodial tissues including cartilage, bone, menisci, ligaments, tendon, hip, synovium, etc. Conventional MRI techniques based on T1 - and T2 -weighted, proton density (PD) contrast are inconclusive in quantifying early biochemically degenerative changes in MSK system in general and articular cartilage in particular. In recent years, quantitative MR parameter mapping techniques have been used to quantify the biochemical changes in articular cartilage, with a special emphasis on evaluating joint injury, cartilage degeneration, and soft tissue repair. In this article we focus on cartilage biochemical composition, basic principles of T1ρ MRI, implementation of T1ρ pulse sequences, biochemical validation, and summarize the potential applications of the T1ρ MRI technique in MSK diseases including osteoarthritis (OA), anterior cruciate ligament (ACL) injury, and knee joint repair. Finally, we also review the potential advantages, challenges, and future prospects of T1ρ MRI for widespread clinical translation. PMID:24935818

  5. Gene therapy approaches to regenerating the musculoskeletal system

    PubMed Central

    Evans, Christopher H.; Huard, Johnny

    2015-01-01

    Injuries to the musculoskeletal system are common, debilitating and expensive. In many cases, healing is imperfect, which leads to chronic impairment. Gene transfer might improve repair and regeneration at sites of injury by enabling the local, sustained and potentially regulated expression of therapeutic gene products; such products include morphogens, growth factors and anti-inflammatory proteins. Proteins produced endogenously as a result of gene transfer are nascent molecules that have undergone post-translational modification. In addition, gene transfer offers particular advantages for the delivery of products with an intracellular site of action, such as transcription factors and noncoding RNAs, and proteins that need to be inserted into a cell compartment, such as a membrane. Transgenes can be delivered by viral or nonviral vectors via in vivo or ex vivo protocols using progenitor or differentiated cells. The first gene transfer clinical trials for osteoarthritis and cartilage repair have already been completed. Various bone-healing protocols are at an advanced stage of development, including studies with large animals, and human trials are envisaged. Other applications in the repair and regeneration of skeletal muscle, intervertebral disc, meniscus, ligament and tendon are in preclinical development. In addition to scientific, medical and safety considerations, clinical translation is constrained by social, financial and logistical issues. PMID:25776949

  6. Novel Musculoskeletal Loading System for Small Exercise Devices

    NASA Technical Reports Server (NTRS)

    Downs, Meghan; Newby, Nate; Trinh, Tinh; Hanson, Andrea

    2016-01-01

    Long duration spaceflight places astronauts at increased risk for muscle strain and bone fracture upon return to a 1-g or partial gravity environment. Functionally limiting decrements in musculoskeletal health are likely during Mars proving-ground and Earth-independent missions given extended transit times and the vehicle limitations for exercise devices (low-mass, small volume, little to no power). This is particularly alarming for exploration missions because astronauts will be required to perform novel and physically demanding tasks (i.e. vehicle egress, exploration, and habitat building activities) on unfamiliar terrain. Accordingly, NASA's exploration roadmap identifies the need for development of small exercise equipment that can prevent musculoskeletal atrophy and has the ability to assess musculoskeletal health at multiple time points during long-duration missions.

  7. Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders.

    PubMed

    Pelletier, René; Higgins, Johanne; Bourbonnais, Daniel

    2015-11-01

    Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across

  8. The Musculoskeletal System [and] Instructor's Guide: The Musculoskeletal System. Health Occupations Education Module: Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    This module on the musculoskeletal system is one of 17 modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. It is part of an eight-unit miniseries on anatomy and physiology within the series of 17 modules. Following a preface which explains to the student how to…

  9. Digital pathology and anatomic pathology laboratory information system integration to support digital pathology sign-out

    PubMed Central

    Guo, Huazhang; Birsa, Joe; Farahani, Navid; Hartman, Douglas J.; Piccoli, Anthony; O’Leary, Matthew; McHugh, Jeffrey; Nyman, Mark; Stratman, Curtis; Kvarnstrom, Vanja; Yousem, Samuel; Pantanowitz, Liron

    2016-01-01

    Background: The adoption of digital pathology offers benefits over labor-intensive, time-consuming, and error-prone manual processes. However, because most workflow and laboratory transactions are centered around the anatomical pathology laboratory information system (APLIS), adoption of digital pathology ideally requires integration with the APLIS. A digital pathology system (DPS) integrated with the APLIS was recently implemented at our institution for diagnostic use. We demonstrate how such integration supports digital workflow to sign-out anatomical pathology cases. Methods: Workflow begins when pathology cases get accessioned into the APLIS (CoPathPlus). Glass slides from these cases are then digitized (Omnyx VL120 scanner) and automatically uploaded into the DPS (Omnyx® Integrated Digital Pathology (IDP) software v.1.3). The APLIS transmits case data to the DPS via a publishing web service. The DPS associates scanned images with the correct case using barcode labels on slides and information received from the APLIS. When pathologists remotely open a case in the DPS, additional information (e.g. gross pathology details, prior cases) gets retrieved from the APLIS through a query web service. Results: Following validation of this integration, pathologists at our institution have signed out more than 1000 surgical pathology cases in a production environment. Integration between the APLIS and DPS enabled pathologists to review digital slides while simultaneously having access to pertinent case metadata. The introduction of a digital workflow eliminated costly manual tasks involving matching of glass slides and avoided delays waiting for glass slides to be delivered. Conclusion: Integrating the DPS and APLIS were instrumental for successfully implementing a digital solution at our institution for pathology sign-out. The integration streamlined our digital sign-out workflow, diminished the potential for human error related to matching slides, and improved the sign

  10. Computer Assisted Learning Systems in Pathology Teaching.

    ERIC Educational Resources Information Center

    Harkin, P. J. R.; And Others

    1986-01-01

    Describes the use of computer assisted instructional systems in the teaching of pathology. Explains the components of a typical computer-based system and compares interactive systems which use visual displays ranging from microfiche projectors to video discs. Discusses computer programs prepared for courses in general pathology and systemic…

  11. Electrical stimulation: Its role in growth, repair and remodeling of the musculoskeletal system

    SciTech Connect

    Black, J.

    1986-01-01

    This book examines the increasingly popular field of electrical stimulation of lesions of the musculoskeletal system, exploring its use in both research and treatment. The book describes clinical experience with electrical stimulation in orthopedic, neuro- and plastic surgery, biological sources of electrical signals, and electromechanical characterization of tissues. Contents include: growth; remodeling and repair; electricity and magnetism; electrical properties of tissues; natural electrical signals in the musculoskeletal system; methods for stimulating tissues; cell, tissue and organ culture; animal studies; clinical applications; overview and a glossary.

  12. [Musculoskeletal pathology in occupational risks and common degenerative disease: reflections on the intensity and duration of the risk].

    PubMed

    Bergamini, Roberta; Astengo, Rossana

    2014-01-01

    Nowadays, in Italy the reports of mnusculoskeletal diseases increase as confirmed in the last INAIL (national insurance for occupational diseases and injuries) annual report. The Emilia-Ronmagna is one of the region with the highest number of reports: 15.9% of the total in 2012. The decree no. 81/08 has partially simplified the medico-legal activities related to musculoskeletal diseases; however, the medico-legal physicians have still to deal with some issues such as risk assessment quality, economic crisis, and specific work environments (e.g. agriculture and many handicraft activities). Tire risk factors of musculoskeletal diseases and their assessments are quite well studied. The latency period of these diseases needs to be investigated, since it could be a relevant aspect for legal medical judgment, insurance protection and prevention. Based on literature data and INAIL experience, authors propose some considerations useful for a scientific debate. PMID:25558730

  13. Application of neural networks for the prediction of cartilage stress in a musculoskeletal system.

    PubMed

    Lu, Yunkai; Pulasani, Palgun Reddy; Derakhshani, Reza; Guess, Trent M

    2013-11-01

    Traditional finite element (FE) analysis is computationally demanding. The computational time becomes prohibitively long when multiple loading and boundary conditions need to be considered such as in musculoskeletal movement simulations involving multiple joints and muscles. Presented in this study is an innovative approach that takes advantage of the computational efficiency of both the dynamic multibody (MB) method and neural network (NN) analysis. A NN model that captures the behavior of musculoskeletal tissue subjected to known loading situations is built, trained, and validated based on both MB and FE simulation data. It is found that nonlinear, dynamic NNs yield better predictions over their linear, static counterparts. The developed NN model is then capable of predicting stress values at regions of interest within the musculoskeletal system in only a fraction of the time required by FE simulation. PMID:23997807

  14. Contemporary issues in computed tomography: Computed tomography of the musculoskeletal system

    SciTech Connect

    Scott, W.W.; Magid, D.; Fishman, E.K.

    1987-01-01

    The purpose of this book is to focus on the application of CT to the musculoskeletal system. Ten chapters deal with tumors, inflammation, trauma, and osteoporosis. There are specific chapters for the foot and ankle, the shoulder, and also for magnetic resonance (MR) imaging and newer CT scanning capabilities. Five interesting case discussions are included. Each chapter provides an up-to-date reference list. Each chapter varies, which reflects the styles of the contributing authors, but each one is well written, concise, comprehensive, and illustrated with good quality and representative scans. This book covers a broad range of musculoskeletal topics.

  15. [Pain syndrome of the musculoskeletal system in children and adolescents].

    PubMed

    Höfel, L; Draheim, N; Häfner, R; Haas, J P

    2016-04-01

    Chronic pain syndromes in children and adolescents are defined as continuous or recurrent pain without an underlying causative diagnosis and lasting for more than 3 months. It is estimated that every fourth child in Germany suffers from chronic pain with every twentieth suffering from extreme recurrent pain. The incidence of chronic pain in children and adolescents is increasing with headache, abdominal pain and musculoskeletal pain being the most frequent. The quality of life declines not only due to the pain but to relieving postural and psychological factors, such as fear and sadness. School attendance, social activities and hobbies are mostly affected. This review summarizes the background of chronic pain syndromes and introduces a multimodal therapeutic approach. PMID:26892925

  16. Organogenesis of the Musculoskeletal System in Horse Embryos and Early Fetuses.

    PubMed

    Barreto, Rodrigo da Silva Nunes; Rodrigues, Márcio Nogueira; Carvalho, Rafael Cardoso; De Oliveira E Silva, Fernanda Menezes; Rigoglio, Náthia Nathaly; Jacob, Júlio César Ferraz; Gastal, Eduardo Leite; Miglino, Maria Angélica

    2016-06-01

    Musculoskeletal system development involves heterotypical inductive interactions between tendons, muscles, and cartilage and knowledge on organogenesis is required for clarification of its function. The aim of this study was to describe the organogenesis of horse musculoskeletal system between 21 and 105 days of gestation, using detailed macroscopic and histological analyses focusing on essential developmental steps. At day 21 of gestation the skin was translucid, but epithelial condensation and fibrocartilaginous tissues were observed on day 25 of pregnancy. Smooth muscle was seen in lymphatic and blood vessel walls and the beginning of cartilaginous chondrocranium was detected at day 30 of gestation. At day 45, typical chondroblasts and chondrocytes were observed and at day 55, mandibular processes expanded toward the ventral midline of the pharynx. At day 75, muscles became thicker and muscle fibers were seen developing in carpal and metacarpal joints with the beginning of the ossification process. At day 105, major muscle groups, similar to those seen in an adult equine, were observed. The caudal area of the nasal capsule and trabecular cartilages increased in size and became ossified, developing into the ethmoid bone. The presence of nasal, frontal, parietal, and occipital bones was observed. In conclusion, novel features of equine musculoskeletal system development have been described here and each process was linked with an early musculoskeletal event. Data presented herein will facilitate a better understanding of the equine muscular system organogenesis and aid in the detection of congenital deformities. Anat Rec, 299:722-729, 2016. © 2016 Wiley Periodicals, Inc. PMID:26934175

  17. Anatomic pathology laboratory information systems: a review.

    PubMed

    Park, Seung Lyung; Pantanowitz, Liron; Sharma, Gaurav; Parwani, Anil Vasdev

    2012-03-01

    The modern anatomic pathology laboratory depends on a reliable information infrastructure to register specimens, record gross and microscopic findings, regulate laboratory workflow, formulate and sign out report(s), disseminate them to the intended recipients across the whole health system, and support quality assurance measures. This infrastructure is provided by the Anatomical Pathology Laboratory Information Systems (APLIS), which have evolved over decades and now are beginning to support evolving technologies like asset tracking and digital imaging. As digital pathology transitions from "the way of the future" to "the way of the present," the APLIS continues to be one of the key effective enablers of the scope and practice of pathology. In this review, we discuss the evolution, necessary components, architecture and functionality of the APLIS that are crucial to today's practicing pathologist and address the demands of emerging trends on the future APLIS. PMID:22313836

  18. Development of Intelligent Suits for Disuse Atrophy of Musculoskeletal System Using Hybrid Exercise Method

    NASA Astrophysics Data System (ADS)

    Shiba, Naoto; Yoshimitsu, Kazuhiro; Matsugaki, Tohru; Narita, Arata; Maeda, Takashi; Inada, Tomohisa; Tagawa, Yoshihiko; Numada, Kiyoshi; Nishi, Tetsuya

    We developed ‘Hybrid exercise’ method that was designed to maintain the musculoskeletal system by using electrically stimulated antagonist muscles to resist volitional contraction of agonist muscles. This approach also produces a minimum of inertial reaction forces and has the advantage that it may minimize the need for external stabilization that is currently necessary during exercise in a weightlessness environment. The purpose of this study was to develop the intelligent suits with virtual reality (VR) system that had function of preventing disuse atrophy of musculoskeletal system using hybrid exercise system. Installing of the hybrid exercise system to the subject became easy by the intelligent suits. VR system realized the sense of sight by computer graphics animation synchronized with subjects' motion, and sense of force induced by electrical stimulation. By using VR system, the management of the exercise accomplishment degree was enabled easily because the device could record the exercise history. Intelligent suits with VR hybrid exercise system might become one of the useful countermeasures for the disuse musculoskeletal system in the space.

  19. Seeing through Musculoskeletal Tissues: Improving In Situ Imaging of Bone and the Lacunar Canalicular System through Optical Clearing.

    PubMed

    Berke, Ian M; Miola, Joseph P; David, Michael A; Smith, Melanie K; Price, Christopher

    2016-01-01

    In situ, cells of the musculoskeletal system reside within complex and often interconnected 3-D environments. Key to better understanding how 3-D tissue and cellular environments regulate musculoskeletal physiology, homeostasis, and health is the use of robust methodologies for directly visualizing cell-cell and cell-matrix architecture in situ. However, the use of standard optical imaging techniques is often of limited utility in deep imaging of intact musculoskeletal tissues due to the highly scattering nature of biological tissues. Drawing inspiration from recent developments in the deep-tissue imaging field, we describe the application of immersion based optical clearing techniques, which utilize the principle of refractive index (RI) matching between the clearing/mounting media and tissue under observation, to improve the deep, in situ imaging of musculoskeletal tissues. To date, few optical clearing techniques have been applied specifically to musculoskeletal tissues, and a systematic comparison of the clearing ability of optical clearing agents in musculoskeletal tissues has yet to be fully demonstrated. In this study we tested the ability of eight different aqueous and non-aqueous clearing agents, with RIs ranging from 1.45 to 1.56, to optically clear murine knee joints and cortical bone. We demonstrated and quantified the ability of these optical clearing agents to clear musculoskeletal tissues and improve both macro- and micro-scale imaging of musculoskeletal tissue across several imaging modalities (stereomicroscopy, spectroscopy, and one-, and two-photon confocal microscopy) and investigational techniques (dynamic bone labeling and en bloc tissue staining). Based upon these findings we believe that optical clearing, in combination with advanced imaging techniques, has the potential to complement classical musculoskeletal analysis techniques; opening the door for improved in situ investigation and quantification of musculoskeletal tissues. PMID:26930293

  20. Seeing through Musculoskeletal Tissues: Improving In Situ Imaging of Bone and the Lacunar Canalicular System through Optical Clearing

    PubMed Central

    Berke, Ian M.; Miola, Joseph P.; David, Michael A.; Smith, Melanie K.; Price, Christopher

    2016-01-01

    In situ, cells of the musculoskeletal system reside within complex and often interconnected 3-D environments. Key to better understanding how 3-D tissue and cellular environments regulate musculoskeletal physiology, homeostasis, and health is the use of robust methodologies for directly visualizing cell-cell and cell-matrix architecture in situ. However, the use of standard optical imaging techniques is often of limited utility in deep imaging of intact musculoskeletal tissues due to the highly scattering nature of biological tissues. Drawing inspiration from recent developments in the deep-tissue imaging field, we describe the application of immersion based optical clearing techniques, which utilize the principle of refractive index (RI) matching between the clearing/mounting media and tissue under observation, to improve the deep, in situ imaging of musculoskeletal tissues. To date, few optical clearing techniques have been applied specifically to musculoskeletal tissues, and a systematic comparison of the clearing ability of optical clearing agents in musculoskeletal tissues has yet to be fully demonstrated. In this study we tested the ability of eight different aqueous and non-aqueous clearing agents, with RIs ranging from 1.45 to 1.56, to optically clear murine knee joints and cortical bone. We demonstrated and quantified the ability of these optical clearing agents to clear musculoskeletal tissues and improve both macro- and micro-scale imaging of musculoskeletal tissue across several imaging modalities (stereomicroscopy, spectroscopy, and one-, and two-photon confocal microscopy) and investigational techniques (dynamic bone labeling and en bloc tissue staining). Based upon these findings we believe that optical clearing, in combination with advanced imaging techniques, has the potential to complement classical musculoskeletal analysis techniques; opening the door for improved in situ investigation and quantification of musculoskeletal tissues. PMID:26930293

  1. Virtual interactive musculoskeletal system (VIMS) in orthopaedic research, education and clinical patient care

    PubMed Central

    Chao, Edmund YS; Armiger, Robert S; Yoshida, Hiroaki; Lim, Jonathan; Haraguchi, Naoki

    2007-01-01

    The ability to combine physiology and engineering analyses with computer sciences has opened the door to the possibility of creating the "Virtual Human" reality. This paper presents a broad foundation for a full-featured biomechanical simulator for the human musculoskeletal system physiology. This simulation technology unites the expertise in biomechanical analysis and graphic modeling to investigate joint and connective tissue mechanics at the structural level and to visualize the results in both static and animated forms together with the model. Adaptable anatomical models including prosthetic implants and fracture fixation devices and a robust computational infrastructure for static, kinematic, kinetic, and stress analyses under varying boundary and loading conditions are incorporated on a common platform, the VIMS (Virtual Interactive Musculoskeletal System). Within this software system, a manageable database containing long bone dimensions, connective tissue material properties and a library of skeletal joint system functional activities and loading conditions are also available and they can easily be modified, updated and expanded. Application software is also available to allow end-users to perform biomechanical analyses interactively. Examples using these models and the computational algorithms in a virtual laboratory environment are used to demonstrate the utility of these unique database and simulation technology. This integrated system, model library and database will impact on orthopaedic education, basic research, device development and application, and clinical patient care related to musculoskeletal joint system reconstruction, trauma management, and rehabilitation. PMID:17343764

  2. Irxl1 mutant mice show reduced tendon differentiation and no patterning defects in musculoskeletal system development.

    PubMed

    Kimura, Wataru; Machii, Masashi; Xue, XiaoDong; Sultana, Nishat; Hikosaka, Keisuke; Sharkar, Mohammad T K; Uezato, Tadayoshi; Matsuda, Masashi; Koseki, Haruhiko; Miura, Naoyuki

    2011-01-01

    Irxl1 (Iroquois-related homeobox like-1) is a newly identified three amino-acid loop extension (TALE) homeobox gene, which is expressed in various mesoderm-derived tissues, particularly in the progenitors of the musculoskeletal system. To analyze the roles of Irxl1 during embryonic development, we generated mice carrying a null allele of Irxl1. Mice homozygous for the targeted allele were viable, fertile, and showed reduced tendon differentiation. Skeletal morphology and skeletal muscle weight in Irxl1-knockout mice appeared normal. Expression patterns of several marker genes for cartilage, tendon, and muscle progenitors in homozygous mutant embryos were unchanged. These results suggest that Irxl1 is required for the tendon differentiation but dispensable for the patterning of the musculoskeletal system in development. PMID:21254332

  3. Health Care System Changes and Reported Musculoskeletal Disorders Among Registered Nurses

    PubMed Central

    Lipscomb, Jane; Trinkoff, Alison; Brady, Barbara; Geiger-Brown, Jeanne

    2004-01-01

    Objectives. We evaluated the impact of health care system changes on nurses’ health, and we studied reported musculoskeletal disorders associated with these changes. Methods. This cross-sectional study (n = 1163) defined a musculoskeletal disorder case as moderate pain that lasted at least 1 week or occurred monthly during the past year. Nurses were asked about changes in the health care system in the past year, and responses to 12 changes were summed and were categorized as low, moderate, or high changes. Results. When the changes were summed, the adjusted odds ratios for musculoskeletal disorders for more than 6 versus 0 to 1 changes were (1) neck: 4.45 (95% confidence interval [CI] = 1.97, 10.08), (2) shoulder: 2.63 (95% CI = 1.17, 5.91), and (3) back: 3.42 (95% CI = 1.61, 7.27). Conclusions. The adverse impact on health caused by the changing health care system must be addressed to prevent further injuries among nurses. PMID:15284055

  4. Musculoskeletal Ultrasound in Pediatrics.

    PubMed

    Harcke, H. Theodore

    1998-01-01

    Ultrasound is ideally suited to the evaluation of the pediatric musculoskeletal system because of the increased ratio of cartilage to bone in the immature skeleton. The purpose of this article is to review the current uses of musculoskeletal ultrasound in pediatric patients. Hip sonography is widely accepted; other applications are increasing in popularity. PMID:11387111

  5. Knowledge-based personalized search engine for the Web-based Human Musculoskeletal System Resources (HMSR) in biomechanics.

    PubMed

    Dao, Tien Tuan; Hoang, Tuan Nha; Ta, Xuan Hien; Tho, Marie Christine Ho Ba

    2013-02-01

    Human musculoskeletal system resources of the human body are valuable for the learning and medical purposes. Internet-based information from conventional search engines such as Google or Yahoo cannot response to the need of useful, accurate, reliable and good-quality human musculoskeletal resources related to medical processes, pathological knowledge and practical expertise. In this present work, an advanced knowledge-based personalized search engine was developed. Our search engine was based on a client-server multi-layer multi-agent architecture and the principle of semantic web services to acquire dynamically accurate and reliable HMSR information by a semantic processing and visualization approach. A security-enhanced mechanism was applied to protect the medical information. A multi-agent crawler was implemented to develop a content-based database of HMSR information. A new semantic-based PageRank score with related mathematical formulas were also defined and implemented. As the results, semantic web service descriptions were presented in OWL, WSDL and OWL-S formats. Operational scenarios with related web-based interfaces for personal computers and mobile devices were presented and analyzed. Functional comparison between our knowledge-based search engine, a conventional search engine and a semantic search engine showed the originality and the robustness of our knowledge-based personalized search engine. In fact, our knowledge-based personalized search engine allows different users such as orthopedic patient and experts or healthcare system managers or medical students to access remotely into useful, accurate, reliable and good-quality HMSR information for their learning and medical purposes. PMID:23149160

  6. Use of Ultrasound Elastography in the Assessment of the Musculoskeletal System

    PubMed Central

    Paluch, Łukasz; Nawrocka-Laskus, Ewa; Wieczorek, Janusz; Mruk, Bartosz; Frel, Małgorzata; Walecki, Jerzy

    2016-01-01

    Summary This article presents possible applications of ultrasound elastography in musculoskeletal imaging based on the available literature, as well as the possibility of extending indications for the use of elastography in the future. Ultrasound elastography (EUS) is a new method that shows structural changes in tissues following application of physical stress. Elastography techniques have been widely used to assess muscles and tendons in vitro since the early parts of the twentieth century. Only recently with the advent of new technology and creation of highly specialized ultrasound devices, has elastography gained widespread use in numerous applications. The authors performed a search of the Medline/PubMed databases for original research and reviewed publications on the application of ultrasound elastography for musculoskeletal imaging. All publications demonstrate possible uses of ultrasound elastography in examinations of the musculoskeletal system. The most widely studied areas include the muscles, tendons and rheumatic diseases. There are also reports on the employment in vessel imaging. The main limitation of elastography as a technique is above all the variability of applied pressure during imaging, which is operator-dependent. It would therefore be reasonable to provide clear guidelines on the technique applied, as well as clear indications for performing the test. It is important to develop methods for creating artifact-free, closed-loop, compression-decompression cycles. The main advantages include cost-effectiveness, short duration of the study, non-invasive nature of the procedure, as well as a potentially broader clinical availability. There are no clear guidelines with regard to indications as well as examination techniques. Ultrasound elastography is a new and still poorly researched method. We conclude, however, that it can be widely used in the examinations of musculoskeletal system. Therefore, it is necessary to conduct large, multi

  7. Use of Ultrasound Elastography in the Assessment of the Musculoskeletal System.

    PubMed

    Paluch, Łukasz; Nawrocka-Laskus, Ewa; Wieczorek, Janusz; Mruk, Bartosz; Frel, Małgorzata; Walecki, Jerzy

    2016-01-01

    This article presents possible applications of ultrasound elastography in musculoskeletal imaging based on the available literature, as well as the possibility of extending indications for the use of elastography in the future. Ultrasound elastography (EUS) is a new method that shows structural changes in tissues following application of physical stress. Elastography techniques have been widely used to assess muscles and tendons in vitro since the early parts of the twentieth century. Only recently with the advent of new technology and creation of highly specialized ultrasound devices, has elastography gained widespread use in numerous applications. The authors performed a search of the Medline/PubMed databases for original research and reviewed publications on the application of ultrasound elastography for musculoskeletal imaging. All publications demonstrate possible uses of ultrasound elastography in examinations of the musculoskeletal system. The most widely studied areas include the muscles, tendons and rheumatic diseases. There are also reports on the employment in vessel imaging. The main limitation of elastography as a technique is above all the variability of applied pressure during imaging, which is operator-dependent. It would therefore be reasonable to provide clear guidelines on the technique applied, as well as clear indications for performing the test. It is important to develop methods for creating artifact-free, closed-loop, compression-decompression cycles. The main advantages include cost-effectiveness, short duration of the study, non-invasive nature of the procedure, as well as a potentially broader clinical availability. There are no clear guidelines with regard to indications as well as examination techniques. Ultrasound elastography is a new and still poorly researched method. We conclude, however, that it can be widely used in the examinations of musculoskeletal system. Therefore, it is necessary to conduct large, multi-center studies to

  8. [Quality Management System in Pathological Laboratory].

    PubMed

    Koyatsu, Junichi; Ueda, Yoshihiko

    2015-07-01

    Even compared to other clinical laboratories, the pathological laboratory conducts troublesome work, and many of the work processes are also manual. Therefore, the introduction of the systematic management of administration is necessary. It will be a shortcut to use existing standards such as ISO 15189 for this purpose. There is no standard specialized for the pathological laboratory, but it is considered to be important to a pathological laboratory in particular. 1. Safety nianagement of the personnel and environmental conditions. Comply with laws and regulations concerning the handling of hazardous materials. 2. Pre-examination processes. The laboratory shall have documented procedures for the proper collection and handling of primary samples. Developed and documented criteria for acceptance or rejection of samples are applied. 3. Examination processes. Selection, verification, and validation of the examination procedures. Devise a system that can constantly monitor the traceability of the sample. 4. Post-examination processes. Storage, retention, and disposal of clinical samples. 5. Release of results. When examination results fall within established alert or critical intervals, immediately notify the physicians. The important point is to recognize the needs of the client and be aware that pathological diagnoses are always "the final diagnoses". PMID:26591432

  9. Running on time: the role of circadian clocks in the musculoskeletal system

    PubMed Central

    Dudek, Michal; Meng, Qing-Jun

    2014-01-01

    The night and day cycle governs the circadian (24 hourly) rhythm of activity and rest in animals and humans. This is reflected in daily changes of the global gene expression pattern and metabolism, but also in the local physiology of various tissues. A central clock in the brain co-ordinates the rhythmic locomotion behaviour, as well as synchronizing various local oscillators, such as those found in the musculoskeletal system. It has become increasingly recognized that the internal molecular clocks in cells allow a tissue to anticipate the rhythmic changes in their local environment and the specific demands of that tissue. Consequently, the majority of the rhythmic clock controlled genes and pathways are tissue specific. The concept of the tissue-specific function of circadian clocks is further supported by the diverse musculoskeletal phenotypes in mice with deletions or mutations of various core clock components, ranging from increased bone mass, dwarfism, arthropathy, reduced muscle strength and tendon calcification. The present review summarizes the current understanding of the circadian clocks in muscle, bone, cartilage and tendon tissues, with particular focus on the evidence of circadian rhythms in tissue physiology, their entrainment mechanisms and disease links, and the tissue-specific clock target genes/pathways. Research in this area holds strong potential to advance our understanding of how circadian rhythms control the health and disease of the musculoskeletal tissues, which has major implications in diseases associated with advancing age. It could also have potential implications in sports performance and sports medicine. PMID:25195734

  10. Running on time: the role of circadian clocks in the musculoskeletal system.

    PubMed

    Dudek, Michal; Meng, Qing-Jun

    2014-10-01

    The night and day cycle governs the circadian (24 hourly) rhythm of activity and rest in animals and humans. This is reflected in daily changes of the global gene expression pattern and metabolism, but also in the local physiology of various tissues. A central clock in the brain co-ordinates the rhythmic locomotion behaviour, as well as synchronizing various local oscillators, such as those found in the musculoskeletal system. It has become increasingly recognized that the internal molecular clocks in cells allow a tissue to anticipate the rhythmic changes in their local environment and the specific demands of that tissue. Consequently, the majority of the rhythmic clock controlled genes and pathways are tissue specific. The concept of the tissue-specific function of circadian clocks is further supported by the diverse musculoskeletal phenotypes in mice with deletions or mutations of various core clock components, ranging from increased bone mass, dwarfism, arthropathy, reduced muscle strength and tendon calcification. The present review summarizes the current understanding of the circadian clocks in muscle, bone, cartilage and tendon tissues, with particular focus on the evidence of circadian rhythms in tissue physiology, their entrainment mechanisms and disease links, and the tissue-specific clock target genes/pathways. Research in this area holds strong potential to advance our understanding of how circadian rhythms control the health and disease of the musculoskeletal tissues, which has major implications in diseases associated with advancing age. It could also have potential implications in sports performance and sports medicine. PMID:25195734

  11. Effect of acupuncture on disorders of musculoskeletal system in Nigerians.

    PubMed

    Ene, E E; Odia, G I

    1983-01-01

    Acupuncture was offered to patients with lesions affecting the locomotor system. These patients had received conventional physiotherapy treatment with limited success. The lesions treated by acupuncture were hemiplegia, low back pain, frozen shoulder, dropped foot, Sciatica, and arthritis of the knee and hip. Response to acupuncture was excellent in the more acute conditions of low back pain and frozen shoulder, where six treatment sessions were required for complete recovery. The more chronic conditions required many more treatment sessions and the improvement recorded was significant, though not complete. It was concluded that acupuncture has a valuable role to play in a physiotherapy department. PMID:6660198

  12. Design and validation of a general purpose robotic testing system for musculoskeletal applications.

    PubMed

    Noble, Lawrence D; Colbrunn, Robb W; Lee, Dong-Gil; van den Bogert, Antonie J; Davis, Brian L

    2010-02-01

    Orthopaedic research on in vitro forces applied to bones, tendons, and ligaments during joint loading has been difficult to perform because of limitations with existing robotic simulators in applying full-physiological loading to the joint under investigation in real time. The objectives of the current work are as follows: (1) describe the design of a musculoskeletal simulator developed to support in vitro testing of cadaveric joint systems, (2) provide component and system-level validation results, and (3) demonstrate the simulator's usefulness for specific applications of the foot-ankle complex and knee. The musculoskeletal simulator allows researchers to simulate a variety of loading conditions on cadaver joints via motorized actuators that simulate muscle forces while simultaneously contacting the joint with an external load applied by a specialized robot. Multiple foot and knee studies have been completed at the Cleveland Clinic to demonstrate the simulator's capabilities. Using a variety of general-use components, experiments can be designed to test other musculoskeletal joints as well (e.g., hip, shoulder, facet joints of the spine). The accuracy of the tendon actuators to generate a target force profile during simulated walking was found to be highly variable and dependent on stance position. Repeatability (the ability of the system to generate the same tendon forces when the same experimental conditions are repeated) results showed that repeat forces were within the measurement accuracy of the system. It was determined that synchronization system accuracy was 6.7+/-2.0 ms and was based on timing measurements from the robot and tendon actuators. The positioning error of the robot ranged from 10 microm to 359 microm, depending on measurement condition (e.g., loaded or unloaded, quasistatic or dynamic motion, centralized movements or extremes of travel, maximum value, or root-mean-square, and x-, y- or z-axis motion). Algorithms and methods for controlling

  13. Becoming a musculoskeletal ultrasonographer.

    PubMed

    Iagnocco, Annamaria; Naredo, Esperanza; Bijlsma, Johannes W J

    2013-04-01

    Over the last decade, increasing numbers of rheumatologists have incorporated musculoskeletal ultrasound (MSUS) as a valuable diagnostic tool into their clinical practice. Some countries have established training programmes for MSUS. The European League Against Rheumatism has developed education guidelines for the content and conductance of MSUS courses and it would be useful to standardise rheumatology MSUS training worldwide. A thorough knowledge of anatomy, US physics and technology, US scanning methods, US pattern of normal and pathological musculoskeletal tissues, definitions for US pathology, artefacts and pitfalls in both greyscale and Doppler modalities is necessary to perform efficient MSUS. MSUS training includes attending theoretical-practical and online courses, as well as studying textbooks and using digital video discs (DVDs). Having access to US equipment and performing supervised normal and pathological MSUS examinations for a training period are mandatory for consolidating MSUS learning. A proposal to accredit and certificate competence in MSUS is now being discussed. PMID:23731935

  14. MR imaging of urgent inflammatory and infectious conditions affecting the soft tissues of the musculoskeletal system.

    PubMed

    Yu, Joseph S; Habib, Paula

    2009-07-01

    Soft tissue infections and inflammatory conditions of the musculoskeletal system are a group of disorders commonly seen by emergency room physicians and radiologists. Many of these entities can either be limb- or life-threatening. Magnetic resonance imaging is currently the best imaging modality to evaluate these conditions. In this review, the characteristic imaging findings of cellulitis, abscess formation, necrotizing fasciitis, pyomyositis, diabetic ischemic infarction, acute and exertional compartment syndromes, and rhabdomyolysis will be emphasized as well as imaging factors that can help to differentiate these disorders. PMID:19132424

  15. Pain associated with the musculoskeletal system in children from Warsaw schools

    PubMed Central

    Słowińska, Iwona; Kwiatkowska, Małgorzata; Jednacz, Ewa; Mańczak, Małgorzata; Raciborski, Filip

    2015-01-01

    Objective To assess the prevalence of pain in the musculoskeletal system and possible reasons for these complaints among early age children from Warsaw schools. Material and methods The study was conducted in 34 randomly selected primary schools in Warsaw in 2011. 2748 survey-questionnaires were given to parents or legal guardians by children. Of these, 1509 surveys were subject to a final analysis. The survey included 66 questions regarding, among other things, pain in the musculoskeletal system in children. Additionally, there were questions about possibly occurring diseases, any postural defects, significant obesity, as well as effects of these complaints on the child's physical activity. Survey data regarded 6–7-year-old children. Results In the group of 1509 respondents, 242 children (16%) complained about pain in the musculoskeletal system. Pain was located most frequently in the knee joints, and more rarely in the spine and joints in the upper extremities. In the group of children who complained about pain, moderate physical activity was statistically significantly limited. According to parents, physicians did not diagnose any medical conditions in 106 children. Joint disease was diagnosed in 33 children. Postural defects were diagnosed in 589 children. In 123 children complaining about pain at least one postural defect was diagnosed. Such defects were diagnosed statistically significantly more rarely (p = 0.011) in 1234 children who did not complain about pain (460 children). Platypodia or other foot deformation was observed in 25% of these children, spinal curvature in 12%, abnormal knee joint position in 11% and uneven hip position in 2% children. Of note, 17% of all children were significantly overweight. In overweight children the prevalence of pain, especially in the knee joints and feet, was significantly higher. Conclusions This study aims to underline the problem of musculoskeletal pain in early-age children which limits their physical activity

  16. An Anatomic Pathology System Using the File Manager

    PubMed Central

    Ginsburg, R. E.; Tatarczuk, J. R.; Roy, G. R.

    1981-01-01

    An Anatomic Pathology System incorporating patient data from surgical pathology, cytopathology and autopsy pathology is presented. The System includes four interconnected files created with the aid of the File Manager. One file, containing patient demographic data, can be used as a connecting node to other patient databases. Five MUMPS routines, using File Manager functions, allow System users unfamiliar with computers and computer programming to easily enter, edit and retrieve patient information. Retrieved information is in a format to reconstruct, when possible, a patient's medical history from the pathology database and to correlate surgical pathology, cytopathology and autopsy pathology data.

  17. Musculoskeletal Injection

    PubMed Central

    Wittich, Christopher M.; Ficalora, Robert D.; Mason, Thomas G.; Beckman, Thomas J.

    2009-01-01

    Patients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians certified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints. This article reviews the clinical presentations of these problems. It also discusses musculoskeletal injections for these problems in terms of medications, indications, injection technique, and supporting evidence from the literature. Experience with joint injection and the pharmacological principles described in this article should allow primary care physicians to become comfortable and proficient with musculoskeletal injections. PMID:19720781

  18. Interactions between muscle and the immune system during modified musculoskeletal loading

    NASA Technical Reports Server (NTRS)

    Tidball, James G.

    2002-01-01

    Interactions between the immune system and skeletal muscle may play a significant role in modulating the course of muscle injury and repair after modified musculoskeletal loading. Current evidence indicates that activation of the complement system is an early event during modified loading, which then leads to inflammatory cell invasion. However, the functions of those inflammatory cells are complex and they seem to be capable of promoting additional injury and repair. Recent findings implicate an early invading neutrophil population in increasing muscle damage that is detected by the presence of muscle membrane lesions. Macrophages that invade subsequently serve to remove cellular debris, and seem to promote repair. However, macrophages also have the ability to increase damage in muscle in which there is an impaired capacity to generate nitric oxide. In vivo and in vitro evidence indicates that muscle-derived nitric oxide can serve an important role in protecting muscle from membrane damage by invading inflammatory cells. Collectively, these findings indicate that the dynamic balance between inflammatory cells, the complement system, and muscle-derived free radicals can play important roles in the secondary damage of muscle during modified musculoskeletal loading.

  19. Musculoskeletal discipline science plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Life sciences research in the musculoskeletal discipline must identify possible consequences of weightlessness on this system, understand the mechanisms of these effects, and develop effective and operationally practical countermeasures to protect crewmembers. The musculoskeletal system is highly plastic in that is possesses the inherent capability to adapt its structural and functional properties in accordance with the type and degree of stimuli imposed on it. Prolonged space travel is essentially a period of significant unloading of the musculoskeletal system. This results in adaptive responses in the structure and function of this system, placing it on the low end of a continuum from one of complete disuse to one of maximal use. There is a high probability that the musculoskeletal system is functionally impaired with increasing duration of weightlessness. The purpose of this Discipline Science Plan is to provide a conceptual strategy for NASA's Life Sciences division research and development activities in the area of musculoskeletal function. This document summarizes the current status of the program, outlines available knowledge, establishes goals and objectives, identifies science priorities, and defines research opportunities, which encompass critical questions in the subdiscipline areas (e.g., muscle, bone, and other musculoskeletal connective tissues). These science activities include ground-based and flight; basic, applied, and operational; and animal and human research and development. This document contains a general plan that will be used by both NASA Headquarters Program Offices and the field centers to review and plan basic, applied, and operational intramural and extramural research and development activities in this area.

  20. Artifacts in musculoskeletal MR imaging.

    PubMed

    Singh, Dinesh R; Chin, Michael S M; Peh, Wilfred C G

    2014-02-01

    MR imaging has become an important diagnostic tool in the evaluation of a vast number of pathologies and is of foremost importance in the evaluation of spine, joints, and soft tissue structures of the musculoskeletal system. MR imaging is susceptible to various artifacts that may affect the image quality or even simulate pathologies. Some of these artifacts have gained special importance with the use of higher field strength magnets and with the increasing need for MR imaging in postoperative patients, especially those with previous joint replacements or metallic implants. Artifacts may arise from patient motion or could be due to periodic motion, such as vascular and cardiac pulsation. Artifacts could also arise from various protocol errors including saturation, wraparound, truncation, shading, partial volume averaging, and radiofrequency interference artifacts. Susceptibility artifact occurs at interfaces with different magnetic susceptibilities and is of special importance with increasing use of metallic joint replacement prostheses. Magic angle phenomenon is a special type of artifact that occurs in musculoskeletal MR imaging. It is essential to recognize these artifacts and to correct them because they may produce pitfalls in image interpretation. PMID:24515878

  1. Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

    PubMed

    Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard

    2015-11-01

    The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach. PMID:26154224

  2. A 'cheap' optimal control approach to estimate muscle forces in musculoskeletal systems.

    PubMed

    Menegaldo, Luciano Luporini; de Toledo Fleury, Agenor; Weber, Hans Ingo

    2006-01-01

    This paper shows a new method to estimate the muscle forces in musculoskeletal systems based on the inverse dynamics of a multi-body system associated optimal control. The redundant actuator problem is solved by minimizing a time-integral cost function, augmented with a torque-tracking error function, and muscle dynamics is considered through differential constraints. The method is compared to a previously implemented human posture control problem, solved using a Forward Dynamics Optimal Control approach and to classical static optimization, with two different objective functions. The new method provides very similar muscle force patterns when compared to the forward dynamics solution, but the computational cost is much smaller and the numerical robustness is increased. The results achieved suggest that this method is more accurate for the muscle force predictions when compared to static optimization, and can be used as a numerically 'cheap' alternative to the forward dynamics and optimal control in some applications. PMID:16033695

  3. Hospital For Special Surgery/Immune System REgulation In Musculoskeletal Disorders

    SciTech Connect

    Eric Meffre; Lionel Ivashkiv

    2007-08-20

    Inflammation on musculoskeletal disorders such as rheumatoid arthritis (RA) is the result of dysregulation of the immune system. When the immune system, which maintains the integrity of the organism in an environment rich in infectious microbes, becomes misdirected toward components of one’s own tissue, autoimmune disease can result with autoantibodies contributing to the inflammation and tissue damage. RA is a chronic autoimmune disease marked by severe inflammation that causes pain, swelling, stiffness and loss of function in the joints, which is estimated to affect 1 percent of the US adult population. Furthermore, autoimmune diseases, which affect women at a higher rate, are the fourth largest cause of disability among women in the US and among the top ten causes of death. The long range goal of this study is to elucidate the mechanisms that regulate the generation of autoantibodies by B cells in normal individuals and in patients with autoimmune diseases and provide insights into potential therapeutic interventions.

  4. Reactions of the rat musculoskeletal system to compressive spinal cord injury (SCI) and whole body vibration (WBV) therapy.

    PubMed

    Schwarz, A; Pick, C; Harrach, R; Stein, G; Bendella, H; Ozsoy, O; Ozsoy, U; Schoenau, E; Jaminet, P; Sarikcioglu, L; Dunlop, S; Angelov, D N

    2015-06-01

    Traumatic spinal cord injury (SCI) causes a loss of locomotor function with associated compromise of the musculo-skeletal system. Whole body vibration (WBV) is a potential therapy following SCI, but little is known about its effects on the musculo-skeletal system. Here, we examined locomotor recovery and the musculo-skeletal system after thoracic (T7-9) compression SCI in adult rats. Daily WBV was started at 1, 7, 14 and 28 days after injury (WBV1-WBV28 respectively) and continued over a 12-week post-injury period. Intact rats, rats with SCI but no WBV (sham-treated) and a group that received passive flexion and extension (PFE) of their hind limbs served as controls. Compared to sham-treated rats, neither WBV nor PFE improved motor function. Only WBV14 and PFE improved body support. In line with earlier studies we failed to detect signs of soleus muscle atrophy (weight, cross sectional diameter, total amount of fibers, mean fiber diameter) or bone loss in the femur (length, weight, bone mineral density). One possible explanation is that, despite of injury extent, the preservation of some axons in the white matter, in combination with quadripedal locomotion, may provide sufficient trophic and neuronal support for the musculoskeletal system. PMID:26032204

  5. pGALS – paediatric Gait Arms Legs and Spine: a simple examination of the musculoskeletal system

    PubMed Central

    2013-01-01

    We describe pGALS (paediatric Gait, Arms, Legs and Spine) – a simple quick musculoskeletal assessment to distinguish abnormal from normal joints in children and young people. The use of pGALS is aimed at the non-specialist in paediatric musculoskeletal medicine as a basic clinical skill to be used in conjunction with essential knowledge about red flags, normal development and awareness of patterns of musculoskeletal pathologies. pGALS has been validated in school-aged children and also in the context of acute general paediatrics to detect abnormal joints. We propose that pGALS is an important part of basic clinical skills to be acquired by all doctors who may be involved in the care of children. The learning of pGALS along with basic knowledge is a useful way to increase awareness of joint disease, facilitate early recognition of joint problems and prompt referral to specialist teams to optimise clinical outcomes. We have compiled this article as a resource that can be used by the paediatric rheumatology community to facilitate teaching. PMID:24219838

  6. Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries.

    PubMed

    Mears, Simon C; Pantle, Hardin A; Bessman, Edward S; Lifchez, Scott D

    2015-05-01

    Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors' institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED. The authors hypothesized that select injuries could be safely managed in the ED by using an electronic system to ensure appropriate follow-up care. Using Kaizen methodology, a multidisciplinary group (including ED staff, orthopedics, plastic surgery, pediatrics, nursing, radiology, therapy, and administration) met to improve care for select musculoskeletal injuries. A system was agreed on in which ED providers managed select musculoskeletal injuries without subspecialist consultation. Follow-up was organized using an electronic system, which facilitated communication between the ED staff and the secretarial staff of the subspecialist departments. Over a 1-year period, 150 patients were treated using this system. Charts and radiographs were reviewed for missed injuries. Radiographic review revealed 2 missed injuries. One patient had additional back pain and a lumbar spine fracture was found during the subspecialist follow-up visit; it was treated nonoperatively. Another patient appeared to have scapholunate widening on the injury radiograph that was not appreciated in the ED. Of the 150 patients, 51 were seen in follow-up by a subspecialist at the authors' institution. An electronic system to organize follow-up with a subspecialist allowed the ED providers to deliver safe and effective care for simple musculoskeletal injuries. PMID:25970368

  7. A flexible, open, decentralized system for digital pathology networks.

    PubMed

    Schuler, Robert; Smith, David E; Kumaraguruparan, Gowri; Chervenak, Ann; Lewis, Anne D; Hyde, Dallas M; Kesselman, Carl

    2012-01-01

    High-resolution digital imaging is enabling digital archiving and sharing of digitized microscopy slides and new methods for digital pathology. Collaborative research centers, outsourced medical services, and multi-site organizations stand to benefit from sharing pathology data in a digital pathology network. Yet significant technological challenges remain due to the large size and volume of digitized whole slide images. While information systems do exist for managing local pathology laboratories, they tend to be oriented toward narrow clinical use cases or offer closed ecosystems around proprietary formats. Few solutions exist for networking digital pathology operations. Here we present a system architecture and implementation of a digital pathology network and share results from a production system that federates major research centers. PMID:22941985

  8. [Childhood and adolescent obesity--consequences for the locomotor system and treatment options. Musculoskeletal complications of overweight children and adolescents].

    PubMed

    Schönau, E

    2013-04-01

    The aim of this article is to present the most relevant musculoskeletal complications known to be associated with being overweight or obese in childhood and adolescence in order to help the clinicians and physiotherapists in the diagnostic and management of these patients. Various musculoskeletal problems like slipped capital femoral epiphysis and Blount disease are well-known complications. More recent studies describe the effects of overweight on musculoskeletal pain and controversial influences on fracture rates. Reduced physical activity is a contributing factor in obesity, but also effects bone mineral accrual. Reduced postural stability and increased falls may be the reason for increased fracture rates. Furthermore these data show relevant changes of locomotion studied by gait analysis. Longitudinal kinematic studies may be needed to understand the entire aspect of gait development in overweight children. Obesity is still a serious health problem and has a relevant impact on the development of a child's musculoskeletal system. Obesity affects the locomotor sytem both functionally and structurally. Future studies are necessary to help us better understand the pathophysiology and development of optimal therapeutic strategies. PMID:23529598

  9. Musculoskeletal Aspiration Procedures

    PubMed Central

    Hansford, Barry Glenn; Stacy, Gregory Scott

    2012-01-01

    With advances in imaging technology, there has been a significant increase in the number and range of interventional musculoskeletal image-guided procedures. One of the most commonly performed image-guided musculoskeletal interventions is the diagnostic and therapeutic percutaneous aspiration and drainage of multiple types of intra-articular, juxta-articular, and intramuscular pathologic fluid collections. These procedures may be performed under fluoroscopic, ultrasound, computed tomography, or even magnetic resonance guidance depending on the location to be accessed, type of pathology, patient characteristics, and operator preference. Musculoskeletal image-guided aspiration and drainage procedures are minimally invasive and generally very safe while offering valuable diagnostic information as well as therapeutic benefit. This article focuses on the appropriate indications, contraindications, and general technique for accessing the major joints via imaging guidance. For each joint, we discuss pertinent anatomy, appropriate imaging modalities, and preferred approaches to gaining intra-articular access. Additionally, the article discusses some of the more frequently encountered juxta-articular and intramuscular fluid collections that can be accessed and aspirated via percutaneous intervention, with mention of the importance of recognizing extremity sarcomas that can mimic these benign collections. PMID:24293800

  10. Associations between Wage System and Risk Factors for Musculoskeletal Disorders among Construction Workers

    PubMed Central

    Ajslev, Jeppe Zielinski Nguyen; Persson, Roger; Andersen, Lars Louis

    2015-01-01

    Piece rate and performance based wage systems are common in the construction industry. Construction workers are known to have an increased risk of pain and musculoskeletal disorders (MSD). In this cross-sectional questionnaire study, we examined the association between wage system and (1) physical exertion, (2) time pressure, (3) pain, and (4) fatigue. The participants comprised 456 male Danish construction workers working on one of three different wage systems: group based performance wage, individually based performance wage, and time based wage system. The statistical analyses indicated differences between the wage systems in relation to physical exertion (ηp = 0.05) and time pressure (ηp = 0.03) but not to pain or fatigue. Workers on group based performance wage scored higher (i.e., worse) than workers on individual performance based wage and workers with an hourly/monthly wage. In conclusion, group performance based wage was associated with higher levels of physical exertion and time pressure. Accordingly, group performance based wage can be viewed as a factor that has the potential to complicate prevention of MSD among construction workers. Since performance based wage systems are common in many countries across the world, more attention should be paid to the health effects of these types of payment. PMID:26605083

  11. Pathological gambling and couple: towards an integrative systemic model.

    PubMed

    Cunha, Diana; Relvas, Ana Paula

    2014-06-01

    This article is a critical literature review of pathological gambling focused in the family factors, particularly in the couple dynamics. Its main goal is to develop an explicative integrative systemic model of pathological gambling, based in these couple dynamics. To achieve that aim, a bibliography search was made, using on-line data bases (e.g., EBSCO Host) and recognized books in pathological gambling subject, as well as in the systemic approach in general. This process privileged the recent works (about 70 % of the reviewed literature was published in the last decade), however, also considered some classic works (the oldest one dates back to 1970). The guiding focus of this literature search evolves according to the following steps: (1) search of general comprehension of pathological gambling (19 references), (2) search specification to the subject "pathological gambling and family" (24 references), (3) search specification to the subject "pathological gambling and couple"(11 references), (4) search of systemic information which integrates the evidence resulted in the previous steps (4 references). The developed model is constituted by different levels of systemic complexity (social context, family of origin, couple and individual) and explains the problem as a signal of perturbation in the marital subsystem vital functions (e.g., power and control) though the regularities of marital dynamics of pathological gamblers. Furthermore, it gives theoretical evidence of the systemic familiar intervention in the pathological gambling. PMID:23423730

  12. Learned parametrized dynamic movement primitives with shared synergies for controlling robotic and musculoskeletal systems

    PubMed Central

    Rückert, Elmar; d'Avella, Andrea

    2013-01-01

    A salient feature of human motor skill learning is the ability to exploit similarities across related tasks. In biological motor control, it has been hypothesized that muscle synergies, coherent activations of groups of muscles, allow for exploiting shared knowledge. Recent studies have shown that a rich set of complex motor skills can be generated by a combination of a small number of muscle synergies. In robotics, dynamic movement primitives are commonly used for motor skill learning. This machine learning approach implements a stable attractor system that facilitates learning and it can be used in high-dimensional continuous spaces. However, it does not allow for reusing shared knowledge, i.e., for each task an individual set of parameters has to be learned. We propose a novel movement primitive representation that employs parametrized basis functions, which combines the benefits of muscle synergies and dynamic movement primitives. For each task a superposition of synergies modulates a stable attractor system. This approach leads to a compact representation of multiple motor skills and at the same time enables efficient learning in high-dimensional continuous systems. The movement representation supports discrete and rhythmic movements and in particular includes the dynamic movement primitive approach as a special case. We demonstrate the feasibility of the movement representation in three multi-task learning simulated scenarios. First, the characteristics of the proposed representation are illustrated in a point-mass task. Second, in complex humanoid walking experiments, multiple walking patterns with different step heights are learned robustly and efficiently. Finally, in a multi-directional reaching task simulated with a musculoskeletal model of the human arm, we show how the proposed movement primitives can be used to learn appropriate muscle excitation patterns and to generalize effectively to new reaching skills. PMID:24146647

  13. Design and optimization of a dedicated cone-beam CT system for musculoskeletal extremities imaging

    NASA Astrophysics Data System (ADS)

    Zbijewski, W.; De Jean, P.; Prakash, P.; Ding, Y.; Stayman, J. W.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Machado, A.; Carrino, J. A.; Siewerdsen, J. H.

    2011-03-01

    The design, initial imaging performance, and model-based optimization of a dedicated cone-beam CT (CBCT) scanner for musculoskeletal extremities is presented. The system offers a compact scanner that complements conventional CT and MR by providing sub-mm isotropic spatial resolution, the ability to image weight-bearing extremities, and the capability for integrated real-time fluoroscopy and digital radiography. The scanner employs a flat-panel detector and a fixed anode x-ray source and has a field of view of ~ (20x20x20) cm3. The gantry allows a "standing" configuration for imaging of weight-bearing lower extremities and a "sitting" configuration for imaging of upper extremities and unloaded lower extremities. Cascaded systems analysis guided the selection of x-ray technique (e.g., kVp, filtration, and dose) and system design (e.g., magnification factor), yielding input-quantum-limited performance at detector signal of 100 times the electronic noise, while maintaining patient dose below 5 mGy (a factor of ~2-3 less than conventional CT). A magnification of 1.3 optimized tradeoffs between source and detector blur for a 0.5 mm focal spot. A custom antiscatter grid demonstrated significant reduction of artifacts without loss of contrast-to-noise ratio or increase in dose. Image quality in cadaveric specimens was assessed on a CBCT bench, demonstrating exquisite bone detail, visualization of intra-articular morphology, and soft-tissue visibility approaching that of diagnostic CT. The capability to image loaded extremities and conduct multi-modality CBCT/fluoroscopy with improved workflow compared to whole-body CT could be of value in a broad spectrum of applications, including orthopaedics, rheumatology, surgical planning, and treatment assessment. A clinical prototype has been constructed for deployment in pilot study trials.

  14. Think Small: Zebrafish as a Model System of Human Pathology

    PubMed Central

    Goldsmith, J. R.; Jobin, Christian

    2012-01-01

    Although human pathologies have mostly been modeled using higher mammal systems such as mice, the lower vertebrate zebrafish has gained tremendous attention as a model system. The advantages of zebrafish over classical vertebrate models are multifactorial and include high genetic and organ system homology to humans, high fecundity, external fertilization, ease of genetic manipulation, and transparency through early adulthood that enables powerful imaging modalities. This paper focuses on four areas of human pathology that were developed and/or advanced significantly in zebrafish in the last decade. These areas are (1) wound healing/restitution, (2) gastrointestinal diseases, (3) microbe-host interactions, and (4) genetic diseases and drug screens. Important biological processes and pathologies explored include wound-healing responses, pancreatic cancer, inflammatory bowel diseases, nonalcoholic fatty liver disease, and mycobacterium infection. The utility of zebrafish in screening for novel genes important in various pathologies such as polycystic kidney disease is also discussed. PMID:22701308

  15. Ultrasound of the digital flexor system: Normal and pathological findings☆

    PubMed Central

    Bianchi, S.; Martinoli, C.; de Gautard, R.; Gaignot, C.

    2007-01-01

    Recent improvements in ultrasound (US) software and hardware have markedly increased the role of this imaging modality in the evaluation of the musculoskeletal system. US is currently one of the main imaging tools used to diagnose and assess most tendon, muscle, and ligament disorders. Compared with magnetic resonance imaging, US is much less expensive; it has no contraindications and is also widely available. Diseases affecting the digital flexor system (DFS) require early diagnosis if treatment is expected to limit functional impairment of the hand. US scans performed with high-resolution, broad-band transducers allows superb visualization of the flexor tendons of the hand and the annular digital pulleys. In addition, dynamic US can be used to assess movement of the tendon within the pulleys during passive or active joint movements. This article examines the anatomy and US appearance of the normal DFS and reviews the US findings associated with the most common disorders affecting it. PMID:23396583

  16. Musculoskeletal MRI.

    PubMed

    Sage, Jaime E; Gavin, Patrick

    2016-05-01

    MRI has the unique ability to detect abnormal fluid content, and is therefore unparalleled in its role of detection, diagnosis, prognosis, treatment planning and follow-up evaluation of musculoskeletal disease. MRI in companion animals should be considered in the following circumstances: a definitive diagnosis cannot be made on radiographs; a patient is nonresponsive to medical or surgical therapy; prognostic information is desired; assessing surgical margins and traumatic and/or infectious joint and bone disease; ruling out subtle developmental or early aggressive bone lesions. The MRI features of common disorders affecting the shoulder, elbow, stifle, carpal, and tarsal joints are included in this chapter. PMID:26928749

  17. On the Design of a CADS for Shoulder Pain Pathology

    NASA Astrophysics Data System (ADS)

    de Ipiña, K. López; Hernández, M. C.; Martínez, E.; Vaquero, C.

    A musculoskeletal disorder is a condition of the musculoskeletal system, which consists in part of it being injured continuously over time. Shoulder disorders are one of the most common musculoskeletal cases attended in primary health care services. Shoulder disorders cause pain and limit the ability to perform many routine activities, affecting about 15-25 % of the general population. Several clinical tests have been described to aid diagnosis of shoulder disorders. However, the current literature acknowledges a lack of concordance in clinical assessment, even among musculoskeletal specialists. We are working on the design of a Computer-Aided Decision Support (CADS) system for Shoulder Pain Pathology. The paper presents the results of our efforts to build a CADS system testing several classical classification paradigms, feature reduction methods (PCA) and K-means unsupervised clustering. The small database size imposes the use of robust covariance matrix estimation methods to improve the system performance. Finally, the system was evaluated by a medical specialist.

  18. 77 FR 59941 - Prospective Grant of Exclusive License: Terahertz Scanning Systems for Cancer Pathology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... Systems for Cancer Pathology AGENCY: National Institutes of Health, Public Health Service, HHS. ACTION... systems for cancer pathology. Upon the expiration or termination of the exclusive evaluation...

  19. Dose and scatter characteristics of a novel cone beam CT system for musculoskeletal extremities

    NASA Astrophysics Data System (ADS)

    Zbijewski, W.; Sisniega, A.; Vaquero, J. J.; Muhit, A.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Carrino, J. A.; Siewerdsen, J. H.

    2012-03-01

    A novel cone-beam CT (CBCT) system has been developed with promising capabilities for musculoskeletal imaging (e.g., weight-bearing extremities and combined radiographic / volumetric imaging). The prototype system demonstrates diagnostic-quality imaging performance, while the compact geometry and short scan orbit raise new considerations for scatter management and dose characterization that challenge conventional methods. The compact geometry leads to elevated, heterogeneous x-ray scatter distributions - even for small anatomical sites (e.g., knee or wrist), and the short scan orbit results in a non-uniform dose distribution. These complex dose and scatter distributions were investigated via experimental measurements and GPU-accelerated Monte Carlo (MC) simulation. The combination provided a powerful basis for characterizing dose distributions in patient-specific anatomy, investigating the benefits of an antiscatter grid, and examining distinct contributions of coherent and incoherent scatter in artifact correction. Measurements with a 16 cm CTDI phantom show that the dose from the short-scan orbit (0.09 mGy/mAs at isocenter) varies from 0.16 to 0.05 mGy/mAs at various locations on the periphery (all obtained at 80 kVp). MC estimation agreed with dose measurements within 10-15%. Dose distribution in patient-specific anatomy was computed with MC, confirming such heterogeneity and highlighting the elevated energy deposition in bone (factor of ~5-10) compared to soft-tissue. Scatter-to-primary ratio (SPR) up to ~1.5-2 was evident in some regions of the knee. A 10:1 antiscatter grid was found earlier to result in significant improvement in soft-tissue imaging performance without increase in dose. The results of MC simulations elucidated the mechanism behind scatter reduction in the presence of a grid. A ~3-fold reduction in average SPR was found in the MC simulations; however, a linear grid was found to impart additional heterogeneity in the scatter distribution

  20. Muscle synergy control model-tuned EMG driven torque estimation system with a musculo-skeletal model.

    PubMed

    Min, Kyuengbo; Shin, Duk; Lee, Jongho; Kakei, Shinji

    2013-01-01

    Muscle activity is the final signal for motion control from the brain. Based on this biological characteristic, Electromyogram (EMG) signals have been applied to various systems that interface human with external environments such as external devices. In order to use EMG signals as input control signal for this kind of system, the current EMG driven torque estimation models generally employ the mathematical model that estimates the nonlinear transformation function between the input signal and the output torque. However, these models need to estimate too many parameters and this process cause its estimation versatility in various conditions to be poor. Moreover, as these models are designed to estimate the joint torque, the input EMG signals are tuned out of consideration for the physiological synergetic contributions of multiple muscles for motion control. To overcome these problems of the current models, we proposed a new tuning model based on the synergy control mechanism between multiple muscles in the cortico-spinal tract. With this synergetic tuning model, the estimated contribution of multiple muscles for the motion control is applied to tune the EMG signals. Thus, this cortico-spinal control mechanism-based process improves the precision of torque estimation. This system is basically a forward dynamics model that transforms EMG signals into the joint torque. It should be emphasized that this forward dynamics model uses a musculo-skeletal model as a constraint. The musculo-skeletal model is designed with precise musculo-skeletal data, such as origins and insertions of individual muscles or maximum muscle force. Compared with the mathematical model, the proposed model can be a versatile model for the torque estimation in the various conditions and estimates the torque with improved accuracy. In this paper, we also show some preliminary experimental results for the discussion about the proposed model. PMID:24110476

  1. Active musculoskeletal structures equipped with a circulatory system and a network of ionic polymeric gel muscles

    SciTech Connect

    Shahinpoor, M.; Mojarrad, M.

    1994-12-31

    Presented are descriptions of design and fabrication of an active musculoskeletal structure composed of an artificial human skeleton of 5.3 feet in height. This skeletal structure is further equipped with an artificial heart in the form of a multi-channel computer-controlled fluid pump. The fluid pump may be programmed to selectively pump either an acid, a base or de-ionized water to a network of veins that feed a network of pairs of antagonist contractile synthetic muscles. These muscles are manufactured in the laboratory from polyacrylonitrile (PAN) fiber bundles that are specially designed and packaged inside flexible, hyperelastic latex membranes. Each pair of muscles act as a pair of antagonist actuator similar to the biceps and triceps muscles of the human arm. The initial fabrication indicates that it is possible to dynamically control such active musculoskeletal structures. A model is also presented for the dynamic control of such antagonist muscles. The model is intended to be used to study the human musculoskeletal dynamics.

  2. Expanding the spectrum of neuronal pathology in multiple system atrophy

    PubMed Central

    Cykowski, Matthew D.; Coon, Elizabeth A.; Powell, Suzanne Z.; Jenkins, Sarah M.; Benarroch, Eduardo E.; Low, Phillip A.; Schmeichel, Ann M.

    2015-01-01

    Multiple system atrophy is a sporadic alpha-synucleinopathy that typically affects patients in their sixth decade of life and beyond. The defining clinical features of the disease include progressive autonomic failure, parkinsonism, and cerebellar ataxia leading to significant disability. Pathologically, multiple system atrophy is characterized by glial cytoplasmic inclusions containing filamentous alpha-synuclein. Neuronal inclusions also have been reported but remain less well defined. This study aimed to further define the spectrum of neuronal pathology in 35 patients with multiple system atrophy (20 male, 15 female; mean age at death 64.7 years; median disease duration 6.5 years, range 2.2 to 15.6 years). The morphologic type, topography, and frequencies of neuronal inclusions, including globular cytoplasmic (Lewy body-like) neuronal inclusions, were determined across a wide spectrum of brain regions. A correlation matrix of pathologic severity also was calculated between distinct anatomic regions of involvement (striatum, substantia nigra, olivary and pontine nuclei, hippocampus, forebrain and thalamus, anterior cingulate and neocortex, and white matter of cerebrum, cerebellum, and corpus callosum). The major finding was the identification of widespread neuronal inclusions in the majority of patients, not only in typical disease-associated regions (striatum, substantia nigra), but also within anterior cingulate cortex, amygdala, entorhinal cortex, basal forebrain and hypothalamus. Neuronal inclusion pathology appeared to follow a hierarchy of region-specific susceptibility, independent of the clinical phenotype, and the severity of pathology was duration-dependent. Neuronal inclusions also were identified in regions not previously implicated in the disease, such as within cerebellar roof nuclei. Lewy body-like inclusions in multiple system atrophy followed the stepwise anatomic progression of Lewy body-spectrum disease inclusion pathology in 25.7% of patients

  3. Quantitative pathological changes in the cerebellum of multiple system atrophy.

    PubMed

    Armstrong, Richard A

    2015-01-01

    Multiple system atrophy (MSA) is a rare neurodegenerative disorder associated with parkinsonism, ataxia, and autonomic dysfunction. Its pathology is primarily subcortical comprising vacuolation, neuronal loss, gliosis, and α-synucleinimmunoreactive glial cytoplasmic inclusions (GCI). To quantify cerebellar pathology in MSA, the density and spatial pattern of the pathological changes were studied in α-synuclein-immunolabelled sections of the cerebellar hemisphere in 10 MSA and 10 control cases. In MSA, densities of Purkinje cells (PC) were decreased and vacuoles in the granule cell layer (GL) increased compared with controls. In six MSA cases, GCI were present in cerebellar white matter. In the molecular layer (ML) and GL of MSA, vacuoles were clustered, the clusters exhibiting a regular distribution parallel to the edge of the folia. Purkinje cells were randomly or regularly distributed with large gaps between surviving cells. Densities of glial cells and surviving neurons in the ML and surviving cells and vacuoles in the GL were negatively correlated consistent with gliosis and vacuolation in response to neuronal loss. Principal components analysis (PCA) suggested vacuole densities in the ML and vacuole density and cell losses in the GL were the main source of neuropathological variation among cases. The data suggest that: (1) cell losses and vacuolation of the GCL and loss of PC were the most significant pathological changes in the cases studied, (2) pathological changes were topographically distributed, and (3) cerebellar pathology could influence cerebral function in MSA via the cerebello-dentato-thalamic tract. PMID:26443310

  4. Intelligent self-tuning of PID control for the robotic testing system for human musculoskeletal joints test.

    PubMed

    Tian, Lianfang

    2004-06-01

    In this paper, an intelligent proportional-integral-derivative (PID) control method is introduced to the robotic testing system for the biomechanical study of human musculoskeletal joints. For the testing system, the robot is a highly nonlinear and heavily coupled complicated system, and the human spinal specimen also demonstrates nonlinear property when undergoing testing. Although the conventional PID control approach is extensively used in most industrial control systems, it will break down for nonlinear systems, particularly for complicated systems that have no precise mathematical models. To overcome those difficulties, an intelligent fuzzy PID controller is proposed replacing the widely used conventional PID controllers. The fuzzy PID algorithm is outlined using the fuzzy set theory. The design techniques are developed based on the linguistic phase plane approach. The heuristic rules of syntheses are summarized into a rule-based expert system. Experiments are carried out and the results demonstrate the good performance of the robotic testing system using the proposed control method. PMID:15255220

  5. Pathology of the peripheral nervous system.

    PubMed

    Fernandez; Marchese; Palma; Lauretti; Procaccini; Pallini

    1999-01-26

    In this review, the first four papers deal with an important chapter in peripheral nerve surgery: cranial nerve reconstruction after injury occurring during skull base surgery. The last paper discusses the problem of peripheral nerves affected by a ganglion cyst. Damage to a cranial nerve is no longer considered to be an absolutely irreparable event. The first two studies are related to facial nerve management during the surgical treatment of vestibular schwannomas. The most common mechanisms responsible for facial nerve injury during tumor removal and the technical means to avoid them are cited. The importance of intraoperative neurophysiologic monitoring to save the facial nerve is stressed. A comparison between microsurgery and radiosurgery results in the conclusion that for vestibular schwannomas, the first choice of treatment is microsurgery. These two large and exceptional series show that by using a refined technique it is possible to obtain both total tumor removal and preservation of the facial nerve in most of the vestibular schwannomas. In the minority of patients in whom the facial nerve is severed, there are several therapeutic options to re-establish facial nerve function. After facial nerve reconstruction, performed immediately during the same tumor operation, a satisfactory reinnervation was obtained in 74% of the cases. After facial nerve reanimation, using as donor nerve the hypoglossus and performed 1 week after the tumor operation, a satisfactory reinnervation was obtained in 96% of the cases. The other two papers deal with the intraoperative transection of the trochlear and abducens nerve during surgery for skull base tumors. These two cranial nerves, owing to their simply organized motor nerve system (they are purely motor nerves and supply one muscle each), show quite a good expectation of functional recovery. The behavior of ganglion cysts involving peripheral nerves is the topic of the last paper reviewed. These cysts are benign lesions

  6. Novel bio-synthetic hybrid materials and coculture systems for musculoskeletal tissue engineering

    NASA Astrophysics Data System (ADS)

    Lee, Hyeseung Janice

    Tissue Engineering is a truly exciting field of this age, trying to regenerate and repair impaired tissues. Unlike the old artificial implants, tissue engineering aims at making a long-term functional biological replacement. One strategy for such tissue engineering requires the following three components: cells, scaffolds, and soluble factors. Cells are cultured in a three-dimensional (3D) scaffold with medium containing various soluble factors. Once a tissue is developed in vitro, then it is implanted in vivo. The overall goal of this thesis was to develop novel bio-synthetic hybrid scaffolds and coculture system for musculoskeletal tissue engineering. The most abundant cartilage extracellular matrix (ECM) components are collagen and glycosaminoglycan (GAG), which are the natural scaffold for chondrocytes. As two different peptides, collagen mimetic peptide (CMP) and hyaluronic acid binding peptide (HABPep) were previously shown to bind to collagen and hyaluronic acid (HA) of GAG, respectively, it was hypothesized that immobilizing CMP and HABP on 3D scaffold would results in an interaction between ECM components and synthetic scaffolds via peptide-ECM bindings. CMP or HABPep-conjugated photopolymerizable poly(ethylene oxide) diacrylate (PEODA) hydrogels were synthesized and shown to retain encapsulated collagen or HA, respectively. This result supported that conjugated CMP and HABPep can interact with collagen and HA, respectively, and can serve as biological linkers in 3D synthetic hydrogels. When chondrocytes or mesenchymal stem cells (MSCs) were seeded, cells in CMP-conjugated scaffolds produced significantly more amount of type II collagen and GAG, compared to those in control scaffolds. Moreover, MSCs cultured in CMP-conjugated scaffolds exhibited lower level of hypertrophic markers, cbfa-1 and type X collagen. These results demonstrated that enhanced interaction between collagen and scaffold via CMP improves chondrogenesis of chondrocytes and MSCs and

  7. System for pathology categorization and retrieval in chest radiographs

    NASA Astrophysics Data System (ADS)

    Avni, Uri; Greenspan, Hayit; Konen, Eli; Sharon, Michal; Goldberger, Jacob

    2011-03-01

    In this paper we present an overview of a system we have been developing for the past several years for efficient image categorization and retrieval in large radiograph archives. The methodology is based on local patch representation of the image content, using a bag of visual words approach and similarity-based categorization with a kernel based SVM classifier. We show an application to pathology-level categorization of chest x-ray data, the most popular examination in radiology. Our study deals with pathology detection and identification of individual pathologies including right and left pleural effusion, enlarged heart and cases of enlarged mediastinum. The input from a radiologist provided a global label for the entire image (healthy/pathology), and the categorization was conducted on the entire image, with no need for segmentation algorithms or any geometrical rules. An automatic diagnostic-level categorization, even on such an elementary level as healthy vs pathological, provides a useful tool for radiologists on this popular and important examination. This is a first step towards similarity-based categorization, which has a major clinical implications for computer-assisted diagnostics.

  8. Fat-suppression techniques for 3-T MR imaging of the musculoskeletal system.

    PubMed

    Del Grande, Filippo; Santini, Francesco; Herzka, Daniel A; Aro, Michael R; Dean, Cooper W; Gold, Garry E; Carrino, John A

    2014-01-01

    Fat suppression is an important technique in musculoskeletal imaging to improve the visibility of bone-marrow lesions; evaluate fat in soft-tissue masses; optimize the contrast-to-noise ratio in magnetic resonance (MR) arthrography; better define lesions after administration of contrast material; and avoid chemical shift artifacts, primarily at 3-T MR imaging. High-field-strength (eg, 3-T) MR imaging has specific technical characteristics compared with lower-field-strength MR imaging that influence the use and outcome of various fat-suppression techniques. The most commonly used fat-suppression techniques for musculoskeletal 3-T MR imaging include chemical shift (spectral) selective (CHESS) fat saturation, inversion recovery pulse sequences (eg, short inversion time inversion recovery [STIR]), hybrid pulse sequences with spectral and inversion-recovery (eg, spectral adiabatic inversion recovery and spectral attenuated inversion recovery [SPAIR]), spatial-spectral pulse sequences (ie, water excitation), and the Dixon techniques. Understanding the different fat-suppression options allows radiologists to adopt the most appropriate technique for their clinical practice. PMID:24428292

  9. Fat-Suppression Techniques for 3-T MR Imaging of the Musculoskeletal System1

    PubMed Central

    Del Grande, Filippo; Santini, Francesco; Herzka, Daniel A.; Aro, Michael R.; Dean, Cooper W.; Gold, Garry E.; Carrino, John A.

    2015-01-01

    Fat suppression is an important technique in musculoskeletal imaging to improve the visibility of bone-marrow lesions; evaluate fat in soft-tissue masses; optimize the contrast-to-noise ratio in magnetic resonance (MR) arthrography; better define lesions after administration of contrast material; and avoid chemical shift artifacts, primarily at 3-T MR imaging. High-field-strength (eg, 3-T) MR imaging has specific technical characteristics compared with lower-field-strength MR imaging that influence the use and outcome of various fat-suppression techniques. The most commonly used fat-suppression techniques for musculoskeletal 3-T MR imaging include chemical shift (spectral) selective (CHESS) fat saturation, inversion recovery pulse sequences (eg, short inversion time inversion recovery [STIR]), hybrid pulse sequences with spectral and inversion-recovery (eg, spectral adiabatic inversion recovery and spectral attenuated inversion recovery [SPAIR]), spatial-spectral pulse sequences (ie, water excitation), and the Dixon techniques. Understanding the different fat-suppression options allows radiologists to adopt the most appropriate technique for their clinical practice. PMID:24428292

  10. Robust passive dynamics of the musculoskeletal system compensate for unexpected surface changes during human hopping

    PubMed Central

    van der Krogt, Marjolein M.; de Graaf, Wendy W.; Farley, Claire T.; Moritz, Chet T.; Richard Casius, L. J.; Bobbert, Maarten F.

    2009-01-01

    When human hoppers are surprised by a change in surface stiffness, they adapt almost instantly by changing leg stiffness, implying that neural feedback is not necessary. The goal of this simulation study was first to investigate whether leg stiffness can change without neural control adjustment when landing on an unexpected hard or unexpected compliant (soft) surface, and second to determine what underlying mechanisms are responsible for this change in leg stiffness. The muscle stimulation pattern of a forward dynamic musculoskeletal model was optimized to make the model match experimental hopping kinematics on hard and soft surfaces. Next, only surface stiffness was changed to determine how the mechanical interaction of the musculoskeletal model with the unexpected surface affected leg stiffness. It was found that leg stiffness adapted passively to both unexpected surfaces. On the unexpected hard surface, leg stiffness was lower than on the soft surface, resulting in close-to-normal center of mass displacement. This reduction in leg stiffness was a result of reduced joint stiffness caused by lower effective muscle stiffness. Faster flexion of the joints due to the interaction with the hard surface led to larger changes in muscle length, while the prescribed increase in active state and resulting muscle force remained nearly constant in time. Opposite effects were found on the unexpected soft surface, demonstrating the bidirectional stabilizing properties of passive dynamics. These passive adaptations to unexpected surfaces may be critical when negotiating disturbances during locomotion across variable terrain. PMID:19589956

  11. [The (putative) pathological impact of fibromyalgia on the orofacial system].

    PubMed

    de Baat, C; Gerritsen, A E; de Baat-Ananta, M; de Baat, P

    2016-03-01

    Fibromyalgia is a syndrome without apparent aetiology, characterised by pain, fatigue, memory disorders, mood disorders, and sleep disturbances. The syndrome is considered to be one of the rheumatic diseases. In the general population, the prevalence varies from 2 to 8%, with a women-men ratio of about 2:1. Suspicion of fibromyalgia arises when a patient has pain at multiple locations that cannot be attributed to trauma or inflammation, and when the pain is especially musculoskeletal. Primary management includes explaining the syndrome and offering reassurance. In addition, one can also attempt to increase mobility, avoid overloading, and improve physical condition and the level of activity, and to activate problem-solving skills. Subsequently, behavioural therapy and pharmacotherapy may be considered. The most important manifestations of fibromyalgia in the orofacial and occlusal system seem to be temporomandibular dysfunction, headache, xerostomia, hyposalivation, burning mouth and dysgeusia. However, with respect to the precise relation of fibromyalgia with the orofacial system, much needs to be elucidated. PMID:26973987

  12. Integrated Hypertext and Expert System in Pathology Laboratory Instruction

    PubMed Central

    Sideli, Robert V.; Lefkowitch, Jay L.

    1988-01-01

    Computer lab exercises in Pathology are described which implement both hypertext and an expert system. The lab exercises served as prototypes which were used to study various aspects of computers in medical education. The software utilized was either found in the public domain or purchased from a vendor. Minor programming modifications allowed the hypertext program and expert system to form an integrated learning environment. Favorable student response and readily accessible programming tools suggest that further work will be educationally valuable.

  13. Virtual reality and gaming systems to improve walking and mobility for people with musculoskeletal and neuromuscular conditions.

    PubMed

    Deutsch, Judith E

    2009-01-01

    Improving walking for individuals with musculoskeletal and neuromuscular conditions is an important aspect of rehabilitation. The capabilities of clinicians who address these rehabilitation issues could be augmented with innovations such as virtual reality gaming based technologies. The chapter provides an overview of virtual reality gaming based technologies currently being developed and tested to improve motor and cognitive elements required for ambulation and mobility in different patient populations. Included as well is a detailed description of a single VR system, consisting of the rationale for development and iterative refinement of the system based on clinical science. These concepts include: neural plasticity, part-task training, whole task training, task specific training, principles of exercise and motor learning, sensorimotor integration, and visual spatial processing. PMID:19592788

  14. A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems

    PubMed Central

    Blana, Dimitra; Hincapie, Juan G.; Chadwick, Edward K.; Kirsch, Robert F.

    2008-01-01

    Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs:motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model-calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems. PMID:18420213

  15. Computer-assisted systems for forensic pathology and forensic toxicology.

    PubMed

    Druid, H; Holmgren, P; Löwenhielm, P

    1996-09-01

    A computer software, RättsBASE (RB), was developed for all forensic pathology units in Sweden and introduced in 1992. Simultaneously, a corresponding software, ToxBASE (TB), was developed for the Department of Forensic Toxicology, where all forensic toxicology in Sweden is managed. Both of the databases were created using dBASE IV, and the programming was carried out according to specifications from the staff at the forensic toxicology and forensic pathology units. since the development or RB and TB was coordinated, the systems can run together smoothly. The purpose of both systems was to automate the offices and to enable compilation of detailed statistics. Installation of Novell Netware and ISDN-connections (Integrated Service Digital Network) has enabled rapid communication between the units and easy compilation of nationwide statistics of forensic pathology and forensic toxicology. the systems offer a wide spectrum of reports and include a simple module for evaluation of the importance of the forensic efforts for th whole death investigation. The configuration of the softwares has also enabled processing of a large amount of related toxicological and autopsy data that in turn has yielded a base for compilation of toxicology interpretation lists. This article includes a summary of the features of the software and a discussion of its benefits and limitations. PMID:15637819

  16. Musculoskeletal system of the neck of the polar bear (Ursus maritimus) and the Malayan bear (Helarctos malayanus).

    PubMed

    Endo, H; Kakegawa, Y; Taru, H; Sasaki, M; Hayashi, Y; Yamamoto, M; Arishima, K

    2001-01-01

    The gross anatomical study was undertaken in the musculoskeletal system of the neck of the polar bear, and the findings were compared with those of the Malayan bear. The Musculus splenius and the M. trapezius were well-developed in the polar bear. The long neck of the polar bear consisted mainly of the M. splenius with the M. biventer cervicis and the M. complexus lying tightly underneath. The cervical vertebrae possessed huge ventral tubercle in the ventral part of the transverse process in the polar bear. These morphological characteristics suggest that the polar bear may rotate and bend the skull and the long cervical vertebrae. We postulate that the polar bear has evolved the high-mobility long neck to adapt for swimming. Unlike the polar bear, the Malayan bear has not specialized in the neck structure. PMID:11206987

  17. Musculoskeletal manifestations of endocrine disorders.

    PubMed

    Boswell, Stephanie B; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J; Forrester, Deborah M; Masih, Sulabha; Matcuk, George R

    2014-01-01

    Endocrine disorders can lead to disturbances in numerous systems within the body, including the musculoskeletal system. Radiological evaluation of these conditions can demonstrate typical appearances of the bones and soft tissues. Knowledge of these patterns can allow the radiologist to suggest a diagnosis that may not be clinically apparent. This review will highlight the typical musculoskeletal findings of acromegaly, hypercortisolism, hyperthyroidism, hypothyroidism, hyperparathyroidism, pseudo- and pseudopseudohypoparathyroidism, and diabetes mellitus. The radiological manifestations of each of these endocrine disorders, along with a brief discussion of the pathophysiology and clinical implications, will be discussed. PMID:24642251

  18. Quality assurance in anatomic pathology. An information system approach.

    PubMed

    Cowan, D F

    1990-02-01

    Quality assurance (QA) is the outcome-oriented process by which the performance of a complex production operation is evaluated. It is strongly focused on the use of resources and the end product, and is closely related to marketing. The pathologist's product is information, and the practice of anatomic pathology is evaluated as a system for producing and effectively communicating information. Our integrated program for QA in surgical pathology, autopsy pathology, and cytopathology recognizes that several discrete elements make up the sequence leading to communication of the diagnostic opinion. These are control and processing of the specimen, accuracy of diagnosis, timely and clear communication, efficiency in production of information, coherence with institutional programs in QA, and relation to licensing and accreditation agencies. Each of these elements may be tested separately and sources of error reduced so that the validity and cost of the pathologist's prediction will ultimately be limited only by the state of the art and not by any failure of the information system. Several components of QA, especially resource utilization by pathologists, are potentially productive areas for operations research. PMID:2302029

  19. TissueCypher™: A systems biology approach to anatomic pathology

    PubMed Central

    Prichard, Jeffrey W.; Davison, Jon M.; Campbell, Bruce B.; Repa, Kathleen A.; Reese, Lia M.; Nguyen, Xuan M.; Li, Jinhong; Foxwell, Tyler; Taylor, D. Lansing; Critchley-Thorne, Rebecca J.

    2015-01-01

    Background: Current histologic methods for diagnosis are limited by intra- and inter-observer variability. Immunohistochemistry (IHC) methods are frequently used to assess biomarkers to aid diagnoses, however, IHC staining is variable and nonlinear and the manual interpretation is subjective. Furthermore, the biomarkers assessed clinically are typically biomarkers of epithelial cell processes. Tumors and premalignant tissues are not composed only of epithelial cells but are interacting systems of multiple cell types, including various stromal cell types that are involved in cancer development. The complex network of the tissue system highlights the need for a systems biology approach to anatomic pathology, in which quantification of system processes is combined with informatics tools to produce actionable scores to aid clinical decision-making. Aims: Here, we describe a quantitative, multiplexed biomarker imaging approach termed TissueCypher™ that applies systems biology to anatomic pathology. Applications of TissueCypher™ in understanding the tissue system of Barrett's esophagus (BE) and the potential use as an adjunctive tool in the diagnosis of BE are described. Patients and Methods: The TissueCypher™ Image Analysis Platform was used to assess 14 epithelial and stromal biomarkers with known diagnostic significance in BE in a set of BE biopsies with nondysplastic BE with reactive atypia (RA, n = 22) and Barrett's with high-grade dysplasia (HGD, n = 17). Biomarker and morphology features were extracted and evaluated in the confirmed BE HGD cases versus the nondysplastic BE cases with RA. Results: Multiple image analysis features derived from epithelial and stromal biomarkers, including immune biomarkers and morphology, showed significant differences between HGD and RA. Conclusions: The assessment of epithelial cell abnormalities combined with an assessment of cellular changes in the lamina propria may serve as an adjunct to conventional pathology in the

  20. Alopecia in Systemic Amyloidosis: Trichoscopic-Pathologic Correlation

    PubMed Central

    Miteva, Mariya; Wei, Erin; Milikowski, Clara; Tosti, Antonella

    2015-01-01

    Alopecia in systemic amyloidosis is very rare and has been described as individual cases of diffuse nonscarring alopecia and a case of alopecia universalis. We report the trichoscopic findings in alopecia associated with systemic amyloidosis. The most prominent feature was a salmon colored halo (0.3-1 mm in diameter) surrounding the follicular ostia. Other features included broken hairs and black dots. The salmon colored halo correlated on pathology with the perifollicular deposition of amyloid. The horizontal sections showed that the sebaceous glands were preserved which supports the nonscarring pattern of the alopecia. PMID:26903748

  1. Ultrasound elastography for musculoskeletal applications

    PubMed Central

    Drakonaki, E E; Allen, G M; Wilson, D J

    2012-01-01

    Ultrasound elastography (EUS) is a method to assess the mechanical properties of tissue, by applying stress and detecting tissue displacement using ultrasound. There are several EUS techniques used in clinical practice; strain (compression) EUS is the most common technique that allows real-time visualisation of the elastographic map on the screen. There is increasing evidence that EUS can be used to measure the mechanical properties of musculoskeletal tissue in clinical practice, with the future potential for early diagnosis to both guide and monitor therapy. This review describes the various EUS techniques available for clinical use, presents the published evidence on musculoskeletal applications of EUS and discusses the technical issues, limitations and future perspectives of this method in the assessment of the musculoskeletal system. PMID:23091287

  2. Impact of overweight and obesity on the musculoskeletal system using lumbosacral angles

    PubMed Central

    Onyemaechi, Ndubuisi OC; Anyanwu, Godson E; Obikili, Emmanuel N; Onwuasoigwe, Okechukwu; Nwankwo, Okechukwu E

    2016-01-01

    Background Overweight and obesity have been identified as independent risk factors for musculoskeletal disorders. However, the association between obesity and low back pain remains controversial. Little is known about the effects of overweight and obesity on the angles of the lumbosacral spine. The objective of this study was to evaluate the effects of body mass index (BMI) and waist–hip ratio (WHR) on lumbosacral angles. Methods The effects of BMI and WHR on the lumbar lordosis angle (LLA), lumbosacral angle (LSA), sacral inclination angle (°°), and lumbosacral disc angle (LSDA) of 174 overweight and obese subjects (test group) and 126 underweight and normal-weight subjects (control group) were analyzed. Results The test group had a significantly higher mean LSA, LLA, sacral inclination angle (SIA), and LSDA (P=0.001). A significant correlation was noted between BMI and LSA (P=0.001), LLA (P=0.001), SIA (P=0.001), and LSDA (P=0.03). There was also a positive relationship between WHR and LSA (P=0.012), LLA (P=0.009), SIA (P=0.02), and LSDA (P=0.01). Conclusion There was an increase in lumbosacral angles in individuals with raised BMI and WHR. This may result in biomechanical changes in the lumbosacral spine, which increase the incidence of low back pain. PMID:27022251

  3. The aging musculoskeletal system and obesity-related considerations with exercise

    PubMed Central

    Vincent, Heather K.; Raiser, Sara N.; Vincent, Kevin R.

    2012-01-01

    Advancing age and adiposity contribute to musculoskeletal degenerative diseases and the development of sarcopenic obesity. The etiology of muscle loss is multifactorial, and includes inflammation, oxidative stress and hormonal changes, and is worsened by activity avoidance due to fear of pain. The risk for mobility disability and functional impairment rises with severity of obesity in the older adult. Performance measures of walking distance, walking speed, chair rise, stair climb, body transfers and ability to navigate obstacles on a course are adversely affected in this population, and this reflects decline in daily physical functioning. Exercise training is an ideal intervention to counteract the effects of aging and obesity. The 18 randomized controlled trials of exercise studies with or without diet components reviewed here indicate that 3–18 month programs that included aerobic and strengthening exercise (2–3 days per week) with caloric restriction (typically 750 kcal deficit/day), induced the greatest change in functional performance measures compared with exercise or diet alone. Importantly, resistance exercise attenuates muscle mass loss with the interventions. These interventions can also combat factors that invoke sarcopenia, including inflammation, oxidative stress and insulin resistance. Therefore, regular multimodal exercise coupled with diet appears to be very effective for counteracting sarocpenic obesity and improving mobility and function in the older, obese adult. PMID:22440321

  4. Musculoskeletal involvement in sarcoidosis*, **

    PubMed Central

    Nessrine, Akasbi; Zahra, Abourazzak Fatima; Taoufik, Harzy

    2014-01-01

    Sarcoidosis is a multisystem inflammatory disorder of unknown cause. It most commonly affects the pulmonary system but can also affect the musculoskeletal system, albeit less frequently. In patients with sarcoidosis, rheumatic involvement is polymorphic. It can be the presenting symptom of the disease or can appear during its progression. Articular involvement is dominated by nonspecific arthralgia, polyarthritis, and Löfgren's syndrome, which is defined as the presence of lung adenopathy, arthralgia (or arthritis), and erythema nodosum. Skeletal manifestations, especially dactylitis, appear mainly as complications of chronic, multiorgan sarcoidosis. Muscle involvement in sarcoidosis is rare and usually asymptomatic. The diagnosis of rheumatic sarcoidosis is based on X-ray findings and magnetic resonance imaging findings, although the definitive diagnosis is made by anatomopathological study of biopsy samples. Musculoskeletal involvement in sarcoidosis is generally relieved with nonsteroidal anti-inflammatory drugs or corticosteroids. In corticosteroid-resistant or -dependent forms of the disease, immunosuppressive therapy, such as treatment with methotrexate or anti-TNF-α, is employed. The aim of this review was to present an overview of the various types of osteoarticular and muscle involvement in sarcoidosis, focusing on their diagnosis and management. PMID:24831403

  5. Long-Term Outcomes in Patients Surviving Large Burns: The Musculoskeletal System.

    PubMed

    Holavanahalli, Radha K; Helm, Phala A; Kowalske, Karen J

    2016-01-01

    The authors have previously described long-term outcomes related to the skin in patients surviving large burns. The objective of this study was to describe the long-term musculoskeletal complications following major burn injury. This is a cross-sectional descriptive study that includes a one-time evaluation of 98 burn survivors (mean age = 47 years; mean TBSA = 57%; and mean time from injury = 17 years), who consented to participate in the study. A comprehensive history and physical examination was conducted by a senior and experienced Physical Medicine and Rehabilitation physician. In addition to completing a Medical Problem Checklist, subjects also completed the Burn-Specific Health Scale (Abbreviated 80 item), a self-report measure used to review the level of functional adaptation. Joint pain, joint stiffness, problems walking or running, fatigue, and weak arms and hands are conditions that continue to be reported at an average of 17 years from the time of burn injury. Seventy-three percent (68 of 93) of the study sample were found to have a limitation of motion and areas most affected were the neck (47%), hands (45%), and axilla (38%). The global (Burn-Specific Health Scale-total) score for the overall sample was 0.78. Subjects with limitation of motion had significant difficulty in areas of mobility, self-care, hand function, and role activities. This study underscores the importance of long-term follow-up care and therapeutic interventions for survivors of major burn injury, as they continue to have significant and persistent burn-related impairments even several years following injury. PMID:26056761

  6. Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review.

    PubMed

    Westgaard, R H; Winkel, J

    2011-01-01

    This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable

  7. Musculoskeletal disorders in construction: A review and a novel system for activity tracking with body area network.

    PubMed

    Valero, Enrique; Sivanathan, Aparajithan; Bosché, Frédéric; Abdel-Wahab, Mohamed

    2016-05-01

    Human body motions have been analysed for decades with a view on enhancing occupational well-being and performance of workers. On-going progresses in miniaturised wearable sensors are set to revolutionise biomechanical analysis by providing accurate and real-time quantitative motion data. The construction industry has a poor record of occupational health, in particular with regard to work-related musculoskeletal disorders (WMSDs). In this article, we therefore focus on the study of human body motions that could cause WMSDs in construction-related activities. We first present an in-depth review of existing assessment frameworks used in practice for the evaluation of human body motion. Subsequently different methods for measuring working postures and motions are reviewed and compared, pointing out the technological developments, limitations and gaps; Inertial Measurement Units (IMUs) are particularly investigated. Finally, we introduce a new system to detect and characterise unsafe postures of construction workers based on the measurement of motion data from wearable wireless IMUs integrated in a body area network. The potential of this system is demonstrated through experiments conducts in a laboratory as well as in a college with actual construction trade trainees. PMID:26851471

  8. Septin functions in organ system physiology and pathology.

    PubMed

    Dolat, Lee; Hu, Qicong; Spiliotis, Elias T

    2014-02-01

    Human septins comprise a family of 13 genes that encode for >30 protein isoforms with ubiquitous and tissue-specific expressions. Septins are GTP-binding proteins that assemble into higher-order oligomers and filamentous polymers, which associate with cell membranes and the cytoskeleton. In the last decade, much progress has been made in understanding the biochemical properties and cell biological functions of septins. In parallel, a growing number of studies show that septins play important roles for the development and physiology of specific tissues and organs. Here, we review the expression and function of septins in the cardiovascular, immune, nervous, urinary, digestive, respiratory, endocrine, reproductive, and integumentary organ systems. Furthermore, we discuss how the tissue-specific functions of septins relate to the pathology of human diseases that arise from aberrations in septin expression. PMID:24114910

  9. Septin functions in organ system physiology and pathology

    PubMed Central

    Dolat, Lee; Hu, Qicong

    2015-01-01

    Human septins comprise a family of 13 genes that encode for >30 protein isoforms with ubiquitous and tissue-specific expressions. Septins are GTP-binding proteins that assemble into higher-order oligomers and filamentous polymers, which associate with cell membranes and the cytoskeleton. In the last decade, much progress has been made in understanding the biochemical properties and cell biological functions of septins. In parallel, a growing number of studies show that septins play important roles for the development and physiology of specific tissues and organs. Here, we review the expression and function of septins in the cardiovascular, immune, nervous, urinary, digestive, respiratory, endocrine, reproductive, and integumentary organ systems. Furthermore, we discuss how the tissue-specific functions of septins relate to the pathology of human diseases that arise from aberrations in septin expression. PMID:24114910

  10. [About the treatment of battlefield injuries of the musculoskeletal system with the help of new "Rod field package"].

    PubMed

    Maksimov, I B; Brizhan', L K; Astashov, V L; Davydov, D V; Kerimov, A A; Arbuzov, Iu V; Varfolomeev, D I

    2014-04-01

    Injuries of the musculoskeletal system are at 60% of all battlefield injures and take first place in modern military conflicts. The main antishock measures are: pain management, emergency bleeding control, bone fragment positioning and fracture fixation. Specialist of the centre of traumatology and orthopaedics of the Burdenko General Military Clinical Hospital in cooperation with specialists of department of battlefield surgery of Mandryka Clinical Research and Training Medical Centre analysed the most effective domestic and foreign external fixators and developed Rod field package (RFP). The above mentioned researched had two stages. On the first (analytical) stage specialists formulated requirements for idea rod field external fixator. On the second (experimental) stage tests with the help of plastic models of long bones were carried out. The performed analysis showed, that installation of the external fixator is easy and fast, the external fixator is light and has capabilities for 3D bone fragment positioning and fracture fixation, the external fixator is radiotransparent. Implementation of this package into the clinical practice of delivery of battlefield emergency surgical care may improve results of treatment. PMID:25051785

  11. Effect of seat and table top slope on the biomechanical stress sustained by the musculo-skeletal system.

    PubMed

    Hamaoui, Alain; Hassaïne, Myriam; Watier, Bruno; Zanone, Pier-Giorgio

    2016-01-01

    The purpose of this study was to assess the effect of table and seat slope on the biomechanical stress sustained by the musculo-skeletal system. Angular position of the head and trunk, and surface electromyography of eleven postural muscles were recorded while seated under different conditions of seat slope (0°, 15° forward) and table slope (0°, 20° backward). The specific stress sustained by C7-T1 joint was estimated with isometric torque calculation. The results showed that the backward sloping table was associated with a reduction of neck flexion and neck extensors EMG, contrasting with a concurrent overactivity of the deltoideus. The forward sloping chair induced an anterior pelvic tilt, but also a higher activity of the knee (vasti) and ankle (soleus) extensors. It was concluded that sloping chairs and tables favor a more erect posture of the spine, but entails an undesirable overactivity of upper and lower limbs muscles to prevent the body from sliding. PMID:26669951

  12. Perspectives in ultrasound-guided musculoskeletal interventions

    PubMed Central

    Daftary, Aditya Ravindra; Karnik, Alpana Sudhir

    2015-01-01

    Ultrasonography (USG) is a safe, easily available, and cost-effective modality, which has the additional advantage of being real time for imaging and image-guided interventions of the musculoskeletal system. Musculoskeletal interventions are gaining popularity in sports and rehabilitation for rapid healing of muscle and tendon injuries in professional athletes, healing of chronic tendinopathies, aspiration of joint effusions, periarticular bursae and ganglia, and perineural injections in acute and chronic pain syndromes. This article aims to provide an overview of the spectrum of musculoskeletal interventions that can be done under USG guidance both for diagnostic and therapeutic purposes. PMID:26288519

  13. Pathology accessioning and retrieval system with encoding by computer (PARSEC). A microcomputer-based system for anatomic pathology featuring automated SNOP coding and multiple administrative functions.

    PubMed

    Foulis, P R; Norbut, A M; Mendelow, H; Kessler, G F

    1980-06-01

    A pathology accessioning and retrieval system with encoding by computer (PARSEC) has been developed, employing a relatively inexpensive microcomputer. PARSEC performs a variety of administrative functions for anatomic pathology, including accessioning of surgical specimens, storage of patient demographic information, editing, retrieval, and archiving of patient data, as well as CAP (college of American Pathologists) workload units, billing, and inventory functions for histopathology. In addition, appropriate gross and microscopic descriptions and pathologic diagnoses can be entered into the system by a text editor. Automatic assignment of SNOP (Systematized Nomenclature of Pathology) codes, is accomplished via an online SNOP lexicon, allowing the ultimate generation of completed surgical pathology reports. The data base management system employed makes optimum use of disk storage space, while permitting rapid data retrieval. Data file maintenance is automatically accomplished by the system, requiring no user intervention. PMID:7395803

  14. 3D-Pathology: a real-time system for quantitative diagnostic pathology and visualisation in 3D

    NASA Astrophysics Data System (ADS)

    Gottrup, Christian; Beckett, Mark G.; Hager, Henrik; Locht, Peter

    2005-02-01

    This paper presents the results of the 3D-Pathology project conducted under the European EC Framework 5. The aim of the project was, through the application of 3D image reconstruction and visualization techniques, to improve the diagnostic and prognostic capabilities of medical personnel when analyzing pathological specimens using transmitted light microscopy. A fully automated, computer-controlled microscope system has been developed to capture 3D images of specimen content. 3D image reconstruction algorithms have been implemented and applied to the acquired volume data in order to facilitate the subsequent 3D visualization of the specimen. Three potential application fields, immunohistology, cromogenic in situ hybridization (CISH) and cytology, have been tested using the prototype system. For both immunohistology and CISH, use of the system furnished significant additional information to the pathologist.

  15. Computational Pathology

    PubMed Central

    Louis, David N.; Feldman, Michael; Carter, Alexis B.; Dighe, Anand S.; Pfeifer, John D.; Bry, Lynn; Almeida, Jonas S.; Saltz, Joel; Braun, Jonathan; Tomaszewski, John E.; Gilbertson, John R.; Sinard, John H.; Gerber, Georg K.; Galli, Stephen J.; Golden, Jeffrey A.; Becich, Michael J.

    2016-01-01

    Context We define the scope and needs within the new discipline of computational pathology, a discipline critical to the future of both the practice of pathology and, more broadly, medical practice in general. Objective To define the scope and needs of computational pathology. Data Sources A meeting was convened in Boston, Massachusetts, in July 2014 prior to the annual Association of Pathology Chairs meeting, and it was attended by a variety of pathologists, including individuals highly invested in pathology informatics as well as chairs of pathology departments. Conclusions The meeting made recommendations to promote computational pathology, including clearly defining the field and articulating its value propositions; asserting that the value propositions for health care systems must include means to incorporate robust computational approaches to implement data-driven methods that aid in guiding individual and population health care; leveraging computational pathology as a center for data interpretation in modern health care systems; stating that realizing the value proposition will require working with institutional administrations, other departments, and pathology colleagues; declaring that a robust pipeline should be fostered that trains and develops future computational pathologists, for those with both pathology and non-pathology backgrounds; and deciding that computational pathology should serve as a hub for data-related research in health care systems. The dissemination of these recommendations to pathology and bioinformatics departments should help facilitate the development of computational pathology. PMID:26098131

  16. Muscle activation during maximal effort tasks: evidence of the selective forces that shaped the musculoskeletal system of humans

    PubMed Central

    Carrier, David R.; Schilling, Nadja; Anders, Christoph

    2015-01-01

    ABSTRACT The selective forces that played a role in the evolution of the musculoskeletal system of the genus Homo have long been debated and remain poorly understood. In this investigation, we introduce a new approach for testing alternative hypotheses. Our analysis is based on the premise that natural selection can be expected to have resulted in muscles that are large enough to achieve necessary levels of maximum performance in essential behaviors, but not larger. We used surface electromyography in male subjects to identify maximum activation levels in 13 muscles of the back and leg during eight behaviors that have been suggested to have been important to foraging, hunting and fighting performance in early humans. We asked two questions: (1) what behaviors produce maximum activation in each of the investigated muscles and (2) are there specific behaviors that elicit maximum recruitment from all or most of the muscles? We found that in eight of the 13 muscles, the highest activity occurred during maximal effort vertical jumping (i.e. whole-body acceleration). Punching produced the highest median activity in the other five muscles. Together, jumping and punching accounted for 73% of the incidences of maximum activity among all of the muscles and from all of the subjects. Thus, the size of the muscles of the back and leg appear to be more related to the demands of explosive behaviors rather than those of high speed sprinting or sustained endurance running. These results are consistent with the hypothesis that selection on aggressive behavior played an important role in the evolution of the genus Homo. PMID:26538637

  17. Muscle activation during maximal effort tasks: evidence of the selective forces that shaped the musculoskeletal system of humans.

    PubMed

    Carrier, David R; Schilling, Nadja; Anders, Christoph

    2015-01-01

    The selective forces that played a role in the evolution of the musculoskeletal system of the genus Homo have long been debated and remain poorly understood. In this investigation, we introduce a new approach for testing alternative hypotheses. Our analysis is based on the premise that natural selection can be expected to have resulted in muscles that are large enough to achieve necessary levels of maximum performance in essential behaviors, but not larger. We used surface electromyography in male subjects to identify maximum activation levels in 13 muscles of the back and leg during eight behaviors that have been suggested to have been important to foraging, hunting and fighting performance in early humans. We asked two questions: (1) what behaviors produce maximum activation in each of the investigated muscles and (2) are there specific behaviors that elicit maximum recruitment from all or most of the muscles? We found that in eight of the 13 muscles, the highest activity occurred during maximal effort vertical jumping (i.e. whole-body acceleration). Punching produced the highest median activity in the other five muscles. Together, jumping and punching accounted for 73% of the incidences of maximum activity among all of the muscles and from all of the subjects. Thus, the size of the muscles of the back and leg appear to be more related to the demands of explosive behaviors rather than those of high speed sprinting or sustained endurance running. These results are consistent with the hypothesis that selection on aggressive behavior played an important role in the evolution of the genus Homo. PMID:26538637

  18. Chest pain in focal musculoskeletal disorders.

    PubMed

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-03-01

    The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice. PMID:20380955

  19. Tuning pathological brain oscillations with neurofeedback: a systems neuroscience framework

    PubMed Central

    Ros, Tomas; J. Baars, Bernard; Lanius, Ruth A.; Vuilleumier, Patrik

    2014-01-01

    Neurofeedback (NFB) is emerging as a promising technique that enables self-regulation of ongoing brain oscillations. However, despite a rise in empirical evidence attesting to its clinical benefits, a solid theoretical basis is still lacking on the manner in which NFB is able to achieve these outcomes. The present work attempts to bring together various concepts from neurobiology, engineering, and dynamical systems so as to propose a contemporary theoretical framework for the mechanistic effects of NFB. The objective is to provide a firmly neurophysiological account of NFB, which goes beyond traditional behaviorist interpretations that attempt to explain psychological processes solely from a descriptive standpoint whilst treating the brain as a “black box”. To this end, we interlink evidence from experimental findings that encompass a broad range of intrinsic brain phenomena: starting from “bottom-up” mechanisms of neural synchronization, followed by “top-down” regulation of internal brain states, moving to dynamical systems plus control-theoretic principles, and concluding with activity-dependent as well as homeostatic forms of brain plasticity. In support of our framework, we examine the effects of NFB in several brain disorders, including attention-deficit hyperactivity (ADHD) and post-traumatic stress disorder (PTSD). In sum, it is argued that pathological oscillations emerge from an abnormal formation of brain-state attractor landscape(s). The central thesis put forward is that NFB tunes brain oscillations toward a homeostatic set-point which affords an optimal balance between network flexibility and stability (i.e., self-organised criticality (SOC)). PMID:25566028

  20. Disuse of the musculo-skeletal system in space and on earth.

    PubMed

    Narici, M V; de Boer, M D

    2011-03-01

    Muscle mass and strength are well known to decline in response to actual and simulated microgravity exposure. However, despite the considerable knowledge gained on the physiological changes induced by spaceflight, the mechanisms of muscle atrophy and the effectiveness of in-flight countermeasures still need to be fully elucidated. The present review examines the effects and mechanisms of actual and simulated microgravity on single fibre and whole muscle structural and functional properties, protein metabolism, tendon mechanical properties, neural drive and reflex excitability. The effects of inflight countermeasures are also discussed in the light of recent advances in resistive loading techniques, in combined physical, pharmacological and nutritional interventions as well as in the development of artificial gravity systems. Emphasis has been given to the pioneering work of Pietro Enrico di Prampero in the development of artificial gravity systems and in the progress of knowledge on the limits of human muscular performance in space. PMID:20617334

  1. Computer-based medical decision support system in diagnosis and treatment of musculoskeletal disorders and injuries.

    PubMed

    Tomaszewski, Wiesław; Bliźniuk, Grzegorz; Czamara, Andrzej; Ameljańczyk, Andrzej; Widuchowski, Wojciech; Klukowski, Krzysztof

    2011-01-01

    The use of information technologies in health care systems around the world dates back to the 1970s. But it was only the dynamic development of information technology in the 1990s that enabled significant development of IT systems supporting broadly defined medical activity. The ongoing process of transformation of the Polish healthcare system has been forcing health care providers to expend financial, material and human resources increasing efficiency. At the same time, the very dynamic development of medical sciences and information technologies has brought about a significant increase in the number of papers of importance for the effectiveness and quality of medical care. As a result, medical specialists are not able to keep up with the constantly updated medical knowledge. These factors are making standardization of health care processes a growing necessity. This paper is an introductory work presenting, on the basis of the available literature and the authors' research experience, a historical outline, stages of development and state of the art of information technology in medicine, as well as theoretical objectives of the project, which are specified in the title of this paper. PMID:21750352

  2. Reprint of: Musculoskeletal system in the old age and the demand for healthy ageing biomarkers.

    PubMed

    Collino, Sebastiano; Martin, François-Pierre; Karagounis, Leonidas G; Horcajada, Marie Noelle; Moco, Sofia; Franceschi, Claudio; Kussmann, Martin; Offord, Elizabeth

    2014-01-01

    Population ageing has emerged as a major demographic trend worldwide due to improved health and longevity. This global ageing phenomenon will have a major impact on health-care systems worldwide due to increased morbidity and greater needs for hospitalization/institutionalization. As the ageing population increases worldwide, there is an increasing awareness not only of increased longevity but also of the importance of "healthy ageing" and "quality of life". Yet, the age related chronic inflammation is believed to be pathogenic with regards to its contribution to frailty and degenerative disorders. In particular, the frailty syndrome is increasingly being considered as a key risk indicator of adverse health outcomes. In addition, elderly may be also prone to be resistant to anabolic stimuli which is likely a key factor in the loss of skeletal muscle mass with ageing. Vital to understand these key biological processes is the development of biological markers, through system biology approaches, aiding at strategies for tailored therapeutic and personalized nutritional program. Overall aim is to prevent or attenuate decline of key physiological functions required to live an active, independent life. This review focus on core indicators of health and functions in older adults, where nutrition and tailored personalized programs could exhibit preventive roles, and where the aid of metabolomics technologies are increasingly displaying potential in revealing key molecular mechanisms/targets linked to specific ageing and/or healthy ageing processes. PMID:24662191

  3. Musculoskeletal system in the old age and the demand for healthy ageing biomarkers.

    PubMed

    Collino, Sebastiano; Martin, François-Pierre; Karagounis, Leonidas G; Horcajada, Marie Noelle; Moco, Sofia; Franceschi, Claudio; Kussmann, Martin; Offord, Elizabeth

    2013-01-01

    Population ageing has emerged as a major demographic trend worldwide due to improved health and longevity. This global ageing phenomenon will have a major impact on health-care systems worldwide due to increased morbidity and greater needs for hospitalization/institutionalization. As the ageing population increases worldwide, there is an increasing awareness not only of increased longevity but also of the importance of "healthy ageing" and "quality of life". Yet, the age related chronic inflammation is believed to be pathogenic with regards to its contribution to frailty and degenerative disorders. In particular, the frailty syndrome is increasingly being considered as a key risk indicator of adverse health outcomes. In addition, elderly may be also prone to be resistant to anabolic stimuli which is likely a key factor in the loss of skeletal muscle mass with ageing. Vital to understand these key biological processes is the development of biological markers, through system biology approaches, aiding at strategies for tailored therapeutic and personalized nutritional program. Overall aim is to prevent or attenuate decline of key physiological functions required to live an active, independent life. This review focus on core indicators of health and functions in older adults, where nutrition and tailored personalized programs could exhibit preventive roles, and where the aid of metabolomics technologies are increasingly displaying potential in revealing key molecular mechanisms/targets linked to specific ageing and/or healthy ageing processes. PMID:24269882

  4. [CLINICAL AND BIOCHEMICAL CHARACTERISTICS OF DISORDERS OF THE NERVOUS SYSTEM AND THE RISKS OF COMMON PATHOLOGICAL SYNDROMES IN MERCURY PRODUCTION WORKERS].

    PubMed

    Kudaeva, I V; Dyakovich, O A; Katamanova, E V; Popkova, O V; Masnavieva, L B

    2015-01-01

    The occupational factors are assigned one out of main parts to the development of occupational and comorbid pathology. At the same time the social aspects of labor relations act as the most important factors influencing on the workers' self-assessment of health status. Quantitative risk assessment of the common pathological syndromes has identified the excess of share of persons with a minimum level of risk over the medium and high. In the structure of risks of common pathological syndromes there are prevailed risks for disorders of the cardiovascular and nervous systems and borderline mental disorders, which is a response to the impact of not only industrial, but also psychosocial factors. The results of self-assessment of health status and clinical examination of employees in conditions of mercury exposure show the similarity of the structure of diseases in these cases. In either event there are dominated diseases of the nervous and mental sphere, and from the comorbid pathology disorders of the cardiovascular system are prove to be important. Clinical manifestations of the mercury exposure, ranging from pre-clinical manifestations to marked changes from the side of the nervous system in toxic encephalopathy, are characterized by the presence of hyperkinetic syndrome. For pre-clinical and early forms of mercury poisoning there is also typical the presence of asthenic (emotional lability) disorders with autonomic dysfunction. Comorbidities in an internship working was manifested primarily by diseases of visual organs, cardiovascular system and diseases of the musculoskeletal system. Observed disorders of the nervous system and psycho-emotional sphere are caused, inter alia disturbances of the balance of catecholamines (the rise of norepinephrine in dynamics with a concomitant increase in the coefficient reflecting the degree of its metabolism: norepinephrine/epinephrine and norepinephrine/(adrenaline + Normetanephrine)) in the body. PMID:26856145

  5. Development of an electronic breast pathology database in a community health system

    PubMed Central

    Nelson, Heidi D.; Weerasinghe, Roshanthi; Martel, Maritza; Bifulco, Carlo; Assur, Ted; Elmore, Joann G.; Weaver, Donald L.

    2014-01-01

    Background: Health care systems rely on electronic patient data, yet access to breast tissue pathology results continues to depend on interpreting dictated free-text reports. Objective: The objective was to develop a method to electronically search and categorize pathologic diagnoses of patients’ breast tissue specimens from dictated free-text pathology reports in a large health system for multiple users including clinicians. Design: A database integrating existing patient-level administrative and clinical information for breast cancer screening and diagnostic services and a web-based application for comprehensive searching of pathology reports were developed by a health system team led by pathologists. The Breast Pathology Assessment Tool and Hierarchy for Diagnosis (BPATH-Dx) provided search terms and guided electronic transcription of diagnoses from text fields on breast pathology clinical reports to standardized categories. Approach: Breast pathology encounters in the pathology database were matched with administrative data for 7332 women with breast tissue specimens obtained from an initial procedure in the health system from January 1, 2008 to December 31, 2011. Sequential queries of the pathology text based on BPATH-Dx categorized biopsies according to their worst pathological diagnosis, as is standard practice. Diagnoses ranged from invasive breast cancer (23.3%), carcinoma in situ (7.8%), atypical lesions (6.39%), proliferative lesions without atypia (27.9%), and nonproliferative lesions (34.7%), and were further classified into subcategories. A random sample of 5% of reports that were manually reviewed indicated 97.5% agreement. Conclusions: Sequential queries of free-text pathology reports guided by a standardized assessment tool in conjunction with a web-based search application provide an efficient and reproducible approach to accessing nonmalignant breast pathology diagnoses. This method advances the use of pathology data and electronic health

  6. An Electromyographic-driven Musculoskeletal Torque Model using Neuro-Fuzzy System Identification: A Case Study.

    PubMed

    Jafari, Zohreh; Edrisi, Mehdi; Marateb, Hamid Reza

    2014-10-01

    The purpose of this study was to estimate the torque from high-density surface electromyography signals of biceps brachii, brachioradialis, and the medial and lateral heads of triceps brachii muscles during moderate-to-high isometric elbow flexion-extension. The elbow torque was estimated in two following steps: First, surface electromyography (EMG) amplitudes were estimated using principal component analysis, and then a fuzzy model was proposed to illustrate the relationship between the EMG amplitudes and the measured torque signal. A neuro-fuzzy method, with which the optimum number of rules could be estimated, was used to identify the model with suitable complexity. Utilizing the proposed neuro-fuzzy model, the clinical interpretability was introduced; contrary to the previous linear and nonlinear black-box system identification models. It also reduced the estimation error compared with that of the most recent and accurate nonlinear dynamic model introduced in the literature. The optimum number of the rules for all trials was 4 ± 1, that might be related to motor control strategies and the % variance accounted for criterion was 96.40 ± 3.38 which in fact showed considerable improvement compared with the previous methods. The proposed method is thus a promising new tool for EMG-Torque modeling in clinical applications. PMID:25426427

  7. An Electromyographic-driven Musculoskeletal Torque Model using Neuro-Fuzzy System Identification: A Case Study

    PubMed Central

    Jafari, Zohreh; Edrisi, Mehdi; Marateb, Hamid Reza

    2014-01-01

    The purpose of this study was to estimate the torque from high-density surface electromyography signals of biceps brachii, brachioradialis, and the medial and lateral heads of triceps brachii muscles during moderate-to-high isometric elbow flexion-extension. The elbow torque was estimated in two following steps: First, surface electromyography (EMG) amplitudes were estimated using principal component analysis, and then a fuzzy model was proposed to illustrate the relationship between the EMG amplitudes and the measured torque signal. A neuro-fuzzy method, with which the optimum number of rules could be estimated, was used to identify the model with suitable complexity. Utilizing the proposed neuro-fuzzy model, the clinical interpretability was introduced; contrary to the previous linear and nonlinear black-box system identification models. It also reduced the estimation error compared with that of the most recent and accurate nonlinear dynamic model introduced in the literature. The optimum number of the rules for all trials was 4 ± 1, that might be related to motor control strategies and the % variance accounted for criterion was 96.40 ± 3.38 which in fact showed considerable improvement compared with the previous methods. The proposed method is thus a promising new tool for EMG-Torque modeling in clinical applications. PMID:25426427

  8. Integrated pathology reporting, indexing, and retrieval system using natural language diagnoses.

    PubMed

    Moore, G W; Boitnott, J K; Miller, R E; Eggleston, J C; Hutchins, G M

    1988-01-01

    Pathology computer systems are making increasing use of natural language diagnoses. The Johns Hopkins Medical Institutions integrated pathology reporting system, a commercial product with extensive, locally added enhancements, covers all information management functions within autopsy and surgical pathology divisions and has on-line linkages to clinical laboratory reports and the medical library's Mini-MEDLINE system. All diagnoses are written in natural language, using a word processor and spelling checker. A security system with personal passwords and different levels of access for different staff members allows reports to be signed out with an electronic signature. The system produces financial reports, overdue case reports, and Boolean searches of the database. Our experience with 128,790 consecutively entered pathology reports suggests that the greater precision of natural language diagnoses makes them the most suitable vehicle for follow-up, retrieval, and systems development functions in pathology. PMID:3070549

  9. A dedicated cone-beam CT system for musculoskeletal extremities imaging: Design, optimization, and initial performance characterization

    SciTech Connect

    Zbijewski, W.; De Jean, P.; Prakash, P.; Ding, Y.; Stayman, J. W.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Machado, A.; Carrino, J. A.; Siewerdsen, J. H.

    2011-08-15

    Purpose: This paper reports on the design and initial imaging performance of a dedicated cone-beam CT (CBCT) system for musculoskeletal (MSK) extremities. The system complements conventional CT and MR and offers a variety of potential clinical and logistical advantages that are likely to be of benefit to diagnosis, treatment planning, and assessment of therapy response in MSK radiology, orthopaedic surgery, and rheumatology. Methods: The scanner design incorporated a host of clinical requirements (e.g., ability to scan the weight-bearing knee in a natural stance) and was guided by theoretical and experimental analysis of image quality and dose. Such criteria identified the following basic scanner components and system configuration: a flat-panel detector (FPD, Varian 3030+, 0.194 mm pixels); and a low-power, fixed anode x-ray source with 0.5 mm focal spot (SourceRay XRS-125-7K-P, 0.875 kW) mounted on a retractable C-arm allowing for two scanning orientations with the capability for side entry, viz. a standing configuration for imaging of weight-bearing lower extremities and a sitting configuration for imaging of tensioned upper extremity and unloaded lower extremity. Theoretical modeling employed cascaded systems analysis of modulation transfer function (MTF) and detective quantum efficiency (DQE) computed as a function of system geometry, kVp and filtration, dose, source power, etc. Physical experimentation utilized an imaging bench simulating the scanner geometry for verification of theoretical results and investigation of other factors, such as antiscatter grid selection and 3D image quality in phantom and cadaver, including qualitative comparison to conventional CT. Results: Theoretical modeling and benchtop experimentation confirmed the basic suitability of the FPD and x-ray source mentioned above. Clinical requirements combined with analysis of MTF and DQE yielded the following system geometry: a {approx}55 cm source-to-detector distance; 1.3 magnification; a

  10. A dedicated cone-beam CT system for musculoskeletal extremities imaging: Design, optimization, and initial performance characterization

    PubMed Central

    Zbijewski, W.; De Jean, P.; Prakash, P.; Ding, Y.; Stayman, J. W.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Machado, A.; Carrino, J. A.; Siewerdsen, J. H.

    2011-01-01

    Purpose: This paper reports on the design and initial imaging performance of a dedicated cone-beam CT (CBCT) system for musculoskeletal (MSK) extremities. The system complements conventional CT and MR and offers a variety of potential clinical and logistical advantages that are likely to be of benefit to diagnosis, treatment planning, and assessment of therapy response in MSK radiology, orthopaedic surgery, and rheumatology. Methods: The scanner design incorporated a host of clinical requirements (e.g., ability to scan the weight-bearing knee in a natural stance) and was guided by theoretical and experimental analysis of image quality and dose. Such criteria identified the following basic scanner components and system configuration: a flat-panel detector (FPD, Varian 3030+, 0.194 mm pixels); and a low-power, fixed anode x-ray source with 0.5 mm focal spot (SourceRay XRS-125-7K-P, 0.875 kW) mounted on a retractable C-arm allowing for two scanning orientations with the capability for side entry, viz. a standing configuration for imaging of weight-bearing lower extremities and a sitting configuration for imaging of tensioned upper extremity and unloaded lower extremity. Theoretical modeling employed cascaded systems analysis of modulation transfer function (MTF) and detective quantum efficiency (DQE) computed as a function of system geometry, kVp and filtration, dose, source power, etc. Physical experimentation utilized an imaging bench simulating the scanner geometry for verification of theoretical results and investigation of other factors, such as antiscatter grid selection and 3D image quality in phantom and cadaver, including qualitative comparison to conventional CT. Results: Theoretical modeling and benchtop experimentation confirmed the basic suitability of the FPD and x-ray source mentioned above. Clinical requirements combined with analysis of MTF and DQE yielded the following system geometry: a ∼55 cm source-to-detector distance; 1.3 magnification; a 20

  11. Musculoskeletal modelling in dogs: challenges and future perspectives.

    PubMed

    Dries, Billy; Jonkers, Ilse; Dingemanse, Walter; Vanwanseele, Benedicte; Vander Sloten, Jos; van Bree, Henri; Gielen, Ingrid

    2016-05-18

    Musculoskeletal models have proven to be a valuable tool in human orthopaedics research. Recently, veterinary research started taking an interest in the computer modelling approach to understand the forces acting upon the canine musculoskeletal system. While many of the methods employed in human musculoskeletal models can applied to canine musculoskeletal models, not all techniques are applicable. This review summarizes the important parameters necessary for modelling, as well as the techniques employed in human musculoskeletal models and the limitations in transferring techniques to canine modelling research. The major challenges in future canine modelling research are likely to centre around devising alternative techniques for obtaining maximal voluntary contractions, as well as finding scaling factors to adapt a generalized canine musculoskeletal model to represent specific breeds and subjects. PMID:27102147

  12. Significant progression of load on the musculoskeletal system with extremely high loads, with rapid weekly weight gains, using the Anatoly Gravitational System, in a 10-week training period.

    PubMed

    Burke, David T; Tran, David; Cui, Di; Burke, Daniel P; Al-Adawi, Samir; Dorvlo, Atsu Ss

    2013-01-01

    In an age of increasing numbers of lifestyle diseases and plasticity of longevity, exercise and weight training have been increasingly recognized as both preventing and mitigating the severity of many illnesses. This study was designed to determine whether significant weight-lifting gains could be realized through the Anatoly Gravitational System. Specifically, this study sought to determine whether this once-weekly weight-training system could result in significant weekly strength gains during a 10-week training period. A total of 50 participants, ranging in age from 17 to 67 years, completed at least 10 weekly 30-minute training sessions. The results suggest participants could, on average, double their weight-lifting capacity within 10 sessions. This preliminary study, which would require further scrutiny, suggests the Anatoly Gravitational System provides a rather unique opportunity to load the musculoskeletal system with extremely high loads, with rapid weekly weight gains, using only short weekly training sessions. More studies are warranted to scrutinize these findings. PMID:24379727

  13. [Is the use of STABHA™ for supplementation of damaged extracellular matrix of soft tissues in the musculoskeletal system an effective treatment of acute injuries and tendinopathies?].

    PubMed

    Tomaszewski, Wiesław

    2015-01-01

    Viscosupplementation, or the intra articular administration of hyaluronic acid in order to stabilise synovial fluid chemistry and improve its functional quality, is now a popular therapeutic method whose efficacy, based on numerous published studies, makes it not only a form of symptomatic treatment, but also, to a considerable extent, a cause-oriented treatment. However, a possibly controversial aspect of this therapy is the use of “intra articular hyaluronate” in the treatment of post-traumatic or inflammatory soft-tissue lesions in in the musculoskeletal system. Inappropriate administration of this dosage form to the area of the injured soft tissue (Achilles tendon, periarticular tendon of tarsal joint or knee, tennis elbow, tendinopathy within the rotator cuff, etc.) may not only lead to a failure to achieve the desired therapeutic effect but can even increase the severity of the symptoms, including a rupture of the frayed tendon. The role and importance of hyaluronate in the process of natural regeneration of damaged soft tissue has been demonstrated unequivocally and beyond any doubt. Subsequent research aimed to produce forms of hyaluronic acid that would be characterised by a greater influence and support of the regeneration processes in musculoskeletal soft tissue after an acute or chronic injury, as well as to develop the technology to produce a formulation which would be biocompatible, efficient and adapted to the treatment of ligament and tendon injuries. Following administration, such formulation would also need to be identified by the body as a naturally produced hyaluronate, which plays an essential role in the repair of damaged tissue, beginning with the bleeding phase and involving in all phases of the healing process, as has been demonstrated in numerous scientific studies. The development of a technology for producing hyaluronic acid known as STABHA™ (Soft Tissue Adapted Biocompatible Hyaluronic Acid) in 2008 proved to be a significant

  14. Whole-Organism Cellular Pathology: A Systems Approach to Phenomics.

    PubMed

    Cheng, K C; Katz, S R; Lin, A Y; Xin, X; Ding, Y

    2016-01-01

    Phenotype is defined as the state of an organism resulting from interactions between genes, environment, disease, molecular mechanisms, and chance. The purpose of the emerging field of phenomics is to systematically determine and measure phenotypes across biology for the sake of understanding. Phenotypes can affect more than one cell type and life stage, so ideal phenotyping would include the state of every cell type within the context of both tissue architecture and the whole organism at each life stage. In medicine, high-resolution anatomic assessment of phenotype is obtained from histology. Histology's interpretative power, codified by Virchow as cellular pathology, is derived from its ability to discern diagnostic and characteristic cellular changes in diseased tissues. Cellular pathology is observed in every major human disease and relies on the ability of histology to detect cellular change in any cell type due to unbiased pan-cellular staining, even in optically opaque tissues. Our laboratory has shown that histology is far more sensitive than stereomicroscopy for detecting phenotypes in zebrafish mutants. Those studies have also shown that more complete sampling, greater consistency in sample orientation, and the inclusion of phenotypes extending over longer length scales would provide greater coverage of common phenotypes. We are developing technical approaches to achieve an ideal detection of cellular pathology using an improved form of X-ray microtomography that retains the strengths and addresses the weaknesses of histology as a screening tool. We are using zebrafish as a vertebrate model based on the overlaps between zebrafish and mammalian tissue architecture, and a body size small enough to allow whole-organism, volumetric imaging at cellular resolution. Automation of whole-organism phenotyping would greatly increase the value of phenomics. Potential societal benefits would include reduction in the cost of drug development, a reduction in the

  15. Burden of major musculoskeletal conditions.

    PubMed Central

    Woolf, Anthony D.; Pfleger, Bruce

    2003-01-01

    Musculoskeletal conditions are a major burden on individuals, health systems, and social care systems, with indirect costs being predominant. This burden has been recognized by the United Nations and WHO, by endorsing the Bone and Joint Decade 2000-2010. This paper describes the burden of four major musculoskeletal conditions: osteoarthritis, rheumatoid arthritis, osteoporosis, and low back pain. Osteoarthritis, which is characterized by loss of joint cartilage that leads to pain and loss of function primarily in the knees and hips, affects 9.6% of men and 18% of women aged > 60 years. Increases in life expectancy and ageing populations are expected to make osteoarthritis the fourth leading cause of disability by the year 2020. Joint replacement surgery, where available, provides effective relief. Rheumatoid arthritis is an inflammatory condition that usually affects multiple joints. It affects 0.3-1.0% of the general population and is more prevalent among women and in developed countries. Persistent inflammation leads to joint destruction, but the disease can be controlled with drugs. The incidence may be on the decline, but the increase in the number of older people in some regions makes it difficult to estimate future prevalence. Osteoporosis, which is characterized by low bone mass and microarchitectural deterioration, is a major risk factor for fractures of the hip, vertebrae, and distal forearm. Hip fracture is the most detrimental fracture, being associated with 20% mortality and 50% permanent loss in function. Low back pain is the most prevalent of musculoskeletal conditions; it affects nearly everyone at some point in time and about 4-33% of the population at any given point. Cultural factors greatly influence the prevalence and prognosis of low back pain. PMID:14710506

  16. System of polarization phasometry of polycrystalline blood plasma networks in mammary gland pathology diagnostics

    NASA Astrophysics Data System (ADS)

    Zabolotna, Natalia I.; Oliinychenko, Bogdan P.; Radchenko, Kostiantyn O.; Krasnoshchoka, Anastasiia K.; Shcherba, Olga K.

    2015-09-01

    The polarizing phase meter system of polycrystalline networks of human blood plasma which is used for the mammary gland pathology diagnostics was proposed in this paper. Increasing the accuracy of the phase value determination was achieved using a combination of low coherent source of radiation and circularly polarized probing of biological object. Thus, high informativity of polarizing phase meter system for the diagnosis of breast pathology using the phase mapping of the human blood plasma films were determined, thereafter statistical, correlational, fractal structure analysis of the obtained phase maps was carried out and the quantitative criterias of the phase diagnostics and differentiation of the breast pathological conditions were determined too.

  17. Silk scaffolds for musculoskeletal tissue engineering.

    PubMed

    Yao, Danyu; Liu, Haifeng; Fan, Yubo

    2016-02-01

    The musculoskeletal system, which includes bone, cartilage, tendon/ligament, and skeletal muscle, is becoming the targets for tissue engineering because of the high need for their repair and regeneration. Numerous factors would affect the use of musculoskeletal tissue engineering for tissue regeneration ranging from cells used for scaffold seeding to the manufacture and structures of materials. The essential function of the scaffolds is to convey growth factors as well as cells to the target site to aid the regeneration of the injury. Among the variety of biomaterials used in scaffold engineering, silk fibroin is recognized as an ideal material for its impressive cytocompatibility, slow biodegradability, and excellent mechanical properties. The current review describes the advances made in the fabrication of silk fibroin scaffolds with different forms such as films, particles, electrospun fibers, hydrogels, three-dimensional porous scaffolds, and their applications in the regeneration of musculoskeletal tissues. PMID:26445979

  18. Musculoskeletal complications of neuromuscular disease in children.

    PubMed

    Driscoll, Sherilyn W; Skinner, Joline

    2008-02-01

    A wide variety of neuromuscular diseases affect children, including central nervous system disorders such as cerebral palsy and spinal cord injury; motor neuron disorders such as spinal muscular atrophy; peripheral nerve disorders such as Charcot-Marie-Tooth disease; neuromuscular junction disorders such as congenital myasthenia gravis; and muscle fiber disorders such as Duchenne's muscular dystrophy. Although the origins and clinical syndromes vary significantly, outcomes related to musculoskeletal complications are often shared. The most frequently encountered musculoskeletal complications of neuromuscular disorders in children are scoliosis, bony rotational deformities, and hip dysplasia. Management is often challenging to those who work with children who have neuromuscular disorders. PMID:18194756

  19. Oligodendrogenesis in the normal and pathological central nervous system.

    PubMed

    El Waly, Bilal; Macchi, Magali; Cayre, Myriam; Durbec, Pascale

    2014-01-01

    Oligodendrocytes (OLGs) are generated late in development and myelination is thus a tardive event in the brain developmental process. It is however maintained whole life long at lower rate, and myelin sheath is crucial for proper signal transmission and neuronal survival. Unfortunately, OLGs present a high susceptibility to oxidative stress, thus demyelination often takes place secondary to diverse brain lesions or pathologies. OLGs can also be the target of immune attacks, leading to primary demyelination lesions. Following oligodendrocytic death, spontaneous remyelination may occur to a certain extent. In this review, we will mainly focus on the adult brain and on the two main sources of progenitor cells that contribute to oligodendrogenesis: parenchymal oligodendrocyte precursor cells (OPCs) and subventricular zone (SVZ)-derived progenitors. We will shortly come back on the main steps of oligodendrogenesis in the postnatal and adult brain, and summarize the key factors involved in the determination of oligodendrocytic fate. We will then shed light on the main causes of demyelination in the adult brain and present the animal models that have been developed to get insight on the demyelination/remyelination process. Finally, we will synthetize the results of studies searching for factors able to modulate spontaneous myelin repair. PMID:24971048

  20. Oligodendrogenesis in the normal and pathological central nervous system

    PubMed Central

    El Waly, Bilal; Macchi, Magali; Cayre, Myriam; Durbec, Pascale

    2014-01-01

    Oligodendrocytes (OLGs) are generated late in development and myelination is thus a tardive event in the brain developmental process. It is however maintained whole life long at lower rate, and myelin sheath is crucial for proper signal transmission and neuronal survival. Unfortunately, OLGs present a high susceptibility to oxidative stress, thus demyelination often takes place secondary to diverse brain lesions or pathologies. OLGs can also be the target of immune attacks, leading to primary demyelination lesions. Following oligodendrocytic death, spontaneous remyelination may occur to a certain extent. In this review, we will mainly focus on the adult brain and on the two main sources of progenitor cells that contribute to oligodendrogenesis: parenchymal oligodendrocyte precursor cells (OPCs) and subventricular zone (SVZ)-derived progenitors. We will shortly come back on the main steps of oligodendrogenesis in the postnatal and adult brain, and summarize the key factors involved in the determination of oligodendrocytic fate. We will then shed light on the main causes of demyelination in the adult brain and present the animal models that have been developed to get insight on the demyelination/remyelination process. Finally, we will synthetize the results of studies searching for factors able to modulate spontaneous myelin repair. PMID:24971048

  1. Pathology tickler: an HL7 monitoring system to provide clinical feedback

    NASA Astrophysics Data System (ADS)

    Mongkolwat, Pattanasak; Davis, Elizabeth; Bhalodia, Pankit; Singh, Harinder; Channin, David S.

    2003-05-01

    The purpose of this project is to develop a software system to provide feedback to radiologists and other clinicians from interventional procedures in which they participate. Using Health Level Seven (HL7) traffic between the anatomy/pathology information system and other major information systems, we were able to develop a semi-automatic 'tickler' system that can notify clinicians of pathology results as well as the absence of pathology results after a specified time interval. By using this system, radiologists can get more rapid feedback concerning their interpretations and thereby learn to distinguish false positive from true positive cases. Potentially, fewer patients would fall through the follow-up cracks when using our system versus a paper-based method. The system demonstrates, among other things, how HL7 information can be a powerful tool at an institution when used for purposes for which it was not intentionally designed.

  2. Diagnostic and interventional musculoskeletal ultrasound: part 2. Clinical applications.

    PubMed

    Smith, Jay; Finnoff, Jonathan T

    2009-02-01

    Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurological and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared to other available imaging modalities; (2) describe how ultrasound machines produce images using sound waves; (3) discuss the steps necessary to acquire and optimize an ultrasound image; (4) understand the difference ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones; and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound. Part 2 of this 2-part article will focus on the clinical applications of musculoskeletal ultrasound in clinical practice, including the ultrasonographic appearance of normal and abnormal tissues as well as specific diagnostic and interventional applications in major body regions. PMID:19627890

  3. Diagnostic and interventional musculoskeletal ultrasound: part 1. Fundamentals.

    PubMed

    Smith, Jay; Finnoff, Jonathan T

    2009-01-01

    Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurologic and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared with other available imaging modalities, (2) describe how ultrasound machines produce images using sound waves, (3) discuss the steps necessary to acquire and optimize an ultrasound image, (4) understand the different ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones, and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound in musculoskeletal practice. Part 1 of this 2-part article reviews the fundamentals of clinical ultrasonographic imaging, including relevant physics, equipment, training, image optimization, and scanning principles for diagnostic and interventional purposes. PMID:19627875

  4. Musculoskeletal chest wall pain

    PubMed Central

    Fam, Adel G.; Smythe, Hugh A.

    1985-01-01

    The musculoskeletal structures of the thoracic wall and the neck are a relatively common source of chest pain. Pain arising from these structures is often mistaken for angina pectoris, pleurisy or other serious disorders. In this article the clinical features, pathogenesis and management of the various musculoskeletal chest wall disorders are discussed. The more common causes are costochondritis, traumatic muscle pain, trauma to the chest wall, “fibrositis” syndrome, referred pain, psychogenic regional pain syndrome, and arthritis involving articulations of the sternum, ribs and thoracic spine. Careful analysis of the history, physical findings and results of investigation is essential for precise diagnosis and effective treatment. ImagesFig. 3Fig. 4Fig. 5 PMID:4027804

  5. Musculoskeletal Disorders among Cosmetologists

    PubMed Central

    Tsigonia, Alexandra; Tanagra, Dimitra; Linos, Athena; Merekoulias, Georgios; Alexopoulos, Evangelos C.

    2009-01-01

    A cross-sectional study was performed to investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of low back, neck, shoulder, hand/wrist and knee musculoskeletal complaints among cosmetologists in Athens, Greece. The study population consisted of 95 female and seven male beauty therapists (response rate 90%) with a mean age and duration of employment of 38 and 16 years, respectively. Neck pain was the most prevalent musculoskeletal complaint, reported by 58% of the subjects, while hand/wrist and low back complaints resulted more frequently in self-reported consequences (chronicity, care seeking and absenteeism). Significant relationships were found between self-reported physical risk factors like prolonged sitting, use of vibrating tools, reaching far and awkward body postures and the occurrence of musculoskeletal disorders at various body sites. Among psychosocial variables co-worker support and skill discretion seem to be the most important reflecting organizational problems and cognitive-behavioral aspects. The study results also suggest that effective intervention strategies most likely have to take into account both ergonomic improvements and organizational aspects. PMID:20049238

  6. Musculoskeletal disorders among cosmetologists.

    PubMed

    Tsigonia, Alexandra; Tanagra, Dimitra; Linos, Athena; Merekoulias, Georgios; Alexopoulos, Evangelos C

    2009-12-01

    A cross-sectional study was performed to investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of low back, neck, shoulder, hand/wrist and knee musculoskeletal complaints among cosmetologists in Athens, Greece. The study population consisted of 95 female and seven male beauty therapists (response rate 90%) with a mean age and duration of employment of 38 and 16 years, respectively. Neck pain was the most prevalent musculoskeletal complaint, reported by 58% of the subjects, while hand/wrist and low back complaints resulted more frequently in self-reported consequences (chronicity, care seeking and absenteeism). Significant relationships were found between self-reported physical risk factors like prolonged sitting, use of vibrating tools, reaching far and awkward body postures and the occurrence of musculoskeletal disorders at various body sites. Among psychosocial variables co-worker support and skill discretion seem to be the most important reflecting organizational problems and cognitive-behavioral aspects. The study results also suggest that effective intervention strategies most likely have to take into account both ergonomic improvements and organizational aspects. PMID:20049238

  7. Would Virchow be a systems biologist? A discourse on the philosophy of science with implications for pathological research.

    PubMed

    Stenzinger, Albrecht; Klauschen, Frederick; Wittschieber, Daniel; Weichert, Wilko; Denkert, Carsten; Dietel, Manfred; Roller, Claudio

    2010-06-01

    Research in pathology spans from merely descriptive work to functional studies, "-omics" approaches and, more recently, systems biology. The work presented here aims at placing pathological research into an epistemological context. Aided by Rudolf Virchow, we give an overview on the philosophy of science including the Wiener Kreis, Popper, Kuhn, Fleck and Rheinberger and demonstrate their implications for routine diagnostics and science in pathology. A focus is on the fields of "-omics" and systems pathology. PMID:20422212

  8. The role of MRI in musculoskeletal practice: a clinical perspective

    PubMed Central

    Dean Deyle, Gail

    2011-01-01

    This clinical perspective presents an overview of current and potential uses for magnetic resonance imaging (MRI) in musculoskeletal practice. Clinical practice guidelines and current evidence for improved outcomes will help providers determine the situations when an MRI is indicated. The advanced competency standard of examination used by physical therapists will be helpful to prevent overuse of musculoskeletal imaging, reduce diagnostic errors, and provide the appropriate clinical context to pathology revealed on MRI. Physical therapists are diagnostically accurate and appropriately conservative in their use of MRI consistent with evidence-based principles of diagnosis and screening. PMID:22851878

  9. Development and validation of a surgical-pathologic staging and scoring system for cervical cancer

    PubMed Central

    Zhou, Hang; Tang, Fangxu; Jia, Yao; Hu, Ting; Sun, Haiying; Yang, Ru; Chen, Yile; Cheng, Xiaodong; Lv, Weiguo; Wu, Li; Zhou, Jin; Wang, Shaoshuai; Huang, Kecheng; Wang, Lin; Yao, Yuan; Yang, Qifeng; Yang, Xingsheng; Zhang, Qinghua; Han, Xiaobing; Lin, Zhongqiu; Xing, Hui; Qu, Pengpeng; Cai, Hongbing; Song, Xiaojie; Tian, Xiaoyu; Shen, Jian; Xi, Ling; Li, Kezhen; Deng, Dongrui; Wang, Hui; Wang, Changyu; Wu, Mingfu; Zhu, Tao; Chen, Gang; Gao, Qinglei; Wang, Shixuan; Hu, Junbo; Kong, Beihua; Xie, Xing; Ma, Ding

    2016-01-01

    Background Most cervical cancer patients worldwide receive surgical treatments, and yet the current International Federation of Gynecology and Obstetrics (FIGO) staging system do not consider surgical-pathologic data. We propose a more comprehensive and prognostically valuable surgical-pathologic staging and scoring system (SPSs). Methods Records from 4,220 eligible cervical cancer cases (Cohort 1) were screened for surgical-pathologic risk factors. We constructed a surgical-pathologic staging and SPSs, which was subsequently validated in a prospective study of 1,104 cervical cancer patients (Cohort 2). Results In Cohort 1, seven independent risk factors were associated with patient outcome: lymph node metastasis (LNM), parametrial involvement, histological type, grade, tumor size, stromal invasion, and lymph-vascular space invasion (LVSI). The FIGO staging system was revised and expanded into a surgical-pathologic staging system by including additional criteria of LNM, stromal invasion, and LVSI. LNM was subdivided into three categories based on number and location of metastases. Inclusion of all seven prognostic risk factors improves practical applicability. Patients were stratified into three SPSs risk categories: zero-, low-, and high-score with scores of 0, 1 to 3, and ≥4 (P=1.08E-45; P=6.15E-55). In Cohort 2, 5-year overall survival (OS) and disease-free survival (DFS) outcomes decreased with increased SPSs scores (P=9.04E-15; P=3.23E-16), validating the approach. Surgical-pathologic staging and SPSs show greater homogeneity and discriminatory utility than FIGO staging. Conclusions Surgical-pathologic staging and SPSs improve characterization of tumor severity and disease invasion, which may more accurately predict outcome and guide postoperative therapy. PMID:27014971

  10. OpenSim: a musculoskeletal modeling and simulation framework for in silico investigations and exchange

    PubMed Central

    Seth, Ajay; Sherman, Michael; Reinbolt, Jeffrey A.; Delp, Scott L.

    2015-01-01

    Movement science is driven by observation, but observation alone cannot elucidate principles of human and animal movement. Biomechanical modeling and computer simulation complement observations and inform experimental design. Biological models are complex and specialized software is required for building, validating, and studying them. Furthermore, common access is needed so that investigators can contribute models to a broader community and leverage past work. We are developing OpenSim, a freely available musculoskeletal modeling and simulation application and libraries specialized for these purposes, by providing: musculoskeletal modeling elements, such as biomechanical joints, muscle actuators, ligament forces, compliant contact, and controllers; and tools for fitting generic models to subject-specific data, performing inverse kinematics and forward dynamic simulations. OpenSim performs an array of physics-based analyses to delve into the behavior of musculoskeletal models by employing Simbody, an efficient and accurate multibody system dynamics code. Models are publicly available and are often reused for multiple investigations because they provide a rich set of behaviors that enables different lines of inquiry. This report will discuss one model developed to study walking and applied to gain deeper insights into muscle function in pathological gait and during running. We then illustrate how simulations can test fundamental hypotheses and focus the aims of in vivo experiments, with a postural stability platform and human model that provide a research environment for performing human posture experiments in silico. We encourage wide adoption of OpenSim for community exchange of biomechanical models and methods and welcome new contributors. PMID:25893160

  11. Scintigraphic evaluation in musculoskeletal sepsis

    SciTech Connect

    Merkel, K.D.; Fitzgerald, R.H. Jr.; Brown, M.L.

    1984-07-01

    In this article, the mechanism of technetium, gallium, and indium-labeled white blood cell localization in septic processes is detailed, and the method of interpretation of these three isotopes with relationship to musculoskeletal infection is outlined. Specific clinical application of technetium, gallium, and indium-labeled white blood cell imaging for musculoskeletal sepsis is reviewed.

  12. Musculoskeletal Disorders in the Elderly

    PubMed Central

    Gheno, Ramon; Cepparo, Juan M.; Rosca, Cristina E.; Cotten, Anne

    2012-01-01

    Musculoskeletal disorders are among the most common problems affecting the elderly. The resulting loss of mobility and physical independence can be particularly devastating in this population. The aim of this article is to present some of the most frequent musculoskeletal disorders of the elderly, such as fractures, osteoporosis, osteoarthritis, microcrystal disorders, infections, and tumors. PMID:22919553

  13. The systemic pathology of cerebral malaria in African children

    PubMed Central

    Milner, Danny A.; Whitten, Richard O.; Kamiza, Steve; Carr, Richard; Liomba, George; Dzamalala, Charles; Seydel, Karl B.; Molyneux, Malcolm E.; Taylor, Terrie E.

    2014-01-01

    Pediatric cerebral malaria carries a high mortality rate in sub-Saharan Africa. We present our systematic analysis of the descriptive and quantitative histopathology of all organs sampled from a series of 103 autopsies performed between 1996 and 2010 in Blantyre, Malawi on pediatric cerebral malaria patients and control patients (without coma, or without malaria infection) who were clinically well characterized prior to death. We found brain swelling in all cerebral malaria patients and the majority of controls. The histopathology in patients with sequestration of parasites in the brain demonstrated two patterns: (a) the “classic” appearance (i.e., ring hemorrhages, dense sequestration, and extra-erythrocytic pigment) which was associated with evidence of systemic activation of coagulation and (b) the “sequestration only” appearance associated with shorter duration of illness and higher total burden of parasites in all organs including the spleen. Sequestration of parasites was most intense in the gastrointestinal tract in all parasitemic patients (those with cerebral malarial and those without). PMID:25191643

  14. Systemic ceramide accumulation leads to severe and varied pathological consequences.

    PubMed

    Alayoubi, Abdulfatah M; Wang, James C M; Au, Bryan C Y; Carpentier, Stéphane; Garcia, Virginie; Dworski, Shaalee; El-Ghamrasni, Samah; Kirouac, Kevin N; Exertier, Mathilde J; Xiong, Zi Jian; Privé, Gilbert G; Simonaro, Calogera M; Casas, Josefina; Fabrias, Gemma; Schuchman, Edward H; Turner, Patricia V; Hakem, Razqallah; Levade, Thierry; Medin, Jeffrey A

    2013-06-01

    Farber disease (FD) is a severe inherited disorder of lipid metabolism characterized by deficient lysosomal acid ceramidase (ACDase) activity, resulting in ceramide accumulation. Ceramide and metabolites have roles in cell apoptosis and proliferation. We introduced a single-nucleotide mutation identified in human FD patients into the murine Asah1 gene to generate the first model of systemic ACDase deficiency. Homozygous Asah1(P361R/P361R) animals showed ACDase defects, accumulated ceramide, demonstrated FD manifestations and died within 7-13 weeks. Mechanistically, MCP-1 levels were increased and tissues were replete with lipid-laden macrophages. Treatment of neonates with a single injection of human ACDase-encoding lentivector diminished the severity of the disease as highlighted by enhanced growth, decreased ceramide, lessened cellular infiltrations and increased lifespans. This model of ACDase deficiency offers insights into the pathophysiology of FD and the roles of ACDase, ceramide and related sphingolipids in cell signaling and growth, as well as facilitates the development of therapy. PMID:23681708

  15. [Advances in musculoskeletal MR imaging].

    PubMed

    Ho, Michael; Andreisek, Gustav

    2015-09-01

    Musculoskeletal imaging is a rapidly developing field offering several new techniques. MR neurography provides an additive value with complementary and precise information about peripheral nerves. Hereby, MR neurography not only enables the radiologist to differentiate between a mononeuropathic or a polyneuropathic process, but also helps to find nerve compression syndromes by visualizing the nerve surrounding structures as well. An additional administration of contrast agent enables detection of tumors and inflammation of peripheral nerves. Whole body MRI opens new possibilities for detection and follow-up in oncological disorders, systemic diseases, in pediatric diagnostics and in preventive medicine. Guidelines are useful for an evidence-based application of this technique. MRI is generally considered to be the gold standard in diagnostic imaging of the spine. Continuous technical developments have led to a better image quality. New guidelines for standardized image interpretation and reporting have been published and should be used to avoid loss of information from high resolution imaging to effective treatment. PMID:26331202

  16. A pathologist-designed imaging system for anatomic pathology signout, teaching, and research.

    PubMed

    Schubert, E; Gross, W; Siderits, R H; Deckenbaugh, L; He, F; Becich, M J

    1994-11-01

    Pathology images are derived from gross surgical specimens, light microscopy, immunofluorescence, electron microscopy, molecular diagnostic gels, flow cytometry, image analysis data, and clinical laboratory data in graphic form. We have implemented a network of desktop personal computers (PCs) that allow us to easily capture, store, and retrieve gross and microscopic, anatomic, and research pathology images. System architecture involves multiple image acquisition and retrieval sites and a central file server for storage. The digitized images are conveyed via a local area network to and from image capture or display stations. Acquisition sites consist of a high-resolution camera connected to a frame grabber card in a 486-type personal computer, equipped with 16 MB (Table 1) RAM, a 1.05-gigabyte hard drive, and a 32-bit ethernet card for access to our anatomic pathology reporting system. We have designed a push-button workstation for acquiring and indexing images that does not significantly interfere with surgical pathology sign-out. Advantages of the system include the following: (1) Improving patient care: the availability of gross images at time of microscopic sign-out, verification of recurrence of malignancy from archived images, monitoring of bone marrow engraftment and immunosuppressive intervention after bone marrow/solid organ transplantation on repeat biopsies, and ability to seek instantaneous consultation with any pathologist on the network; (2) enhancing the teaching environment: building a digital surgical pathology atlas, improving the availability of images for conference support, and sharing cases across the network; (3) enhancing research: case study compilation, metastudy analysis, and availability of digitized images for quantitative analysis and permanent/reusable image records for archival study; and (4) other practical and economic considerations: storing case requisition images and hand-drawn diagrams deters the spread of gross room

  17. Developing and evaluating a simple, spreadsheet-based pathology report extraction system for cancer registrars.

    PubMed

    Liang, Ya-Fen; Chu, Pei-Yi; Chang, Cheng-Shyong; Wang, Chen-Hsi; Chang, Polun

    2006-01-01

    Surgical pathology reports are essential for cancer registry. However, cancer registrars in Taiwan still code manually from the pathology reports written in unstructured free-text. The purpose of this study was to develop a cost-effective tool to automatically code the free-text reports with Microsoft-û Excel VBA too. The time and accuracy performances between these two approaches were compared. Results showed that the cost-effectiveness and time-saving of the system and the potentials of using spreadsheet tools for healthcare professionals. PMID:17238627

  18. Activation of the endothelin system mediates pathological angiogenesis during ischemic retinopathy.

    PubMed

    Patel, Chintan; Narayanan, S Priya; Zhang, Wenbo; Xu, Zhimin; Sukumari-Ramesh, Sangeetha; Dhandapani, Krishnan M; Caldwell, R William; Caldwell, Ruth B

    2014-11-01

    Retinopathy of prematurity adversely affects premature infants because of oxygen-induced damage of the immature retinal vasculature, resulting in pathological neovascularization (NV). Our pilot studies using the mouse model of oxygen-induced retinopathy (OIR) showed marked increases in angiogenic mediators, including endothelins and endothelin receptor (EDNR) A. We hypothesized that activation of the endothelin system via EDNRA plays a causal role in pathological angiogenesis and up-regulation of angiogenic mediators, including vascular endothelial growth factor A (VEGFA) in OIR. Mice were exposed to 75% oxygen from post-natal day P7 to P12, treated with either vehicle or EDNRA antagonist BQ-123 or EDNRB antagonist BQ-788 on P12, and kept at room air from P12 to P17 (ischemic phase). RT-PCR analysis revealed increased levels of EDN2 and EDNRA mRNA, and Western blot analysis revealed increased EDN2 expression during the ischemic phase. EDNRA inhibition significantly increased vessel sprouting, resulting in enhanced physiological angiogenesis and decreased pathological NV, whereas EDNRB inhibition modestly improved vascular repair. OIR triggered significant increases in VEGFA protein and mRNA for delta-like ligand 4, apelin, angiopoietin-2, and monocyte chemoattractant protein-1. BQ-123 treatment significantly reduced these alterations. EDN2 expression was localized to retinal glia and pathological NV tufts of the OIR retinas. EDN2 also induced VEGFA protein expression in cultured astrocytes. In conclusion, inhibition of the EDNRA during OIR suppresses pathological NV and promotes physiological angiogenesis. PMID:25203536

  19. Non-Newtonian flow of pathological bile in the biliary system: experimental investigation and CFD simulations

    NASA Astrophysics Data System (ADS)

    Kuchumov, Alex G.; Gilev, Valeriy; Popov, Vitaliy; Samartsev, Vladimir; Gavrilov, Vasiliy

    2014-02-01

    The paper presents an experimental study of pathological human bile taken from the gallbladder and bile ducts. The flow dependences were obtained for different types of bile from patients with the same pathology, but of different age and sex. The parameters of the Casson's and Carreau's equations were found for bile samples. Results on the hysteretic bile behavior at loading-unloading tests are also presented, which proved that the pathologic bile is a non-Newtonian thixotropic liquid. The viscosity of the gallbladder bile was shown to be higher compared to the duct bile. It was found that at higher shear stress the pathological bile behaves like Newtonian fluid, which is explained by reorientation of structural components. Moreover, some pathological bile flow in the biliary system CFD simulations were performed. The velocity and pressure distributions as well as flow rates in the biliary segments during the gallbladder refilling and emptying phases are obtained. The results of CFD simulations can be used for surgeons to assess the patient's condition and choose an adequate treatment.

  20. Processing system of jaws tomograms for pathology identification and surgical guide modeling

    SciTech Connect

    Putrik, M. B. Ivanov, V. Yu.; Lavrentyeva, Yu. E.

    2015-11-17

    The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient’s examination always includes up to 600 images (or tomograms), that’s why the development of processing system for fast automation search of pathologies is necessary. X-rays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation – for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation.

  1. Processing system of jaws tomograms for pathology identification and surgical guide modeling

    NASA Astrophysics Data System (ADS)

    Putrik, M. B.; Lavrentyeva, Yu. E.; Ivanov, V. Yu.

    2015-11-01

    The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient's examination always includes up to 600 images (or tomograms), that's why the development of processing system for fast automation search of pathologies is necessary. X-rays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation - for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation.

  2. Musculoskeletal manifestations of the antiphospholipid syndrome.

    PubMed

    Noureldine, M H A; Khamashta, M A; Merashli, M; Sabbouh, T; Hughes, G R V; Uthman, I

    2016-04-01

    The scope of clinical and laboratory manifestations of the antiphospholipid syndrome (APS) has increased dramatically since its discovery in 1983, where any organ system can be involved. Musculoskeletal complications are consistently reported in APS patients, not only causing morbidity and mortality, but also affecting their quality of life. We reviewed all English papers on APS involvement in the musculoskeletal system using Google Scholar and Pubmed; all reports are summarized in a table in this review. The spectrum of manifestations includes arthralgia/arthritis, avascular necrosis of bone, bone marrow necrosis, complex regional pain syndrome type-1, muscle infarction, non-traumatic fractures, and osteoporosis. Some of these manifestations were reported in good quality studies, some of which showed an association between aPL-positivity and the occurrence of these manifestations, while others were merely described in case reports. PMID:26923284

  3. 3D printing from diagnostic images: a radiologist's primer with an emphasis on musculoskeletal imaging-putting the 3D printing of pathology into the hands of every physician.

    PubMed

    Friedman, Tamir; Michalski, Mark; Goodman, T Rob; Brown, J Elliott

    2016-03-01

    Three-dimensional (3D) printing has recently erupted into the medical arena due to decreased costs and increased availability of printers and software tools. Due to lack of detailed information in the medical literature on the methods for 3D printing, we have reviewed the medical and engineering literature on the various methods for 3D printing and compiled them into a practical "how to" format, thereby enabling the novice to start 3D printing with very limited funds. We describe (1) background knowledge, (2) imaging parameters, (3) software, (4) hardware, (5) post-processing, and (6) financial aspects required to cost-effectively reproduce a patient's disease ex vivo so that the patient, engineer and surgeon may hold the anatomy and associated pathology in their hands. PMID:26592802

  4. Focus on Diffusion MR Investigations of Musculoskeletal Tissue to Improve Osteoporosis Diagnosis: A Brief Practical Review

    PubMed Central

    Capuani, Silvia; Manenti, Guglielmo; Tarantino, Umberto

    2015-01-01

    Nowadays, a huge number of papers have documented the ability of diffusion magnetic resonance imaging (D-MRI) to highlight normal and pathological conditions in a variety of cerebral, abdominal, and cardiovascular applications. To date, however, the role of D-MRI to investigate musculoskeletal tissue, specifically the cancellous bone, has not been extensively explored. In order to determine potentially useful applications of diffusion techniques in musculoskeletal investigation, D-MRI applications to detect osteoporosis disease were reviewed and further explained. PMID:25861652

  5. Content based sub-image retrieval system for high resolution pathology images using salient interest points.

    PubMed

    Mehta, Neville; Alomari, Raja' S; Chaudhary, Vipin

    2009-01-01

    Content-based image retrieval systems for digital pathology require sub-image retrieval rather than the whole image retrieval for the system to be of clinical use. Digital pathology images are huge in size and thus the pathologist is interested in retrieving specific structures from the whole images in the database along with the previous diagnosis of the retrieved sub-image. We propose a content-based sub-image retrieval system (sCBIR) framework for high resolution digital pathology images. We utilize scale-invariant feature extraction and present an efficient and robust searching mechanism for indexing the images as well as for query execution of sub-image retrieval. We present a working sCBIR system and show results of testing our system on a set of queries for specific structures of interest for pathologists in clinical use. The outcomes of the sCBIR system are compared to manual search and there is an 80% match in the top five searches. PMID:19965011

  6. Thalamic changes in mesial temporal sclerosis: a limbic system pathology. A case report.

    PubMed

    Caranci, F; Bartiromo, F; Cirillo, L; Aiello, A; Cirillo, S; Brunetti, A

    2007-04-30

    Hippocampal abnormalities correlated with mesial temporal sclerosis (MTS) are well documented. MTS may be associated with extrahippocampal anomalies involving limbic structures along a known neuroanatomic pathway (Papez circuit). We report a patient with MTS and thalamic changes. Seizure-related thalamic damage could have been caused by abnormal electric discharges from the mamillary body to the anterior thalamus through the mamillothalamic tract. This suggests that MTS is not limited to the temporal lobe but could represent a limbic system pathology. PMID:24299648

  7. Musculoskeletal Sonopathology and Ultrasound-Guided Regional Anesthesia

    PubMed Central

    Macfarlane, Alan J. R.; Sites, Brian D.; Sites, Vincent R.; Naraghi, Ali M.; Chan, Vincent W. S.; Singh, Mandeep; Antonakakis, John G.

    2010-01-01

    The use of real-time ultrasound guidance has revolutionized the practice of regional anesthesia. Ultrasound is rapidly becoming the technique of choice for nerve blockade due to increased success rates, faster onset, and potentially improved safety. In the course of ultrasound-guided regional anesthesia, unexpected pathology may be encountered. Such anomalous or pathological findings may alter the choice of nerve block and occasionally affect surgical management. This case series presents a variety of musculoskeletal conditions that may be encountered during ultrasound-guided regional anesthesia practice. PMID:22294960

  8. The spectrum of pathological involvement of the striatonigral and olivopontocerebellar systems in multiple system atrophy: clinicopathological correlations.

    PubMed

    Ozawa, Tetsutaro; Paviour, Dominic; Quinn, Niall P; Josephs, Keith A; Sangha, Hardev; Kilford, Linda; Healy, Daniel G; Wood, Nick W; Lees, Andrew J; Holton, Janice L; Revesz, Tamas

    2004-12-01

    Multiple system atrophy (MSA) has varying clinical (MSA-P versus MSA-C) and pathological [striatonigral degeneration (SND) versus olivopontocerebellar atrophy (OPCA)] phenotypes. To investigate the spectrum of clinicopathological correlations, we performed a semi-quantitative pathological analysis of 100 MSA cases with well-characterized clinical phenotypes. In 24 areas, chosen from both the striatonigral (StrN) and olivopontocerebellar (OPC) regions, the severity of neuronal cell loss and gliosis as well as the frequency of glial (oligodendroglial) cytoplasmic inclusions (GCIs) and neuronal cytoplasmic inclusions (NCIs) were determined. Clinical information was abstracted from the patients' medical records, and the severity of bradykinesia in the first year of disease onset and in the final stages of disease was graded retrospectively. The degree of levodopa responsiveness and the presence or absence of cerebellar ataxia and autonomic symptoms were also recorded. We report that 34% of the cases were SND- and 17% were OPCA-predominant, while the remainder (49%) had equivalent SND and OPCA pathology. We found a significant correlation between the frequency of GCIs and the severity of neuronal cell loss, and between these pathological changes and disease duration. Our data also suggest that GCIs may have more influence on the OPC than on the StrN pathology. Moreover, we raise the possibility that a rapid process of neuronal cell loss, which is independent of the accumulation of GCIs, occurs in the StrN region in MSA. There was no difference in the frequency of NCIs in the putamen, pontine nucleus and inferior olivary nucleus between the SND and OPCA subtypes of MSA, confirming that this pathological abnormality is not associated with a particular subtype of the disease. In the current large post-mortem series, 10% of the cases had associated Lewy body pathology, suggesting that this is not a primary process in MSA. As might be expected, there was a significant

  9. Operational and Research Musculoskeletal Summit: Summit Recommendations

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Walton, Marlei; Davis-Street, Janis; Smaka, Todd J.; Griffin, DeVon

    2006-01-01

    The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.

  10. Musculoskeletal health, frailty and functional decline.

    PubMed

    Milte, R; Crotty, M

    2014-06-01

    Frailty in older people is associated with a vulnerability to adverse events. While ageing is associated with a loss of physiological reserves, identifying those with the syndrome of frailty has the potential to assist clinicians to tailor treatments to those at the risk of future decline into disability with an increased risk of complications, morbidity and mortality. Sarcopenia is a key component of the frailty syndrome and on its own puts older people at risk of fragility fractures; however, the clinical syndrome of frailty affects the musculoskeletal and non-musculoskeletal systems. Hip fractures are becoming a prototype condition in the study of frailty. Following a hip fracture, many of the interventions are focused on limiting mobility disability and restoring independence with activities of daily living, but there are multiple factors to be addressed including osteoporosis, sarcopenia, delirium and weight loss. Established techniques of geriatric evaluation and management allow systematic assessment and intervention on multiple components by multidisciplinary teams and deliver the best outcomes. Using the concept of frailty to identify older people with musculoskeletal problems as being at the risk of a poor outcome assists in treatment planning and is likely to become more important as effective pharmacological treatments for sarcopenia emerge. This review will focus on the concept of frailty and its relationship with functional decline, as well as describing its causes, prevalence, risk factors, potential clinical applications and treatment strategies. PMID:25481423

  11. Curriculum Guidelines for Pathology and Oral Pathology.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines for dental school pathology courses describe the interrelationships of general, systemic, and oral pathology; primary educational goals; prerequisites; a core curriculum outline and behavioral objectives for each type of pathology. Notes on sequencing, faculty, facilities, and occupational hazards are included. (MSE)

  12. Advancing the Assessment of Personality Pathology With the Cognitive-Affective Processing System.

    PubMed

    Huprich, Steven K; Nelson, Sharon M

    2015-01-01

    The Cognitive-Affective Processing System (CAPS) is a dynamic and expansive model of personality proposed by Mischel and Shoda (1995) that incorporates dispositional and processing frameworks by considering the interaction of the individual and the situation, and the patterns of variation that result. These patterns of cognition, affect, and behavior are generally defined through the use of if … then statements, and provide a rich understanding of the individual across varying levels of assessment. In this article, we describe the CAPS model and articulate ways in which it can be applied to conceptualizing and assessing personality pathology. We suggest that the CAPS model is an ideal framework that integrates a number of current theories of personality pathology, and simultaneously overcomes a number of limits that have been empirically identified in the past. PMID:26214351

  13. A Multilayer Perceptron Based Smart Pathological Brain Detection System by Fractional Fourier Entropy.

    PubMed

    Zhang, Yudong; Sun, Yi; Phillips, Preetha; Liu, Ge; Zhou, Xingxing; Wang, Shuihua

    2016-07-01

    This work aims at developing a novel pathological brain detection system (PBDS) to assist neuroradiologists to interpret magnetic resonance (MR) brain images. We simplify this problem as recognizing pathological brains from healthy brains. First, 12 fractional Fourier entropy (FRFE) features were extracted from each brain image. Next, we submit those features to a multi-layer perceptron (MLP) classifier. Two improvements were proposed for MLP. One improvement is the pruning technique that determines the optimal hidden neuron number. We compared three pruning techniques: dynamic pruning (DP), Bayesian detection boundaries (BDB), and Kappa coefficient (KC). The other improvement is to use the adaptive real-coded biogeography-based optimization (ARCBBO) to train the biases and weights of MLP. The experiments showed that the proposed FRFE + KC-MLP + ARCBBO achieved an average accuracy of 99.53 % based on 10 repetitions of K-fold cross validation, which was better than 11 recent PBDS methods. PMID:27250502

  14. Improved education in musculoskeletal conditions is necessary for all doctors.

    PubMed Central

    Akesson, Kristina; Dreinhöfer, Karsten E.; Woolf, A. D.

    2003-01-01

    It is likely that everyone will, at some time, suffer from a problem related to the musculoskeletal system, ranging from a very common problem such as osteoarthritis or back pain to severely disabling limb trauma or rheumatoid arthritis. Many musculoskeletal problems are chronic conditions. The most common symptoms are pain and disability, with an impact not only on individuals' quality of life but also, importantly, on people's ability to earn a living and be independent. It has been estimated that one in four consultations in primary care is caused by problems of the musculoskeletal system and that these conditions may account for up to 60% of all disability pensions. In contrast, teaching at undergraduate and graduate levels--and the resulting competence and confidence of many doctors--do not reflect the impact of these conditions on individuals and society. Many medical students do not have any clinical training in assessing patients with bone and joint problems. Under the umbrella of the Bone and Joint Decade 2000-2010, experts from all parts of the world with an interest in teaching have developed recommendations for an undergraduate curriculum to improve the teaching of musculoskeletal conditions in medical schools. The goal for each medical school should be a course in musculoskeletal medicine concentrating on clinical assessment, common outpatient musculoskeletal problems and recognition of emergencies. Improving competency in the management of musculoskeletal problems within primary care settings through improved education is the next aim, but there are needs for improvement for all professionals and at all levels within the health care system. PMID:14710510

  15. Somatostatinergic systems: an update on brain functions in normal and pathological aging

    PubMed Central

    Martel, Guillaume; Dutar, Patrick; Epelbaum, Jacques; Viollet, Cécile

    2012-01-01

    Somatostatin is highly expressed in mammalian brain and is involved in many brain functions such as motor activity, sleep, sensory, and cognitive processes. Five somatostatin receptors have been described: sst1, sst2 (A and B), sst3, sst4, and sst5, all belonging to the G-protein-coupled receptor family. During the recent years, numerous studies contributed to clarify the role of somatostatin systems, especially long-range somatostatinergic interneurons, in several functions they have been previously involved in. New advances have also been made on the alterations of somatostatinergic systems in several brain diseases and on the potential therapeutic target they represent in these pathologies. PMID:23230430

  16. A medical software system for volumetric analysis of cerebral pathologies in magnetic resonance imaging (MRI) data.

    PubMed

    Egger, Jan; Kappus, Christoph; Freisleben, Bernd; Nimsky, Christopher

    2012-08-01

    In this contribution, a medical software system for volumetric analysis of different cerebral pathologies in magnetic resonance imaging (MRI) data is presented. The software system is based on a semi-automatic segmentation algorithm and helps to overcome the time-consuming process of volume determination during monitoring of a patient. After imaging, the parameter settings-including a seed point-are set up in the system and an automatic segmentation is performed by a novel graph-based approach. Manually reviewing the result leads to reseeding, adding seed points or an automatic surface mesh generation. The mesh is saved for monitoring the patient and for comparisons with follow-up scans. Based on the mesh, the system performs a voxelization and volume calculation, which leads to diagnosis and therefore further treatment decisions. The overall system has been tested with different cerebral pathologies-glioblastoma multiforme, pituitary adenomas and cerebral aneurysms- and evaluated against manual expert segmentations using the Dice Similarity Coefficient (DSC). Additionally, intra-physician segmentations have been performed to provide a quality measure for the presented system. PMID:21384268

  17. Regulation of dopamine system responsivity and its adaptive and pathological response to stress

    PubMed Central

    Belujon, Pauline; Grace, Anthony A.

    2015-01-01

    Although, historically, the norepinephrine system has attracted the majority of attention in the study of the stress response, the dopamine system has also been consistently implicated. It has long been established that stress plays a crucial role in the pathogenesis of psychiatric disorders. However, the neurobiological mechanisms that mediate the stress response and its effect in psychiatric diseases are not well understood. The dopamine system can play distinct roles in stress and psychiatric disorders. It is hypothesized that, even though the dopamine (DA) system forms the basis for a number of psychiatric disorders, the pathology is likely to originate in the afferent structures that are inducing dysregulation of the DA system. This review explores the current knowledge of afferent modulation of the stress/DA circuitry, and presents recent data focusing on the effect of stress on the DA system and its relevance to psychiatric disorders. PMID:25788601

  18. Dawn of the digital diagnosis assisting system, can it open a new age for pathology?

    NASA Astrophysics Data System (ADS)

    Saito, Akira; Cosatto, Eric; Kiyuna, Tomoharu; Sakamoto, Michiie

    2013-03-01

    Digital pathology is developing based on the improvement and popularization of WSI (whole slide imaging) scanners. WSI scanners are widely expected to be used as the next generation microscope for diagnosis; however, their usage is currently mostly limited to education and archiving. Indeed, there are still many hindrances in using WSI scanners for diagnosis (not research purpose), two of the main reasons being the perceived high cost and small gain in productivity obtained by switching from the microscope to a WSI system and the lack of WSI standardization. We believe that a key factor for advancing digital pathology is the creation of computer assisted diagnosis systems (CAD). Such systems require high-resolution digitization of slides and provide a clear added value to the often costly conversion to WSI. We (NEC Corporation) are creating a CAD system, named e-Pathologist ®. This system is currently used at independent pathology labs for quality control (QC/QA), double-checking pathologists diagnosis and preventing missed cancers. At the end of 2012, about 80,000 slides, 200,000 tissues of gastric and colorectal samples will have been analyzed by e-Pathologist ®. Through the development of e-Pathologist ®, it has become clear that a computer program should be inspired by the pathologist diagnosis process, yet it should not be a mere copy or simulation of it. Indeed pathologists often approach the diagnosis of slides in a "holistic" manner, examining them at various magnifications, panning and zooming in a seemingly haphazard way that they often have a hard time to precisely describe. Hence there has been no clear recipe emerging from numerous interviews with pathologists on how to exactly computer code a diagnosis expert system. Instead, we focused on extracting a small set of histopathological features that were consistently indicated as important by the pathologists and then let the computer figure out how to interpret in a quantitative way the presence or

  19. Management of chronic musculoskeletal pain.

    PubMed

    Uhl, Richard L; Roberts, Timothy T; Papaliodis, Dean N; Mulligan, Michael T; Dubin, Andrew H

    2014-02-01

    Chronic musculoskeletal pain results from a complex interplay of mechanical, biochemical, psychological, and social factors. Effective management is markedly different from that of acute musculoskeletal pain. Understanding the physiology of pain transmission, modulation, and perception is crucial for effective management. Pharmacologic and nonpharmacologic therapies such as psychotherapy and biofeedback exercises can be used to manage chronic pain. Evidence-based treatment recommendations have been made for chronic pain conditions frequently encountered by orthopaedic surgeons, including low back, osteoarthritic, posttraumatic, and neuropathic pain. Extended-release tramadol; select tricyclic antidepressants, serotonin reuptake inhibitors, and anticonvulsants; and topical medications such as lidocaine, diclofenac, and capsaicin are among the most effective treatments. However, drug efficacy varies significantly by indication. Orthopaedic surgeons should be familiar with the widely available safe and effective nonnarcotic options for chronic musculoskeletal pain. PMID:24486756

  20. Musculoskeletal ageing and primary prevention.

    PubMed

    Nedergaard, Anders; Henriksen, Kim; Karsdal, Morten A; Christiansen, Claus

    2013-10-01

    Loss of musculoskeletal mass and function is a natural ageing trait, reinforced by an unhealthy life style. Loss of bone (osteoporosis) and muscle (sarcopaenia) are conditions whose prevalence are increasing because of the change in population distribution in the western world towards an older mean age. Improvements in lifestyle factors, such as diet, smoking and exercise, are the most powerful tools to combat this decline efficiently; however, public health interventions aimed at tackling these problems have shown abysmal success at the population level, mostly due to failure in compliance. With these issues in mind, we believe that the primary prevention modality in coming decades will be pharmacological. We review the basic biology of musculoskeletal ageing and what measures can be taken to prevent ageing-associated loss of musculoskeletal mass and function, with particular emphasis on pharmacological means. PMID:23891483

  1. Evaluation of musculoskeletal sepsis with indium-111 white blood cell imaging

    SciTech Connect

    Ouzounian, T.J.; Thompson, L.; Grogan, T.J.; Webber, M.M.; Amstutz, H.C.

    1987-08-01

    The detection of musculoskeletal sepsis, especially following joint replacement, continues to be a challenging problem. Often, even with invasive diagnostic evaluation, the diagnosis of infection remains uncertain. This is a report on the first 55 Indium-111 white blood cell (WBC) images performed in 39 patients for the evaluation of musculoskeletal sepsis. There were 40 negative and 15 positive Indium-111 WBC images. These were correlated with operative culture and tissue pathology, aspiration culture, and clinical findings. Thirty-eight images were performed for the evaluation of possible total joint sepsis (8 positive and 30 negative images); 17 for the evaluation of nonarthroplasty-related musculoskeletal sepsis (7 positive and 10 negative images). Overall, there were 13 true-positive, 39 true-negative, two false-positive, and one false-negative images. Indium-111 WBC imaging is a sensitive and specific means of evaluating musculoskeletal sepsis, especially following total joint replacement.

  2. Pharmacologic Therapies in Musculoskeletal Conditions.

    PubMed

    Loveless, Melinda S; Fry, Adrielle L

    2016-07-01

    Musculoskeletal conditions are common, and there are many options for pharmacologic therapy. Unfortunately, there is not strong evidence for the use of many of these medications. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are generally first-line medications for most musculoskeletal pain, but there is more evidence these medications are not as safe as once thought. Other analgesic and antispasmodic medications can be effective for acute pain but generally are not as effective for chronic pain. Antidepressants and anticonvulsants can be more effective for chronic or neuropathic pain. Topical formulations of NSAIDs can be effective for pain with fewer side effects. PMID:27235619

  3. Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature

    PubMed Central

    Valenzuela, F. J.; Vera, J.; Venegas, C.; Muñoz, S.; Oyarce, S.; Muñoz, K.; Lagunas, C.

    2016-01-01

    The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1–3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined. PMID:27313610

  4. Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature.

    PubMed

    Valenzuela, F J; Vera, J; Venegas, C; Muñoz, S; Oyarce, S; Muñoz, K; Lagunas, C

    2016-01-01

    The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1-3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined. PMID:27313610

  5. Musculoskeletal Fitness and Risk of Mortality.

    ERIC Educational Resources Information Center

    Katzmarzyk, Peter T.; Craig, Cora L.

    2002-01-01

    Quantified the relationship between musculoskeletal fitness and all-cause mortality in Canada, using measures of musculoskeletal fitness (situps, pushups, grip strength, and sit- and-reach trunk flexibility) from adult male and female participants in the Canadian Fitness Survey. Results indicated that some components of musculoskeletal fitness,…

  6. System Re-set: High LET Radiation or Transient Musculoskeletal Disuse Cause Lasting Changes in Oxidative Defense Pathways Within Bone

    NASA Technical Reports Server (NTRS)

    Kumar, Akhilesh; Chatterjee, A.; Alwood, Joshua S.; Dvorochkin, Natalya; Almeida, Eduardo A. C.

    2011-01-01

    Six months post-IR, there were no notable changes in skeletal expression of 84 principal genes in the p53 signaling pathway due to low dose IR (0.5Gy), HU, or both. In contrast, numerous genes relevant to oxidative stress were regulated by the treatments, typically in a direction indicative of increased oxidative stress and impaired defense. IR and HU independently reduced (between 0.46 to 0.88 fold) expression levels of Noxa1, Gpx3, Prdx2, Prdx3, and Zmynd17. Surprisingly, transient HU alone (sham-irradiated) decreased expression of several redox-related genes (Gpx1,Gstk1, Prdx1, Txnrd2), which were not affected significantly by IR alone. Irradiation increased (1.13 fold) expression of a gene responsible for production of superoxides by neutrophils (NCF2). Of interest, only combined treatment with HU and IR led to increased expression levels of Ercc2, (1.19 fold), a DNA excision repair enzyme. Differences in gene expression levels may reflect a change in gene expression on a per cell basis, a shift in the repertoire of specific cell types within the tissue, or both. Serum nitrite/nitrate levels were elevated to comparable levels (1.6-fold) due to IR, HU or both, indicative of elevated systemic nitrosyl stress. CONCLUSIONS The magnitude of changes in skeletal expression of oxidative stress-related genes six months after irradiation and/or transient unloading tended to be relatively modest (0.46-1.15 fold), whereas the p53 pathway was not affected. The finding that many different oxidative stress-related genes differed from controls at this late time point implicates a generalized impairment of oxidative defense within skeletal tissue, which coincides with both profound radiation damage to osteoprogenitors/stem cells in bone marrow and impaired remodeling of mineralized tissue.

  7. Integration of scanned document management with the anatomic pathology laboratory information system: analysis of benefits.

    PubMed

    Schmidt, Rodney A; Simmons, Kim; Grimm, Erin E; Middlebrooks, Michael; Changchien, Rosy

    2006-11-01

    Electronic document management systems (EDMSs) have the potential to improve the efficiency of anatomic pathology laboratories. We implemented a novel but simple EDMS for scanned documents as part of our laboratory information system (AP-LIS) and collected cost-benefit data with the intention of discerning the value of such a system in general and whether integration with the AP-LIS is advantageous. We found that the direct financial benefits are modest but the indirect and intangible benefits are large. Benefits of time savings and access to data particularly accrued to pathologists and residents (3.8 h/d saved for 26 pathologists and residents). Integrating the scanned document management system (SDMS) into the AP-LIS has major advantages in terms of workflow and overall simplicity. This simple, integrated SDMS is an excellent value in a practice like ours, and many of the benefits likely apply in other practice settings. PMID:17050064

  8. A comparison of Aβ amyloid pathology staging systems and correlation with clinical diagnosis

    PubMed Central

    Boluda, Susana; Toledo, Jon B.; Irwin, David J.; Raible, Kevin M.; Byrne, Matt D.; Lee, Edward B.; Lee, Virginia M.-Y.

    2015-01-01

    Current neuropathological Alzheimer's disease (AD) criteria from the National Institute on Aging-Alzheimer's Association (NIA-AA) incorporate two staging systems for Aβ pathology, namely the Thal Aβ phase (TAP) and the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) methods. The goal of this study was to compare and contrast results obtained with these two different staging systems for Aβ pathology since this is critical for future correlations of Aβ amyloid imaging data with Aβ neuropathology data based on immunohistochemical detection of Aβ deposits. A total of 123 cases, divided into 82 training and 41 validation cases, with a diagnosis of either unremarkable adult brain (normal) or AD and CERAD scores ranging from none to frequent were included. There was no clear and consistent relationship between CERAD and the TAP Aβ scores with the exception of scores for the highest plaque burdens (i.e., CERAD C3 and TAP A3) in the cases studied here. However, we developed an algorithm that relates CERAD scores to TAP scores with high agreement (94 % in training and 98 % in the validation set). In addition, TAP scores were a better predictor of dementia (sensitivity of 94 % specifcity 87.7 %) than CERAD scores (sensitivity of 57 % specifcity 100 %). Yet, further research is needed to define strategies to relate CERAD and TAP Aβ plaque scores to compare their utility and for determining the clinical associations of these different amyloid staging systems with aging and AD. PMID:24916271

  9. Tinnitus: pathology of synaptic plasticity at the cellular and system levels.

    PubMed

    Guitton, Matthieu J

    2012-01-01

    Despite being more and more common, and having a high impact on the quality of life of sufferers, tinnitus does not yet have a cure. This has been mostly the result of limited knowledge of the biological mechanisms underlying this adverse pathology. However, the last decade has witnessed tremendous progress in our understanding on the pathophysiology of tinnitus. Animal models have demonstrated that tinnitus is a pathology of neural plasticity, and has two main components: a molecular, peripheral component related to the initiation phase of tinnitus; and a system-level, central component-related to the long-term maintenance of tinnitus. Using the most recent experimental data and the molecular/system dichotomy as a framework, we describe here the biological basis of tinnitus. We then discuss these mechanisms from an evolutionary perspective, highlighting similarities with memory. Finally, we consider how these discoveries can translate into therapies, and we suggest operative strategies to design new and effective combined therapeutic solutions using both pharmacological (local and systemic) and behavioral tools (e.g., using tele-medicine and virtual reality settings). PMID:22408611

  10. Tinnitus: pathology of synaptic plasticity at the cellular and system levels

    PubMed Central

    Guitton, Matthieu J.

    2012-01-01

    Despite being more and more common, and having a high impact on the quality of life of sufferers, tinnitus does not yet have a cure. This has been mostly the result of limited knowledge of the biological mechanisms underlying this adverse pathology. However, the last decade has witnessed tremendous progress in our understanding on the pathophysiology of tinnitus. Animal models have demonstrated that tinnitus is a pathology of neural plasticity, and has two main components: a molecular, peripheral component related to the initiation phase of tinnitus; and a system-level, central component-related to the long-term maintenance of tinnitus. Using the most recent experimental data and the molecular/system dichotomy as a framework, we describe here the biological basis of tinnitus. We then discuss these mechanisms from an evolutionary perspective, highlighting similarities with memory. Finally, we consider how these discoveries can translate into therapies, and we suggest operative strategies to design new and effective combined therapeutic solutions using both pharmacological (local and systemic) and behavioral tools (e.g., using tele-medicine and virtual reality settings). PMID:22408611

  11. [Musculoskeletal medicine--strategies towards a "good musculoskeletal consultation"].

    PubMed

    Vulfsons, Simon

    2011-03-01

    The burden of musculoskeletal disease and disability is huge. The direct costs of diagnosis and treatment are dwarfed by the indirect costs to society comprised of sick leave, early retirement, pension funds and disability allowances. Chronic musculoskeletal pain and dysfunction account for the most common cause for chronic pain and for up to 25% of all consultations to family practitioners in the developed world. It is therefore surprising to find that education and training in musculoskeletal medicine has been given short shrift by medical schools, specialist training programs for family practitioners and post graduate continuing medical education. This has been shown quite comprehensively by Mashov and Tabenkin in this edition of the journal. At the close of the Bone and Joint Decade 2000-2010, as declared by the WHO, it is timely to see what has been achieved in terms of the original goals for this decade. There has been a major effort for increasing awareness both in the health community and the general public towards managing chronic musculoskeletal pain. Much has been written, but far less performed in changing the priorities of medical schools and family practice programs towards teaching and training doctors to adequately recognize and treat patients suffering from chronic musculoskeletal problems. In Israel, it is estimated that the indirect costs through lost productivity amount to up to 1.15 billion shekels a year. Investing time and money in training programs for medical students and doctors, together with building an incentive program for primary care physicians to adequately treat this huge chronically disabled population is not only feasible, but can also make great inroads towards easing suffering while curtailing costs. PMID:21574355

  12. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module IX. Musculoskeletal.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on the musculoskeletal system is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Five units of study are presented: (1) the major bones, joints, and muscles of the body; (2) patient assessment of a musculoskeletal injury; (3) pathophysiology and management…

  13. A dBASE III system for managing 35 mm slides in pathology.

    PubMed

    Wong, K T; Chan, K S

    1990-12-01

    We describe the design and management of a 35 mm slide database using a menu-driven dBASE III PLUS programme and a microcomputer in a large department of pathology that also caters for the individual pathologist. Existing systems described in the literature are geared towards slides of general medicine and do not address the needs of the individual pathologist. A total of 11,481 slides in the Department of Pathology, Faculty of Medicine, University of Malaya, were filed into a single database with each record representing one slide. Nine fields which comprised the slide accession number, reference number, slide category, SNOMED codes, and a description of the slide in natural language, seemed adequate for slide definition. The menu-driven programme had functions which included the abilities to add, delete, edit and back-up records, and to search for desired slides. Although slides may be searched for in various fields, we found that searches using natural language alone were both comprehensive and efficient, provided a standard format of description was adhered to and data entries scrutinized carefully for errors. We believe therefore, that for the pathologist working alone, coded language fields are not absolutely necessary, as manual coding and additional data entry can be time consuming. As expected, for databases larger than 10,000 slides, a 80286 microprocessor-based microcomputer was more efficient. We are of the opinion that a system such as ours is very useful for a large department of pathology or the individual pathologist to file and retrieve 35 mm slides. PMID:2102964

  14. Physiological and pathological roles of tissue plasminogen activator and its inhibitor neuroserpin in the nervous system

    PubMed Central

    Lee, Tet Woo; Tsang, Vicky W. K.; Birch, Nigel P.

    2015-01-01

    Although its roles in the vascular space are most well-known, tissue plasminogen activator (tPA) is widely expressed in the developing and adult nervous system, where its activity is believed to be regulated by neuroserpin, a predominantly brain-specific member of the serpin family of protease inhibitors. In the normal physiological state, tPA has been shown to play roles in the development and plasticity of the nervous system. Ischemic damage, however, may lead to excess tPA activity in the brain and this is believed to contribute to neurodegeneration. In this article, we briefly review the physiological and pathological roles of tPA in the nervous system, which includes neuronal migration, axonal growth, synaptic plasticity, neuroprotection and neurodegeneration, as well as a contribution to neurological disease. We summarize tPA's multiple mechanisms of action and also highlight the contributions of the inhibitor neuroserpin to these processes. PMID:26528129

  15. MRI of the Musculoskeletal System

    MedlinePlus

    ... a powerful magnetic field, radio waves and a computer to produce detailed pictures of joints, soft tissues ... powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, ...

  16. The Circadian Timing System: A Recent Addition in the Physiological Mechanisms Underlying Pathological and Aging Processes

    PubMed Central

    Arellanes-Licea, Elvira; Caldelas, Ivette; De Ita-Pérez, Dalia; Díaz-Muñoz, Mauricio

    2014-01-01

    Experimental findings and clinical observations have strengthened the association between physio-pathologic aspects of several diseases, as well as aging process, with the occurrence and control of circadian rhythms. The circadian system is composed by a principal pacemaker in the suprachiasmatic nucleus (SNC) which is in coordination with a number of peripheral circadian oscillators. Many pathological entities such as metabolic syndrome, cancer and cardiovascular events are strongly connected with a disruptive condition of the circadian cycle. Inadequate circadian physiology can be elicited by genetic defects (mutations in clock genes or circadian control genes) or physiological deficiencies (desynchronization between SCN and peripheral oscillators). In this review, we focus on the most recent experimental findings regarding molecular defects in the molecular circadian clock and the altered coordination in the circadian system that are related with clinical conditions such as metabolic diseases, cancer predisposition and physiological deficiencies associated to jet-lag and shiftwork schedules. Implications in the aging process will be also reviewed. PMID:25489492

  17. In-111 WBC imaging in musculoskeletal sepsis

    SciTech Connect

    Thompson, L.; Ouzounian, T.J.; Webber, M.M.; Amstutz, H.C.

    1984-01-01

    This study evaluated the accuracy and utility of the In-111 labeled WBC imaging in a series of patients who were suspected of having musculoskeletal sepsis. The labeling of the WBCs was patterned after a method previously described, in which the WBCs are labeled with In-111 oxine in plasma. The WBCs from 100 ml of blood are separated and incubated with In-111 oxine complex, and then 500 ..mu..Ci. of the labeled cells were reinjected into the patient. Images of the areas in question were obtained at 24 hrs. In some instances, 48 hour images were also obtained. Images were interpreted using consistent criteria. Forty imaging procedures were done on 39 patients. These included 39 total joint protheses, and 17 other images to evaluate possible osteomyelitis, septic arthritis or deep abscesses. Of these studies, 15 were positive, and 42 negative. The findings were then correlated with operative culture and pathology in 21, aspiration cultures and gram stains in 14, and with clinical findings in the remaining 21. This correlation showed 41 true negatives, 12 true positives, 1 false negative, and 2 false positives. The sensitivity was 92.9% and the specificity was 95.2%l. The false negative occurred in a patient on chronic suppressive antibiotic therapy for an infected total hip replacement. The false positive images occurred in a patient with active rheumatoid arthritis and in a patient imaged one month post operative placement of the prosthesis. These images were very useful in several septic patients who had many possible sites of infection. The authors conclude that In-III imaging is an accurate and useful non-invasive method of evaluating musculoskeletal sepsis.

  18. Why is epigenetics important in understanding the pathogenesis of inflammatory musculoskeletal diseases?

    PubMed Central

    2013-01-01

    In its widest sense, the term epigenetics describes a range of mechanisms in genome function that do not solely result from the DNA sequence itself. These mechanisms comprise DNA and chromatin modifications and their associated systems, as well as the noncoding RNA machinery. The epigenetic apparatus is essential for controlling normal development and homeostasis, and also provides a means for the organism to integrate and react upon environmental cues. A multitude of functional studies as well as systematic genome-wide mapping of epigenetic marks and chromatin modifiers reveal the importance of epigenomic mechanisms in human pathologies, including inflammatory conditions and musculoskeletal disease such as rheumatoid arthritis. Collectively, these studies pave the way to identify possible novel therapeutic intervention points and to investigate the utility of drugs that interfere with epigenetic signalling not only in cancer, but possibly also in inflammatory and autoimmune diseases. PMID:23566317

  19. Systemic Inflammation: Methodological Approaches to Identification of the Common Pathological Process

    PubMed Central

    Zotova, N. V.; Chereshnev, V. A.; Gusev, E. Yu.

    2016-01-01

    We defined Systemic inflammation (SI) as a “typical, multi-syndrome, phase-specific pathological process, developing from systemic damage and characterized by the total inflammatory reactivity of endotheliocytes, plasma and blood cell factors, connective tissue and, at the final stage, by microcirculatory disorders in vital organs and tissues.” The goal of the work: to determine methodological approaches and particular methodical solutions for the problem of identification of SI as a common pathological process. SI can be defined by the presence in plasma of systemic proinflammatory cell stress products—cytokines and other inflammatory mediators, and also by the complexity of other processes signs. We have developed 2 scales: 1) The Reactivity Level scale (RL)–from 0 to 5 points: 0-normal level; RL-5 confirms systemic nature of inflammatory mediator release, and RL- 2–4 defines different degrees of event probability. 2) The SI scale, considering additional criteria along with RL, addresses more integral criteria of SI: the presence of ≥ 5 points according to the SI scale proves the high probability of SI developing. To calculate the RL scale, concentrations of 4 cytokines (IL-6, IL-8, IL-10, TNF-α) and C-reactive protein in plasma were examined. Additional criteria of the SI scale were the following: D-dimers>500ng/ml, cortisol>1380 or <100nmol/l, troponin I≥0.2ng/ml and/or myoglobin≥800ng/ml. 422 patients were included in the study with different septic (n-207) and aseptic (n-215) pathologies. In 190 cases (of 422) there were signs of SI (lethality 38.4%, n-73). In only 5 of 78 cases, lethality was not confirmed by the presence of SI. SI was registered in 100% of cases with septic shock (n-31). There were not significant differences between AU-ROC of CR, SI scale and SOFA to predict death in patients with sepsis and trauma. PMID:27153324

  20. Idiopathic systemic granulomatous pathology causing sudden death due to myocarditis: a rare case report.

    PubMed

    Singh, Harpal; Kundal, Ramesh

    2015-01-01

    Idiopathic granulomatous myocarditis is extremely rare, particularly since the introduction of drugs effective against tuberculosis (TB), viruses, fungi and the effective treatment of sarcoidosis. Here is a case of a 65-year-old female prisoner having history of sudden collapse and ultimately death. Autopsy findings of various viscera on histopathological examination show granulomatous pathology, that is, in spleen, liver and in the left ventricular wall of heart. Ziehl-Neelsen staining of the sections show the absence of acid fast bacilli, negative for fungal staining as most of the granulomas are noncaseating type with presence of giant cells having no asteroid body and Schuamann body, real-time polymerase chain reaction for TB is negative. Idiopathic giant cell myocarditis is a disease of relatively young adults, that is, between 3 rd and 4 th decade of life. So, this case is strongly considered to be a case of sudden death due to myocarditis as a result of idiopathic systemic granulomatous pathology, a rare case in in literature. PMID:25673606

  1. Comparison of the diagnostic utility of digital pathology systems for telemicrobiology

    PubMed Central

    Rhoads, Daniel D.; Habib-Bein, Nadia F.; Hariri, Rahman S.; Hartman, Douglas J.; Monaco, Sara E.; Lesniak, Andrew; Duboy, Jon; Salama, Mohamed El-Sayed; Pantanowitz, Liron

    2016-01-01

    Introduction: Telemicrobiology is a growing component of clinical microbiology informatics. However, few studies have been performed to assess the diagnostic utility of telemicroscopy systems in evaluating infectious agents. Objective: Evaluate multiple contemporary digital pathology platforms for use in diagnostic telemicrobiology. Materials and Methods: A mix of thirty cases that included viral, bacterial, fungal, and parasitological findings were evaluated by four experts using ×40 whole slide imaging (WSI) scans, ×83 oil-immersion WSI scans, ×100 oil-immersion WSI scans, digital photomicrographs, and glass slides. Results: The ×83 WSI, ×100 WSI, and photomicrograph interpretations were not significantly different in quality and accuracy when compared to glass slide interpretations. The ×40 WSI interpretations were of lower quality and were more likely to be incorrect when compared to glass slide interpretations. Conclusions: In this study, high magnification, oil-immersion digital pathology platforms are better suited to support telemicrobiology applications and yield interpretations on par with glass slide evaluations. PMID:27076988

  2. Biomarkers of vascular risk, systemic inflammation, and microvascular pathology and neuropsychiatric symptoms in Alzheimer's disease.

    PubMed

    Hall, James R; Wiechmann, April R; Johnson, Leigh A; Edwards, Melissa; Barber, Robert C; Winter, A Scott; Singh, Meharvan; O'Bryant, Sid E

    2013-01-01

    Numerous serum and plasma based biomarkers of systemic inflammation have been linked to both neuropsychiatric disorders and Alzheimer's disease (AD). The present study investigated the relationship of clinical biomarkers of cardiovascular risk (cholesterol, triglycerides, and homocysteine) and a panel of markers of systemic inflammation (CRP, TNF-α, IL1-ra, IL-7, IL-10, IL-15, IL-18) and microvascular pathology (ICAM-1, VCAM-1) to neuropsychiatric symptoms in a sample with mild AD. Biomarker data was analyzed on a sample of 194 diagnosed with mild to moderate probable AD. The sample was composed of 127 females and 67 males. The presence of neuropsychiatric symptoms was gathered from interview with caretakers/family members using the Neuropsychiatric Inventory. For the total sample, IL-15, VCAM (vascular adhesion molecule), and triglycerides were significantly and negatively related to number of neuropsychiatric symptoms, and total cholesterol and homocysteine were positively related and as a group accounted for 16.1% of the variance. When stratified by gender, different patterns of significant biomarkers were found with relationships more robust for males for both total symptoms and symptom clusters. A combination of biomarkers of systemic inflammation, microvascular pathology, and clinical biomarkers of cardiovascular risk can account for a significant portion of the variance in the occurrence of neuropsychiatric symptoms in AD supporting a vascular and inflammatory component of psychiatric disorders found in AD. Gender differences suggest distinct impact of specific risks with total cholesterol, a measure of cardiovascular risk, being the strongest marker for males and IL-15, a marker of inflammation, being the strongest for females. PMID:23403534

  3. Techno economic systems and excessive consumption: a political economy of 'pathological' gambling.

    PubMed

    Reith, Gerda

    2013-12-01

    This article argues that gambling is a paradigmatic form of consumption that captures the intensified logic at the heart of late modern capitalist societies. As well as a site of intensified consumption, it claims that gambling has also become the location of what has been described as a new form of 'social pathology' related to excess play. Drawing on Castells' (1996) notion of techno-economic systems, it explores the ways that intersections between technology, capital and states have generated the conditions for this situation, and critiques the unequal distribution of gambling environments that result. It argues that, while the products of these systems are consumed on a global scale, the risks associated with them tend to be articulated in bio-psychological discourses of 'pathology' which are typical of certain types of knowledge that have salience in neo-liberal societies, and which work to conceal wider structural relationships. We argue that a deeper understanding of the political and cultural economy of gambling environments is necessary, and provide a synoptic overview of the conditions upon which gambling expansion is based. This perspective highlights parallels with the wider global economy of finance capital, as well as the significance of intensified consumption, of which gambling is an exemplary instance. It also reveals the existence of a geo-political dispersal of 'harms', conceived as deteriorations of financial, temporal and social relationships, which disproportionately affect vulnerable social groups. From this, we urge an understanding of commercial gambling based on a critique of the wider social body of gambling environments within techno economic systems, rather than the (flawed) individual bodies within them. PMID:24320073

  4. Factors Influencing the Selection of Speech Pathology as a Career: A Qualitative Analysis Utilising the Systems Theory Framework

    ERIC Educational Resources Information Center

    Byrne, Nicole

    2007-01-01

    Factors identified by 16 participants during in-depth interviews as influencing selection of speech pathology as a career were described using the Systems Theory Framework (STF, Patton & McMahon, 2006). Participants were highly likely to identify factors from the individual and social systems, but not the environmental-societal system, of the STF…

  5. Does the choice of display system influence perception and visibility of clinically relevant features in digital pathology images?

    NASA Astrophysics Data System (ADS)

    Kimpe, Tom; Rostang, Johan; Avanaki, Ali; Espig, Kathryn; Xthona, Albert; Cocuranu, Ioan; Parwani, Anil V.; Pantanowitz, Liron

    2014-03-01

    Digital pathology systems typically consist of a slide scanner, processing software, visualization software, and finally a workstation with display for visualization of the digital slide images. This paper studies whether digital pathology images can look different when presenting them on different display systems, and whether these visual differences can result in different perceived contrast of clinically relevant features. By analyzing a set of four digital pathology images of different subspecialties on three different display systems, it was concluded that pathology images look different when visualized on different display systems. The importance of these visual differences is elucidated when they are located in areas of the digital slide that contain clinically relevant features. Based on a calculation of dE2000 differences between background and clinically relevant features, it was clear that perceived contrast of clinically relevant features is influenced by the choice of display system. Furthermore, it seems that the specific calibration target chosen for the display system has an important effect on the perceived contrast of clinically relevant features. Preliminary results suggest that calibrating to DICOM GSDF calibration performed slightly worse than sRGB, while a new experimental calibration target CSDF performed better than both DICOM GSDF and sRGB. This result is promising as it suggests that further research work could lead to better definition of an optimized calibration target for digital pathology images resulting in a positive effect on clinical performance.

  6. Musculoskeletal adverse drug reactions: a review of literature and data from ADR spontaneous reporting databases.

    PubMed

    Conforti, Anita; Chiamulera, Christian; Moretti, Ugo; Colcera, Sonia; Fumagalli, Guido; Leone, Roberto

    2007-01-01

    The musculoskeletal system can be a target organ for adverse drug reactions (ADRs). Drug-induced muscle, bone or connective tissue injuries may be due to, i), primary direct drug action, or, ii), undirected consequence of generalized drug-induced disease. Musculoskeletal ADRs may be only temporarily disabling, such as muscle cramps, as well as in other cases may be serious and life-threatening, such as rhabdomyolysis. In the last few years there has been an increasing awareness of musculoskeletal ADRs. Some recent drug safety issues dealt with serious or uncommon musculoskeletal reactions like rhabdomyolysis associated to statins and tendon rupture associated to fluoroquinolones. In this review, we firstly selected those drug classes having a significantly high percentage of musculoskeletal disorder reports in the WHO adverse drug reaction database, maintained by the Uppsala Monitoring Centre. Secondly, the different musculoskeletal ADRs were closely analyzed through the data obtained from an Italian interregional ADRs spontaneous reporting database. The findings on drugs associated to different musculoskeletal disorders, have been integrated with a review of the epidemiological data available in the literature. For the most involved drugs (HMG-CoA reductase inhibitors, fluoroquinolones, corticosteroids, bisphosphonates, retinoids) the underlying musculoskeletal ADR mechanisms were also reviewed and discussed. PMID:18690950

  7. Radionuclide Imaging of Musculoskeletal Infection: A Review.

    PubMed

    Palestro, Christopher J

    2016-09-01

    There are numerous imaging tests for diagnosing musculoskeletal infection. Radiographs are routinely performed, because even when not diagnostic, they provide an anatomic overview of the region of interest that could influence subsequent procedure selection and interpretation. MRI is sensitive and provides superb anatomic detail. Bone scintigraphy accurately diagnoses osteomyelitis in bones not affected by underlying conditions. (67)Ga is used primarily for spondylodiskitis. Although in vitro labeled leukocyte imaging is the radionuclide test of choice for complicating osteomyelitis such as diabetic pedal osteomyelitis and prosthetic joint infection, it is not useful for spondylodiskitis. Antigranulocyte antibodies and antibody fragments have limitations and are not widely available. (111)In-biotin is useful for spondylodiskitis. Radiolabeled synthetic fragments of the antimicrobial peptide ubiquicidin are promising infection-specific agents. (18)F-FDG is the radiopharmaceutical of choice for spondylodiskitis. Its role in diabetic pedal osteomyelitis and prosthetic joint infection is not established. Preliminary data suggest (68)Ga may be useful in musculoskeletal infection. (124)I-fialuridine initially showed promise as an infection-specific radiopharmaceutical, but subsequent investigations were disappointing. The development of PET/CT and SPECT/CT imaging systems, which combine anatomic and functional imaging, has revolutionized diagnostic imaging. These hybrid systems are redefining the diagnostic workup of patients with suspected or known infection and inflammation by improving diagnostic accuracy and influencing patient management. PMID:27390160

  8. Musculoskeletal interventional radiology: ultrasound and CT.

    PubMed

    Martel Villagrán, J; Bueno Horcajadas, Á; Agrela Rojas, E

    2016-05-01

    We aim to describe imaging-guided (ultrasound and CT) interventional techniques in the musculoskeletal system that can be performed by general radiologists, whether in hospitals, primary care clinics, private offices, or other settings. The first requirement for doing these procedures is adequate knowledge of the anatomy of the musculoskeletal system. The second requirement is to inform the patient thoroughly about the technique, the risks involved, and the alternatives available in order to obtain written informed consent. The third requirement is to ensure that the procedure is performed in accordance with the principles of asepsis in relation to the puncture zone and to all the material employed throughout the procedure. The main procedures that can be done under ultrasound guidance are the following: fine needle aspiration cytology (FNAC), core needle biopsy (CNB), diagnostic and/or therapeutic arthrocentesis, drainage of juxta-articular fluid collections, drainage of abscesses, drainage of hematomas, treatment of Baker's cyst, treatment of ganglia, treatment of bursitis, infiltrations and treatment of plantar fasciitis, plantar fibrosis, epicondylitis, Achilles tendinopathy, and Morton's neuroma, puncture and lavage of calcifications in calcifying tendinopathy. We also review the following CT-guided procedures: diagnosis of spondylodiscitis, FNAC of metastases, arthrography, drainages. Finally, we also mention more complex procedures that can only be done in appropriate settings: bone biopsies, treatment of facet joint pain, radiofrequency treatment. PMID:27134018

  9. Recommendations from NASA's Operational and Research Musculoskeletal Summit

    NASA Technical Reports Server (NTRS)

    Jones, J. A.; Johnson-Throop, K. A.; Scheuring, R. A.; Walton, M. E.; Davis-Street, J. E.; Smaka, T.; McCulley, P. A.; Jones, J. A.; Stokes, C. R.; Parker, K. K.; Wear, M.; Johnson-Throop, K. A.

    2006-01-01

    Introduction: Continuously evolving medical standards of care, limited crew training time, and the inherent constraints of space flight necessitate regular revisions of the mission medical support infrastructure and methodology. A three-day Operational and Research Musculoskeletal Summit was held to review NASA s current strategy for preflight health maintenance and injury screening, risk mitigation for musculoskeletal injuries or syndromes, treatment methods during flight, and research topics to mitigate risks to astronaut health. The Summit also undertook consideration of the best evidence-based terrestrial musculoskeletal practices to recommend their adaptation for use in space. Methods: The types and frequencies of musculoskeletal injuries sustained by short- and long-duration astronauts were obtained from the Longitudinal Study of Astronaut Health. The Summit panel was comprised of experts from the clinical and research communities, as well as representatives from NASA Headquarters, the Astronaut corps, and the offices of JSC Medical Operations, JSC Human Adaptation and Countermeasures, Glenn Research Center Human Research, and Astronaut Strength Conditioning and Rehabilitation. Before the summit, panelists participated in a Web-based review of NASA s Space Medical Conditions List (SMCL). Results: The Summit generated seventy-five operational and research recommendations to the NASA Office of Space Medicine, including changes to the SMCL and to the musculoskeletal section of the ISS debrief questionnaire. From these recommendations, seven were assigned highest value and priority, and could be immediately adopted for the exploration architecture. Discussion: Optimized exercise and conditioning to improve performance and forestall musculoskeletal damage on orbit were the primary area of focus. Special attention was paid to exercise timing and muscle group specificity. The panel s recommendations are currently in various stages of consideration or integration

  10. Ageing, musculoskeletal health and work

    PubMed Central

    Palmer, Keith; Goodson, Nicola

    2016-01-01

    Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses, and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered. PMID:26612237

  11. Ageing, musculoskeletal health and work.

    PubMed

    Palmer, Keith T; Goodson, Nicola

    2015-06-01

    Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter, we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered. PMID:26612237

  12. Radiology of musculoskeletal stress injuries

    SciTech Connect

    Keats, T.E.

    1989-01-01

    With the new emphasis on physical fitness, musculoskeletal stress injuries are being seen with greater frequency in children and adults, and in locations that are not widely associated with stress injury. Some of the injuries continue to be mistaken for signs of more serious illnesses, such as infection and neoplasm, and this may lead to unnecessary investigative effort. This book covers both the classic stress injuries and the new manifestations.

  13. [Pathology of the heart conducting system in the thanatogenesis of sudden death from alcoholic cardiomyopathy and coronary heart disease].

    PubMed

    Kul'bitskiĭ, B N; Larev, Z V; Fedulova, M V; Denisova, O P; Bogomolov, D V

    2012-01-01

    The present literature review is focused on the contribution of various pathological changes in the heart conducting system to the tanatogenesis of sudden death from alcoholic cardiomyopathy and coronary heart disease viewed from the perspective of a forensic medical expert. The currently available data on the disorders in the heart conducting system in the subjects with these diseases are presented. Various aspects of pathology of the heart conducting system are considered in the modern and historical contexts. The prospects for the further investigations into the tanatogenic mechanisms of sudden death by reason of alcoholic cardiomyopathy and coronary heart disease are outlined. PMID:22686063

  14. Palliative Care in Musculoskeletal Oncology.

    PubMed

    Gulia, Ashish; Byregowda, Suman; Panda, Pankaj Kumar

    2016-01-01

    Patients in advanced stages of illness trajectories with local and widespread musculoskeletal incurable malignancies, either treatment naive or having recurrence are referred to the palliative care clinic to relieve various disease-related symptoms and to improve the quality of life. Palliative care is a specialized medicine that offers treatment to the disease-specific symptoms, places emphasis on the psychosocial and spiritual aspects of life and help the patients and their family to cope with advance stage cancer in a stronger and reasonable way. The overall outcome of musculoskeletal malignancies has improved with the advent of multidisciplinary management. Even then these tumors do relapse and leads to organ failures and disease-specific deaths in children and young adults in productive age group thus requiring an integrated approach to improve the supportive/palliative care needs in end-stage disease. In this article, we would like to discuss the spectrum of presentation of advanced musculoskeletal malignancies, skeletal metastasis, and their management. PMID:27559251

  15. Palliative Care in Musculoskeletal Oncology

    PubMed Central

    Gulia, Ashish; Byregowda, Suman; Panda, Pankaj Kumar

    2016-01-01

    Patients in advanced stages of illness trajectories with local and widespread musculoskeletal incurable malignancies, either treatment naive or having recurrence are referred to the palliative care clinic to relieve various disease-related symptoms and to improve the quality of life. Palliative care is a specialized medicine that offers treatment to the disease-specific symptoms, places emphasis on the psychosocial and spiritual aspects of life and help the patients and their family to cope with advance stage cancer in a stronger and reasonable way. The overall outcome of musculoskeletal malignancies has improved with the advent of multidisciplinary management. Even then these tumors do relapse and leads to organ failures and disease-specific deaths in children and young adults in productive age group thus requiring an integrated approach to improve the supportive/palliative care needs in end-stage disease. In this article, we would like to discuss the spectrum of presentation of advanced musculoskeletal malignancies, skeletal metastasis, and their management. PMID:27559251

  16. Body mass index and musculoskeletal pain: is there a connection?

    PubMed Central

    2013-01-01

    Background Back pain is one of the most common complaints that patients report to physicians and two-thirds of the population has an elevated body mass index (BMI), indicating they are either overweight or obese. It was once assumed that extra body weight would stress the low back and lead to pain, however, researchers have reported inconsistencies association between body weight and back pain. In contrast, more recent studies do indicate that an elevated BMI is associated with back pain and other musculoskeletal pain syndromes due to the presence of a chronic systemic inflammatory state, suggesting that the relationship between BMI and musculoskeletal pains be considered in more detail. Objective To describe how an elevated BMI can be associated with chronic systemic inflammation and pain expression. To outline measurable risk factors for chronic inflammation that can be used in clinical practice and discuss basic treatment considerations. Discussion Adiposopathy, or “sick fat” syndrome, is a term that refers to an elevated BMI that is associated with a chronic systemic inflammatory state most commonly referred to as the metabolic syndrome. The best available evidence suggests that the presence of adiposopathy determines if an elevated BMI will contribute to musculoskeletal pain expression. It is not uncommon for physicians to fail to identify the presence of adiposopathy/metabolic syndrome. Conclusion Patients with an elevated BMI should be further examined to identify inflammatory factors associated with adiposopathy, such as the metabolic syndrome, which may be promoting back pain and other musculoskeletal pain syndromes. PMID:23687943

  17. Synoptic reporting in tumor pathology: advantages of a web-based system.

    PubMed

    Qu, Zhenhong; Ninan, Shibu; Almosa, Ahmed; Chang, K G; Kuruvilla, Supriya; Nguyen, Nghia

    2007-06-01

    The American College of Surgeons Commission on Cancer (ACS-CoC) mandates that pathology reports at ACS-CoC-approved cancer programs include all scientifically validated data elements for each site and tumor specimen. The College of American Pathologists (CAP) has produced cancer checklists in static text formats to assist reporting. To be inclusive, the CAP checklists are pages long, requiring extensive text editing and multiple intermediate steps. We created a set of dynamic tumor-reporting templates, using Microsoft Active Server Page (ASP.NET), with drop-down list and data-compile features, and added a reminder function to indicate missing information. Users can access this system on the Internet, prepare the tumor report by selecting relevant data from drop-down lists with an embedded tumor staging scheme, and directly transfer the final report into a laboratory information system by using the copy-and-paste function. By minimizing extensive text editing and eliminating intermediate steps, this system can reduce reporting errors, improve work efficiency, and increase compliance. PMID:17509987

  18. Increased Functional Connectivity between Prefrontal Cortex and Reward System in Pathological Gambling

    PubMed Central

    Koehler, Saskia; Ovadia-Caro, Smadar; van der Meer, Elke; Villringer, Arno; Heinz, Andreas

    2013-01-01

    Pathological gambling (PG) shares clinical characteristics with substance-use disorders and is thus discussed as a behavioral addiction. Recent neuroimaging studies on PG report functional changes in prefrontal structures and the mesolimbic reward system. While an imbalance between these structures has been related to addictive behavior, whether their dysfunction in PG is reflected in the interaction between them remains unclear. We addressed this question using functional connectivity resting-state fMRI in male subjects with PG and controls. Seed-based functional connectivity was computed using two regions-of-interest, based on the results of a previous voxel-based morphometry study, located in the prefrontal cortex and the mesolimbic reward system (right middle frontal gyrus and right ventral striatum). PG patients demonstrated increased connectivity from the right middle frontal gyrus to the right striatum as compared to controls, which was also positively correlated with nonplanning aspect of impulsiveness, smoking and craving scores in the PG group. Moreover, PG patients demonstrated decreased connectivity from the right middle frontal gyrus to other prefrontal areas as compared to controls. The right ventral striatum demonstrated increased connectivity to the right superior and middle frontal gyrus and left cerebellum in PG patients as compared to controls. The increased connectivity to the cerebellum was positively correlated with smoking in the PG group. Our results provide further evidence for alterations in functional connectivity in PG with increased connectivity between prefrontal regions and the reward system, similar to connectivity changes reported in substance use disorder. PMID:24367675

  19. Small Molecule based Musculoskeletal Regenerative Engineering

    PubMed Central

    Lo, Kevin W.-H.; Jiang, Tao; Gagnon, Keith A.; Nelson, Clarke; Laurencin, Cato T.

    2014-01-01

    Clinicians and scientists working in the field of regenerative engineering are actively investigating a wide range of methods to promote musculoskeletal tissue regeneration. Small molecule-mediated tissue regeneration is emerging as a promising strategy for regenerating various musculoskeletal tissues and a large number of small molecule compounds have been recently discovered as potential bioactive molecules for musculoskeletal tissue repair and regeneration. In this review, we summarize the recent literature encompassing the past four years in the area of small bioactive molecule for promoting repair and regeneration of various musculoskeletal tissues including bone, muscle, cartilage, tendon, and nerve. PMID:24405851

  20. Meeting current musculoskeletal health demand through deeper insights into tissue homeostasis and regeneration.

    PubMed

    Andia, Isabel; Maffulli, Nicola

    2015-06-01

    The burden of chronic musculoskeletal disorders is challenging and prompts therapeutic advancements. The notion that chronic conditions such as osteoarthritis and tendinopathy are linked to deficient healing by failure of one or several of the cellular/molecular processes involved is gaining ground. Alterations underpinning disruption of healing mechanisms that contribute to the development of chronic musculoskeletal pathologies include unresolved inflammation, abnormal angiogenic status, alterations in paracrine communication, decline in stem cell functioning and inability to maintain homeostasis in the extracellular matrix compartment. The complexity of failed healing may be challenged with interventions that target multiple biological processes such as cell therapies and/or platelet-rich plasma. PMID:25772645

  1. Connectivity of Pathology: The Olfactory System as a Model for Network-Driven Mechanisms of Alzheimer’s Disease Pathogenesis

    PubMed Central

    Franks, Katherine H.; Chuah, Meng Inn; King, Anna E.; Vickers, James C.

    2015-01-01

    The pathogenesis of Alzheimer’s disease (AD) has been postulated to preferentially impact specific neural networks in the brain. The olfactory system is a well-defined network that has been implicated in early stages of the disease, marked by impairment in olfaction and the presence of pathological hallmarks of the disease, even before clinical presentation. Discovering the cellular mechanisms involved in the connectivity of pathology will provide insight into potential targets for treatment. We review evidence from animal studies on sensory alteration through denervation or enrichment, which supports the notion of using the olfactory system to investigate the implications of connectivity and activity in the spread of pathology in AD. PMID:26696886

  2. Optical quality assessment of whole slide imaging systems for digital pathology.

    PubMed

    Shakeri, S Mojtaba; Hulsken, Bas; van Vliet, Lucas J; Stallinga, Sjoerd

    2015-01-26

    Whole Slide Imaging (WSI) systems are high-throughput automated microscopes for digital pathology applications. We present a method for testing and monitoring the optical quality of WSI-systems using a measurement of the through-focus Optical Transfer Function (OTF) obtained from the edge response of a custom made resolution target, composed of sagittal and tangential edges. This enables quantitative analysis of a number of primary aberrations. The curvature of the best focus as a function of spatial frequency is indicative for spherical aberration, the argument of the OTF quantifies for coma, and the best focus as a function of field position for sagittal and tangential edges allows assessment of astigmatism and field curvature. The statistical error in the determined aberrations is typically below 20 mλ. We use the method to compare different tube lens designs and to study the effect of objective lens aging. The results are in good agreement with direct measurement of aberrations based on Shack-Hartmann wavefront sensing with a typical error ranging from 10 mλ to 40 mλ. PMID:25835891

  3. Shack-Hartmann sensor based optical quality testing of whole slide imaging systems for digital pathology

    NASA Astrophysics Data System (ADS)

    Shakeri, S. M.; Hulsken, Bas; van Vliet, Lucas J.; Stallinga, Sjoerd

    2015-03-01

    Whole Slide Imaging (WSI) systems are used in the emerging field of digital pathology for capturing high-resolution images of tissue slides at high throughput. We present a technique to measure the optical aberrations of WSI systems using a Shack-Hartmann wavefront sensor as a function of field position. The resulting full-field aberration maps for the lowest order astigmatism and coma are analyzed using nodal aberration theory. According to this theory two coefficients describe the astigmatism and coma inherent to the optical design and another six coefficients are needed to describe the cumulative effects of all possible misalignments on astigmatism and coma. The nodal aberration theory appears to fit well to the experimental data. We have measured and analyzed the full-field aberration maps for two different objective lens-tube lens assemblies and found that only the optical design related astigmatism coefficient differed substantially between the two cases, but in agreement with expectations. We have also studied full-field aberration maps for intentional decenter and tilt and found that these affect the misalignment coefficient for constant coma (decenter) and the misalignment coefficient for linear astigmatism (tilt), while keeping all other nodal aberration theory coefficients constant.

  4. [One of the variants of larvate cyclothymic disorder simulating pathology of the locomotor system].

    PubMed

    Lisina, M A

    1990-01-01

    Based on the reported data and the authors' findings 40 cases of larvate cyclothymia are described. The pivotal symptomatology of the disease involved masked hypochondriac subdepressions that imitated pathology of the bones and joints. In view of this fact the mental disease could not be recognized by the physicians and was diagnosed erroneously as a pathology of the bones and joints. The author provides a 3-component structure of the given hypochondriac depressions and differential diagnostic criteria for their separation from genuine pathology of the bones and joints. PMID:2163178

  5. Musculoskeletal Pain in Gynecologic Surgeons

    PubMed Central

    Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

    2013-01-01

    Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

  6. Bacteriology laboratories and musculoskeletal tissue banks in Australia.

    PubMed

    Varettas, Kerry

    2012-11-01

    In Australia, there are six Therapeutic Goods Administration-licensed clinical bacteriology laboratories providing bacterial and fungal bioburden testing of allograft musculoskeletal samples sent from 10 tissue banks. Musculoskeletal swab and/or tissue biopsy samples are collected at the time of allograft retrieval and sent to bacteriology laboratories for bioburden testing, in some cases requiring interstate transport. Bacteria and fungi may be present within the allograft at the time of retrieval or contaminated from an external source. The type of organism recovered will determine if the allograft is rejected for transplant, which may include all allografts from the same donor. Bacteriology staff also provides unpaid support of tissue banks through meeting involvement, consultations, licence-related activities, validations and research funded by their organisation and not part of any contractual agreement. Bacteriology laboratories and tissue banks must be compliant to the Code of Good Manufacturing Practice - Human Blood and Tissues and regulated by the Therapeutic Goods Administration. Clinical bacteriology laboratories also require mandatory accreditation to Standards Australia International Organisation for Standardisation (ISO) 15189:2009 medical laboratories - particular requirements for quality and competence, and may also attain Standards Australia/New Zealand Standard ISO 9001:2000 quality management systems certification. Bacteriology laboratories and musculoskeletal tissue banks are integral partners in providing safe allograft musculoskeletal tissue for transplant. PMID:22882601

  7. Ultrasound Examination of Pediatric Musculoskeletal Diseases and Neonatal Spine.

    PubMed

    Karnik, Alka Sudhir; Karnik, Alpana; Joshi, Alpana

    2016-06-01

    Ultrasound (US) is a simple, non-invasive imaging modality which allows high-resolution imaging of the musculoskeletal (MSK) system. Its increasing popularity in pediatrics is due to the fact that it does not involve radiation, has an ability to visualize non-ossified cartilaginous and vascular structures, allows dynamic imaging and quick contralateral comparison. US is the primary imaging modality in some pediatric MSK conditions like infant hip in developmental dysplasia (DDH), hip joint effusion, epiphyseal trauma and evaluation of the neonatal spine. US is the modality of choice in infants with DDH, both in the initial evaluation and post-treatment follow-up. US has a sensitivity equivalent to MRI in evaluation of the neonatal spine in experienced hands and is a good screening modality in neonates with suspected occult neural tube defects. In other MSK applications, it is often used for the initial diagnosis or in addition to other imaging modalities. In trauma and infections, US can often detect early and subtle soft tissue abnormalities and a quick comparison with the contralateral side aids in diagnoses. Dynamic imaging is crucial in evaluating congenital instabilities and dislocations, soft tissue and ligamentous injuries, epiphyseal injuries and fracture separations. High-resolution imaging along with color Doppler (CD) is useful in the characterization of soft tissue masses. This article reviews the applications of US in pediatric MSK with emphasis on conditions where it is a primary modality. Limitations of US include inability to penetrate bone, hence, limited diagnosis of intraosseous pathology and operator dependency. PMID:26830280

  8. [Musculoskeletal disorders and housework in Italy].

    PubMed

    Rosano, A; Moccaldi, R; Cioppa, M; Lanzieri, G; Persechino, B; Spagnolo, A

    2004-01-01

    The housework exposes to the risk of musculoskeletal disorders, which may appear as disabling diseases, both temporary and permanent ones. To evaluate the epidemiology of the phenomenon a retrospective survey was conducted by administering a mail questionnaire to a sample of 1,000 families residing in the whole national territory. The participation rate was 31.7%. Among respondents 20.5% reported spinal pain, 65.6% of them with continuous pains (41.4% assumed pain-killer drugs). 37.0% of the interviewed persons reported to disorders in upper limbs. It was analysed the association between the presence of disorders and the frequency in making some housework duties. Washing clothes (OR=1.8; C.I. 95%: 0.6-4.5), making beds (OR=1.5; C.I. 95%: 0.2-13.1), and taking care of pets (OR=1.4; C.I. 95%: 0.6-3.4) were associated, even if not in a statistically significant way, with the presence of spinal pain. Upper limbs disorders were associated with duties naturally related to such a disorder, like washing dishes (OR=4.6; C.I. 95%: 1.3-16.5), cleaning clothes (OR=3.1; C.I. 95%: 1.3-7.0), cleaning up carpets (OR=2.3; C.I. 95%: 1.3-3.9). To assist the relatives in state of need was identified as risk factor for both the body areas (OR=2.9; C.I. 95%: 1.2-6.7 for the spine, OR=2.6; C.I. 95%: 1.3-5.2 for upper limbs), putting in evidence the physical stress attributable to the duty. The exact identification of the typology of housework which can induce musculoskeletal disorders, and the level of related risks, are essential information to devise campaigns and protocols of health education aimed at the prevention of chronic pathologies caused by the housework. PMID:15368941

  9. Effect of helium-neon laser on musculoskeletal trigger points

    SciTech Connect

    Snyder-Mackler, L.; Bork, C.; Bourbon, B.; Trumbore, D.

    1986-07-01

    Cold lasers have been proposed recently as a therapeutic tool for treating a wide variety of pathological conditions, including wounds, arthritis, orthopedic problems, and pain. These proposed therapeutic effects largely have been unsubstantiated by research. A randomized, double blind study was undertaken to ascertain the effect of a helium-neon (He-Ne) laser on the resistance of areas of skin overlying musculoskeletal trigger points. These areas usually demonstrate decreased skin resistance when compared with the surrounding tissue. Thirty patients with musculoskeletal trigger points were assigned randomly to either an experimental or a placebo group. In addition to standard physical therapy, each patient received three 15-second applications of a He-Ne laser or placebo stimulation from an identical unit that did not emit a laser. The results of a two-way analysis of covariance with one repeated measure showed a statistically significant increase (p less than .007) in skin resistance. This increase in an abnormal skin resistance pattern may accompany the resolution of pathological conditions.

  10. Relationship between Comorbid Health Problems and Musculoskeletal Disorders Resulting in Musculoskeletal Complaints and Musculoskeletal Sickness Absence among Employees in Korea

    PubMed Central

    Baek, Ji Hye; Kim, Young Sun; Yi, Kwan Hyung

    2015-01-01

    Background To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. Methods In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. Results The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2–6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6–11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. Conclusion Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered. PMID:26106512

  11. Characterizing psychological dimensions in non-pathological subjects through autonomic nervous system dynamics

    PubMed Central

    Nardelli, Mimma; Valenza, Gaetano; Cristea, Ioana A.; Gentili, Claudio; Cotet, Carmen; David, Daniel; Lanata, Antonio; Scilingo, Enzo P.

    2015-01-01

    The objective assessment of psychological traits of healthy subjects and psychiatric patients has been growing interest in clinical and bioengineering research fields during the last decade. Several experimental evidences strongly suggest that a link between Autonomic Nervous System (ANS) dynamics and specific dimensions such as anxiety, social phobia, stress, and emotional regulation might exist. Nevertheless, an extensive investigation on a wide range of psycho-cognitive scales and ANS non-invasive markers gathered from standard and non-linear analysis still needs to be addressed. In this study, we analyzed the discerning and correlation capabilities of a comprehensive set of ANS features and psycho-cognitive scales in 29 non-pathological subjects monitored during resting conditions. In particular, the state of the art of standard and non-linear analysis was performed on Heart Rate Variability, InterBreath Interval series, and InterBeat Respiration series, which were considered as monovariate and multivariate measurements. Experimental results show that each ANS feature is linked to specific psychological traits. Moreover, non-linear analysis outperforms the psychological assessment with respect to standard analysis. Considering that the current clinical practice relies only on subjective scores from interviews and questionnaires, this study provides objective tools for the assessment of psychological dimensions. PMID:25859212

  12. Chondroitin sulfate proteoglycans: Key modulators in the developing and pathologic central nervous system.

    PubMed

    Dyck, Scott M; Karimi-Abdolrezaee, Soheila

    2015-07-01

    Chondroitin Sulfate Proteoglycans (CSPGs) are a major component of the extracellular matrix in the central nervous system (CNS) and play critical role in the development and pathophysiology of the brain and spinal cord. Developmentally, CSPGs provide guidance cues for growth cones and contribute to the formation of neuronal boundaries in the developing CNS. Their presence in perineuronal nets plays a crucial role in the maturation of synapses and closure of critical periods by limiting synaptic plasticity. Following injury to the CNS, CSPGs are dramatically upregulated by reactive glia which form a glial scar around the lesion site. Increased level of CSPGs is a hallmark of all CNS injuries and has been shown to limit axonal plasticity, regeneration, remyelination, and conduction after injury. Additionally, CSPGs create a non-permissive milieu for cell replacement activities by limiting cell migration, survival and differentiation. Mounting evidence is currently shedding light on the potential benefits of manipulating CSPGs in combination with other therapeutic strategies to promote spinal cord repair and regeneration. Moreover, the recent discovery of multiple receptors for CSPGs provides new therapeutic targets for targeted interventions in blocking the inhibitory properties of CSPGs following injury. Here, we will provide an in depth discussion on the impact of CSPGs in normal and pathological CNS. We will also review the recent preclinical therapies that have been developed to target CSPGs in the injured CNS. PMID:25900055

  13. Therapies for Musculoskeletal Disease: Can we Treat Two Birds with One Stone?

    PubMed Central

    Girgis, Christian M.; Mokbel, Nancy; DiGirolamo, Douglas J.

    2014-01-01

    Musculoskeletal diseases are highly prevalent with staggering annual health care costs across the globe. The combined wasting of muscle (sarcopenia) and bone (osteoporosis)— both in normal aging and pathologic states—can lead to vastly compounded risk for fracture in patients. Until now, our therapeutic approach to the prevention of such fractures has focused solely on bone, but our increasing understanding of the interconnected biology of muscle and bone has begun to shift our treatment paradigm for musculoskeletal disease. Targeting pathways that centrally regulate both bone and muscle (eg, GH/IGF-1, sex steroids, etc.) and newly emerging pathways that might facilitate communication between these 2 tissues (eg, activin/myostatin) might allow a greater therapeutic benefit and/or previously unanticipated means by which to treat these frail patients and prevent fracture. In this review, we will discuss a number of therapies currently under development that aim to treat musculoskeletal disease in precisely such a holistic fashion. PMID:24633910

  14. Exploring Occupational Therapists’ Perceptions of the Usefulness of Musculoskeletal Sonography in Upper-Extremity Rehabilitation

    PubMed Central

    McLaughlin Gray, Julie; Frank, Gelya; Wolkoff, Monique

    2015-01-01

    OBJECTIVE. To identify the potential utility of musculoskeletal sonographic imaging in upper-extremity rehabilitation. METHOD. Two occupational therapists in an outpatient hand rehabilitation clinic were recruited by convenience, were trained in the use of sonography, and implemented sonographic imaging in their clinical practice. Qualitative data were obtained during and after the implementation period by means of questionnaires and interviews. Data collection, analysis, and interpretation were completed in an iterative process that culminated in a thematic analysis of the therapists’ perceptions. RESULTS. The data indicate four potential areas of utility for musculoskeletal sonography in upper-extremity rehabilitation: (1) mastering anatomy and pathology, (2) augmenting clinical reasoning, (3) supplementing intervention, and (4) building evidence. CONCLUSION. Numerous potential uses were identified that would benefit both therapist and client. Further exploration of complexities and efficacy for increasing patient outcomes is recommended to determine best practices for the use of musculoskeletal sonography in upper-extremity rehabilitation. PMID:26114469

  15. [MRI-guided musculoskeletal biopsy].

    PubMed

    Daecke, W; Libicher, M; Mädler, U; Rumpf, C; Bernd, L

    2003-02-01

    MRI-guided musculoskeletal biopsy has been mentioned to be a minimally invasive method to obtain specimens for diagnostic purposes in bone tumors. To evaluate the viability, to assess the accuracy, and to record possible complications of this method, clinical data of 19 MRI-guided biopsies were analyzed. Interventions were performed on 18 patients (1-78 years) as an outpatient procedure: 15 skeletal and 4 soft tissue biopsies were taken from the pelvis, upper limb,or lower limb. We used T1-weighted gradient echoes (GE) for locating the puncture site and T2-weighted turbo spin echoes (TSE) for visualization of needle position. In 14 of 18 MRI-guided biopsies, a definite histological diagnosis was obtained. According to the pathologist, the inadequate size of the specimen was the main reason for missing the diagnoses in four cases.Long intervention time and inappropriate biopsy tools proved to be the main disadvantages of MRI-guided biopsy, but technical improvement might solve these technical problems in future.A postbiopsy hematoma was the only complication observed. Once technically improved, MRI-guided biopsy could be a precise alternative routine method for musculoskeletal biopsies in future. PMID:12607083

  16. Heme oxygenase and the immune system in normal and pathological pregnancies.

    PubMed

    Ozen, Maide; Zhao, Hui; Lewis, David B; Wong, Ronald J; Stevenson, David K

    2015-01-01

    Normal pregnancy is an immunotolerant state. Many factors, including environmental, socioeconomic, genetic, and immunologic changes by infection and/or other causes of inflammation, may contribute to inter-individual differences resulting in a normal or pathologic pregnancy. In particular, imbalances in the immune system can cause many pregnancy-related diseases, such as infertility, abortions, pre-eclampsia, and preterm labor, which result in maternal/fetal death, prematurity, or small-for-gestational age newborns. New findings imply that myeloid regulatory cells and regulatory T cells (Tregs) may mediate immunotolerance during normal pregnancy. Effector T cells (Teffs) have, in contrast, been implicated to cause adverse pregnancy outcomes. Furthermore, feto-maternal tolerance affects the developing fetus. It has been shown that the Treg/Teff balance affects litter size and adoptive transfer of pregnancy-induced Tregs can prevent fetal rejection in the mouse. Heme oxygenase-1 (HO-1) has a protective role in many conditions through its anti-inflammatory, anti-apoptotic, antioxidative, and anti-proliferative actions. HO-1 is highly expressed in the placenta and plays a role in angiogenesis and placental vascular development and in regulating vascular tone in pregnancy. In addition, HO-1 is a major regulator of immune homeostasis by mediating crosstalk between innate and adaptive immune systems. Moreover, HO-1 can inhibit inflammation-induced phenotypic maturation of immune effector cells and pro-inflammatory cytokine secretion and promote anti-inflammatory cytokine production. HO-1 may also be associated with T-cell activation and can limit immune-based tissue injury by promoting Treg suppression of effector responses. Thus, HO-1 and its byproducts may protect against pregnancy complications by its immunomodulatory effects, and the regulation of HO-1 or its downstream effects has the potential to prevent or treat pregnancy complications and prematurity. PMID

  17. Primary central nervous system lymphomas and related diseases: Pathological characteristics and discussion of the differential diagnosis.

    PubMed

    Sugita, Yasuo; Muta, Hiroko; Ohshima, Koichi; Morioka, Motohiro; Tsukamoto, Yoshihiro; Takahashi, Hitoshi; Kakita, Akiyoshi

    2016-08-01

    Although primary diffuse large B-cell lymphomas of the CNS are designated as primary CNS lymphomas according to the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue in 2008, a variety of other lymphomas (Burkitt lymphomas, EBV-positive diffuse large B-cell lymphoma of the elderly) and related diseases (lymphomatoid granulomatosis) that are also found in the CNS have been spotlighted in recent years. The histopathology of primary CNS Burkitt lymphomas mimics that of primary diffuse large B-cell lymphomas of the CNS after steroid administration. Therefore, for correct diagnosis of the involved lymphoma, comprehensive fluorescent in situ hybridization analysis for c-MYC and BCL2 is recommended in all primary CNS lymphoma cases with aggressive clinical course, multifocal involvement of the CNS, and a high proliferation index. The pathological characteristics of primary CNS EBV-positive diffuse large B-cell lymphoma of the elderly have similarities with those of the latency phenotype III, EBV lymphoproliferative disorders that arise in the setting of immunodeficiency. These age-related lymphomas usually occur in elderly immunocompetent patients, and the incidence of this disease was estimated to range from 4.0% to 13.6% of all primary CNS lymphomas. Shorter overall survival has been reported for patients with this disease. Lymphomatoid granulomatosis (LYG) is a systemic, EBV-driven, angiocentric and angiodestructive lymphoproliferative disorder. Primary LYG that shows distinct clinicopathological features compared with systemic LYG was recently reported. Finally, this review focuses on the relationship between primary CNS lymphomas and demyelinating diseases, and the concomitant use of intraoperative cytology and frozen sections that are helpful in rapid intraoperative diagnosis. PMID:26607855

  18. Heme oxygenase and the immune system in normal and pathological pregnancies

    PubMed Central

    Ozen, Maide; Zhao, Hui; Lewis, David B.; Wong, Ronald J.; Stevenson, David K.

    2015-01-01

    Normal pregnancy is an immunotolerant state. Many factors, including environmental, socioeconomic, genetic, and immunologic changes by infection and/or other causes of inflammation, may contribute to inter-individual differences resulting in a normal or pathologic pregnancy. In particular, imbalances in the immune system can cause many pregnancy-related diseases, such as infertility, abortions, pre-eclampsia, and preterm labor, which result in maternal/fetal death, prematurity, or small-for-gestational age newborns. New findings imply that myeloid regulatory cells and regulatory T cells (Tregs) may mediate immunotolerance during normal pregnancy. Effector T cells (Teffs) have, in contrast, been implicated to cause adverse pregnancy outcomes. Furthermore, feto-maternal tolerance affects the developing fetus. It has been shown that the Treg/Teff balance affects litter size and adoptive transfer of pregnancy-induced Tregs can prevent fetal rejection in the mouse. Heme oxygenase-1 (HO-1) has a protective role in many conditions through its anti-inflammatory, anti-apoptotic, antioxidative, and anti-proliferative actions. HO-1 is highly expressed in the placenta and plays a role in angiogenesis and placental vascular development and in regulating vascular tone in pregnancy. In addition, HO-1 is a major regulator of immune homeostasis by mediating crosstalk between innate and adaptive immune systems. Moreover, HO-1 can inhibit inflammation-induced phenotypic maturation of immune effector cells and pro-inflammatory cytokine secretion and promote anti-inflammatory cytokine production. HO-1 may also be associated with T-cell activation and can limit immune-based tissue injury by promoting Treg suppression of effector responses. Thus, HO-1 and its byproducts may protect against pregnancy complications by its immunomodulatory effects, and the regulation of HO-1 or its downstream effects has the potential to prevent or treat pregnancy complications and prematurity. PMID

  19. Musculoskeletal evaluation in severe haemophilia A patients from Latin America

    PubMed Central

    Ozelo, M C; Villaça, P R; Pérez-Bianco, R; Candela, M; Garcia-Chavez, J; Moreno-Rodriguez, B; Rodrigues, M B; Rodriguez-Grecco, I; Solano, M H; Chumpitaz, G; Morales-Gana, M M; Ruiz-Sáez, A

    2013-01-01

    Summary There is a paucity of literature on haemophilia treatment in Latin American countries, a region characterized by rapidly improving systems of care, but with substantial disparities in treatment between countries. The aim of this study was to evaluate the musculoskeletal status of haemophilia patients from Latin America and to examine the relationship between musculoskeletal status and treatment practices across countries. The Committee of Latin America on the Therapeutics of Inhibitor Groups conducted a survey of its member country representatives on key aspects of haemophilia treatment in 10 countries. Musculoskeletal status of patients was obtained during routine comprehensive evaluations between March 2009 and March 2011. Eligible patients had severe haemophilia A (factor VIII <1%) without inhibitors (<0.6 BU mL−1) and were ≥5 years of age. Musculoskeletal status was compared between three groups of countries, based primarily on differences in the availability of long-term prophylaxis. Overall, 143 patients (5–66 years of age) were enrolled from nine countries. In countries where long-term prophylaxis had been available for at least 10 years (Group A), patients aged 5–10 years had significantly better mean World Federation of Hemophilia clinical scores, fewer target joints and fewer affected joints than patients from countries where long-term prophylaxis has been available for about 5 years (Group B) or was not available (Group C). In Latin America, the musculoskeletal status of patients with severe haemophilia without inhibitors has improved significantly in association with the provision of long-term prophylaxis. As more countries in Latin America institute this practice, further improvements are anticipated. PMID:24354487

  20. Utility of positron emission tomography-magnetic resonance imaging in musculoskeletal imaging

    PubMed Central

    Chaudhry, Ammar A; Gul, Maryam; Gould, Elaine; Teng, Mathew; Baker, Kevin; Matthews, Robert

    2016-01-01

    Differentiation between neoplastic and nonneoplastic conditions magnetic resonance imaging (MRI) has established itself as one of the key clinical tools in evaluation of musculoskeletal pathology. However, MRI still has several key limitations which require supplemental information from additional modalities to complete evaluation of various disorders. This has led to the development hybrid positron emission tomography (PET)-MRI which is rapidly evolving to address key clinical questions by using the morphological strengths of MRI and functional information of PET imaging. In this article, we aim to review physical principles and techniques of PET-MRI and discuss clinical utility of functional information obtained from PET imaging and structural information obtained from MRI imaging for the evaluation of musculoskeletal pathology. More specifically, this review highlights the role of PET-MRI in musculoskeletal oncology including initial diagnosis and staging, treatment planning and post-treatment follow-up. Also we will review utility of PET-MRI in evaluating musculoskeletal infections (especially in the immunocompromised and diabetics) and inflammatory condition. Additionally, common pitfalls of PET-MRI will be addressed. PMID:27027320

  1. Pathological gambling.

    PubMed

    Hollander, E; Buchalter, A J; DeCaria, C M

    2000-09-01

    With increasing access to gambling facilities through casinos, the Internet, and other venues, PG is a rapidly emerging mental health concern. This impulse-control disorder tends to be comorbid with a wide range of other disorders and is reportedly associated with a high rate of suicide. For most gamblers, gambling is a form of entertainment, but for many individuals, the activity leads to far-reaching disruption of family and work. The personal and societal financial ramifications are severe, and many individuals with PG end up in the criminal justice system. An understanding of the neurobiology of PG is beginning to surface. 5-HT is linked to behavioral initiation and disinhibition, which are important in the onset of the gambling cycle and the difficulty in ceasing the behavior. Norepinephrine is associated with the arousal and risk taking in patients with PG. Dopamine is linked to positive and negative reward, the addictive component of this disorder. Effective treatment strategies for pathological gamblers are emerging. Potentially useful pharmacologic agents include SRIs (clomipramine and fluvoxamine), mood stabilizers for pathological gamblers with comorbid bipolar disorders (lithium), and naltrexone. Cognitive-behavioral psychotherapies offer promising results in the treatment of patients with this disorder. To devise prevention and early-intervention programs, research is needed to identify specific features of the individuals at risk for gambling problems. Education targeting vulnerable youth that show early signs of gambling behavior may be worthwhile and should be investigated further. Funding is necessary to support these endeavors, so perhaps a portion of tax revenues generated from the gambling industry should go toward specialized treatment facilities, educational efforts, and research into the neurobiology and treatment of PG. PMID:10986732

  2. [Musculoskeletal hydatidosis: an unusual location].

    PubMed

    Pleguezuelo Navarro, M; Iglesias Flores, E M; Domínguez Jiménez, J L; González Galilea, A; Abad Lara, J A; Jiménez Sánchez, C; De Dios Vega, J F

    2006-05-01

    Hydatidosis is a zoonosis with a continuing high prevalence in our environment. The most commonly affected organs are the lungs and the liver, with the musculoskeletal location being considered an unusual one. We comment the case of a patient who presented a series of lesions in his left iliac crest and middle left buttock with spontaneous fistulization to the skin surface. In this case a combined treatment was given; prior to the surgical operation we administered a cycle of albendazol. Following removal of the lesion, the patient was given two further cycles of albendazol in order to minimize the risk of a recurrence of the illness. This patient is currently free of any symptoms relating to this illness. PMID:16817701

  3. Musculoskeletal trauma: the baseball bat.

    PubMed Central

    Bryant, D. D.; Greenfield, R.; Martin, E.

    1992-01-01

    Between July 1987 and December 1990 in Washington, DC, 116 patients sustained 146 fractures and seven dislocations due to an assault with a baseball bat. The ulna was the most common site of trauma (61 fractures), followed by the hand (27 injuries) and the radius (14 injuries). Forty-two of the 146 fractures were significantly displaced and required open reduction and internal fixation to restore satisfactory alignment. Twenty-nine of the 146 fractures were open fractures. Treatment protocol for open fractures consisted of irrigation and debridement, antibiotic therapy, and bone stabilization with either internal or external fixation, or casting. Recognition of the severity of the soft tissue and bone damage is important in the management of musculoskeletal trauma secondary to the baseball bat. Images Figure 1 Figure 2 Figure 3 PMID:1460683

  4. Musculoskeletal imaging insight 2015: Kenya.

    PubMed

    Stevens, Kathryn J; Mutiso, Kavulani; Sconfienza, Luca Maria; Monu, Johnny

    2016-07-01

    Over the past 6 years the International Skeletal Society (ISS) outreach programs have become popular amongst the various radiology organizations in sub-Saharan Africa. So much so that that the ISS outreach is now routinely expected to participate in many of the international radiology conferences in that part of the world. The organizational planning for an outreach visit to Kenya took place over a 3-year period. Eventually a double-headed event; the seventh and eighth sub-Saharan outreach efforts were organized in Nairobi and in Mombasa, Kenya. The Nairobi outreach was an educational course on musculoskeletal imaging at the University of Nairobi and the Aga Khan University in Nairobi from 26 to 28 May 2015. The Mombasa outreach was organized in collaboration with the African Society of Radiology (ASR) at their annual meeting in Mombasa from 30 May to 2 June 2015. PMID:27115883

  5. A computer-aided diagnosis system to identify regions of pathologic change in temporal subtraction images of the chest

    NASA Astrophysics Data System (ADS)

    Ho, Charles; Lee, Katherine; Armato, Samuel G.

    2015-03-01

    Radiologists often compare sequential radiographs side-by-side in order to identify regions of change and evaluate the clinical significance of such regions. Some changes in pathology, however, may be overlooked or misinterpreted. For this reason, temporal subtraction (TS) images provide an important tool for enhanced visualization. Not all areas of "change" demonstrated on a TS image, however, are caused by pathology. The purpose of this study was to develop an automated computer-aided diagnosis (CAD) system to locate regions of change in TS images as well as to classify such regions as being true regions of pathologic change or false regions of change caused by misregistration artifacts. The dataset used in this study contained 120 images, on which an experienced radiologist outlined 74 regions of true pathologic change that were used as the gold standard. Through gray-level thresholding and initial false-positive reduction, an initial set of candidates was extracted and inputted into a classifier. A five-fold cross-validation method was employed to create training and testing groups. Both false-candidate regions as well as the gold-standard regions were used as training data. Of the three classifiers tested (support vector machine, logistic regression, and linear discriminant analysis), the logistic regression classifier performed the best with a sensitivity of 96% and specificity of 84%; receiver operating characteristic (ROC) analysis resulted in an area under the ROC curve of 0.94. These results show promise in the performance of the CAD system to detect regions of pathologic changes in TS images of the chest.

  6. Developmental process of musculoskeletal integration in ostracod antenna.

    PubMed

    Kaji, Tomonari

    2012-03-01

    The functional morphology of arthropod appendages shows remarkable diversity. Plausible functional integrations, particularly between muscles and the exoskeleton, must be achieved in these diverse morphologies. This study provides an insight into the evolutionary pathway of diversified appendages from a functional point of view. The musculoskeletal structure and development of antennae in five species of Cypridocopina were compared. The muscle and skeletal systems are integrated in several ways: The integration in Propontocypris attenuata occurs during various stages of the molting growth, whereas that in Fabaeformiscandona breuili occurs during the myogenesis. These two types of developmental processes have notable similarities, despite their occurrence during different developmental phases. From the overview of the molecular phylogeny presented by earlier studies, it is suggested that the integrated musculoskeletal system has reappeared repeatedly in cypridoid lineages as an atavism. This study demonstrates how arthropod appendages evolve without losing the integrity of the functional whole. PMID:22305643

  7. Teaching General and Systemic Pathology in a New Veterinary School. II. Materials and Costs

    ERIC Educational Resources Information Center

    Crowell, W. A.; And Others

    1976-01-01

    The amounts, types and costs of materials used to initiate a Year II (sophomore) pathology course in the L.S.U. School of Veterinary Medicine were tabulated. Use of the autotutorial method resulted in slightly greater costs than the traditional method, but this was offset by general satisfaction with it. (Author/LBH)

  8. Teaching General and Systemic Pathology in a New Veterinary School. I. Method of Instruction

    ERIC Educational Resources Information Center

    Crowell, W. A.; And Others

    1976-01-01

    The Year II pathology course presented to the first two classes of veterinary students at L.S.U. was favorably evaluated. The method of instruction included learner objectives, the autotutorial approach with minicourses, modified mastery evaluation, and the Postlethwait means of presentation. (Author/LBH)

  9. Biochemical pathology and treatment strategies in Alzheimer's disease: emphasis on the cholinergic system.

    PubMed

    Winblad, B; Messamore, E; O'Neill, C; Cowburn, R

    1993-01-01

    The neurochemical pathology of Alzheimer's disease (AD) has been consistently shown to involve cholinergic degeneration in the cerebral cortex. This together with evidence from experimental animal studies showing that cholinergic neurones play a role in learning and memory processes has formed the basis of the cholinergic hypothesis of Alzheimer's dementia and the major rationale for neurotransmitter replacement therapy of the disorder. PMID:8128837

  10. Ultrasound-assisted musculoskeletal procedures: A practical overview of current literature

    PubMed Central

    Royall, Nelson A; Farrin, Emily; Bahner, David P; Stawicki, Stanislaw PA

    2011-01-01

    Traditionally performed by a small group of highly trained specialists, bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and treatment. Due to this limitation, a need evolved for more portability and accessibility to allow performance of emergent musculoskeletal procedures by adequately trained non-radiology personnel. The emergence of ultrasound-assisted bedside techniques and increased availability of portable sonography provided such an opportunity in select clinical scenarios. This review summarizes the current literature describing common ultrasound-based musculoskeletal procedures. In-depth discussion of each ultrasound procedure including pertinent technical details, indications and contraindications is provided. Despite the limited amount of prospective, randomized data in this area, a substantial body of observational and retrospective evidence suggests potential benefits from the use of musculoskeletal bedside sonography. PMID:22474637