Articles: function.
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The analgesic effectiveness of physical therapy in rheumatology is dependent on the differentiated clinical picture (joint, soft parts, spinal column, musculature) and on the differentiated therapeutic remedy (intensity, duration of single treatments, frequency, duration of therapeutic series). Physico- and kinesitherapy can be distinguished with regard to objective and subjective doses; manual therapy is between them. ⋯ The problem "rheumatism and pain" mainly exists at the level of "chronic"; diagnostics of movement function (articular and muscular functions) on one hand and dosage of therapeutic remedies (drugs and remedies of physiotherapy) on the other are the guidelines. Course (rehabilitation) as well as onset (prevention) of rheumatic clinical pictures determine the further strategy of pain therapy.
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Myofascial pain syndromes, fibromyalgia, and articular dysfunctions may all be contributing to our patients' ubiquitous musculoskeletal pain problems that generally are poorly understood and poorly managed. Thepectoralis minor myofascial pain syndrome, for example, results from trigger points (TrPs) activated by stress overload of the muscle. ⋯ Snapping palpation at the TrP elicits a local twitch response (LTR). The increased muscle tension of a pectoralis minor syndrome commonly entraps the lower trunk of the brachial plexus, producing symptoms of a cervical radiculopathy.
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Mol. Cell. Neurosci. · Dec 1990
Sex steroids and fos expression in the CNS of prepubertal and newborn rats.
Fos-like immunoreactivity (IR) within estrogen-concentrating regions of the hypothalamus and within sexually dimorphic regions of the hypothalamus and spinal cord was studied both as a function of estrogen treatment and during specific stages of postnatal development. Two sets of experiments were performed. First, Fos expression in the arcuate (Arc) and ventromedial (VMN) nuclei of the hypothalamus of 25-day-old female rats was examined 1, 3, and 6 h after estrogen treatment. ⋯ Specific patterns of staining were observed, some of which were different by 10 days after birth. Most striking was the striatum in which Fos-like IR cells were distributed in patches and along the border adjacent to the corpus callosum on Postnatal Day 0, but were no longer observed 10 days after birth. These data were confirmed by in situ hybridization studies in which the expression and distribution of c-fos mRNA in many of these areas were consistent with the distribution of Fos-like IR cells.
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We examined the effect of enflurane on diaphragmatic contractility in six anesthetized mechanically ventilated dogs. The diaphragmatic force was assessed from transdiaphragmatic pressure (Pdi) developed at functional residual capacity against an occluded airway during cervical phrenic nerve stimulation. Pdi-stimulus frequency relationship was compared at three levels of anesthesia, namely 1, 1.5, and 2 MAC (minimum alveolar concentration) of enflurane. ⋯ Pdi of 20 Hz stimulation was significantly decreased at 2 MAC as compared to those at 1 and 1.5 MAC. We conclude that enflurane decreases contractility of the diaphragm mainly through impairment of the neuromuscular transmission and/or membrane excitability. Part of its effects is, however, probably related to the impairment of excitation-contraction coupling, as suggested by the depression of Pdi at 2 MAC in response to 20 Hz stimulation.
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The therapeutic results of operatively and conservatively treated patients with lumbar disc syndromes were reviewed in a retrospective study. The patients were treated during a 10-years period (1976-1985). A total of 330 patients with lumbar disc prolapses were treated in the hospital during this period 44% were treated surgically. ⋯ There were no definite advantages found for either of the two methods of treatment. The necessity for a specialized follow-up treatment of patients with sciatica due to herniated lumbar discs is discussed, and differentiated selection for operative therapy is given. Here the treatment of pain should be considered most important.