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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the study was to assess the rate of thumb osteoarthritis in an ancient population (before the industrial revolution) according to the age, the sex and the side affected, and to compare the results to the current epidemiologic data. This study was performed in bones from the convent graveyard of the Soeurs Grises de Beauvais (15th to 18th century). The rate of thumb osteoarthritis was assessed in 73 adult individuals (34 men and 39 women) divided into 2 age groups: 35-49 and over 50. The rates of thumb osteoarthritis in each group were compared according to different factors (age, sex, side affected). The statistical study showed a higher rate of thumb osteoarthritis in elder people in general, and in male but not in female individuals. The rate of bilateral thumb osteoarthritis was higher in women. However, no difference was found between both sides of human body whatever the age or sex. As for the female population, the results were identical those of the current data. However, there was a higher rate of thumb osteoarthritis in men of any age group. A functional fatigue could provide a higher rate of secondary thumb osteoarthritis since the women in this series (nuns), who were less affected by overwork, had a rate of primary thumb osteoarthritis identical to the rate found in the current literature.
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PMID:[Thumb arthritis yesterday and today. Epidemiologic comparison in an ancient population]. 1198 Mar 53

Few studies have examined the effect of pain on the quality of life of individuals with slowly progressive neuromuscular disease (NMD). The purpose of this study was to determine the frequency and extent to which subjects with slowly progressive NMD report pain and the association between pain and health-related quality of life in persons with NMD. The study design was a descriptive, nonexperimental survey. Of a total of 1,432 subjects with slowly progressive NMDs recruited from a university-based NMD clinic and the membership rosters of worldwide NMD support organizations, 859 agreed to participate. The primary measurement tool used was the Medical Outcomes Study SF-36 health survey. Our results indicated that, with the exception of adult spinal muscular atrophy (SMA), the frequency and severity of pain reported in slowly progressive NMDs was significantly greater than levels of pain reported by the general US population and was comparable to pain reported by subjects with osteoarthritis and chronic low back pain. There was a significant correlation between increased pain and lower levels of general health, vitality, social function, and physical role. Pain was moderately associated with increased fatigue, inability to cope adequately with stress, and sleep disturbance. In conclusion, with the exception of adult SMA, the frequency and severity of pain reported in slowly progressive NMDs was significant.
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PMID:Assessment of pain and health-related quality of life in slowly progressive neuromuscular disease. 1217 12

Noxious stimuli and painful disorders interfere with sleep, but disturbances in sleep also contribute to the experience of pain.Chronic paroxysmal hemicrania and possibly cluster headaches are related to REM sleep. Whereas headache is associated with snoring and sleep apnea, morning headaches are not specific for any primary sleep disorder. Nevertheless, the management of the sleep disorder ameliorates both morning headache and migraine.Noxious stimuli administered into muscles during slow-wave sleep (SWS) result in decreases in delta and sigma but an increase in alpha and beta EEG frequencies during sleep. Noise stimuli that disrupt SWS result in unrefreshing sleep, diffuse musculoskeletal pain, tenderness, and fatigue in normal healthy subjects. Such symptoms accompany alpha EEG sleep patterns that often occur in patients with fibromyalgia. The alpha EEG patterns include phasic and tonic alpha EEG sleep as well as periodic K alpha EEG sleep or frequent periodic cyclical alternating pattern. Moreover, alpha EEG sleep, as well as sleep-related breathing disorder and periodic limb movement disorder, occur in some patients with fibromyalgia, rheumatoid arthritis and osteoarthritis. Depression and not alpha EEG sleep are features of somatoform pain disorder. Disturbances in sleep, pain behaviour and psychological distress influence return to work in workers who have suffered a soft tissue injury, e.g. low back pain. Patients with irritable bowel disorder have disturbed sleep and have increased REM sleep. In conclusion, there is a reciprocal relationship between sleep quality and pain. The recognition of disturbed or unrefreshing sleep influences the management of painful medical disorders.
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PMID:Sleep and pain. 1253 Oct 4

Scoliosis, a lateral deviation of the spine frequently associated with rotation, is not a specific disease but a deformity complicating many diseases. Curve progression is the major concern irrespective of the initiating cause. Idiopathic scoliosis is arguably postural in nature and in some subjects develops from intrauterine compression. Analysis of the pathogenesis leads to the conclusion that progression is due to an accelerated premature osteoarthrosis induced by insidious tissue fatigue of biomechanical origin. The chronic cumulative effect of repetitive tensile stresses applied asymmetrically to the postural deformity, manifested by loss of tensile strength and tissue cohesion, leads to fragility and eventual tissue disintegration of vertebrae, intervertebral discs, and laxity of ligaments. Early treatment, prevention, and avoidance of stresses that accentuate progression are of paramount import.
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PMID:Pathogenesis of idiopathic scoliosis revisited. 1264 32

New loss of function among patients with previous polio is frequently reported and has several causes. All patients referred to the Department of Neurology, Haukeland University Hospital, Bergen, for 13 months during 2000-2001 with diagnosis late effects of polio were examined prospectively to identify their symptoms and loss of function. Eighty-five patients aged 47-91 years with mean of 61 years were included. The most common complaints were pain (44%), muscular weakness (27%), and fatigue (16%). Muscular weakness occurred in lower limbs in 75%, in respiratory muscles in only 5%. Walking in stairs was impaired in 72% and outdoor walking in 65%. Seventeen patients (19%) reported no loss of function. Post-polio syndrome was diagnosed in 26% of the patients. Polio-related loss of function including cervical and lumbosacral radiculopathies, mononeuropathies and degenerative joint disease were found in an additional 53%. Eleven patients (13%) had distinct non-polio-related disorders that caused new loss of function. The remaining 8% had a stable condition. In conclusion, the majority of polio patients who seek hospital, experience a new loss of function because of polio-related disorders. A careful neurological examination is necessary to identify the correct diagnosis and treatment.
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PMID:Post-polio syndrome and total health status in a prospective hospital study. 1282 93

An intensive 5-day quality-of-life (QoL) session was constructed based on a psychosomatic model. The session was comprised of teaching on philosophy of life, psychotherapy, and body therapy. The three elements were put together in such a way that they mutually supported each other. The synergy attained was considerable. The pilot study demonstrated that in the course of only 1 week, patients had time to revise essential life-denying views and to integrate important, unfinished life events involving negative feelings. Consequently, the patients became more present in the body's blocked-off areas and subjectively healthier. Nineteen persons with chronic illness and pain (fibromyalgia, chronic tiredness, whiplash, mild depression, and problems involving pain in arms and legs including osteoarthritis), and unemployed for 5-7 years attended the course. In the week before and after the 5-day course, the participants completed the validated SEQOL (Self-Evaluation of Quality of Life Questionnaire) including questions on self-evaluated health and the unvalidated "Self-Evaluation of Working-Life Quality Questionnaire" (SEQWL). This pilot study was without a control group or clinical control. As far as diagnoses were concerned, the group was inhomogeneous. Common for the group was a low QoL, poor quality of working life QWL, and numerous health problems. The study showed an 11.2% improvement in QoL (p < 0.05), a 6.3% improvement in QWL (p < 0.05), and a 12.0% improvement in self-perceived physical health (p = 0.08). There was a 17.3% improvement in self-perceived psychological health (p < 0.05) and satisfaction with health in general improved by 21.4% (p < 0.05). Symptoms like pain were almost halved and several of the participants were free of pain for the first time in years. In conclusion it seemed that the combination of training in philosophy of life, psychotherapy, and body therapy can give patients a large, fast, and efficient improvement in QoL, QWL, and health. It is not known if these changes will be permanent and if all kinds of patients with different health problems will gain from this cure. Further research should be conducted.
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PMID:Quality of life as medicine: a pilot study of patients with chronic illness and pain. 1284 1

Identifying the cause of polyarticular joint pain can be difficult because of the extensive differential diagnosis. A thorough history and a complete physical examination are essential. Six clinical factors are helpful in narrowing the possible causes: disease chronology, inflammation, distribution, extra-articular manifestations, disease course, and patient demographics. Patients with an inflammatory arthritis are more likely to have palpable synovitis and morning stiffness; if the condition is severe, they may have fever, weight loss, and fatigue. Viral infections, crystal-induced arthritis, and serum sickness reactions are common causes of acute, self-limited polyarthritis. Because chronic arthritides may present abruptly, they need to be considered in patients who present with acute polyarticular joint pain. Joint palpation can help to distinguish inflammatory synovitis from the bony hypertrophy and crepitus that typically occur with osteoarthritis. Extra-articular manifestations of rheumatologic disease may be helpful in arriving at a more specific diagnosis. Many classic rheumatologic laboratory tests are nonspecific. A complete blood count, urinalysis, and a metabolic panel may provide more useful diagnostic clues. Plain-film radiographs may demonstrate classic findings of specific rheumatologic diseases; however, radiographs can be normal or only show nonspecific changes early in the disease process.
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PMID:Diagnostic approach to polyarticular joint pain. 1452 3

Studies on jaw kinematics have provided a good understanding of the motion of the mandible in space, but are of little biomechanical relevance because they could not relate the movements to anatomic structures. This is possible by the combination of three-dimensional reconstructions of the temporomandibular joint (TMJ) anatomy with jaw motion recordings. This technique allows us to analyze the variation of the relationship between the articular surfaces, providing indirect insight into disk deformation during function and parafunction as well as TMJ loading. As far as the variation of the condyle-fossa distance is concerned, data indicated that during chewing the distance was smaller 1) on closing than on opening; 2) on the balancing than on the working side; and 3) during chewing of hard than soft food. Moreover, during a forceful static biting, the condyle-fossa distance decreased more on the contralateral, i.e. on the balancing side than on the working side. The decrease was related to the degree of clenching force. These results support the content that both condyles are loaded during chewing and the balancing side joint more than the working one. Biomechanically, the development of osteoarthrosis is more likely related to the magnitude and frequency of stresses applied on the cartilage. Joint movements produce tractional forces that may cause shear stresses contributing to cartilage wear and fatigue. Tractional forces are the result of frictional forces caused by the cartilage surface rubbing and of plowing forces caused by the translation of a stress-field through the cartilage matrix, as the intra-articular space changes during motion. Translation of the stress-field in mediolateral direction seems to be particularly important for the integrity of the TMJ disk because of its anisotropic properties. Dynamic stereometry showed that stress-fields translate in mediolateral direction during opening/closing, protrusion and laterotrusion, and that their translatory velocity varies intraindividually and with the rate of the condylar movement. Furthermore, the results seem to indicate that the lateral area of the TMJ disk is more often exposed to shear stresses caused by stress-field translation than the medial one. In conclusion, dynamic stereometry provides a good visualization of the movement of the condyles in the respective fossae. This helps improving our understanding for the complexity of condylar movements. The technique may also contribute to ameliorate our knowledge of TMJ biomechanics and therefore of the etiology of degenerative joint diseases and possibly also of internal derangement.
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PMID:Dynamic stereometry of the temporomandibular joint. 1460 33

A novel animal model of osteoarthritis has been established for studies on the disease process as well as on mechanisms underlying the symptoms of osteoarthritis, principally pain and fatigue. The model is established by cutting the anterior cruciate ligament in the rat to introduce instability of the joint, removing the medial meniscus to induce further derangement of the joint, and exercising the rat on a modified rota-rod to generate weight-bearing mobility of the joint; this exercise can be regulated in terms of duration to govern severity of the model. The model exhibits many of the characteristics of osteoarthritis in humans, including bone and cartilage remodelling, infiltration of the joint tissues by immune cells and alterations in sensory mechanisms. This model will find application in development of novel interventions for the treatment of osteoarthritis and its symptoms as well as development of diagnostic tools for early detection.
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PMID:Molecular events of chronic pain: from neuron to whole animal in an animal model of osteoarthritis. 1528 48

Although the construct of "a symptom-free day" has been widely applied in asthma and gastric reflux disease, there is no analogous concept in the field of pain management. This study represents the initial development of a "day of acceptable or manageable pain control," a construct which reflects patients' daily strategic use of pain medication in order to allow the accomplishment of desired activities while minimizing side effects. Focus group methodology was used to extract patient-generated themes of "an acceptable day of pain control." Fifty-three outpatients with persistent moderate to severe average pain intensity due to osteoarthritis (n=18), metastatic cancer (n=15), and low back pain (n=20) participated. Participants preferred the term "manageable" or "tolerable" to "acceptable." Thematic analysis revealed components of a manageable/tolerable day of pain control as including: 1) taking the edge off the pain, 2) performing valued activities; 3) relief from dysphoria and irritability; 4) reduced medication side effects; 5) feeling well enough to socialize. Additional cancer-specific themes included relief from fatigue and ability to have a positive day when one's future days were perceived as being limited. The set of themes is presented and their relevance for developing a measure of "a manageable day of pain control" discussed. Study findings identify a novel construct that can inform development of an outcome for evaluating the effectiveness of different pharmacotherapies for pain management.
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PMID:Acceptable, manageable, and tolerable days: patient daily goals for medication management of persistent pain. 1550 24


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