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Marcus Schiltenwolf
Medicolegal assessments of claimants with chronic muskuloskeletal pain conditions are frequent. The first German guideline published in 2005 for the medicolegal assessment of claimants in chronic pain is now available in its 4th version (AWMF register number 094 - 003). It gives recommendations for the procedure and serves to ensure the quality of expert opinions when complaints about chronic pain are the leading symptom. In the current version, the indications for ordering medical assessments in pain syndromes have been reformulated, the assessment criteria have been adapted to ICF specifications, and an unequivocal distinction has been introduced between questions of state and causal assessment...
March 9, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Bary Berghmans
INTRODUCTION AND HYPOTHESIS: Chronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results...
May 2018: International Urogynecology Journal
James H Bishop, Marina Shpaner, Antoni Kubicki, Sarah Clements, Richard Watts, Magdalena R Naylor
Chronic musculoskeletal pain is a condition that influences central nervous system structure. In this study, we combined novel structural neuroimaging techniques, using well-validated software packages including FSL, Mrtrix3, and DSI Studio, to characterize brain grey (GM) and white matter (WM) differences in chronic musculoskeletal pain participants (n = 74), compared to age-matched pain-free controls (n = 31). In participants with chronic pain, we identified significantly higher volume in subcortical GM structures using voxel-based morphometry (FSLVBM)...
December 11, 2017: NeuroImage
S Ray, T El Khassawna, U Sommer, U Thormann, N D Wijekoon, K Lips, C Heiss, V Alt
Wnt/β-catenin signalling components was shown to affect bone cells function including chondrocytes.Secreted Dkk1, a potent osteogenesis inhibiting factor mediates bone loss in diseased bones by suppressing the biological actions of Wnt proteins. In addition, increased Dkk1 signalling inhibits chondrogenesis in new bone formation. Recent findings also show there exists a cross-talk between the chondrocytes and the cells of the osteoblast lineage, which are the most affected cell types in muskuloskeletal disorders...
January 2017: Journal of Microscopy
Magnus Diller, Martin Fleck
Muskuloskeletal ultrasound and dual-energy-CT (DECT) findings are increasingly relevant for the establishment of the diagnosis of gout, and are therefore incorporated into the novel ACR / EULAR classification criteria. Canakinumab, a monoclonal antibody directed against interleukin-1β (IL-1β) has been approved in 2013 for the treatment of acute gout and for prophylaxis of flares. In patients demonstrating an inadequate response upon treatment with allopurinol or febuxostat, combination therapy with lesinurad might reduce uric acid levels to the target of < 6 mg / dl (< 5 mg / dl in tophaceous gout)...
August 2016: Deutsche Medizinische Wochenschrift
Frank W Roemer, Aida Aydemir, Stefan Lohmander, Michel D Crema, Monica Dias Marra, Norma Muurahainen, David T Felson, Felix Eckstein, Ali Guermazi
BACKGROUND: A recent publication on efficacy of Sprifermin for knee osteoarthritis (OA) using quantitatively MRI-defined central medial tibio-femoral compartment cartilage thickness as the structural primary endpoint reported no statistically significant dose response. However, Sprifermin was associated with statistically significant, dose-dependent reductions in loss of total and lateral tibio-femoral cartilage thickness. Based on these preliminary promising data a post-hoc analysis of secondary assessment and endpoints was performed to evaluate potential effects of Sprifermin on semi-quantitatively evaluated structural MRI parameters...
July 9, 2016: BMC Musculoskeletal Disorders
Alessandra Marinelli, C Negro, A Prodi, G Pesel, Francesca Larese Filon
UNLABELLED: «Muskuloskeletal pain and perceived stress in civil servants». BACKGROUND: Musculoskeletal pain is the most important symptom reported in many occupations causing disability and long-term sick absence. Epidemiological research has linked this symptom to physical activities in the workplace but also to psychosocial factors, than can increase pain perception. OBJECTIVES: To evaluate pain perception, psychosocial factors and stress in 413 workers in hospitals compared to 294 white collar workers at University of Trieste...
September 2015: La Medicina del Lavoro
Niina Hopper, John Wardale, Roger Brooks, Jonathan Power, Neil Rushton, Frances Henson
This study characterized peripheral blood mononuclear cells (PBMC) in terms of their potential in cartilage repair and investigated their ability to improve the healing in a pre-clinical large animal model. Human PBMCs were isolated with gradient centrifugation and adherent PBMC's were evaluated for their ability to differentiate into adipogenic, chondrogenic and osteogenic lineages and also for their expression of musculoskeletal genes. The phenotype of the PBMCs was evaluated using Stro-1, CD34, CD44, CD45, CD90, CD106, CD105, CD146 and CD166 cell surface markers...
2015: PloS One
M J Fernandez-Lopez, S Verlinden, M Van Hoydonck, E Dragan, P Eloundou, A Peretz, J Bentin
Muskuloskeletal ultrasound has been incorporated by rheumatologist to the clinical practice over the past decade. The technical improvements of the devices allowed the production of high quality images contributing to better identification of joint inflammation and structural damage. In this review, we highlight the applications of ultrasound in the study of different rheumatic conditions.
September 2014: Revue Médicale de Bruxelles
Benedikt Horn
Chest pain in ambulatory setting is predominantly not heart-associated. Most patients suffer from muskuloskeletal or functional (psychogenic) chest pain. Differential diagnosis covers aortic dissection, rib-fracture, shingles, GERD, Tietze-Syndrome, pulmonary embolism, pleuritis, pneumothorax, pleurodynia and metastatic disease. In most cases history, symptoms and signs allow a clinical diagnosis of high pretest-probability.
January 2015: Therapeutische Umschau. Revue Thérapeutique
Jon Etxano Cantera, María Páramo Alfaro, David Cano Rafart, Romina Zalazar, Maite Millor Muruzabal, Paula García Barquín, Isabel Vivas Pérez
OBJECTIVES: To present the most important characteristics of inflammatory myofibroblastic tumours (IMTs) arising in different locations of the body with histological correlation. METHODS: To review the symptoms and main radiological findings of IMTs. On ultrasonography (US), these tumours can appear as hypoechoic or hyperechoic masses and a variable Doppler appearance with increased vascularity. Computed tomography (CT) and magnetic resonance (MR) are the most used imaging tools in their evaluation...
February 2015: Insights Into Imaging
C Multerer, L Döderlein
BACKGROUND: As developmental dysplasia of the hip (DDH) is the most common congenital muskuloskeletal anomaly, it seems necessary to give an update on the normal growth, pathoanatomy, diagnostic and therapeutic procedures. OBJECTIVES: Which investigations or procedures have withstood the test of time? What are new therapeutic strategies and considerations? What are the problems? METHODS: Review of the current literature on DDH supplemented by several years experience in the treatment of this condition by the authors...
August 2014: Der Orthopäde
C A Valcu, W Kurth, B Remy, P Gillet
Aging of the population represents an ubiquitous and ever-growing phenomenon in the developed countries. Geriatric traumatology is a constant-developping sub-speciality of orthopedics and traumatology; it deals with the specific medical problems developed by older patients when affected by muskuloskeletal trauma. The optimal treatment of this pathology as well as the age threshold used to define the "geriatric" patient are still subjects of debate. Chronological age cannot be used as the sole inclusion criteria; physiological age as defined by comorbidities seems to be more appropriate...
May 2014: Revue Médicale de Liège
P M Rommens
The last decades have been characterized by rapid changes in society, medicine and surgery. There is a distinct evolution towards specialization and super-specialization. Trauma surgery also evolves towards a specialty, focused on the care of the injured. To optimize the quality of care and meet the needs of patients and care providers, a well-structured trauma surgery training program as well as the regionalization of trauma care with the implementation of Level I trauma centers are needed. The core competence of the European trauma surgeon is the coordination of the early management of the severely injured and the treatment of muskuloskeletal trauma, which represent the most common pathologies in our countries...
January 2014: Acta Chirurgica Belgica
Aaron F Hajart, Forrest Pecha, Mary Hasty, Sean M Burfeind, Joseph Greene
The provision of care and business of musculoskeletal medicine have evolved signifncalty over the last two decades. It has become ever more important that those who are leading muskuloskeletal medicine practices evolve with the changing healthcare landscape and find new ways to provide higher quliaty and more cost-effetive care. To meet these new challenges, many orthopedic physicians are choosing to hire athletic trainers as a part of their office staff. Athletic trainers provide value to a medical practice through their skills in triage, taking patient histories, performing musculoskeletal evaluations, providing instruction on exercise prescription, rehabilitation, and general patient education...
January 2014: Journal of Medical Practice Management: MPM
T Histing, J Jung, D Wincheringer, J Ludwig, A Pizanis, T Pohlemann, M D Menger
BACKGROUND: Students often complain about a lack of teaching of practical skills. This may be a cause for the low attractiveness of surgical disciplines. We therefore established a practical course to improve teaching quality to inspire the students for orthopedic and trauma surgery. METHODS: The platforms of the course included the teaching and acquisition of suture techniques, arthroscopy and osteosynthesis techniques. A total of 119 students participated in 9 courses and performed a detailed evaluation...
August 2013: Zeitschrift Für Orthopädie und Unfallchirurgie
M Santini, M M Riva, G Mosconi
The authors analyse 493 hospital cases in 356 workers from the construction industry, came to observation for musculoskeletal disorders (average age 48, 2 years, SD 9; work seniority 32, 2 years, SD 9, 7; work seniority in construction industry 27, 3 years, SD 12, 4). The evaluation was required in 305 subjects (85.7% of the sample) to investigate one or more suspected WMDS; in 51 subjects (14.3% of the sample) to express an opinion on fitness to work or residual work capacity. Investigations led to diagnosis of 479 musculoskeletal disorders; the districts most affected are spine and upper limb...
July 2012: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
S N Kunz, N Grove, F Fischer
Conducted electrical weapons (CEWs) deliver short high-voltage, low current energy pulses to temporarily paralyze a person by causing muscular contraction. The narrative of this article is a methodical analysis on acute pathophysiological changes within the central nervous system, cardiovascular, neuroendocrine, sympatho-adrenergic and muskuloskeletal system which can occur after application of conducted electrical weapons on human subjects. The results are based on wide-ranging literature analysis and source studies...
September 10, 2012: Forensic Science International
Wen He, Dong-ying Xiang, Jian-ping Dai
OBJECTIVE: The purpose of this study was to evaluate the application of sonography at the polyclinic of the Olympic/Paralympic village during the Olympic/Paralympic Games. METHODS: We retrospectively reviewed 759 consecutive patients who underwent sonography at the ultrasound division of the polyclinic in the Olympic/Paralympic village from July 20, 2008, to September 20, 2008. Prevalence of emergency sonography after sports injury and non-sports-related urgent conditions during the games was analyzed...
March 2011: Clinical Imaging
V Trnka, Z Matejovský
In the period 1982-1992 the authors have performed 1276 peroperative biopsies from frozen sections in 607 patients with suspect diagnosis of a musku-loskeletal tumor. In 174 a diagnosis of a primary malignant tumor was established, in 166 of a benigne tumor, in 53 of metastasis, in 104 of a tumor-like lesion, in 33 of an inflamation. In 77 patients (12,6 %) it was not possible to establish peroperatively the diagnosis and it became necessary to wait for the definite histological examination. Gaining a peroperative histological diagnosis makes an immediate start of preoperative chemotherapy in osteosarcoma and Ewing's sarcoma possible...
1994: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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