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A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2001. / Hendler et al. (1995) describes low back pain as the most common, costly and disabling musculosketetal condition. Giles (1997: 28) supports this, stating that the annual incidence of low back pain in the adult population is between two and five percent, with a lifetime prevalence of well over 50%. For clinicians to choose the most appropriate therapy for managing this common condition it is essential for research to be carried out to define the most effective treatment. Shekelle (1994) explains that spinal manipulative therapy is an effective treatment for patients with low back pain, while Cherkin et al. (1995) states that there is strong evidence to support the use of nonsteroidal antiinflammatory drugs in the management of mechanical low back pain. It is therefore the purpose of this investigation to determine the relative effectiveness of spinal manipulative therapy compared to Diclofenac Sodium, in terms of subjective and objective measures, in the management of mechanical low back pain. This randomized controlled trial consisted of sixty patients between the ages of 18 and 65, complaining of mechanical low back pain. The sixty patients were randomly divided into two treatment groups of thirty each. One group received spinal manipulative therapy and the remaining thirty were administered Diclofenac Sodium. These patients were carefully screened to allow the researcher to diagnose the patient, with Lumbar Facet Syndrome, Sacroiliac Syndrome or Myofascial Pain Syndrome; or any combination of these syndromes. This is in accordance with Kirkaldy-Willis (1992: 105 - 119) classification system. The thorough examination ensured that each patient had no contra-indications to spinal manipulative therapy or Diclofenac Sodium. / M

A total of 22 non-steroidal anti-inflammatory drugs and derivatives were added to microsomes to study the denaturation of cytochrome P-450 to cytochrome P-420 in the absence of an NADPH-generating system. There was a highly significant correlation among the different compounds between the extent of denaturation of cytochrome P-450 and their surfactant potency. Endotoxin administration to rats caused a maximum decrease in hepatic microsomal enzymes after 24 hours. Significant decreases in cytochrome P-450 (40%), cytochrome b5 levels (22%), aminopyrine N-demethylase (31%) and biphenyl 4-hydroxylase (54%) activities were obtained. Concomitant intravenous injection of 16,16-DMPG F2 and 16,16-DMPG E2 prevented some of the endotoxin-induced changes in hepatic microsomal enzymes. Three days treatment with cocaine was required to obtain hepatic damage in mice. Decreases in cytochrome P-450 content (41%), aminopyrine N-demethylase (31%) and FAD-monooxygenase (35%) activities were obtained, when compared to saline treated mice. The serum enzyme activities were markedly increased (SGOT 13-fold and SOCT 44-fold). Histological changes in form of centrilobular necrosis and fatty changes were present. Repeated subcutaneous administration of iloprost or synthetic prostaglandins just before cocaine prevented some of the hepatic lesions. Iloprost was found to be a better hepatoprotective agent than synthetic prostaglandins against the cocaine mediated liver toxicity. Carbon tetrachloride administration to mice produced similar lesions to those obtained with cocaine. Administration of iloprost prevented some of the lesions caused by carbon tetrachloride, giving a partial protection to the carbon tetrachloride-induced decrease in cytochrome P-450 and the increase in SGOT. Iloprost also partially prevented the carbon tetrachloride mediated centrilobular necrosis.

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Thesis (Ph. D.)--University of Wisconsin--Madison, 1959. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 144-157).