Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · May 2002
Case ReportsMissed cervical spine fracture-dislocations: the importance of clinical and radiographic assessment.
To review the case of a patient who suffered a cervical spine fracture-dislocation missed at a hospital emergency department. ⋯ Cervical spine fracture-dislocations are often missed during standard radiographic examinations in emergency department settings. Chiropractors are encouraged to perform a comprehensive evaluation of patients presenting with cervical trauma even if they have had prior x-ray films reported as normal. Standard x-ray films taken at emergency department facilities are not entirely reliable for detecting or revealing cervical spine fracture-dislocations. This case stresses the importance of careful clinical assessment and imaging procedures on patients who have encountered cervical spine trauma.
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J Manipulative Physiol Ther · May 2002
Clinical Trial Controlled Clinical TrialEndogenous opioid effects on motoneuron pool excitability: potential analgesic effect of acute exercise.
Metabolic and thermal stresses of exercise mediate the release of endogenous opioids depressing motoneuron activation (MNA). Although exercise is routinely presented as a coequal treatment for management of acute and chronic low back pain (LBP), it is not clear that exercise-induced endogenous opioid release can play a role in the analgesic and treatment outcomes for patients with LBP. Furthermore, if opioid involvement is present, it is not clear what level of exercise might be beneficial in the suppression of MNA and possibly LBP. ⋯ Endogenous opioids do not appear to modulate motoneuron responses to exercise under these experimental conditions.