This article explains the orthopedic approach to limping in children. This is a review article including a selected collection of new articles extracted from PubMed and Google Scholar searched for clinical points and ...This article explains the orthopedic approach to limping in children. This is a review article including a selected collection of new articles extracted from PubMed and Google Scholar searched for clinical points and beneficial approaches to limping children. In this paper, limping is divided into two categories, painful and painless. After stating the important points in the patient’s medical history and explaining specific examinations in this area, different gait types in children are explained and the best evaluation method for them is presented. Then, paraclinical examinations and imaging are described in a practical evaluation, high-risk etiologies of limping such as infections, tumors, and fractures are explained in detail and red flags are considered at each step. The algorithms and the list of differential diagnoses for each age group are included, which can provide physicians with a more comprehensive approach to limping in children.展开更多
Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower lim...Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower limb. We explored a variety of methods treating neuropathic pain such as low-level laser, monochromatic near-infrared treatment, TENS, acupuncture and pulsed electromagnetic fields that demonstrated inconclusive, limited or temporary pain relief with minor or short-term improvements in mobility. Research conducted by ultra-low energy technologies reports pain relief and reduction of inflammation as a result of anti-oxidant electron donation transforming free radicals into stable molecules. We report the results of a randomized double blind one-year-long longitudinal clinical study on 10 diabetic mellitus (DM) subjects with chronic neuropathy, treated with ultra-low energy nanotechnology who experienced substantial long-term neuropathic pain relief. Importantly, pain analgesia and improvement in neuropathic symptomatology were not age-contingent. This contradicts past research postulating that age-accumulated inflammation and endothelial dysfunction can further exacerbate diabetic neuropathy. Importantly, a method offering age-independent, cost-effective, long-term neuropathic pain relief and increased mobility has major implications in reducing hospitalization time and overall expenses by offering a solution that enhances quality of life.展开更多
In this study, an effective noncontact and nonattached technique that is based on electrostatic induction current generated during walking motion is proposed for the detection and assessment of human physical activity...In this study, an effective noncontact and nonattached technique that is based on electrostatic induction current generated during walking motion is proposed for the detection and assessment of human physical activity. In addition, a theoretical model is proposed for the electrostatic induction current generated owing to variation in the electric potential of the human body. The proposed electrostatic induction current model is compared with the theoretical model, and the proposed model is shown to effectively explain the behavior of the electrostatic induction current waveform. The normal walking motions of daily living are recorded with a portable sensor located in a regular house. The obtained results show that detailed information of physical activity such as a gait cycle can be estimated using our proposed technique. Additionally, the walking signal was measured when the subject walked with the ankle and knee fastened to a splint with bandages to simulate a limp. Therefore, the proposed technique, which is based on the detection of signal generated during walking, can be successfully employed to assess human physical activity.展开更多
Melorheostosis, also known as Leri disease or flowing periosteal hyperostosis, is a rare, non-hereditary, benign, skle-rosing bone dysplasia which radiologically characterized by the appearance of “melting wax flowin...Melorheostosis, also known as Leri disease or flowing periosteal hyperostosis, is a rare, non-hereditary, benign, skle-rosing bone dysplasia which radiologically characterized by the appearance of “melting wax flowing down a candle”. We report on a 43-year-old woman with melorheostosis who had pain in the upper limp for 10 years, limitation of joint movement and a deformity in the left third finger. Radiographies and bone scintigraphy were evaluated. All lesions of melorheostosis in radiography were seen in bone scintigraphy. More than half of increased uptakes on bone scintigra-phy are due to degenerative process.展开更多
Background Musculoskeletal(MSK)complaints in children vary,ranging from benign,self-limited conditions to serious disorders.Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease,initially presenting w...Background Musculoskeletal(MSK)complaints in children vary,ranging from benign,self-limited conditions to serious disorders.Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease,initially presenting with MSK complaints.Delayed diagnosis and appropriate treatment have an enormous impact on the long-term outcomes and the level of disability.This study aimed to identify the features distinguishing JIA among children presenting with MSK complaints and to describe the spectrum of diseases at a large,single,tertiary center.Methods A retrospective chart review was performed of patients evaluated by pediatric rheumatology consultation at the Faculty of Medicine,Siriraj Hospital,Mahidol University,Bangkok,Thailand,from July 2011 to June 2015.Results Of 531 patients,285(53.6%)had at least one MSK complaint.The mean age of the patients was 9.1+4.1 years.Joint pain was the most common MSK complaint(86.3%),followed by limping(33%)and refusal to walk(19.6%).Joint swelling and limited range of motion were found in 146(51.2%)and 115(40.4%)patients,respectively.Seventy-three(25.6%)patients were diagnosed as JIA.The other common diagnoses included Henoch-Schtnlein purpura(16.1%),reactive arthritis(14.2%),and systemic lupus erythematosus(13.7%).Morning stiffness≥15 minutes[odds ratio(OR)8.217(3.404-19.833)];joint swelling on MSK examination[OR 3.505(1.754-7.004)];a duration of MSK complaints of more than 6 weeks[OR 2.071(1.120-3.829)];and limping[OR 1.973(1.048-3.712)]were significantly associated with the ultimate diagnosis of JIA.Conclusions Morning stiffness≥15 minutes is a strong predictor of JIA.Comprehensive history taking and an MSK examination will provide clues for making the ultimate diagnosis for children with MSK complaints.展开更多
This paper lays out a hierarchical,appropriate-complexity framework for conceptualizing movement-path segments at different spatiotemporal scales in a way that facilitates comparative analyses and bridges behavior and...This paper lays out a hierarchical,appropriate-complexity framework for conceptualizing movement-path segments at different spatiotemporal scales in a way that facilitates comparative analyses and bridges behavior and mathematical concepts.It then outlines a process for generating a multimode,multiscale stochastic simulation model that can be used to test animal movement hypotheses and make predictions of movement responses to management and global change.Many methods for analyzing movement data begin by generating step-length(SL)and turning-angle(TA)distributions from relocation time-series data,some of which are linked to ecological,landscape,and environmental covariates.The frequency at which these data are collected may vary from sub-seconds to several hours.The kinds of questions that may be asked of these data,however,are very much scale dependent.The hierarchical path-segmentation(HPS)framework presented here clarifies how the scale at which SL and TA data are collected relates to other sub-and super-diel scales.Difficulties arise because the information contained in SL and TA time series are often not directly relatable to the physiological,ecological,and sociological factors that drive the structure of movement paths at longer scales.These difficulties are overcome by anchoring the classification of movement types around the concept of fixed-period(24 h)diel activity routines and providing a bridge between behavioral/ecological and stochastic-walk concepts(means,variances,correlations,individual-state and local environmental covariates).This bridge is achieved through the generation of relatively short segments conceived as characteristic sequences of fundamental movement elements.These short segments are then used to characterize longer canonical-activity-mode segments that emerge through movement at behaviorally relevant sub-diel scales.HPS thus provides a novel system for integrating sub-minute movement sequences into canonical activity modes(CAMs)that,in turn,can be strung together into various types of diel activity routines(DARs).These DARs both vary among individuals within a given day,and for any given individual across time and under the influence of landscape factors.An understanding of how DARs are influenced by environmental inputs will help us predict the response of supra-diel lifetime movement phases(LiMPs)of individuals,as well as their complete lifetime tracks(LiTs),to anthropogenically induced global change.展开更多
文摘This article explains the orthopedic approach to limping in children. This is a review article including a selected collection of new articles extracted from PubMed and Google Scholar searched for clinical points and beneficial approaches to limping children. In this paper, limping is divided into two categories, painful and painless. After stating the important points in the patient’s medical history and explaining specific examinations in this area, different gait types in children are explained and the best evaluation method for them is presented. Then, paraclinical examinations and imaging are described in a practical evaluation, high-risk etiologies of limping such as infections, tumors, and fractures are explained in detail and red flags are considered at each step. The algorithms and the list of differential diagnoses for each age group are included, which can provide physicians with a more comprehensive approach to limping in children.
文摘Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower limb. We explored a variety of methods treating neuropathic pain such as low-level laser, monochromatic near-infrared treatment, TENS, acupuncture and pulsed electromagnetic fields that demonstrated inconclusive, limited or temporary pain relief with minor or short-term improvements in mobility. Research conducted by ultra-low energy technologies reports pain relief and reduction of inflammation as a result of anti-oxidant electron donation transforming free radicals into stable molecules. We report the results of a randomized double blind one-year-long longitudinal clinical study on 10 diabetic mellitus (DM) subjects with chronic neuropathy, treated with ultra-low energy nanotechnology who experienced substantial long-term neuropathic pain relief. Importantly, pain analgesia and improvement in neuropathic symptomatology were not age-contingent. This contradicts past research postulating that age-accumulated inflammation and endothelial dysfunction can further exacerbate diabetic neuropathy. Importantly, a method offering age-independent, cost-effective, long-term neuropathic pain relief and increased mobility has major implications in reducing hospitalization time and overall expenses by offering a solution that enhances quality of life.
文摘In this study, an effective noncontact and nonattached technique that is based on electrostatic induction current generated during walking motion is proposed for the detection and assessment of human physical activity. In addition, a theoretical model is proposed for the electrostatic induction current generated owing to variation in the electric potential of the human body. The proposed electrostatic induction current model is compared with the theoretical model, and the proposed model is shown to effectively explain the behavior of the electrostatic induction current waveform. The normal walking motions of daily living are recorded with a portable sensor located in a regular house. The obtained results show that detailed information of physical activity such as a gait cycle can be estimated using our proposed technique. Additionally, the walking signal was measured when the subject walked with the ankle and knee fastened to a splint with bandages to simulate a limp. Therefore, the proposed technique, which is based on the detection of signal generated during walking, can be successfully employed to assess human physical activity.
文摘Melorheostosis, also known as Leri disease or flowing periosteal hyperostosis, is a rare, non-hereditary, benign, skle-rosing bone dysplasia which radiologically characterized by the appearance of “melting wax flowing down a candle”. We report on a 43-year-old woman with melorheostosis who had pain in the upper limp for 10 years, limitation of joint movement and a deformity in the left third finger. Radiographies and bone scintigraphy were evaluated. All lesions of melorheostosis in radiography were seen in bone scintigraphy. More than half of increased uptakes on bone scintigra-phy are due to degenerative process.
文摘Background Musculoskeletal(MSK)complaints in children vary,ranging from benign,self-limited conditions to serious disorders.Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease,initially presenting with MSK complaints.Delayed diagnosis and appropriate treatment have an enormous impact on the long-term outcomes and the level of disability.This study aimed to identify the features distinguishing JIA among children presenting with MSK complaints and to describe the spectrum of diseases at a large,single,tertiary center.Methods A retrospective chart review was performed of patients evaluated by pediatric rheumatology consultation at the Faculty of Medicine,Siriraj Hospital,Mahidol University,Bangkok,Thailand,from July 2011 to June 2015.Results Of 531 patients,285(53.6%)had at least one MSK complaint.The mean age of the patients was 9.1+4.1 years.Joint pain was the most common MSK complaint(86.3%),followed by limping(33%)and refusal to walk(19.6%).Joint swelling and limited range of motion were found in 146(51.2%)and 115(40.4%)patients,respectively.Seventy-three(25.6%)patients were diagnosed as JIA.The other common diagnoses included Henoch-Schtnlein purpura(16.1%),reactive arthritis(14.2%),and systemic lupus erythematosus(13.7%).Morning stiffness≥15 minutes[odds ratio(OR)8.217(3.404-19.833)];joint swelling on MSK examination[OR 3.505(1.754-7.004)];a duration of MSK complaints of more than 6 weeks[OR 2.071(1.120-3.829)];and limping[OR 1.973(1.048-3.712)]were significantly associated with the ultimate diagnosis of JIA.Conclusions Morning stiffness≥15 minutes is a strong predictor of JIA.Comprehensive history taking and an MSK examination will provide clues for making the ultimate diagnosis for children with MSK complaints.
基金Funded by the A Starker Leopold Chair of Wildlife Ecology at UC Berkeley.
文摘This paper lays out a hierarchical,appropriate-complexity framework for conceptualizing movement-path segments at different spatiotemporal scales in a way that facilitates comparative analyses and bridges behavior and mathematical concepts.It then outlines a process for generating a multimode,multiscale stochastic simulation model that can be used to test animal movement hypotheses and make predictions of movement responses to management and global change.Many methods for analyzing movement data begin by generating step-length(SL)and turning-angle(TA)distributions from relocation time-series data,some of which are linked to ecological,landscape,and environmental covariates.The frequency at which these data are collected may vary from sub-seconds to several hours.The kinds of questions that may be asked of these data,however,are very much scale dependent.The hierarchical path-segmentation(HPS)framework presented here clarifies how the scale at which SL and TA data are collected relates to other sub-and super-diel scales.Difficulties arise because the information contained in SL and TA time series are often not directly relatable to the physiological,ecological,and sociological factors that drive the structure of movement paths at longer scales.These difficulties are overcome by anchoring the classification of movement types around the concept of fixed-period(24 h)diel activity routines and providing a bridge between behavioral/ecological and stochastic-walk concepts(means,variances,correlations,individual-state and local environmental covariates).This bridge is achieved through the generation of relatively short segments conceived as characteristic sequences of fundamental movement elements.These short segments are then used to characterize longer canonical-activity-mode segments that emerge through movement at behaviorally relevant sub-diel scales.HPS thus provides a novel system for integrating sub-minute movement sequences into canonical activity modes(CAMs)that,in turn,can be strung together into various types of diel activity routines(DARs).These DARs both vary among individuals within a given day,and for any given individual across time and under the influence of landscape factors.An understanding of how DARs are influenced by environmental inputs will help us predict the response of supra-diel lifetime movement phases(LiMPs)of individuals,as well as their complete lifetime tracks(LiTs),to anthropogenically induced global change.
