American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Dec 2012
Randomized Controlled TrialThe effect of repetitive transcranial magnetic stimulation on fibromyalgia: a randomized sham-controlled trial with 1-mo follow-up.
The aim of this study was to determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the right dorsolateral prefrontal cortex or high-frequency rTMS applied to the left motor cortex could influence pain level or mood status in patients with intractable fibromyalgia. ⋯ Low-frequency rTMS may play a role in the long-term treatment of fibromyalgia. Notably, the findings of this study are the first to show that the right dorsolateral prefrontal cortex or the left motor cortex rTMS could have an antidepressive and pain-modulating effect in patients with fibromyalgia.
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Am J Phys Med Rehabil · Dec 2012
Case ReportsChylothorax complicating inpatient rehabilitation after thoracic spinal cord injury: a review of risk factors and anatomy for the physiatrist.
After malignancy, traumatic and surgical injuries to the upper abdomen and chest are the leading causes of chylothorax. Thoracic spine extension injury, blunt or penetrating chest trauma, anterior thoracic spine surgery, and increased intra-abdominal pressure have all been implicated in the development of chylothorax. ⋯ We present the case of a patient with traumatic spinal cord injury from a high-speed motor vehicle accident who was diagnosed with a left-sided chylothorax while wearing a thoracolumbosacral orthosis 4 wks into her inpatient rehabilitation stay. Knowledge of the anatomy of the thoracic duct can be useful for diagnosing chylothorax in patients with thoracic spine fractures, upper abdomen/chest injury, or thoracic surgery, as the trajectory of the duct often determines the location of pleural effusion.