1,721,120 research outputs found
Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: A randomized double-blind clinical trial of active and simulated spinal manipulations
No full textBackground Context: Acute back pain and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. Purpose: To assess the short- and long-term effects of spinal manipulations on acute back pain and sciatica with disc protrusion. Study Design/Setting: Randomized double-blind trial comparing active and simulated manipulations in rehabilitation medical centers in Rome and suburbs. Patient Sample: 102 ambulatory patients with at least moderate pain on a visual analog scale for local pain (VAS1) and/or radiating pain (VAS2). Outcome Measures: Pain-free patients at end of treatment; treatment failure (proportion of patients stopping the assigned treatment for lack of effect on pain); number of days with no, mild, moderate, or severe pain; quality of life; number of days on nonsteroidal anti-inflammatory drugs; number of drug prescriptions; VAS1 and VAS2 scores; quality of life and psychosocial findings; and reduction of disc protrusion on magnetic resonance imaging. Methods: Manipulations or simulated manipulations were done 5 days per week by experienced chiropractors, with a number of sessions which depended on pain relief or up to a maximum of 20, using a rapid thrust technique. Patients were assessed at admission and at 15, 30, 45, 90, and 180 days. At each visit, all indicators of pain relief were used. Results: A total of 64 men and 38 women aged 19-63 years were randomized to manipulations (53) or simulated manipulations (49). Manipulations appeared more effective on the basis of the percentage of pain-free cases (local pain 28 vs. 6%; p<.005; radiating pain 55 vs. 20%; p<.0001), number of days with pain (23.6 vs. 27.4; p<.005), and number of days with moderate or severe pain (13.9 vs. 17.9; p<.05). Patients receiving manipulations had lower mean VAS1 (p<.0001) and VAS2 scores (p<.001). A significant interaction was found between therapeutic arm and time. There were no significant differences in quality of life and psychosocial scores. There were only two treatment failures (manipulation 1; simulated manipulation 1) and no adverse events. Conclusions: Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion. © 2006 Elsevier Inc. All rights reserved
Reply to "intraoperative dynamic pressure measurements in carpal tunnel syndrome: correlations with clinical signs"
No full textWe have read with high attention the paper of Lee et al. entitled
“Intraoperative dynamic pressure measurements in carpal tunnel
syndrome: Correlations with clinical signs” [1]. The authors
have pre- and postoperatively assessed the carpal tunnel pressure
in neutral position, passive flexion and passive extension. This
dynamic evaluation of carpal tunnel pressure could be important
to understand the association between the changes in pressure and
carpal tunnel syndrome (CTS) symptoms and, consequently, the
best surgical management. The paper is very interesting because
it provides tools to better understand the pathological events that
occur in CTS. However, the findings of this study are focused on the
functional aspects of CTS. In future, correlations between tunnel
pressure, nerve morphological changes and relationship between
nerve and surrounding structures should be desirable. The use of
imaging may be considered for this type of evaluation. In particular,
the dynamic morphological evaluation of nerves can be performed
by the use of ultrasound (US). This tool allows visualizing and measuring
median nerve in carpal tunnel. Furthermore, it is possible
changing the position of wrist (neutral, flexed and extended), to
assess the relationship between median nerve and other structures,
and register the modification of nerve dimensions, in terms of cross
sectional area and antero-posterior and latero-lateral diameters [2].
This assessment let us know, for example, the point where the nerve
presents the greatest compression and likely the greatest suffering.
Finally, US is well-tolerated and relatively fast technique, which is
usually used for surgical planning and in follow-up after operation.
Moreover, US may be considered as a guide for the catheter
positioning, as in authors’ study, and especially for the depiction
of anatomical variations (i.e. bifid median nerve, accessory muscles,
etc.) [3,4]. The possible integration of these above mentioned
values and the values of carpal tunnel pressure may give morphofunctional
information useful for a comprehensive understand
Tinnitus in postherpetic neuralgia
No full textWe describe a woman who developed postherpetic neuralgia (PHN) located on the skin areas of the left ophthalmic division of the fifth cranial nerve without ocular involvement. PHN was associated with tinnitus, which was located ipsilaterally to the painful side and increased in proportion to the intensity of pain. Tinnitus was responsive to treatment with duloxetine, 60 mg daily, and subsided when the PHN resolved. This is the first description of tinnitus in PHN
Consideration about "sonographic evaluation of peripheral nerves in subtypes of Guillain-Barré syndrome
No full textN
Comment on "Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition"
No full textBahat and colleagues presented cut-off values for muscle mass and strength and calf circumference for correct application, in Turkish population, of European Working Group on Sarcopenia in Older People criteria. The work is important to assess this condition on the basis of population-specific data. Ageing care represents a target of modern medicine and sarcopenia, consequence of it, can worse the quality of life. Assessing this, considering population characteristics, as authors described, is very functional in medical practice. We would suggest consideration of people older than 90 years as different elderly subclass and application of technological tools to monitor muscular performance
- …
