Articles: human.
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Musculoskeletal care · Jan 2005
How effective is physiotherapy in the treatment of complex regional pain syndrome type I? A review of the literature.
Complex regional pain syndrome (CRPS) is a debilitating pain disorder for which patients commonly receive physiotherapy. The objective of this literature review is to assess how effective physiotherapy is in the management of adult and childhood CRPS type I. An electronic literature search was performed of the databases AMED, Cinahl, Embase, Ovid Medline, Pubmed, PEDro and PsycINFO, from their inception to November 2004. ⋯ The review suggests that exercise, motor imagery and mirror feedback exercises, relaxation techniques, acupuncture, electroacupuncture, transcutaneous nerve stimulation and combined treatment programmes may help in the treatment of CRPS type I. However, since numerous methodological weaknesses (e.g. small sample sizes, not employing control groups, not evaluating findings against statistical tests) littered the limited literature, it was not possible to determine the effectiveness of individual treatments. Recommendations are made to develop the evidence base.
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Ont Health Technol Assess Ser · Jan 2005
Deep brain stimulation for Parkinson's disease and other movement disorders: an evidence-based analysis.
To determine the effectiveness and adverse effects of deep brain stimulation (DBS) in the treatment of symptoms of idiopathic Parkinson's disease, essential tremor, and primary dystonia and to do an economic analysis if evidence for effectiveness is established. ⋯ According to the estimates of prevalence and evidence of effectiveness, there is a shortfall in the numbers of DBS currently done in Ontario for drug-resistant PD, essential tremor, and primary dystonia.Since complication rates are lower if DBS is performed in specialized centres, the number of sites should be limited.The cost per procedure to institutions with the expertise to undertake DBS and the human resource considerations are likely to be limiting factors in the further diffusion of DBS.
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Ont Health Technol Assess Ser · Jan 2005
Osteogenic protein-1 for long bone nonunion: an evidence-based analysis.
To assess the efficacy of osteogenic protein-1 (OP-1) for long bone nonunion. ⋯ Friedlaender et al. conducted a prospective, randomized, partially blinded clinical trial on the treatment tibial nonunions with OP-1. Tibial nonunions were chosen for this study because of their high frequency, challenging treatment requirements, and substantial morbidity. All of the nonunions were at least 9 months old and had shown no progress toward healing over the previous 3 months. The patients were randomized to receive either treatment with autologous bone grafting or treatment with OP-1 in a type-1 collagen carrier. Both groups received reduction and fixation with an intramedullary rod. Table 1 summarizes the clinical outcomes of this study. Table 1:Outcomes in a Randomized Clinical Trial on Tibial Nonunions: Osteogenic Protein-1 versus Autologous Bone GraftingClinical Indicator at 9 monthsSuccess by ProcedureOP-1 % (range)Autograft % (range)PWeight-bearing*8685not significantPain on Weight-bearing*8990not significantBridging seen on radiograph (at least 1 view)7584not significantBridging seen on radiograph (at least 3 views)6274not significantRepeated surgery*510not significantPhysician satisfaction8690not significantMean operative time in minutes (range)169 (58 - 420)178 (58 - 420)not significantMean operative blood loss in ml (range)254 (10-1,150)345 (35 - 1,200).049Mean length of stay in days (range)3.7 (0 - 18)4.1 (1 - 24)not significantPain at the donor siteN/A80N/AAt 6 months postsurgery20At 12 months postsurgery13Osteomyelitis % (number)3 (2/61)21 (13/61). (ABSTRACT TRUNCATED)
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Toxicol. Mech. Methods · Jan 2005
Human exposure to selamectin from dogs treated with revolution: methodological consideration for selamectin isolation.
This study was undertaken to determine selamectin residue in dog's blood and in gloves worn while petting dogs after Revolution application. Revolution contains the active ingredient selamectin (a semisynthetic avermectin), which controls endoparasites and ectoparasites, including adult fleas, flea eggs, ticks, heartworms, ear mites, and sarcoptic mange in dogs, for 30 days. Revolution was applied topically on a group of six adult house hold dogs (240 mg selamectin/dog). ⋯ No selamectin residue was detected in the glove extracts after the fifth week. In spite of selamectin's binding to the sebaceous glands of the skin, gloves contained significant transferable residue. Thus, these findings suggest that repeated exposure to selamectin can pose potential health risks, especially to veterinarians, veterinary technologists, dog trainers/handlers, and pet owners.
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Shock is a broad category of injury to the human body caused by a variety of insults. Fluid resuscitation is the cornerstone of initial therapy for nearly all forms of shock. This article reviews the basic physiology determining body fluid composition, the goals of fluid resuscitation in shock, the types of fluids available for use, and clinical evidence for use of specific fluids based on etiology of the insult.