840 resultados para low back pain


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Pin on disc wear machines were used to study the boundary lubricated friction and wear of AISI 52100 steel sliding partners. Boundary conditions were obtained by using speed and load combinations which resulted in friction coefficients in excess of 0.1. Lubrication was achieved using zero, 15 and 1000 ppm concentrations of an organic dimeric acid additive in a hydrocarbon base stock. Experiments were performed for sliding speeds of 0.2, 0.35 and 0.5 m/s for a range of loads up to 220 N. Wear rate, frictional force and pin temperature were continually monitored throughout tests and where possible complementary methods of measurement were used to improve accuracy. A number of analytical techniques were used to examine wear surfaces, debris and lubricants, namely: Scanning Electron Microscopy (SEM), Auger Electron Spectroscopy (AES), Powder X-ray Diffraction (XRD), X-ray Photoelectron Spectroscopy (XPS), optical microscopy, Back scattered Electron Detection (BSED) and several metallographic techniques. Friction forces and wear rates were found to vary linearly with load for any given combination of speed and additive concentration. The additive itself was found to act as a surface oxidation inhibitor and as a lubricity enhancer, particularly in the case of the higher (1000 ppm) concentration. Wear was found to be due to a mild oxidational mechanism at low additive concentrations and a more severe metallic mechanism at higher concentrations with evidence of metallic delamination in the latter case. Scuffing loads were found to increase with increasing additive concentration and decrease with increasing speed as would be predicted by classical models of additive behaviour as an organo-metallic soap film. Heat flow considerations tended to suggest that surface temperature was not the overriding controlling factor in oxidational wear and a model is proposed which suggests oxygen concentration in the lubricant is the controlling factor in oxide growth and wear.

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Monoamines have an important role in neural plasticity, a key factor in cortical pain processing that promotes changes in neuronal network connectivity. Monoamine oxidase type A (MAOA) is an enzyme that, due to its modulating role in monoaminergic activity, could play a role in cortical pain processing. The X-linked MAOA gene is characterized by an allelic variant of length, the MAOA upstream Variable Number Tandem Repeat (MAOA-uVNTR) region polymorphism. Two allelic variants of this gene are known, the high-activity MAOA (HAM) and low-activity MAOA (LAM). We investigated the role of MAOA-uVNTR in cortical pain processing in a group of healthy individuals measured by the trigeminal electric pain-related evoked potential (tPREP) elicited by repeated painful stimulation. A group of healthy volunteers was genotyped to detect MAOA-uVNTR polymorphism. Electrical tPREPs were recorded by stimulating the right supraorbital nerve with a concentric electrode. The N2 and P2 component amplitude and latency as well as the N2-P2 inter-peak amplitude were measured. The recording was divided into three blocks, each containing 10 consecutive stimuli and the N2-P2 amplitude was compared between blocks. Of the 67 volunteers, 37 were HAM and 30 were LAM. HAM subjects differed from LAM subjects in terms of amplitude of the grand-averaged and first-block N2-P2 responses (HAM>LAM). The N2-P2 amplitude decreased between the first and third block in HAM subjects but not LAM subjects. The MAOA-uVNTR polymorphism seemed to influence the brain response in a repeated tPREP paradigm and suggested a role of the MAOA as a modulator of neural plasticity related to cortical pain processing. Monoamines have an important role in neural plasticity, a key factor in cortical pain processing that promotes changes in neuronal network connectivity. Monoamine oxidase type A (MAOA) is an enzyme that, due to its modulating role in monoaminergic activity, could play a role in cortical pain processing. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

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Background: The Melbourne Edge Test (MET) is a portable forced-choice edge detection contrast sensitivity (CS) test. The original externally illuminated paper test has been superseded by a backlit version. The aim of this study was to establish normative values for age and to assess change with visual impairment. Method: The MET was administered to 168 people with normal vision (18-93 years old) and 93 patients with visual impairment (39-97 years old). Distance visual acuity (VA) was measured with a log MAR chart. Results: In those eyes without disease, MET CS was stable until the age of 50 years (23.8 ± .7 dB) after which it decreased at a rate of ≈1.5 dB per decade. Compared with normative values, people with low vision were found to have significantly reduced CS, which could not be totally accounted for by reduced VA. Conclusions: The MET provides a quick and easy measure of CS, which highlights a reduction in visual function that may not be detectable using VA measurements. © 2004 The College of Optometrists.

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Transmission of a net 467-Gb/s PDM-16QAM Nyquist-spaced superchannel is reported with an intra-superchannel net spectral efficiency (SE) of 6.6 (b/s)/Hz, over 364-km SMF-28 ULL ultra-low loss optical fiber, enabled by bi-directional second-order Raman amplification and digital nonlinearity compensation. Multi-channel digital back-propagation (MC-DBP) was applied to compensate for nonlinear interference; an improvement of 2 dB in Q2 factor was achieved when 70-GHz DBP bandwidth was applied, allowing an increase in span length of 37 km.

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Mallorca, the largest of the Balearic Islands, is a well-known summer holidays destination; an ideal place to relax and enjoy the sun and the sea. That tourist gaze reflected on postcards results from advertising campaigns, where cinema played an important role with documentaries and fiction films. The origins of that iconography started in the decades of the 1920’s and 1930’s, reflecting the so-called myth of the “island of calm”. On the other hand, the films of the 1950’s and 1960’s created new stereotypes related to the mass tourism boom. Busy beaches and the white bodies of tourists replaced white sandy beaches, mountains and landscapes shown up in the movies of the early decades of the 20th century. Besides, hotels and nightclubs also replaced monuments, rural landscapes and folk exhibitions. These tourist images mirror the social and spatial transformations of Mallorca, under standardization processes like other seaside mass tourist destinations. The identity was rebuilt on the foundations of "modernity". Although "balearization" has not ceased, nowadays filmmaking about Mallorca is advertising again a stereotype close to that one of the 1920s and 1930s, glorifying the myth of the "island of calm". This singular identity makes the island more profitable for capital that searches socio-spatial differentiation in post-fordist times.

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Thesis (Ph.D.)--University of Washington, 2016-08

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The work presented in this thesis is concerned with the dynamical behavior of a CBandola's acoustical box at low resonances -- Two models consisting of two and three coupled oscillators are proposed in order to analyse the response at the first two and three resonances, respectively -- These models describe the first resonances in a bandola as a combination of the lowest modes of vibration of enclosed air, top and back plates -- Physically, the coupling between these elements is caused by the fluid-structure interaction that gives rise to coupled modes of vibration for the assembled resonance box -- In this sense, the coupling in the models is expressed in terms of the ratio of effective areas and masses of the elements which is an useful parameter to control the coupling -- Numerical models are developed for the analysis of modal coupling which is performed using the Finite Element Method -- First, it is analysed the modal behavior of separate elements: enclosed air, top plate and back plate -- This step is important to identify participating modes in the coupling -- Then, a numerical model of the resonance box is used to compute the coupled modes -- The computation of normal modes of vibration was executed in the frequency range of 0-800Hz -- Although the introduced models of coupled oscillators only predict maximum the first three resonances, they also allow to study qualitatively the coupling between the rest of the computed modes in the range -- Considering that dynamic response of a structure can be described in terms of the modal parameters, this work represents, in a good approach, the basic behavior of a CBandola, although experimental measurements are suggested as further work to verify the obtained results and get more information about some characteristics of the coupled modes, for instance, the phase of vibration of the air mode and the radiation e ciency

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Introduction. Total mesorectal excision (TME) is the cornerstone of a correct surgical therapy for extraperitoneal rectal cancer. Aim of the study is to evaluate our 5 years experience confronting retrospectively laparoscopic (lap) TME in respect to its laparotomic (open) counterpart. Patients and Methods. 30 patients were treated laparoscopically for stage I-III extraperitoneal rectal cancer and retrospectively compared to a homogeneous group, stratified for sex, age, comorbidities and stage of disease. Results. 30 days mortality was zero for both groups, while morbidity was 20% for the lap group and 36.6% for the open group. Mean lymph nodes harvested was 24 ± 12 for the lap group, 26 ± 14 for the open group (p > 0.05). Five years overall and disease free survival was respectively 82.2% and 81.4% in the lap group, 79.9% and 79.6% in the open group, without statistical significance (p>0.05). Discussion. Minimally invasive TME resulted a safe, effective and oncologically adequate procedure when retrospectively compared to its laparotomic counterpart, with 5 years overall survival and disease free survival reaching no statistical significance compared to the open approach, but with all the advantages of the laparoscopy such as less pain and blood loss, faster recovery, less morbidity and better cosmetics. Conclusions. Our study has retrospectively demonstrated that laparoscopic TME is feasible and oncologically effective, even if it remains a complex minimally invasive procedure, requiring adequate skill. More prospective, randomized studies are necessary to define such a procedure as the new gold standard in treatment of stage I-III extraperitoneal rectal cancer.

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Purpose: To evaluate synergy in the analgesic effects of a combination therapy of carbamazepine (CBZ) and gabapentin (GBP) in diabetic neuropathic pain. Methods: Neuropathic pain was produced in rats by a single intraperitoneal injection of streptozotocin (STZ) at 60 mg/kg. CBZ, GBP, and their combination were orally administered at varying doses (GBP 30 - 180 mg/kg; CBZ 20 - 40 mg/kg) comparable to their therapeutic doses in humans. Nociceptive responses in the diabetic rats were assessed using hot plate test. Results: Hot plate latency significantly increased with oral administration of GBP at a dose of 180 mg/kg when compared with control group (p < 0.05), while at a dose of 90 mg/kg, the increase was not significant. Oral administration of CBZ at doses of 20 and 40 mg/kg did not produce any significant impact on hot plate latency. However, a combination of GBP at 90 mg/kg and CBZ at 20 mg/kg produced significant increase in latency, compared with control group and other groups (p < 0.05), except the group that received 180 mg/kg GBP. The combination of low dose GBP 30 mg/kg and carbamazepine 30 mg/kg had no significant effect on latency (p > 0.05). Conclusion: The results obtained in this study provide useful information on the combination therapy of GBP and CBZ, which may be applied in the treatment of pain in diabetic neuropathy.

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Background:
Many Australians with arthritis self-manage their pain with prescription and/or over-the-counter pain medications, containing paracetamol. If taken appropriately, these medications are relatively safe; however, if mismanaged through patients' iinability to understand medication labels and instructions, these medications may cause adverse drug events and/or toxicities.
Aim:
This study explored the prescription and over-the-counter pain medications most commonly used by people with arthritis and the ability of these patients to correctly identify paracetamol as an active ingredient in commonly available preparations. The study also investigated the functional health literacy of these patients and their inclination to borrow and/or share pain medications.
Method:
Adult participants diagnosed with arthritis were invited to complete an anonymous survey which included questions about their prescription and over-the-counter pain medications; their medication borrowing and sharing behaviours; their functional health literacy; and their knowledge about preparations containing paracetamol as an active ingredient.
Results:
Most of the 254 participants used analgesic agents containing paracetamol, as combination tablets (paracetamol 500 mg and codeine 30 mg) or paracetamol-only tablets (paracetamol 665 mg) to self-manage their pain. Respondents with low functional health literacy scores were significantly less likely to identify paracetamol as an active ingredient in both combination and paracetamol-only pharmaceutical products, and were more likely to guess or did not know how to identify that paracetamol was an active ingredient in these products. Almost 30% of the respondents indicated that they had and/or intended to borrow/share their over-the-counter
pain medications whereas less than 10% suggested that they had and/or intended to borrow/share their prescription pain medication.
Conclusion:
Australians with arthritis, especially those with low functional health literacy scores, self-managing their pain with paracetamol-containing products, do not always recognise paracetamol as an active ingredient in combination products, and may risk potential paracetamol-related adverse effects and/or toxicities.

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Excellent superplastic elongations (in excess of 1,200%) were achieved in a commercial cast AZ31 alloy processed by low temperature equal-channel angular pressing (ECAP) with a back-pressure to produce a bimodal grain structure. In contrast, AZ31 alloy processed by ECAP at temperatures higher than 200 °C showed a reasonably uniform grain structure and relatively low ductility. It is suggested that a bimodal grain structure is advantageous because the larger grains contribute to strain hardening thus delaying the onset of necking, while grain boundary sliding associated with small grains provides a stabilizing effect due to enhanced strain rate sensitivity. © 2008 Springer Science+Business Media, LLC.

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There are numerous evidence-based wound debridement techniques that promote wound healing. However, some of these techniques may cause discomfort and pain for the patient and can be costly for the health care provider. A new, non-invasive wound debridement technique known as low-frequency ultrasonic debridement (LFUD) has been used for the removal of unhealthy tissue and bacterial load in wound management in the clinical setting. This paper reports the use of LFUD by a skin integrity clinical nurse consultant (CNC) as an adjuvant wound debridement and healing technique in a patient with a parastomal abscess. LFUD was found to benefit this patient in terms of expedited wound healing and increased comfort, enabling the patient to have a successful skin graft that led to complete wound closure and discharge from hospital in a timely manner.

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Introducción: La artritis reumatoide (AR) es una enfermedad autoinmune-inflamatoria, que compromete las articulaciones diartrodiales. Tiene una importante repercusión sistémica que incluye la depresión; por lo tanto, tiene un severo impacto sobre la calidad de vida. Es posible que mecanismos de defensa, tales como la resiliencia, puedan amortiguar dicho impacto. Metodología: estudio de corte transversal, multicéntrico (análisis inicial dentro del grupo AR, con muestra no probabilística de 66 pacientes, posterior selección aleatoria simple de 16 pacientes de la muestra inicial y selección de 16 individuos sanos pareados). Posteriormente, se comparó la resiliencia entre sujetos con AR y sujetos sanos, mediante las escalas RS y CD-RISC25. Adicionalmente, se aplicaron las escalas EEAE, EADZ, SF-36 y PANAS. Los datos fueron evaluados mediante el coeficiente de correlación de Spearman, las pruebas U Mann-Whitney, Kruskall-Wallis, T de Student y análisis de varianza. Resultados: se encontraron diferencias significativas en las estrategias de afrontamiento no espirituales en grupos de resiliencia baja, media y alta; diferencias en las medianas de resiliencia en los grupos de depresión por EAZD en los pacientes. No se encontraron resultados significativos en las variables clínicas de la AR ni en la comparación con sujetos sanos. Conclusiones: el uso de estrategias de afrontamiento no espirituales y la ausencia de depresión, se asoció a mayores niveles de resiliencia en los pacientes con AR, por lo cual, los componentes emocionales y cognitivos se asocian a la resiliencia.

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Introducción Los lugares de trabajo contribuyen al bienestar del individuo y en algunos casos pueden constituirse en factores que llevan a alteraciones en la condición de salud. Los trabajadores pueden estar predispuestos a algún tipo de desórdenes musculo-esqueléticos que se generan durante la jornada laboral creando molestia y algunas veces estar asociados a factores de riesgo psicosocial. Objetivo Establecer la relación entre los factores de riesgo psicosocial con síntomas músculo-esqueléticos en trabajadores vinculados a una empresa social del estado Bogotá, 2014. Métodos Se realizó un estudio de corte transversal en una muestra de 203 trabajadores. Como instrumentos se utilizó la Batería de riesgo psicosocial y cuestionario Nórdico. Se realizó análisis estadístico empleando medidas de tendencia central y de dispersión y se midieron asociaciones con el fin de conocer las variables que se relacionan con el evento. Se manejó el programa estadístico SPSS 20 para Windows. Resultados El 78,8% de los trabajadores correspondieron al sexo femenino, con una edad media de 38 ±10,28 años. El promedio de años de antigüedad dentro de la empresa fue de 3,9 ±,6553, se encontró que el 90.4% están expuestos a factores psicosocial extra laborales con clasificación de riesgo despreciable y el 91,6% a factores intralaboral con clasificación de riesgo muy alto. Se encontró prevalencia de sintomatología musculo esquelética a nivel de cuello con un 70%, dorso lumbar con el 56,2%, mano o muñeca el 54,7% y hombro con el 51,7%. Se encontró diferencia significativa entre el dominio de demandas del trabajo con síntomas presentes en hombro y mano/muñeca (p<0,05), seguido de las dimensiones de control sobre el trabajo con síntomas en hombro (p<0,05). Conclusiones La población estudiada presento una elevada prevalencia de síntomas musculo esqueléticos y un alto riesgo psicosocial intralaboral probablemente debido a características del trabajo y de su organización que influyen en la salud y bienestar del individuo.