Neck or Shoulder? Establishing Consensus for Spine Screening in Patients with Shoulder Pain: an International Modified Delphi Study.

Objective: There is no established consensus for screening the spine in patients with shoulder pain. The aim of this study was to explore the role of the spine in shoulder pain and generate a set of recommendations for assessing the potential involvement of the spine in patients with shoulder pain.

Methods: A modified Delphi study was conducted through use of an international shoulder physical therapist's expert panel.

Defining Insights.

Background: Insights, when acted upon, can result in positive changes to the business, for HCPs, and ultimately for patients. Medical Information, as a customer facing function, is one of the groups that generate insights. Data and insights across different functions of an organization need to be compiled to provide a comprehensive view.

Understanding information (in)equity: influencing factors and medical information's role in bridging the gap.

Medical Information in the pharmaceutical industry involves the creation and dissemination of evidence-based scientific medical content in response to questions about medicines and therapy areas for patients and healthcare professionals. Health information equity can be broadly defined as the distribution of health information in a way that is accessible and understandable to all users, allowing them to benefit and reach their full potential for health. Ideally, this information would be made available to all those in need across the globe.

In vivo uptake of iodine from a Fucus serratus Linnaeus seaweed bath: does volatile iodine contribute?

Seaweed baths containing Fucus serratus Linnaeus are a rich source of iodine which has the potential to increase the urinary iodide concentration (UIC) of the bather. In this study, the range of total iodine concentration in seawater (22-105 µg L) and seaweed baths (808-13,734 µg L) was measured over 1 year. The seasonal trend shows minimum levels in summer (May-July) and maximum in winter (November-January).

Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain.

Background: The diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP.

Methods And Findings: In a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited.

Shoulder pain in primary care--part 2: predictors of clinical outcome to 12 months.

Objective: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up.

Design: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months.

Patients: Of 208 patients, 161 agreed to participate with 96.

Shoulder pain patients in primary care--part 1: Clinical outcomes over 12 months following standardized diagnostic workup, corticosteroid injections, and community-based care.

Objective: Measure changes in pain and disability of primary care shoulder pain patients over a 12-month period.

Design: A non-randomized audit with repeated measures of pain and disability at 3 weeks, 3, 6 and 12 months.

Patients: Of 208 patients, 161 agreed to participate with 96.

Diagnostic accuracy of clinical examination features for identifying large rotator cuff tears in primary health care.

Objectives: Rotator cuff tears are a common and disabling complaint. The early diagnosis of medium and large size rotator cuff tears can enhance the prognosis of the patient. The aim of this study was to identify clinical features with the strongest ability to accurately predict the presence of a medium, large or multitendon (MLM) rotator cuff tear in a primary care cohort.

Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain.

Background: Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort.

Methods: Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics.

Clinical predictors of a positive response to guided diagnostic block into the subacromial bursa.

Objective: To compare the accuracy of combinations of clinical examination findings for predicting a positive response to injection of local anaesthetic into the subacromial bursa.

Design: Prospective, cohort, diagnostic validity design.

Subjects: Consecutive patients with shoulder pain recruited from primary care physiotherapy and general medical practices.

Comparison of a novel direct measure of rapid pain intensity change to traditional serial 100 mm VAS measurement of pain intensity.

Objectives: Key diagnostic decisions often turn on measurement of change in pain intensity after diagnostic anesthetic blocks. This study aimed to introduce a new direct measure pain intensity change and compare it with percent change as calculated from the traditional preprocedure and postprocedure pain visual analog scales.

Methods: Shoulder pain patients enrolled in a diagnostic accuracy study comparing clinical variables with image-guided local anesthetic injections were assessed with both the traditional preprocedure and postprocedure visual analog scales and the new direct method.

Synthesis, full chemical characterisation and development of validated methods for the quantification of (±)-4'-methylmethcathinone (mephedrone): a new "legal high".

The recent global increase in the abuse of 4'-methylmethcathinone and related compounds has developed a requirement for full chemical characterisation of these products. In this work we present full synthetic and chemical characterisation data and supplemental information for mephedrone synthesised as both the hydrobromide and hydrochloride salt. Additionally we report the first fully validated chromatographic methods for the detection and quantitative analysis of the substance both in its pure form and in the presence of a number of common adulterants used in illicit drug manufacture.

Interexaminer reliability of orthopaedic special tests used in the assessment of shoulder pain.

Orthopaedic special tests (OST) are commonly used in the assessment of the painful shoulder to assist to rule-in or rule-out specific pathology. A small number of tests with high levels of diagnostic accuracy have been identified but interexaminer reliability data is variable or lacking. The aim of this study was to determine the interexaminer reliability of a group of OST with demonstrated diagnostic accuracy at primary care level.

Reliability of a new hand-held dynamometer in measuring shoulder range of motion and strength.

Acceptable reliability is a prerequisite for inclusion of physical examination tests in clinical examinations of the painful shoulder. The aim of this study was to establish the intraexaminer and interexaminer reliability of measures of shoulder range of motion (ROM) and muscle force using a new hand-held dynamometer with the ability to standardize overpressure force during passive ROM tests. Forty consecutive subjects with shoulder pain were recruited, and tests were performed by two physiotherapists.

Modification of 5-HT2 receptor mediated behaviour in the rat by oleamide and the role of cannabinoid receptors.

Oleamide (cis-9,10-octadecenoamide) is an endogenous brain lipid which has been suggested to induce sleep in experimental animals. The mechanism of action is unclear but shares many of the characteristics of endogenous cannabinoids such as anandamide and has been shown to enhance in vitro responses to 5-HT and GABA. In the present study we investigated the effects of oleamide on two motor behaviours, back muscle contractions (BMC) and wet-dog shakes (WDS) induced in rats by treatment with the 5-HT2 receptor agonist DOI ((+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride).

Influence of cannabinoids on electrically evoked dopamine release and cyclic AMP generation in the rat striatum.

Using the endogenous cannabinoid receptor agonist anandamide, the synthetic agonist CP 55940 [[1alpha,2beta(R)5alpha]-(-)-5-(1,1-dimethylheptyl+ ++)-2-[5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]phenol], and the specific antagonist SR 141716 [N-(piperidin-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-me thyl-1H-pyrazole-3-carboxamide hydrochloride], second messenger activation of the central cannabinoid receptor (CB1) was examined in rat striatal and cortical slices. The effects of these cannabinoid ligands on electrically evoked dopamine (DA) release from [3H] dopamine-prelabelled striatal slices were also investigated. CP 55940 (1 microM) and anandamide (10 microM) caused significant reductions in forskolin-stimulated cyclic AMP accumulation in rat striatal slices, which were reversed in the presence of SR 141716 (1 microM).

Analysis of protein-bound metabolites of furazolidone and furaltadone in pig liver by high-performance liquid chromatography and liquid chromatography-mass spectrometry.

Studies undertaken using radiolabelled furazolidone have demonstrated the covalent binding of residues of the drug to cellular protein in vivo. A portion of these bound residues and those formed by furaltadone, a related nitrofuran drug, possess intact side-chains, 3-amino-2-oxazolidinone (AOZ) and 5-morpholino-methyl-3-amino-2-oxazolidinone (AMOZ), respectively. These side-chains have molecular characteristics in common with the parent compounds and may be released from liver tissue under mild acidic conditions.

Social interaction increases 5-HT release and cAMP efflux in the rat ventral hippocampus in vivo.

The aim of the present study was to combine in vivo microdialysis in the rat with behaviour in the social interaction test in order to investigate changes in both 5-HT release and cyclic AMP (cAMP) efflux in the ventral hippocampus with simultaneous measurement of behaviour. Exposure of the rat to a 10min period of social interaction with an unfamiliar partner in a brightly lit, unfamiliar arena resulted in an increase in extracellular 5-HT and extracellular cAMP in the ventral hippocampus. Pretreatment with diazepam (1mg/kg i.

Serotonin 5-HT1A receptor activation increases cyclic AMP formation in the rat hippocampus in vivo.

In vivo microdialysis was used to examine the efflux of cyclic AMP (cAMP) into the extracellular fluid of the ventral hippocampus in the freely moving rat. The changes in extracellular cAMP concentration were monitored in response to forskolin and the serotonin 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT). The basal level of hippocampal extracellular cAMP was 2.

Evidence that chronic administration of paroxetine or fluoxetine enhances 5-HT2 receptor function in the brain of the guinea pig.

The effects of chronic treatment with antidepressants on 5-HT-stimulated hydrolysis of phosphoinositide (PI) in the cerebral cortex of the guinea pig were examined. The pharmacological profile of the response was consistent with it being mediated by a 5-HT2 receptor. Chronic (but not acute) treatment with the selective 5-HT uptake inhibitors, paroxetine and fluoxetine (10 mg/kg, p.

Anionic responses of electrochemically synthesized polypyrrole films.

Conducting polypyrrole films with thickness of about 8 mum were prepared on platinum by continuous scanning in 0.1M pyrrole and 0.1M electrolyte (LiCl, LiBF(4) or NaBF(4)).