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Defining novel clinical syndromes and emerging pathogensWoo, Chiu-yat, Patrick., 胡釗逸. January 2002 (has links)
published_or_final_version / abstract / toc / Medicine / Master / Doctor of Medicine
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A preliminary exploration of the construct validity of the Berlin questionnaire as a measure of obstructive sleep apnoea in a South African population : a clinical health psychology perspective.Baker, Michelle Lydia. January 2006 (has links)
Clinical professionals in South Africa are generally unaware of the impact of obstructive sleep apnoea (OS A). The cost to the state of untreated apnoea may be extremely high. In primary health care encounters OSA often goes undiagnosed. The cascade of symptoms linked to OSA is profound, placing patients at risk for debilitating problems impacting on self and others. The aim of this study was to validate a questionnaire, which could be used at a primary health care level to identify patients with OSA thus cutting costs and improving efficient, effective and ethical service to patients. The Berlin Questionnaire (BQ) (Netzer et al. 1999) was administered to a clinical sample of consenting patients at a private sleep laboratory in Durban, South Africa (N = 119)(completed n = 110). Home-based sleep studies (n = 116) on a portable cardio-respiratory screening device were also obtained for objective comparison. From the results obtained in this South African sample, the BQ showed low validity and reliability (Cronbach a = 0.62 - 0.84) to individual items of the BQ. The total BQ score and high-risk symptom category analysis showed mildly significant correlations with internationally approved protocols. The BQ identified 60% of the high-risk group (AHI >5). Furthermore, risk categories were useful in predicting AHI ratings in 64% of moderate OSA cases and 25% of severe OSA cases. The BQ therefore has useful psychometric properties as an adjunct assessment tool to screen for high-risk OSA cases where resources are scant. Clinical health psychologists are in an ideal position to recognise the risk factors and symptoms of OSA. The clinical assessment and the value of the correct diagnosis will alleviate the treatment of psychological symptoms at a superficial level in primary health care facilities. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.
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Deficits of cognitive executive functions in patients with obstructive sleep apnea syndrome.Vonk, Michael Frederik. January 2001 (has links)
Although a broad range of neuropsychological deficits have been reported to occur in patients with Obstructive Sleep Apnea Syndrome (OSAS), few studies have examined the executive functions in this patient group. The executive functions provide conscious control of the more basic cognitive functions and play an important role in daily living. They include capacities such as concept formation, planning, cognitive flexibility and resistance to interference. This study compared the performance of groups of moderate and severe OSAS patients with a group of unaffected individuals (N=24), on five tests of executive functioning. Two indices of sleep disordered breathing, sleep fragmentation and . hypoxemia, obtained from overnight polysomnography, were respectively used to categorise participants. ID patients with severe OSAS, executive function deficits were evident, while in those with moderate OSAS these abilities appeared largely intact. Further analyses revealed that the observed findings could not be attributed to differences in vigilance. These results suggest a discontinuity in the manifestation of executive function deficits between moderate and severe OSAS patients. There may be a threshold of OSAS severity, which if exceeded, impairments tend to occur. The magnitude of the impairment in patients with severe OSAS may be sufficient to interfere with daily cognitive functioning. Further research is needed both to replicate these findings and to establish the underlying pathogenesis of these deficits. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.
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The significance of subthreshold symptoms of anxiety in the aetiology of bruxism.Basson, Reneda A. January 2007 (has links)
<p>Bruxism is an oral parafunctional habit involving clenching and grinding of the teeth that occurs mainly unconsciously, diurnally and nocturnally. It is considered an important contributory factor in the aetiology of myofascial pain (MFP) and temporomandibular disorders (TMD). The aetiology of bruxism is considered to be multifactorial, involving physiological and psychological factors. The aim of this study was to examine the relationship between the subthreshold symptoms (subtle, prodromal, atypical and subclinical symptoms of which the severity precludes diagnosis as a disorder) of anxiety and bruxism in a sample of subjects using a spectrum model.</p>
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The relative effectiveness of proprioceptive neuromuscular facilitation versus ultrasound therapy in the treatment of temporamandibular joint dysfunction caused by masticatory myofascial trigger points, in terms of subjective and objective clinical findingsGray, Derick January 2002 (has links)
Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2002 / The purpose of this randomized controlled clinical trial was to investigate the relative effectiveness of proprioceptive neuromuscular facilitation (PNF) versus ultrasound therapy for the treatment of Temporomandibular joint (TMJ) dysfunction caused by masticatory myofascial trigger points, in terms of subjective and objective clinical findings.
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An investigation into the relationship of myofascial trigger points in the head and neck region in association with temporomandibular joint dysfunctionSeagreen, Michelle Elizabeth January 2009 (has links)
A dissertation presented to the Faculty of Health Sciences at the Durban
University of Technology in partial compliance with the requirements for the
Master’s Degree in Technology:
Chiropractic, 2009 / Introduction: The aetiology of Temporomandibular Joint Dysfunction (TMJD) is
not fully understood and the treatment of TMJD is controversial. Most treatment
plans are based on postulated aetiology. Treatment plans currently range from
pharmacological to surgical and occasionally physical therapy is also used for
any myofascial component. Myofacial Trigger Points (MFTP’s) in the head and
neck region have similar pain referral patterns as TMJD and there is overlap in
aetiology and epidemiology. If correlation can be proved to exist between the
severities of TMJD and MFTP’s then the treatment of MFTP’s can potentially
decrease the severity of TMJD and then the more radical treatments can be
avoided.
Objectives: To determine whether TMJD was present and establish severity. To
locate any MFTP’s in the Sternocleidomastiod (SCM), Temporalis, Masseter,
Posterior Cervical (PC), Lateral and Medial Pterygoid muscles and determine
their severity.
Methods: A random sample of 25 participants were evaluated. A p value <0.05
was considered as statistically significant. Quantitative variables were
summarized using median, inter-quartile range and range due to skewness of
distribution, while categorical variables were described using frequency
distributions and bar charts. Spearman’s nonparametric correlation analysis, and
curve estimation were used to determine the existence of a relationship between
TMJ severity and MFTP severity. A scatterplot was used to graphically assess
the relationship.
Conclusion: The results suggested that the participants were actually chronic
neck pain suffers that developed TMJD over the long term as a result of chronic
neck pain changing the kinematic biomechanics or as a result of a completely
different and independent event as suggested by Foreman and Croft (1995).
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The effect of action potential simulation on post dry-needling soreness in the treatment of active trapezius myofascitisManga, Hitesh January 2008 (has links)
Dissertation submitted to the faculty of health in partial compliance with the
requirements for the Masters Degree in Technology: Chiropractic, at the
Durban University of Technology, 2008 / Introduction: Myofascial Pain Syndrome (MPS) is a painful and prevalent muscular
condition. It is characterized by the development of Myofascial trigger points (TrPs) that are locally tender when active and which can refer pain through specific patterns to other areas of the body distal from the trigger point.
There exist many types of treatments for MPS of which dry needling is one of the most effective forms. However, a very common side-effect experienced is postneedling
soreness, which when compared to trigger point injections are more painful, with respect to both intensity and duration. Studies have shown that the exact cause
of post-needling soreness has not been clearly documented.
Action Potential Simulation (APS) Therapy operates using a direct electric current
(DC) on muscles. It stimulates action potentials that are stronger than the natural
nerve impulses. It operates on a similar principle to the gate control theory of Melzack and Wall (1988) which results in the inhibition of nociceptive signals. Stimulation by the APS unit creates a normal action potential that restores the inherent biochemical processes in the region. This low to medium frequency current (below 150 Hz) has been reported to alleviate pain, decrease inflammation, enhance blood circulation and aid in wound and bone fracture healing.
Methodology: This study was designed as a prospective, randomised, controlled
experimental investigation. Sixty subjects were randomly allocated into three equal
groups of 20 subjects each. Group One received the fanning dry needling technique;
Group Two received a combination of fanning dry needling plus APS Therapy. Group
Three was the control group in which the subjects were treated with fanning dry
needling with „Sham‟ APS Therapy.
Algometer and Numerical Pain Rating Scale 101 (NRS 101) readings were taken
immediately before and after the dry needling procedure and again at the follow-up
visit 24 hours later. Subjects used a 24-hour pain diary and the NRS 101 scale which was filled out at 3 hour intervals, to record any post-needling soreness.
Results: An intra-group analysis revealed that, objectively and subjectively, all
groups experienced some degree of post-needling soreness, which deceased
significantly over time. This decrease of pain was not significantly related to the
treatment group, and there is no evidence of the differential time effect with the
treatment. An inter-group analysis yielded no statistically significant results regarding the effectiveness of the treatments received by the patients. This could be because of the small sample size or because „„Sham‟‟ APS is not a useful intervention.
Conclusion: The results from this study revealed that all three treatment groups
responded equally in the alleviation of pain. However, the dry-needling treatment
group alone (Group One) revealed a much more significant decrease in pain compared to the other two. It can thus be concluded that APS Therapy had no significant beneficial effects on post-needling soreness.
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The relative effectiveness of myofascial trigger point manipulation as compared to proprioceptive neuromuscular facilitative stretching in the treatment of active myofascial trigger points: a pilot clinical investigationBerry, Jason January 2006 (has links)
Dissertation submitted to the Department of Chiropractic in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, 2006. / Myofascial pain syndrome (MPS) is defined as the sensory, motor and autonomic symptoms caused by myofascial trigger points (MFTPs), or hyperirritable spots within skeletal muscles that are associated with palpable nodules in a taut band.
The fact that MFTPs have been described in the literature for acupuncturists, anaesthesiologists, chronic pain managers, dentists, family practitioners, gynaecologists, neurologists, nurses, orthopaedic surgeons, paediatricians, physical therapists, physiologists, rheumatologists and veterinarians is evidence of the syndrome’s clinical importance.
As a result of a large amount of research, a large number of different treatments have been shown to be clinically effective in the treatment of MFTP. These treatments include amongst others:
- Ischaemic compression.
- Myofascial manipulation.
- Spray and stretch.
- Ultrasound.
- Transcutaneous electrical nerve stimulation.
- Dry needling.
As can be seen from the above, it is important to be able to treat MPS effectively because it is such a common disorder. According to Schneider an effective treatment is needed for MPS, despite the array of treatments available to a clinician. Han and Harrison agree that more studies are required to determine the efficacy of these treatments. The aim of this study is to evaluate the relative effectiveness of Myofascial
Trigger point Manipulation (MFTPM) as compared to Proprioceptive Neuromuscular Facilitative (PNF) stretching in the treatment of active Myofascial Trigger Points (MFTPs) in the trapezius muscle (TP 1 and/or TP 2) in terms of subjective and objective clinical findings.
The study required a total of 60 patients, which following acceptance were then randomly divided into two groups of 30, with an equal number of male patients in Group one (MFTPM) and two (PNF), and female patients in Group one and Group two. Each patient had four consultations (three treatments and one follow up visit) in a two week period. Subjective and Objective Data was recorded at each consultation prior to the treatment.
Subjective measurements (Numerical Pain Rating Scale and Short Form McGill Pain Questionnaire) were taken prior to the treatment at all four visits. Objective measurements (Cervical Range of Motion Meter and Algometer) were also taken prior to the treatment at all four visits, except for Algometer readings which were taken at the initial consultation and the fourth treatment only.
SPSS version 11.5 was used for analysis of data (SPSS Inc, Chicago, Ill, USA). Baseline comparisons were done between treatment groups using Pearson’s chi square tests or Fisher’s exact tests as appropriate for categorical variables, and student’s t-tests for quantitative normally distributed variables. Treatment effect was assessed with repeated measures ANOVA. A significant time by group interaction indicated a significant differential treatment effect. A p value <0.05 designated statistical significance. The direction of the treatment effect was assessed with profile plots.
Evaluation of data collected from both groups showed a significant improvement in terms of objective and subjective clinical findings to a value of p=< 0.001. There was no statistical difference between the two groups in terms of objective and subjective clinical findings, although a trend was shown when looking at the objective findings that suggest that MFTPM was more effective than PNF stretching.
The sample population was drawn from a very homogenous group of people (i.e. SARS call centre), in order to achieve greatest emphasis on clinical outcomes. This process however limits the clinical applicability of the results and thus will not always be applicable to all patients within the population.
It is therefore the researcher’s conclusion that there is no statistical difference between MFTPM and PNF stretching in terms of objective and subjective clinical findings. Both treatment modalities have been shown to be equally effective in the treatment of subacute active TPs in the upper tarpezius.
There is a definite trend when looking at the objective data that may support the hypothesis that MFTPM is as effective as, if not more effective than PNF stretching. It is of the opinion of the author that a larger sample size is needed to make it clinically significant.
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PRE-COPULATORY SEXUAL CANNIBALISM IN FISHING SPIDERS: THE ECOLOGY OF AN EXTREME SEXUAL CONFLICTJohnson, J. Chadwick 01 January 2003 (has links)
Pre-copulatory sexual cannibalism (pre-SC), or predation of a potential mate before sperm transfer, provides an ideal model system for behavioral ecology's current focus on inter-sexual conflict. Studying the North American fishing spider (Dolomedes triton), I tested three female-benefit hypotheses for pre-SC: indirect benefits, direct benefits, and aggressive spillover. First, pre-SC may reflect a mating bias providing females with 'good-genes' benefits. By manipulating each female's options with regard to the most cited phenotypic advantage in male spiders, body size, I show that while females exhibit no bias in their attack tendency on males of different body sizes, large males mate significantly more often than small males. Second, pre-SC may be explained by direct benefits if females use it as an adaptive foraging/mating trade-off. My work provides mixed support for this idea: (i) females vary attacks according to the availability of mates, (ii) females do not vary attacks according to the availability of food, and (iii) females derive discrete fecundity benefits from consuming a male. Finally, I tested the aggressive-spillover hypothesis, which posits that pre-SC is a by-product of selection for high levels of aggression towards prey in traditional foraging contexts. Path analysis indicated intra-individual, positive correlations between aggression in foraging contexts and the mating context, thus supporting the hypothesis. I conclude by stressing that pre-SC in a given species may rarely be explained by one hypothesis, and that studies accounting for multiple benefits that fluctuate as behavioral-ecological contexts shift should give a more realistic glimpse of behavioral ecology and evolution.
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Search for the retroviral origin of a novel murine spontaneous lymphomaKercher, Lisa A. January 1994 (has links)
It is known that many types of leukemias and lymphomas are of viral origin. A new strain of immunologically deficient mice, the BALB/c x C57B1/6 beige nude mice, has been observed to develop spontaneous lymphomas of unknown origin at a high frequency. It is possible the tumors originate from a retroviral infection, which we attempted to show by detection of viral reverse transcriptase (RT) activity. We measured the (RT) activity in the supernatants of cocultures from the spleen and lymph node tissues of the beige nude animals by two methods, tritiated thymidine triphosphate incorporation in a standard RT assay, and the commercially available RT-DetectTM (DuPont) method. Of all supernatants tested, none showed a significant amount of RT activity compared with a cell line that was known to be actively producing the retrovirus MuLV. Upon electron microscopic analysis of the tumor-like cells grown in coculture, no viral particles were observed. Flow cytometric analysis of the tumor-like cells showed two general phenotypes; one predominately of a helper T cell type, and the other of a less differentiated immature thymocyte type. / Department of Biology
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