Chronic Pain Syndromes: Myofascial Pain Syndrome.

Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder characterized by trigger points within the muscle or fascia. There are no universally accepted diagnostic criteria. Diagnosis currently is based on a physical examination finding of at least one localized trigger point that, when palpated, recreates the pain at the site or produces pain away from the site in a referral pattern.

Artemisia Species with High Biological Values as a Potential Source of Medicinal and Cosmetic Raw Materials.

species play a vital role in traditional and contemporary medicine. Among them, , , , , and are the most popular. The chemical composition and bioactivity of these species have been extensively studied.

Pre-positioned Outbreak Research: The Joint Medical Emerging Diseases Intervention Clinical Capability Experience in Uganda.

The West Africa Ebola virus disease outbreak of 2014-2016 demonstrated that responses to viral hemorrhagic fever epidemics must go beyond emergency stopgap measures and should incorporate high-quality medical care and clinical research. Optimal patient management is essential to improving outcomes, and it must be implemented regardless of geographical location or patient socioeconomic status. Coupling clinical research with improved care has a significant added benefit: Improved data quality and management can guide the development of more effective supportive care algorithms and can support regulatory approvals of investigational medical countermeasures (MCMs), which can alter the cycle of emergency response to reemerging pathogens.

Pupillometer Use: Validation for Use in Military and Occupational Medical Surveillance and Response to Organophosphate and Chemical Warfare Agent Exposure.

Introduction: To analyze the effectiveness and suitability of pupillometer use in military and occupational medicine, specifically when pupil size is measured as part of medical surveillance. Pupil size is the most sensitive physical exam finding in vapor exposure to substances that inhibit acetylcholinesterase, such as nerve agent (chemical warfare) and organophosphates (used in agriculture). Pupillometer use permits real-time, accurate pupil measurements, which are of significant value in occupational setting where exposure to organophosphates is suspected and in dynamic military settings where it may be unclear if service members were exposed to nerve agent or not.

Clinical utility of the mBIAS and NSI validity-10 to detect symptom over-reporting following mild TBI: A multicenter investigation with military service members.

Self-report measures are commonly relied upon in military healthcare environments to assess service members following a mild traumatic brain injury (mTBI). However, such instruments are susceptible to over-reporting and rarely include validity scales. This study evaluated the utility of the mild Brain Injury Atypical Symptoms scale (mBIAS) and the Neurobehavioral Symptom Inventory Validity-10 scale to detect symptom over-reporting.

Mindfulness as a Weight Loss Treatment for Veterans.

Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.

Clinical utility of the memory complaints inventory to detect invalid test performance.

Objective: This investigation was designed to examine the classification statistics of Memory Complaints Inventory (MCI) scores relative to the Medical Symptom Validity Test (MSVT) and the Non-Verbal Medical Symptom Validity Test (NV-MSVT), as well as various validity scales on the Personality Assessment Inventory (PAI) and Minnesota Multiphasic Personality Inventory-2 Restructured Form(MMPI-2-RF).

Method: The sample consisted of 339 active duty service members with a history of concussion who completed performance validity tests (PVTs), symptom validity tests (SVTs), and the MCI.

Results: Those who failed the MSVT and NV-MSVT had significantly higher scores across all MCI scales.

Bilateral differences in the upper quarter function of high school aged baseball and softball players.

Purpose/background: The Upper Quarter Y Balance Test (YBT-UQ) was developed as a way to identify upper extremity and trunk mobility in the open kinetic chain in the reaching limb as well as midrange limitations and asymmetries of upper extremity and core stability in the closed kinetic chain on the stabilizing limb. Performance on the YBT-UQ is similar between genders and between limbs; however, this has not been examined in athletes who participate in sports that result in upper extremity asymmetries. The primary purpose of this study is to determine if differences exist between the throwing vs.

Paclitaxel and trastuzumab for breast cancer.

The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A.

Yoga to treat nonspecific low back pain.

Low back pain is common and poses a challenge for clinicians to find effective treatment to prevent it from becoming chronic. Chronic low back pain can have a significant impact on an employee's ability to remain an active and productive member of the work force due to increased absenteeism, duty restrictions, or physical limitations from pain. Low back pain is the most common cause of work-related disability among employees younger than 46 years.

How to stop fighting ourselves: removing the stigma of mental health treatment for soldiers.

Soldiers' fear of stigmatization by peers and superiors is the primary barrier that the US Army must overcome as a prerequisite to providing successful mental health treatment to Soldiers who have been exposed to the combat environment. Untreated mental health conditions can lead to increased severity of symptoms and adversely affect mission readiness. Command leadership must become aware of the effects of combat exposure upon their Soldiers, and refer Soldiers to behavioral health facilities when necessary, so that their Soldiers are peak performers and mission ready.

Benign joint hypermobility syndrome: evaluation, diagnosis, and management.

Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder with hypermobility in which musculoskeletal symptoms occur in the absence of systemic rheumatologic disease. Although BJHS has been well recognized in the rheumatology and orthopedic literature, it has not been discussed in the family medicine literature. Because most patients with musculoskeletal complaints are first seen by family physicians, it behooves primary care physicians to be familiar with recognizing and diagnosing BJHS.

Common bacterial dermatoses: protecting competitive athletes.

Athletes competing in a wide variety of sports are at risk of contracting and spreading bacterial skin infections. Bacteria proliferate in environments of wet, macerated skin that is repeatedly abraded against competing athletes, equipment, clothing, or objects in the field of play. Common infections include impetigo, folliculitis, furunculosis, pitted keratolysis, and otitis externa.

Delayed hemothorax after blunt trauma without rib fractures.

Delayed hemothorax after blunt trauma is a rare, significantly morbid entity described in the current literature associated with displaced rib fractures. This report describes a case of delayed hemothorax after blunt trauma without rib fracture. The patient presented to a routine clinic appointment 72 hours after injuring himself while snowboarding.

Exertional heatstroke in an infantry soldier taking ephedra-containing dietary supplements.

This is a case report of a highly trained, heat-acclimatized infantry soldier who suffered from exertional heatstroke during a 12-mile road march shortly after taking an ephedra-based supplement. Heatstroke is associated with systemic complications and a high mortality rate if not recognized early. Control of risk factors is key to the prevention of heatstroke.

Exposure to liquid sulfur mustard.

Chemical weapons continue to pose a serious threat to humanity. With the use of chemical weapons by terrorists in Tokyo, and the projected disarming of the chemical weapon stockpile in this country, the possibility that emergency physicians will encounter patients contaminated by chemical munitions, such as sulfur mustard, exists. Mustard is a vesicating agent with a long latency between exposure and symptoms.

Transient hyperthyroidism of hyperemesis gravidarum: a sheep in wolf's clothing.

Background: Transient hyperthyroidism of hyperemesis gravidarum (THHG) is a self-limiting hyperthyroidism occurring in the context of hyperemesis gravidarum.

Methods: A literature search of MEDLINE was undertaken, and a case report of a woman with THHG in pregnancy is described.

Results And Conclusions: Because thyroid function tests cannot distinguish Graves disease from THHG, the diagnosis of THHG rests largely on the concurrent development of hyperemesis and hyperthyroidism and the absence of signs and symptoms of hyperthyroidism before and during pregnancy.

Effort thrombosis with sepsis.

This report of a recreational athlete who had arm discomfort, fever, headache, and emesis frames a discussion of the diagnosis and treatment for primary upper-extremity deep vein thrombosis (PUEDVT). An unusual aspect of the case was sepsis without typical risk factors. Treatment of PUEDVT usually involves immediate anticoagulation and local thrombolysis followed by evaluation for postthrombosis management; septic thrombophlebitis usually responds to intravenous antibiotics.

Oncogenes in X-ray-transformed C3H 10T1/2 mouse cells and in X-ray-induced mouse fibrosarcoma (RIF-1) cells.

In order to better understand the molecular basis of X-ray induced carcinogenesis we have investigated RNA levels of oncogenes in an X-ray transformed C3H 10T1/2 fibroblast line (XTD) and RIF-1 cells isolated from an X-ray-induced fibrosarcoma in a C3H mouse. Steady-state levels of K-ras, H-ras, N-ras, abl, sis, src, and fos were unchanged in the X-ray-transformed cells compared with non-transformed C3H 10T1/2 cells. However, myc and raf mRNA levels were increased dramatically in the transformed cells.