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

The postoperative radiographs of 48 patients who underwent posterolateral in situ fusion for spondylolysis and Grade 1 or less spondylolisthesis over an 11-year period showed healing of the pars defects in 90% of the cases. The patients who showed healing had an average preoperative duration of symptoms of 17 months (mean, 12 months). The five patients whose radiographs showed persistent defects postoperatively were found to have had preoperative symptoms for an average of 47 months (mean, 48 months). This significantly greater (P 0.05) duration of symptoms prior to stabilization was the only variable that proved to be statistically significant. Controversy continues to exist as to the etiology of spondylolysis; however, the ability to heal the defect with lumbar spinal stability certainly supports the theory that the defect is a result of fatigue stresses, which finally manifest as a fracture seen on radiographs as the spondylolytic defect. Posterior spinal stabilization in those patients with symptoms for a period of less than 2 years who have failed conservative management can be expected to heal the pars defects.
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PMID:Postoperative radiographic evidence for fatigue fracture as the etiology in spondylolysis. 261 64

Posterior arthrodesis is a preferred treatment for posttraumatic instability of the cervical spine. While most surgical constructs yield predictably high rates of fusion in satisfactory alignment, certain injury patterns involving fractures of the lamina or spinous processes may preclude rigid immobilization by simple wiring techniques. Plate fixation of the posterolateral masses has been advocated for such injuries. The purpose of this biomechanical study was to test the relative stiffness provided by different posterior fusion constructs, including lateral mass plating. All testing was performed on fresh, unembalmed cadaveric spines divided into two vertebral segment units. Muscular tissue was stripped from the specimens, but all discal and ligamentous structures were preserved. Four different posterior fixation constructs were tested. These included 1) Rogers interspinous wiring, 2) Halifax laminar clamps, 3) bilateral 1/3 tubular plates on the lateral masses, using unicortical screws, and 4) bilateral 1/3 tubular plates on the lateral masses, using bicortical screws. Stiffness measurements were taken in both flexion and extension on all specimens. Yield strength and fatigue strength of the spines were not measured. It was found that 1/3 tubular plates secured with bicortical screws to the lateral masses provided the highest mean stiffness. Less stiffness was found in spines stabilized by Halifax clamps, interspinous wiring, and plates secured with unicortical screws. There was, however, no statistically significant difference in stiffness provided by any of these four implants. It was concluded that there is no advantage in plate fixation over standard fusion constructs in augmenting the stiffness of posterior fixation of the cervical spine.
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PMID:Posterior plating of the cervical spine. A biomechanical comparison of different posterior fusion techniques. 319 91

Of 10 patients with spondylolisthesis of the fifth lumbar vertebra, 8 had characteristic tight hamstrings syndrome, and 4 showed a Grade IV slip. Sciatic pain was present in all cases. In 5 there were also signs of compression of the first sacral root. In 4 cases impaired pattern of walking was the first symptom. Extraperitoneal anterior interbody fusion was performed in 9 cases. Laminectomy was combined with posterior fusion in one. Posterior fusion alone was performed in another. The follow-up period ranged from 2 to 14 years. All patients were free from symptoms at the last follow-up examination and they had normal living patterns and physical activities. Fusion was obtained in every case. There were no complications in this series, except for one fatigue fracture of the neural arch of the vertebra one level above fusion, discovered at 6 months after the operation; this patient has had no symptoms in a period of time of 14 years since the operation. The above described excellent results of anterior fusion without reduction raises questions as to the necessity of extensive major surgical interventions to obtain operative reduction of the displacement in patients, even with Grade IV spondylolisthesis.
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PMID:Operative treatment of spondylolisthesis in children and adolescents with tight hamstrings syndrome. 737 Dec 94

Posterior laryngeal granuloma is an infrequent pathology of multidisciplinary interest. Actually, its real prevalence is difficult to quantify because in some cases it is asymptomatic and in other instances it may either be reabsorbed or eliminated spontaneously. It is located at the vocal apophysis of the arytenoid or, less frequently, above it or on the laryngeal side of the arytenoid. The many etiologic factors (laryngeal intubation, gastro-esophageal refluxes, blunt trauma of the larynx, vocal dysfunction), sometimes concomitant and with the possible addition of enhancing circumstances (upper aerodigestive tract inflammation, naso-gastric tube, smoking and alcohol abuse), converge to a single pathogenetic mechanism: an ulceration of the mucosa and the pericondrium, sometimes complicated by an infection, which does not heal but instead produces a typical granulation tissue with capillaries oriented radially from the center of the lesion. Post intubation granulomas, extremely rare in children, are more frequent in females. It appears that there is no correlation with duration of intubation in that granulomas, can also occur after short general anesthesia. Idiopathic or contact granulomas are more frequent in the males. They are the result of vocal laryngeal hyperfunction, habitual throat clearing or cough-like throat clearing. Gastro-esophageal reflux of gastric juice, coughing or throat clearing may injure the mucosa. A blunt trauma of the larynx may cause a granuloma if the cartilage of the vocal process is exposed. Symptoms, when present, are dysphonia, tiredness during or after voicing, bolus, laryngeal unilateral pain, sensation of something in the throat which is mobile during breathing and swallowing, traces of blood in the expectoration. Therapeutic options are surgical, medical or logopedic. Surgery, although followed by frequent recurrences, is mandatory when the granuloma causes dispnea or if a pathologic essay is needed. Medical treatment aims at solving gastroesophageal reflux and/or inflammations of the district. Logopedic rehabilitation is the most successful therapy. Since January 1992 the Authors have been adopting the rehabilitation protocol planned by the French phoniatrician Brigitte Arnoux-Sindt for post-intubation granulomas, which, moreover, is utilyzed for all type of granulomas, including those arising during the early postoperative period after cordectomy. This protocol is analytically presented and discussed. In the cases of contact granulomas, and when there is concomitant vocal dysfunction, logopedic treatment is prolonged after granuloma dissapearance with some sessions aiming at restoring correct vocal behaviour. In all the ten patients rehabilitated up to now, granulomas disappeared after a mean of 16.3 sessions held twice a week. After several months of follow-up we had no recurrences. This clinical experience, while limited in number, seems to confirm the good results already reported in French Literature.
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PMID:[Logopedic rehabilitation of laryngeal granulomas]. 872 28

We report a 54-year-old man with vitamin B12 deficiency myelopathy limited to the upper extremity region. He was well until October, 1995, when he had an onset of exertional dyspnea and general fatigue. Then he noted tingling sensation in bilateral upper extremities in March, 1996. He had undergone total gastrectomy due to gastric ulcer 15 years ago. Neurological examination revealed superficial and vibratory sensory loss in the upper extremities distal to elbows, and pseudoathetoid movement of the left fingers. Otherwise neurological examination was unremarkable. Laboratory examination revealed macrocytic anemia, and low serum vitamin B12. However, serum folate was within the normal range. In SEP studies, median nerve stimulation evoked peripheral N9 and N13 potentials, but not cortical N20 one. Posterior tibial nerve stimulation elicited normal responses. MEP, VEP, needle EMG, and nerve conduction studies gave normal findings. T2-weighted MRI showed high signal intensity lesions at the C1-Th1 level in the posterior column, especially in the cuneate fascicles. The gracile fascicles were spared. This is a very rare case of myelopathy due to vitamin B12 deficiency presenting only sensory disturbances in both upper extremities. The lesions limited in the cuneate fascicle were confirmed by electrophysiological, and neuroradiological examinations.
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PMID:[Myelopathy due to vitamin B12 deficiency presenting only sensory disturbances in upper extremities: a case report]. 916 47

Posterior composite restorative materials undergo accelerated wear in the occlusal contact area, primarily through a fatigue mechanism. To facilitate the timely development of new and improved materials, a predictive wear model is desirable. The objective of this study was to develop a finite element model enabling investigators to predict crack propagation directions in resins used as the matrix material in composites, and to verify these predictions by observing cracks formed during the pin-on-disc wear of a 60:40 BISGMA:TEGDMA resin and an EBPADMA resin. Laser confocal scanning microscopy was used to measure crack locations. Finite element studies were done by means of ABAQUS software, modeling a cylinder sliding on a material with pre-existing surface-breaking cracks. Variables included modulus, cylinder/material friction coefficient, crack face friction, and yield behavior. Experimental results were surprising, since most crack directions were opposite previously published observations. The majority of surface cracks, though initially orthogonal to the surface, changed direction to run 20 to 30 degrees from the horizontal in the direction of indenter movement. Finite element modeling established the importance of subsurface shear stresses, since calculations provided evidence that cracks propagate in the direction of maximum K(II)(theta), in the same direction as the motion of the indenter, and at an angle of approximately 20 degrees. These findings provide the foundation for a predictive model of sliding wear in unfilled glassy resins.
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PMID:Crack propagation directions in unfilled resins. 982 24

Posterior lumbar interbody fusion is an accepted surgical technique to treat disabling lower back pain due to degenerative disc disease. In the techniques that prevail, installation of large fixed-size twin cages dictate the sacrifice of the posterior stabilizing structures. Moreover, excessive retraction of the dural sac imposes potential neurological hazard. The authors present a novel technique based on a spacer capable of threefold expansion once it has been installed in the disc space. The spacer was laboratory tested under controlled loading conditions. Strength and fatigue tests of an isolated spacer were performed using an artificial model. Pullout resistance and ultimate compression strength of the surgical construct were evaluated using a cadaveric specimen. The yield force and the ultimate force for the single spacer averaged 2660 +/- 483 N and 4313 +/- 420 N, respectively, while the endurance limit at 5 million cycles averaged 931 N. The single-spacer resistance to pullout averaged 556 +/- 207 N, while the ultimate compressive strength of bone-spacer interface averaged 3399 +/- 136 N for a pair of spacers. The results of the study indicate that the B-twin ESS is expected to withstand the loads imposed upon it during everyday activity and resist migration or significant subsidence until fusion is achieved.
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PMID:B-twin expandable spinal spacer for posterior lumbar interbody stabilization: mechanical testing. 1731 32

The aim of the study was to compare the clinical performance, quantitative and qualitative wear patterns of conventional hybrid (Tetric Ceram), micro-filled hybrid (Gradia Direct Posterior) and nano-hybrid (Tetric EvoCeram, TEC) posterior composite restorations in a 3-year randomised clinical trial. Sixteen Tetric Ceram, 17 TEC and 16 Gradia Direct Posterior restorations were placed in human molars and evaluated at baseline, 6, 12, 24 and 36 months of clinical service according to US Public Health Service criteria. The gypsum replicas at each recall were used for 3D laser scanning to quantify wear, and the epoxy resin replicas were observed under scanning electron microscope to study the qualitative wear patterns. After 3 years of clinical service, the three hybrid restorative materials performed clinically well in posterior cavities. Within the observation period, the nano-hybrid and micro-hybrid restorations evolved better in polishability with improved surface gloss retention than the conventional hybrid counterpart. The three hybrid composites showed enamel-like vertical wear and cavity-size dependant volume loss magnitude. Qualitatively, while the micro-filled and nano-hybrid composite restorations exhibited signs of fatigue similar to the conventional hybrid composite restorations at heavy occlusal contact area, their light occlusal contact areas showed less surface pitting after 3 years of clinical service.
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PMID:Three-year randomised clinical trial to evaluate the clinical performance, quantitative and qualitative wear patterns of hybrid composite restorations. 1966 76

We discuss a patient who had poorly differentiated HCC with pyrexia and high CRP in laboratory data, which are not commonly observed in the usual HCC. A 50-year-old man with a history of liver dysfunction was admitted with a chief complaint of a prolonged fever and general fatigue. Preoperative diagnosis was HCC with portal vein tumor thrombus. Posterior segmentectomy of the liver and thrombectomy was performed. Rapid tumor recurrence occurred after surgery, and he died 79 days after the operation. Immunohistochemical stain of HCC in this patient revealed the production of proinflammatory cytokine, interleukin-8 (IL-8). IL-8 production may have contributed to the high fever, high inflammatory reaction, and poor prognosis in this case.
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PMID:Interleukin-8 producing hepatocellular carcinoma with pyrexia. 1970 35

We previously reported that 6 weeks of exercise training had positive effects on feelings of vigor and fatigue among college students who reported persistent fatigue. Here we examined whether transient mood changes after single sessions of exercise would mimic those chronic effects and whether they would be related to changes in brain activity measured by electroencephalography (EEG). Feelings of vigor were higher after both low- and moderate-intensity exercise during Weeks 1, 3, and 6 compared to a control condition. Feelings of fatigue were lower after low-intensity exercise during Weeks 3 and 6. Posterior theta activity accounted for about half the changes in vigor. Studies that manipulate mood, EEG activity, or both during exercise are needed to determine whether EEG changes after exercise are causally linked with mood.
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PMID:Effects of cycling exercise on vigor, fatigue, and electroencephalographic activity among young adults who report persistent fatigue. 2040 16


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