Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain

Study Design. A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain and unilateral, segmental inhibition of the multifidus muscle. Patients were allocated randomly to a control or treatment group. Objectives. To document the natural course of lumbar multifidus recovery and to evaluate the effectiveness of specific, localized, exercise therapy on muscle recovery. Summary of Background Data. Acute low back pain usually resolves spontaneously, but the recurrence rate is high. Inhibition of multifidus occurs with acute, first-episode, low back pain, and pathologic changes in this muscle have been linked with poor outcome and recurrence of symptoms. Methods. Patients in group 1 received medical treatment only. Patients in group 2 received medical treatment and specific, localized, exercise therapy. Outcome measures for both groups included 4 weekly assessments of pain, disability, range of motion, and size of the multifidus cross-sectional area. Independent examiners were blinded to group allocation. Patients were reassessed at a 10-week follow-up examination. Results. Multifidus muscle recovery was not spontaneous on remission of painful symptoms in patients in group 1. Muscle recovery was more rapid and more complete in patients in group 2 who received exercise therapy (P = 0.0001). Other outcome measurements were similar for the two groups at the 4-week examination. Although they resumed normal levels of activity, patients in group 1 still had decreased multifidus muscle size at the 10-week follow-up examination. Conclusions. Multifidus muscle recovery is not spontaneous on remission of painful symptoms. Lack of localized, muscle support may be one reason for the high recurrence rate of low back pain following the initial episode.

Semantic priming in Alzheimer's dementia: Evidence for dissociation of automatic and attentional processes

The nature of the semantic memory deficit in dementia of the Alzheimer's type (DAT) was investigated in a semantic priming task which was designed to assess both automatic and attention-induced priming effects. Ten DAT patients and 10 age-matched control subjects completed a word naming semantic priming task in which both relatedness proportion (RP) and stimulus-onset asynchrony (SOA) were varied. A clear dissociation between automatic and attentional priming effects in both groups was demonstrated; however, the DAT subjects pattern of priming deviated significantly from that of the normal controls. The DAT patients failed to produce any priming under conditions which encouraged automatic semantic processing and produced facilitation only when the RP was high. In addition, the DAT group produced hyperpriming, with significantly larger facilitation effects than the control group. These results suggest an impairment of automatic spreading activation in DAT and have implications for theories of semantic memory impairment in DAT as well as models of normal priming. (C) 2001 Academic Press.

Automatic construction of explicit R matrices for the one-parameter families of irreducible typical highest weight (0(m)vertical bar alpha(n)) representations of U-q[gl(m vertical bar n)]

We detail the automatic construction of R matrices corresponding to (the tensor products of) the (O-m\alpha(n)) families of highest-weight representations of the quantum superalgebras Uq[gl(m\n)]. These representations are irreducible, contain a free complex parameter a, and are 2(mn)-dimensional. Our R matrices are actually (sparse) rank 4 tensors, containing a total of 2(4mn) components, each of which is in general an algebraic expression in the two complex variables q and a. Although the constructions are straightforward, we describe them in full here, to fill a perceived gap in the literature. As the algorithms are generally impracticable for manual calculation, we have implemented the entire process in MATHEMATICA; illustrating our results with U-q [gl(3\1)]. (C) 2002 Published by Elsevier Science B.V.

Chemotherapy and radiotherapy: When to call it quits

Abstract: Background: Patients diagnosed with cancer are often treated with chemotherapy and radiotherapy with curative intent. The transition from curative to palliative intent involves re-evaluation of treatment, and has to take into account the attitudes, beliefs and life aims of the patient. Objective: To discuss the difficulties in determining when to cease chemotherapy and radiotherapy in patients with advanced cancer. Discussion: The concept of treatment evaluation using a ‘burden versus benefit’ paradigm is discussed. Treatment aims must be in concordance with those of the patient, which are often couched in functional terms or linked to future significant life events. Chemotherapy and radiotherapy can offer patients in the palliative phase of cancer illness, benefits in terms of relief of symptoms and meaningful prolongation of life, and should be considered in appropriate circumstances. (author abstract)