Articles: function.
-
The high prevalence of persistent neck pain due to involvement of cervical facet joints has been described in controlled studies. Therapeutic interventions utilized in managing chronic neck pain of facet joint origin include intraarticular injections, medial branch nerve blocks, and neurolysis of medial branch nerves by means of radiofrequency. ⋯ Cervical medial branch blocks were an effective modality of treatment in managing chronic neck pain secondary to facet joint involvement confirmed by controlled, comparative local anesthetic blocks.
-
Although enthusiasm of intensivists has been raised during the last 2-3 years due to several successful clinical trials, severe sepsis and septic shock still have an increasing incidence with more or less unchanged mortality. Within the last 12 months, the progress in sepsis research covering definitions, epidemiology, pathophysiology, diagnosis, standard and adjunctive therapy, as well as experimental approaches is encouraging. In this review, state-of-the-art publications of 2003 are presented to elucidate the possible impact on clinical routine. ⋯ Scientific progress in areas of sepsis has been continuing throughout 2003, although the challenges are still enormous. The identification of more specific markers and new therapeutic approaches will hopefully improve the diagnosis, monitoring of therapy, and outcome in the septic patient.
-
Chronic, refractory low back pain is a common problem. Percutaneous adhesiolysis with hypertonic saline neurolysis was described in the management of chronic refractory low back pain, non-responsive to conservative modalities of management. ⋯ Percutaneous adhesiolysis, with or without hypertonic saline neurolysis, is an effective treatment for chronic low back pain.
-
To discuss the diagnostic relevance and safety concerns of performing magnetic resonance imaging (MRI) in the presence of an implanted spinal cord stimulator (SCS). ⋯ The diagnostic value of MRI may outweigh the potential dangers of using this imaging modality when a patient with a neurostimulation device presents with a new-onset neurological deficit. Thorough informed consent and close physician monitoring of these patients during the MRI is imperative.
-
We examine the ontogeny and phylogeny of object and fantasy play from a functional perspective. Each form of play is described from an evolutionary perspective in terms of its place in the total time and energy budgets of human and nonhuman juveniles. As part of discussion of functions of play, we examine sex differences, particularly as they relate to life in the environment of evolutionary adaptedness and economic activities of human and nonhuman primates. ⋯ Although fantasy play has been viewed as limited to humans, we speculate that certain types of fantasy play may be present in some nonhuman primates. Fantasy play may enable juveniles to see situations from different perspectives. We conclude that fantasy play may have immediate effects and object play may have deferred effects.