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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adolescent patients with idiopathic scoliosis were treated with long-term electrical stimulation (30 Hz) at the posterior axillary line on the convex side of the curvature in order to correct the spinal deformity. The patients were also followed with muscle biopsies from the latissimus dorsi of the stimulated side taken before, after 3 and 6 months of electrical stimulation. There was a tendency for an increase in the percentage of type I and especially the type II C (undifferentiated) fibers after stimulation. The mean muscle fiber area and the fiber areas of the various fiber types did not change significantly. Histopathological findings were generally rare before as well as after 3 months of electrical stimulation, the only noticeable finding being a somewhat increased frequency of atrophic fibers in groups after 6 months of stimulation. In all studied patients the enzymatic activity of citrate synthase increased after 3 months and further in three studied patients after 6 months of stimulation. The present study gives some evidence of an adaptive process caused by electrical stimulation towards a more fatigue-resistant muscle.
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PMID:Changes in histochemical profile of muscle after long-term electrical stimulation in patients with idiopathic scoliosis. 393 68

Fifty patients (14-55 years of age) with unstable thoracolumbar fractures were studied: 24 patients treated conservatively 1971-1977 and 26 patients treated surgically with Harrington instrumentation 1977-1981. The treatment groups were comparable in all respects. Radiologic evaluation showed that Harrington distraction rods restored the fractured vertebra almost to its original shape, and the gibbus and scoliosis were significantly reduced. However, at the follow-up examination at least 2 years after the injury, the gibbus angle had recurred almost to the value at admission in patients with the rods removed. The conservatively treated patients showed a continuous increase of the gibbus angle and of the anterior and central vertebral compression. At the follow-up evaluation, all fractures in both treatment groups were healed. There was no difference between the treatment groups regarding neurologic improvement. Thirteen of 14 patients with severe or moderate paraparesis considerably improved their neurological status. A rehabilitation index with special reference to paraparetic patients showed no difference between the treatment groups already three months after the injury. Thoracolumbar fatigue, thoracolumbar pain and stiffness, skin problems, and pain at direct pressure at the fracture site occurred equally in the conservative and Harrington groups. The overall complications were few. The aseptic intermittent catheterization method introduced in 1977 considerably diminished the frequency of upper urinary tract infections. The treatment with open reduction, fusion, and stabilization with Harrington rods considerably reduced the immobilization and hospitalization times. The average immobilization time was reduced from 67 to 18 days. The hospitalization time in neurologically intact patients was reduced from 80 to 30 days.
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PMID:Unstable thoracolumbar fractures. A comparative clinical study of conservative treatment and Harrington instrumentation. 400 35

Radiographs were obtained of the lumbosacral spines of 143 patients that had never walked. The frequency of spondylolysis and spondylolisthesis was determined, as well as that of other spinal abnormalities. The average age of the patients was 27 years, with a range of 11 to 93 years. The underlying diagnoses responsible for the nonambulatory status varied, but cerebral palsy predominated. No case of spondylolysis or spondylolisthesis was detected, and when compared to the 5.8% incidence in the general population, this finding is significant at the P less than 0.001 level. The incidences of spinal bifida (8.4%) and of transitional vertebrae (10.9%) are similar to those found in the general population. Scoliosis was found in 49% and vertebral body height was increased in 32.9%. Degenerative changes occurred in only 2.8%. These results support the theory that spondylolysis and isthmic spondylolisthesis represent a fatigue fracture resulting from activities associated with ambulation.
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PMID:The incidence of spondylolysis and spondylolisthesis in nonambulatory patients. 720 72

A series of eight 60-second dialogues was cooperatively produced by the Tacoma-Pierce County Health Department's Adolescent Clinic and KTAC Radio, Tacoma, Washington. The format was one in which the radio announcer made a statement concerning adolescent health, followed by an adolescent's asking a specific health question, a response being made by a health professional, and the announcer's concluding by giving a local resource and phone number. Included in this series were questions about weight reduction, scoliosis, headaches, hypertension, sexually transmitted diseases, temper and anger, stress, and fatigue. The dialogues were aired ten times a day at times appropriate for the adolescent listener. In addition to acquainting the adolescent with clinic and community services, this series gave answers to many developmental questions that may influence the adolescent's behavior and self-concept.
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PMID:The media as an approach to adolescent health education. 733 26

We compared the results in eighty-one patients (average age, fifty-six years; range, forty-three to eighty-three years) who had had operative treatment of idiopathic scoliosis with those in thirty patients (average age, fifty-eight years; range, forty-five to seventy years) who had declined operative treatment. Seventy-six individuals (average age, forty-eight years; range, thirty-five to seventy-four years) who did not have scoliosis served as a control group. The average duration of follow-up was five years (range, two to seventeen years). The population base consisted of 454 patients who were seen between 1970 and 1985. The treated patients were drawn from a group of 160 patients for whom an operation had been recommended; 110 patients agreed to the operation and fifty refused. The remaining 294 patients had curves of insufficient severity to warrant concern about progression, had symptoms unrelated to the scoliosis, or had curves that did not necessitate any intervention. The functional status since the operation (for the treated patients), since recommendation of the operation (for the untreated patients), or within the last ten years (for the control group) was evaluated with a comprehensive questionnaire designed to elicit details regarding pain, fatigue, and any disability in the performance of twenty-six activities of daily living. At the most recent follow-up examination, the treated patients reported a significantly greater decrease in pain and fatigue and significantly more improvement in self-image and in the ability to perform physical, functional, and positional tasks than did the untreated patients (p = 0.0001).
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PMID:Results of operative treatment of idiopathic scoliosis in adults. 771 67

Chronic fatigue of the respiratory pump may be due either to constant overexertion of otherwise healthy muscles of respiration (e.g. due to chronic obstructive lung disease, scoliosis) or to certain neuromuscular diseases (e.g. Duchenne type muscular dystrophy). Intermittent self-ventilation (ISV) is employed--in particular at night--in order to prevent imminent exhaustion of the respiratory muscles. The relief provided by ISV gives the muscles a chance to recover. The muscles of respiration can be largely rested by the use of volume-controlled ventilation (IPPV), or partially rested by-BiPAP ventilation (Stimotron). Two main approaches to ventilation are available: non-invasive via a breathing mask or, if this is not possible, invasive ventilation via a tracheostomy. In addition to the commercially available standard nasal masks, we more often make use of custom-made so-called Grafschaft nose-and-mouth masks. The early provision of support for the muscles of respiration can obviate, or at least delay, the need for emergency intubation and subsequent assisted ventilation in an icu in endangered patients.
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PMID:[Intermittent self-ventilation. Therapy of chronic respiratory pump fatigue]. 788 66

We reviewed the clinical charts and roentgenogram of 111 patients operated with Harrington-DTT instrumentation for idiopathic adolescent scoliosis at Copenhagen University Hospital from 1983 to 1989. Male/female ratio was 1:9. Median age was 14.5 (11-21) years at the time of surgery. Median follow-up time was 4.0 (1-7) years. Of the 111 patients, complications were registered in fifteen. Seven were reoperated, four due to gliding of the upper hook, three due to fatigue fracture of the Harrington rod before union. We found no deep infections or persisting neurological damage.
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PMID:[Surgical management of idiopathic scoliosis using Harrington DTT instruments]]. 832 45

Fifty-two posterior spinal fusions were performed for pediatric idiopathic, congenital, and neuromuscular scoliotic curves. Cotrel-Dubousset instrumentation was used in all patients. Nine had prior anterior spinal releases and fusions. The patterns were mixed, with a predominance of right thoracic curvatures. The average preoperative curve measured 60.6 degrees, with correction to 29. Seven patients required revision surgery, and 17 wore orthoses after operation. There were 17 complications in this group, including hook pullout, prominent hardware, infection, pseudarthrosis, and two cases of broken Cotrel-Dubousset instrumentation rods. Fatigue failure of this instrumentation, secondary to pseudarthrosis, has not been reported previously, and these two cases are presented in detail. The operative morbidity and difficulty were increased in the larger idiopathic curves and in neuromuscular and congenital scoliosis. Cotrel-Dubousset instrumentation is an overall excellent tool for the multiplanar correction of scoliosis and is amenable to revision surgery.
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PMID:Cotrel-Dubousset instrumentation. Results in 52 patients. 847 1

The authors report a comparative biomechanical study of the suitability of four types of stainless steel wire for sublaminar fixation. Tensile and fatigue tests were performed on wires in the configuration used at surgery. They conclude that annealed 18-gauge (1.2 mm) wire should be used at each end of a scoliosis fusion, at the upper end of a lumbar fusion, and throughout for thoracolumbar fractures. Cold-worked 20-gauge (0.87 mm) wire may be used in all other situations, but the use of annealed 20-gauge wire should be restricted to the cervical spine. The authors emphasize the importance of achieving the correct balance between wire stiffness and flexibility, of care in the handling of wires, and of proper technique in achieving secure fixation.
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PMID:The selection of wires for sublaminar fixation. 847 12

This study is designed to analyse the behavior, in the sagittal plane, of a complete human dorso-lumbar rachis, made rigid by the posterior instrumentation used for the treatment of scoliosis, on subjects suffering from DMD (Duchenne Muscular Dystrophy). The object of this analysis is to demonstrate the reliability of early surgery made possible by new instrumentation. Close review of the literature shows that the currently used Harrington or Luque instrumentations lead to mechanical complications, especially rod breaking, at the thoraco-lumbar junction. 8 specimens were non-destructively tested in-vitro. Compression and flexion were applied. For each test, rachis movements with and then without instrumentation, and also rod restraints were noted. The results show a linear stiffness multiplied by 8.3 in flexion and 11.6 in extension. The maximum restraint recorded for physiological displacements is 77 MPa. This remains largely under the fatigue-breaking limit of the metal used (stainless steel hammer-hardened 316 L, Young's modulus = 200,000 MPa, Poisson's ratio = 0.21, endurance limit = 350 MPa at 5 x 10(6) cycles). The results of this study encourage us to continue and develop early surgery in children affected by myopathy, with fixation of the complete rachis, including a lumbo-sacral arthrodesis and a supple dorsal part of the mounting, in the sagittal plane.
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PMID:In-vitro biomechanical study of a dorso-lumbo-sacral posterior supple instrumentation with variable section. 893 35


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