			Home About us Contact

Shoulder Pain (shoulder + pain)

Distribution by Scientific Domains

Medical Sciences	92%
Life Sciences	7%

Selected Abstracts

Subcutaneous Injection of Anakinra in Patients with Shoulder Pain Due to Rotator Cuff Tendonitis and Subacromial Bursitis

PAIN MEDICINE, Issue 2 2004
Sota Omoigui MD
No abstract is available for this article. [source]

Incidence of shoulder pain after neck dissection: A clinical explorative study for risk factors

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2001
Pieter U. Dijkstra PhD
Abstract Background It is the purpose of this study to determine the incidence of shoulder pain and restricted range of motion of the shoulder after neck dissection, and to identify risk factors for the development of shoulder pain and restricted range of motion. Methods Clinical patients who underwent a neck dissection completed a questionnaire assessing shoulder pain. The intensity of pain was assessed using a visual analog scale (100 mm). Range of motion of the shoulder was measured. Information about reconstructive surgery and side and type of neck dissection was retrieved from the medical records. Results Of the patients (n = 177, mean age 60.3 years [SD, 11.9]) 70% experienced pain in the shoulder. Forward flexion and abduction of the operated side was severely reduced compared to the non-operated side, 21° and 47°, respectively. Non-selective neck dissection was a risk factor for the development of shoulder pain (9.6 mm) and a restricted shoulder abduction (55°). Reconstruction was risk factor for a restricted forward flexion of the shoulder (24.5°). Conclusions Shoulder pain after neck dissection is clinically present in 70% of the patients. Non-selective neck dissection is a risk factor for shoulder pain and a restricted abduction. Reconstruction is a risk factor for a restricted forward flexion of the shoulder. © 2001 John Wiley & Sons, Inc. Head Neck 23: 947,953, 2001. [source]

Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors

CANCER, Issue 1 2008
A randomized controlled trial
Abstract BACKGROUND. Shoulder pain and disability are well recognized complications associated with surgery for head and neck cancer. This study was designed to examine the effects of progressive resistance exercise training (PRET) on upper extremity pain and dysfunction in postsurgical head and neck cancer survivors. METHODS. Fifty-two head and neck cancer survivors were assigned randomly to PRET (n = 27) or a standardized therapeutic exercise protocol (TP) (n = 25) for 12 weeks. The primary endpoint was change in patient-rated shoulder pain and disability from baseline to postintervention. Secondary endpoints were upper extremity strength and endurance, range of motion, fatigue, and quality of life. RESULTS. Follow-up assessment for the primary outcome was 92%, and adherence to the supervised PRET and TP programs were 95% and 87%, respectively. On the basis of intention-to-treat analyses, PRET was superior to TP for improving shoulder pain and disability (,9.6; 95% confidence interval [95% CI], ,16.4 to ,4.5; P = .001), upper extremity strength (+10.8 kg; 95% CI, 5.4,16.2 kg; P < .001), and upper extremity endurance (+194 repetitions × kg; 95% CI, 10,378 repetitions × kg; P = .039). Changes in neck dissection impairment, fatigue, and quality of life favored the PRET group but did not reach statistical significance. CONCLUSIONS. The PRET program significantly reduced shoulder pain and disability and improved upper extremity muscular strength and endurance in head and neck cancer survivors who had shoulder dysfunction because of spinal accessory nerve damage. Clinicians should consider the addition of PRET in the rehabilitation of postsurgical head and neck cancer survivors. Cancer 2008. © 2008 American Cancer Society. [source]

Follow-up of neck and shoulder pain among sewing machine operators: The Los Angeles garment study

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2010
Pin-Chieh Wang MS
Abstract Background The aim of the present study is to explore factors affecting or modifying self-reported neck/shoulder pain in sewing machine operators. Methods We investigated self-report neck/shoulder pain in 247 workers who participated in a 4-month prospective intervention study for musculoskeletal disorders. All participants were immigrants. We examine the influence of individual and work-related factors on changes in neck/shoulder pain during follow-up employing linear mixed models with time-spline functions. Results We observed a dramatic decline (72%) in self-reported pain intensity in the first month of follow-up, followed by a small increase from the first to fourth month (4% per month). Workers who perceived and reported their physical workload as high or worked overtime experienced less overall pain reduction. Higher baseline pain intensity, being of Hispanic ethnicity (vs. Asian), and taking cumulative daily rest time during work of 35,min or more allowing for muscles to rest were associated with a larger pain reduction in the first month, but not thereafter. Conclusion Our findings indicate that some work-related factors may be of clinical relevance for reducing neck/shoulder pain. Having lower physical workloads and less overtime work should be considered when treating patients or planning workplace interventions for managing work-related musculoskeletal disorders in this underserved immigrant population. Am. J. Ind. Med. 53:352,360, 2010. © 2009 Wiley-Liss, Inc. [source]

On functional motor adaptations: from the quantification of motor strategies to the prevention of musculoskeletal disorders in the neck,shoulder region

ACTA PHYSIOLOGICA, Issue 2010
P. Madeleine
Abstract Background:, Occupations characterized by a static low load and by repetitive actions show a high prevalence of work-related musculoskeletal disorders (WMSD) in the neck,shoulder region. Moreover, muscle fatigue and discomfort are reported to play a relevant initiating role in WMSD. Aims: To investigate relationships between altered sensory information, i.e. localized muscle fatigue, discomfort and pain and their associations to changes in motor control patterns. Materials & Methods:, In total 101 subjects participated. Questionnaires, subjective assessments of perceived exertion and pain intensity as well as surface electromyography (SEMG), mechanomyography (MMG), force and kinematics recordings were performed. Results:, Multi-channel SEMG and MMG revealed that the degree of heterogeneity of the trapezius muscle activation increased with fatigue. Further, the spatial organization of trapezius muscle activity changed in a dynamic manner during sustained contraction with acute experimental pain. A graduation of the motor changes in relation to the pain stage (acute, subchronic and chronic) and work experience were also found. The duration of the work task was shorter in presence of acute and chronic pain. Acute pain resulted in decreased activity of the painful muscle while in subchronic and chronic pain, a more static muscle activation was found. Posture and movement changed in the presence of neck,shoulder pain. Larger and smaller sizes of arm and trunk movement variability were respectively found in acute pain and subchronic/chronic pain. The size and structure of kinematics variability decreased also in the region of discomfort. Motor variability was higher in workers with high experience. Moreover, the pattern of activation of the upper trapezius muscle changed when receiving SEMG/MMG biofeedback during computer work. Discussion:, SEMG and MMG changes underlie functional mechanisms for the maintenance of force during fatiguing contraction and acute pain that may lead to the widespread pain seen in WMSD. A lack of harmonious muscle recruitment/derecruitment may play a role in pain transition. Motor behavior changed in shoulder pain conditions underlining that motor variability may play a role in the WMSD development as corroborated by the changes in kinematics variability seen with discomfort. This prognostic hypothesis was further, supported by the increased motor variability among workers with high experience. Conclusion:, Quantitative assessments of the functional motor adaptations can be a way to benchmark the pain status and help to indentify signs indicating WMSD development. Motor variability is an important characteristic in ergonomic situations. Future studies will investigate the potential benefit of inducing motor variability in occupational settings. [source]

Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2004
C. P. van Wilgen PT
Abstract Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how these outcomes compared between patients who had undergone surgery and a control group. Methods. We analyzed physical symptoms, psychological symptoms, and social and functional well-being at least 1 year after surgery and evaluated the differences in quality of life between patients who had undergone head and neck surgery and a control group. Results. Depression scores contributed significantly to all domains of quality of life. Reduced shoulder abduction, shoulder pain, and neck pain are related to several domains of quality of life. The patient group scored significantly worse for social functioning and limitations from physical problems but scored significantly better for bodily pain and health changes. Conclusion. Depression and shoulder and neck morbidity are important factors in quality of life for patients who have undergone surgery for head and neck cancer. © 2004 Wiley Periodicals, Inc. Head Neck26: 839,844, 2004 [source]

Incidence of shoulder pain after neck dissection: A clinical explorative study for risk factors

Lidocaine vs. magnesium: effect on analgesia after a laparoscopic cholecystectomy

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2010
I. M. SAADAWY
Background: This double-blinded study aimed at evaluating and comparing the effects of magnesium and lidocaine on pain, analgesic requirements, bowel function, and quality of sleep in patients undergoing a laparoscopic cholecystectomy (LC). Methods: Patients were randomized into three groups (n=40 each). Group M received magnesium sulfate 50 mg/kg intravenously (i.v.), followed by 25 mg/kg/h i.v., group L received lidocaine 2 mg/kg i.v., followed by 2 mg/kg/h i.v., and group P received saline i.v. Bolus doses were given over 15 min before induction of anesthesia, followed by an i.v. infusion through the end of surgery. Intraoperative fentanyl consumption and averaged end-tidal sevoflurane concentration were recorded. Abdominal and shoulder pain were evaluated up to 24 h using a visual analog scale (VAS). Morphine consumption was recorded at 2 and 24 h, together with quality of sleep and time of first flatus. Results: Lidocaine or magnesium reduced anesthetic requirements (P<0.01), pain scores (P<0.05), and morphine consumption (P<0.001) relative to the control group. Lidocaine resulted in lower morphine consumption at 2 h [4.9 ± 2.3 vs. 6.8 ± 2.8 (P<0.05)] and lower abdominal VAS scores compared with magnesium (1.8 ± 0.8 vs. 3.2 ± 0.9, 2.2 ± 1 vs. 3.6 ± 1.6, and 2.1 ± 1.4 vs. 3.3 ± 1.9) at 2, 6, and 12 h, respectively (P<0.05). Lidocaine was associated with earlier return of bowel function and magnesium was associated with better sleep quality (P<0.05). Conclusion: I.v. lidocaine and magnesium improved post-operative analgesia and reduced intraoperative and post-operative opioid requirements in patients undergoing LC. The improvement of quality of recovery might facilitate rapid hospital discharge. [source]

Sonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent stroke

JOURNAL OF CLINICAL ULTRASOUND, Issue 4 2009
Ya-Ping Pong MD
Abstract Purpose. To examine the hemiplegic shoulders for soft-tissue injury by musculoskeletal sonography and to determine the relationship between the motor functions of the upper extremity and these injuries, which play an important role in hemiplegic shoulder pain and may impede rehabilitation. Methods. The following characteristics of 34 acute stroke patients were recorded: age, gender, height, body weight, side of hemiplegia, type and duration of stroke, Brunnstrom stage, subluxation, and degree of spasticity of the upper extremity. On the basis of the Brunnstrom stage, the patients were divided into 2 groups. Patients with stages I, II, or III were categorized under the lower Brunnstrom stage (LBS) group (n = 21), and those with stages IV, V, or VI were allocated to the higher Brunnstrom stage (HBS) group (n = 13). Both shoulders of each patient were examined by musculoskeletal sonography with a 5,10-MHz linear transducer on 2 separate occasions (i.e., at admission and 2 weeks after rehabilitation). Results. With the exception of age, there were no significant differences in the demographic and clinical characteristics of the patients in the 2 groups. Shoulder musculoskeletal sonography revealed soft-tissue injury in 7 patients (33%) and 15 patients (71%) in the LBS group at admission and 2 weeks after rehabilitation, respectively (p < 0.05), and in 4 patients (31%) in the HBS group both at admission and 2 weeks after rehabilitation. Conclusions. Acute stroke patients with poor upper limb motor functions are more prone to soft-tissue injury of the shoulder during rehabilitation. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009. [source]

Sonography of the shoulder after arthrography (arthrosonography): Preliminary results

JOURNAL OF CLINICAL ULTRASOUND, Issue 1 2002
Hak Soo Lee MD
Abstract Purpose The purpose of this study was to verify whether arthrosonography improves diagnostic accuracy in diseases of the shoulder and provides additional information for therapeutic planning, compared with conventional sonography. Methods We prospectively studied 113 consecutive patients with chronic shoulder pain. Sonography was performed before and after arthrography, with the radiologist blinded to the results of arthrography. When a rotator cuff tear was detected sonographically, its type, location, and size were recorded; we also evaluated any changes in the subacromial-subdeltoid bursa and any abnormalities in the biceps tendon sheath. The diagnostic accuracy of conventional sonography and arthrosonography was compared with that of arthrography for rotator cuff tear. Changes in the subacromial-subdeltoid bursa and biceps tendon sheath seen on conventional sonography were also compared with those seen on arthrosonography. Results The sensitivity and specificity of conventional sonography in the diagnosis of rotator cuff tear were 86% (25/29) and 95% (80/84), respectively; for arthrosonography, the values were 97% (28/29) and 95% (80/84), respectively. The differences in sensitivity and specificity for the 2 sonographic techniques were not statistically significant (p > 0.05). The accuracy in localizing the tear was also not significantly different between the 2 sonographic techniques. Synovial proliferation was more easily detected with arthrosonography than it was with conventional sonography in the subacromial-subdeltoid bursa (p < 0.01) and in the biceps tendon sheath (p < 0.0001). Conclusions Our preliminary results suggest that although arthrosonography was not superior to conventional sonography in the diagnosis of rotator cuff tears, it may provide a better assessment of the size of tears and additional information about synovial proliferation in the subacromial-subdeltoid bursa and the biceps tendon sheath. © 2002 John Wiley & Sons, Inc. J Clin Ultrasound 30:23,32, 2002. [source]

Acupuncture and arthroscopic acromioplasty

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 4 2003
Barbara Gilbertson
Background. Acupuncture alleviates acute and chronic shoulder pain. Yet it has not been determined whether acupuncture is useful following musculoskeletal surgery. Hypothesis: Compared to sham acupuncture, arthroscopic acromioplasty subjects who received real acupuncture would manifest significantly better recovery as demonstrated by: UCLA shoulder scale, improved range of motion, diminished pain, decreased need and duration of analgesic use, and enhanced patient satisfaction. Methods. Forty arthroscopic acromioplasty patients were randomized to real or sham acupuncture. UCLA shoulder scale scores, pain intensity, analgesic use, range of motion, and quality of life were monitored for four months. Data were analyzed with the general linear model ANOVA for repeated measures. Results. Thirty-five subjects completed the study. Real acupuncture subjects scored significantly better on UCLA shoulder scale (p < 0.000); pain intensity (p < 0.022); self-reported analgesic use (p < 0.008); angles of abduction (p < 0.046); and in six of eight health status questionnaire components. Conclusions. Following arthroscopic acromioplasty, real acupuncture compared to sham acupuncture offered significantly greater improvement via: (1) lower pain level, (2) less analgesic use, (3) range of motion, and (4) patient satisfaction. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

Neuromuscular electrical stimulation in neurorehabilitation,

MUSCLE AND NERVE, Issue 5 2007
Lynne R. Sheffler MD
Abstract This review provides a comprehensive overview of the clinical uses of neuromuscular electrical stimulation (NMES) for functional and therapeutic applications in subjects with spinal cord injury or stroke. Functional applications refer to the use of NMES to activate paralyzed muscles in precise sequence and magnitude to directly accomplish functional tasks. In therapeutic applications, NMES may lead to a specific effect that enhances function, but does not directly provide function. The specific neuroprosthetic or "functional" applications reviewed in this article include upper- and lower-limb motor movement for self-care tasks and mobility, respectively, bladder function, and respiratory control. Specific therapeutic applications include motor relearning, reduction of hemiplegic shoulder pain, muscle strengthening, prevention of muscle atrophy, prophylaxis of deep venous thrombosis, improvement of tissue oxygenation and peripheral hemodynamic functioning, and cardiopulmonary conditioning. Perspectives on future developments and clinical applications of NMES are presented. Muscle Nerve, 2007 [source]

Evidence-based review of shoulder pain

MUSCULOSKELETAL CARE, Issue 4 2006
Kay Stevenson MPhil GradDipPhys SRP MCSPArticle first published online: 21 NOV 200
[source]

Radiofrequency Treatment of Peripheral Nerves

PAIN PRACTICE, Issue 3 2002
O.J.J.M. Rohof MD
Neurolysis by surgical, chemical, cryogenic, or thermal means may be considered as an option on seldom occasions, because of the risk of neuritis and deafferentation pain, motor deficit, and potential unintentional damage to nontargeted tissue. To our knowledge, there is only 1 report concerning selective radiofrequency (RF) treatment of the obturator and femoral nerves that was published. The introduction of the non-neurodestructive pulsed radiofrequency technique has provided new possibilities for the treatment of peripheral nerves. Today there is some experience with the management of chronic shoulder pain and additional case reports on other indications. [source]

Physical Medicine and Rehabilitation (85)

PAIN PRACTICE, Issue 1 2001
Erbil Dursun
Glenohumeral joint subluxation and reflex sympathetic dystrophy in hemiplegic patients. (Kocaeli University, Kocaeli, Turkey) Arch Phys Med Rehabil 1999; 81:944,946. This is a case-controlled study of the relationship between glenohumeral joint subluxation and reflex sympathetic dystrophy (RSD) in hemiplegic patients set in an inpatient rehabilitation hospital. Thirty-five hemiplegic patients with RSD (RSD group) and 35 hemiplegic patients without RSD (non-RSD group) were included in this study. Patients with rotator cuff rupture, brachial plexus injury, or spasticity greater than stage 2 on the Ashworth scale were excluded. Both the RSD and non-RSD groups were assessed for presence and grade of subluxation from radiographs using a 5-point categorization. The degree of shoulder pain of the non-RSD group was assessed by a visual analogue scale of 10 points. Glenohumeral subluxation was found in 74.3% of the RSD group and 40% of the non-RSD group (P = 0.004). In the non-RSD group, 78.6% of the patients with subluxation and 38.1% of the patients without subluxation reported shoulder pain (P = 0.019). No correlation was found between the degree of shoulder pain and grade of subluxation in the non-RSD group (P = 0.152). Conclude that the findings suggest that shoulder subluxation may be a causative factor for RSD. Therefore, prevention and appropriate treatment of glenohumeral joint subluxation should be included in rehabilitation of hemiplegic patients. Comment by Miles Day, MD. The purpose of this study was to examine the relationship between shoulder subluxation in hemiplegic patients and reflex sympathetic dystrophy. They also examined if subluxation is associated with shoulder pain and the grade of subluxation in patients with subluxation and no reflex sympathetic dystrophy (RSD). Patients with injuries to the rotator cuff of the brachial plexus, marked spasticity, and major trauma to joint structures were excluded as these can be precipitating factors for RSD. The study noted a significantly higher presence of shoulder subluxation within the RSD group and the presence of pain was significantly high in patients with shoulder subluxation in the non-RSD group. The take home message of this article is that any measure or treatment that can be applied to the glenohumeral joint should be performed to eliminate the possibility of the patient developing RSD and subsequently hindering further rehabilitation in these patients. [source]

Association between psychosocial factors and musculoskeletal symptoms among Iranian nurses

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2010
Ramin Mehrdad MD
Abstract Background While psychosocial factors have been associated with musculoskeletal symptoms among nurses in some countries, previous studies of Iranian nurses show little association using a demand and control questionnaire. The aim of this study is to assess and evaluate the prevalence of musculoskeletal symptoms and to assess their relationships with psychosocial factors among nurses in Iran. Methods In a cross-sectional study, 347 hospital nurses completed a self-reported questionnaire containing the Standardized Nordic questionnaire for musculoskeletal symptoms and the General Nordic questionnaire for Psychological and Social factors at work (QPS Nordic 34+ Questionnaire). Results Prevalence of low back pain, knee pain, shoulder pain, and neck pain were 73.2%, 68.7%, 48.6%, and 46.3%, respectively. Middle and high stress groups had higher crude and adjusted odds than the low stress group for all body sites. The association for neck, wrist/hand, and upper back and ankle/foot reports (adjusted odds ratio for high stress ranging from 2.4 to 3.0) were statistically significant. Conclusions We observed a high prevalence of self-reported musculoskeletal symptoms at a number of body sites, which were associated with psychosocial factors and specifically stress as defined by the QPS Nordic 34+ Questionnaire. Am. J. Ind. Med. 53:1032,1039, 2010. © 2010 Wiley-Liss, Inc. [source]

Psychosocial work factors and shoulder pain in hotel room cleaners,

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2010
Barbara J. Burgel RN, FAAN
Abstract Background Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group. Methods Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses. Results Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort,reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95,4.59, P,=,0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain. Conclusions ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors. Am. J. Ind. Med. 53:743,756, 2010. © 2010 Wiley-Liss, Inc. [source]

Follow-up of neck and shoulder pain among sewing machine operators: The Los Angeles garment study

Shoulder Disability After Different Selective Neck Dissections (Levels II,IV Versus Levels II,V): A Comparative Study

THE LARYNGOSCOPE, Issue 2 2005
Johnny Cappiello MD
Abstract Objectives/Hypothesis: The objective was to compare the results of clinical and electrophysiological investigations of shoulder function in patients affected by head and neck carcinoma treated with concomitant surgery on the primary and the neck with different selective neck dissections. Study Design: Retrospective study of 40 patients managed at the Department of Otolaryngology, University of Brescia (Brescia, Italy) between January 1999 and December 2001. Methods: Two groups of 20 patients each matched for gender and age were selected according to the type of neck dissection received: patients in group A had selective neck dissection involving clearance of levels II,IV, and patients in group B had clearance of levels II,V. The inclusion criteria were as follows: no preoperative signs of myopathy or neuropathy, no postoperative radiotherapy, and absence of locoregional recurrence. At least 1 year after surgery, patients underwent evaluation of shoulder function by means of a questionnaire, clinical inspection, strength and motion tests, electromyography of the upper trapezius and sternocleidomastoid muscles, and electroneurography of the spinal accessory nerve. Statistical comparisons of the clinical data were obtained using the contingency tables with Fisher's Exact test. Electrophysiological data were analyzed by means of Fisher's Exact test, and electromyography results by Kruskal-Wallis test. Results: A slight strength impairment of the upper limb, slight motor deficit of the shoulder, and shoulder pain were observed in 0%, 5%, and 15% of patients in group A and in 20%, 15%, and 15% of patients in group B, respectively. On inspection, in group B, shoulder droop, shoulder protraction, and scapular flaring were present in 30%, 15%, and 5% of patients, respectively. One patient (5%) in group A showed shoulder droop as the only significant finding. In group B, muscle strength and arm movement impairment were found in 25% of patients, 25% showed limited shoulder flexion, and 50% had abnormalities of shoulder abduction with contralateral head rotation. In contrast, only one patient (5%) in group A presented slight arm abduction impairment. Electromyographic abnormalities were less frequently found in group A than in group B (40% vs. 85% [P = .003]), and the distribution of abnormalities recorded in the upper trapezius muscle and sternocleidomastoid muscle was quite different: 20% and 40% in group A versus 85% and 45% in group B, respectively. Only one case of total upper trapezius muscle denervation was observed in group B. In both groups, electroneurographic data from the side of the neck treated showed a statistically significant increase in latency (P = .001) and decrease in amplitude (P = .008) compared with the contralateral side. There was no significant difference in electroneurographic data from the side with and the side without dissection in either group. Even though a high number of abnormalities was found on electrophysiological testing, only a limited number of patients, mostly in group B, displayed shoulder function disability affecting daily activities. Conclusion: The study data confirm that clearance of the posterior triangle of the neck increases shoulder morbidity. However, subclinical nerve impairment can be observed even after selective neck dissection (levels II,IV) if the submuscular recess is routinely dissected. [source]

Anesthesia-Related Complications in Living Liver Donors: The Experience from One Center and the Reporting of One Death

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2008
S. Ozkardesler
Living donor liver transplantation has become an alternative therapy for patients with end-stage liver disease. Donors are healthy individuals and donor safety is the primary concern. The objective of this study was to evaluate the anesthetic complications and outcomes for our donor cases; we report one death. The charts of the patients who underwent donor hepatectomy from February 1997 to June 2007 were retrospectively reviewed. Right hepatectomy (resection of segments 5,8) was done in 101 donors, left lobectomy (resection of segments 2,3) in 11 donors, and left hepatectomy (resection of segments 2,4) in one donor. Minor anesthetic complications were shoulder pain, pruritus and urinary retention related to epidural morphine, and major morbidity included central venous catheter-induced thrombosis of the brachial and subclavian vein, neuropraxia, foot drop and prolonged postdural puncture headache. One of 113 donors died from pulmonary embolism on the 11th postoperative day. This procedure has some major risks related to anesthesia and surgery. Although careful attention will lower complication rate, we have to keep in mind that the risks of donor surgery will not be completely eliminated. [source]

Doppler sonographic findings in the long bicipital tendon sheath in patients with rheumatoid arthritis as compared with patients with degenerative diseases of the shoulder

ARTHRITIS & RHEUMATISM, Issue 7 2003
Johannes Strunk
Objective To compare power Doppler sonography (PDS) findings inside the bicipital tendon sheath in patients with rheumatoid arthritis (RA) and degenerative disorders of the shoulder, in order to evaluate the diagnostic value of PDS in distinguishing between inflammatory and noninflammatory shoulder pain. Methods The glenohumeral joints of 41 consecutive patients with shoulder pain were examined by ultrasound. Using ventral transverse and longitudinal scanning, the vascularity near and/or inside the bicipital tendon sheath was visualized by PDS. One fully trained and experienced examiner performed the sonography. Representative images were digitally stored and were read, under blinded conditions, by 2 independent investigators, who categorized the Doppler signals as being either inside or outside the tendon sheath. Results Biceps tendon sheath effusion, represented by the typical hypoechoic rim, was found in 95.8% of the RA patients (23 of 24) and in 58.8% of the patients with degenerative disorders (10 of 17). PDS signals were localized to inside the tendon sheath in 22 of the RA patients (91.7%) and in none of the patients with degenerative disorders. Although no PDS signal was found inside the tendon sheath in patients with degenerative disorders, in 9 of these patients (52.9%), signals could be localized to the environment of the tendon sheath. Conclusion PDS demonstrates vascularity in the long bicipital tendon sheath of patients with RA, but not in those with degenerative shoulder disorders. [source]