Articles: cations.
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Objective. To investigate whether a simple static stiffness model adequately relates the angles and net joint torques (NJT) developed in the ankles (sagittal plane) and in the hips (frontal plane) following perturbations delivered in multiple directions to partially constrained subjects standing quietly. Materials and Methods. ⋯ Conclusions. The relationship between the ankle angles and NJT and hip angles and NJT following perturbed stance can be described as static stiffness. The implications for arm-free paraplegic standing are discussed and a new control scheme is proposed.
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To review recent studies in pathogenesis and management of ventilator-induced lung injury. ⋯ Ventilator-induced lung injury is an iatrogenic disturbance that increases morbidity and mortality associated with acute respiratory distress syndrome. Tidal volume reduction and increased levels of PEEP have reduced inflammatory mediators and the mortality associated with ARDS.
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Despite psychosocial factors playing an important role in the course of chronic pain disorder, there is a noticeable imbalance between demand and availability of psychosomatic care for these patients. This led us to establish a psychosomatic pain clinic within the framework of our outpatient clinic at the Department of Psychosomatic Medicine and Psychotherapy at the Central Institute of Mental Health, Mannheim, Germany. A recent study aimed at the evaluation of sociodemographic variables, state of chronification, symptom load and psychiatric comorbidity. Additionally we wanted to determine whether existing conditions at our hospital can be considered suitable for those patients. ⋯ Our examination routine effectively demonstrated the special needs of chronic pain patients. As there is significant demand for psychosomatic intervention in those patients, earlier referral appears highly desirable. As pain patients differ also greatly from the remaining hospital population, specialized therapeutic concepts must be developed.
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Internal disc disruption is a common cause of disabling low back pain in a substantial number of young, healthy adults. A clinical diagnosis of internal disruption, in absence of objective clinical findings, is convincingly established only by means of provocation discography. Intradiscal electrothermal therapy has been shown to be effective in managing chronic disabling discogenic pain. ⋯ Further, the assessment of functional status showed significant improvement with standing and walking, whereas sitting also demonstrated significant improvement in 62% of the patients, though it was not statistically significant. No complications were noted in the perioperative period or during the follow-up period. In conclusion, intradiscal electrothermal therapy is a safe and effective procedure in patients suffering with chronic functionally limiting discogenic pain who fail to respond to aggressive conservative modalities of treatments as well as interventional therapy with injections.
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The debate continues as to whether regional anesthesia is safer than general anesthesia. However, the choice of anesthetic technique is a complex decision. This review of the most recent publications compares the safety of regional anesthesia with that of general anesthesia.