Faculty Bibliography

This self-directed learning module reviews the history and physical examination of common acute musculoskeletal conditions that occur in the occupational setting. It is part of the industrial medicine and acute musculoskeletal rehabilitation study guide in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article presents case vignettes to review the diagnostic evaluation of heel pain, whiplash, repetitive strain injuries, and low back pain. OVERALL ARTICLE OBJECTIVE: To understand the important components of a history, physical examination, and concise diagnostic testing when evaluating acute industrial and musculoskeletal injuries.

This learning module highlights the unique challenges faced by physicians treating the aging workforce. It is part of the industrial medicine and acute musculoskeletal rehabilitation study guide in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Factors intrinsic and extrinsic to the patient that increase the risk of injury with aging are outlined. Low back injuries are the most common musculoskeletal complaint in the aging workforce. A conceptual framework for low back pain with aging, a differential diagnosis, and appropriate laboratory and radiographic investigations are also presented. Determination of causation in the setting of comorbid medical conditions and rehabilitation strategies are reviewed. OVERALL ARTICLE OBJECTIVE: To recognize diagnosis and treatment issues that are unique to the aging worker.

OBJECTIVES: Dengue fever is endemic in the country of Grenada and is grossly underreported as a source of morbidity. The goal of this study was to assess the status of dengue fever in a representative community in Grenada. METHODS: Surveys were conducted in the Mont Tout/Grand Anse Valley area in the parish of St. George's from March to June 1996. The objectives of the survey were to: (1) to assess the knowledge, attitudes, and practices (KAP) of residents; (2) to determine the presence of larval and adult Aedes aegypti and their potential breeding sites; and (3) to identify the seroprevalence of specific immunoglobulin G (IgG) dengue antibodies in the local population. RESULTS: Out of the 102 respondents to the KAP survey, 100 of them (98%) reported never having had dengue fever. Of the 75 persons who agreed to have blood samples taken, 70 of them (93%) (95% confidence interval = 85.1%-97.8%) tested positive with the IgG enzyme-linked immunosorbent assay, indicating past exposure. In terms of water storage, 98 of 102 respondents (96%) stored fresh water in containers. The vector survey found 57 of the 102 households (56%) had Ae. aegypti larvae in water containers on their property, and 94 of 102 dwellings (92%) had adult Ae. aegypti mosquitoes indoors. CONCLUSIONS: Although many people were familiar with dengue fever and mosquitoes, the 1996 survey found that their knowledge of the important relationships among mosquitoes, human behavior, and disease transmission was incomplete. Since 1996, continued education efforts have been made in the public school system and with national public health campaigns, yet little effort has been specifically targeted towards our study community. These data suggest Grenada has a need for continued community education that addresses dengue fever transmission and Ae. aegypti reduction.

OBJECTIVE: Magnetic therapy has been used in the treatment of a wide variety of chronic pain syndromes. It has not been studied in the treatment of myofascial shoulder pain in persons with spinal cord injury (SCI). Because this type of pain is commonly refractory to traditional therapy, alternative treatments often are considered. The primary objective is to determine whether myofascial shoulder pain in persons with SCI can be temporarily ameliorated with static magnetic fields. DESIGN: Case series. SETTING: Clinic of a university hospital system. PARTICIPANTS: A volunteer sample of 8 participants with SCI; 3 women, 5 men; mean age = 45 years; mean duration of injury = 12.3 years. INTERVENTIONS: Placement of a commercially available magnet with a static magnetic field of 500 gauss on the affected shoulder for 1 hour. MAIN OUTCOME MEASURES: Pretreatment and posttreatment scores on the short-form McGill Pain Questionnaire and pressure algometry were compared. RESULTS: The short-form McGill Pain Questionnaire descriptors demonstrated significant decreases: stabbing, 0.75 +/- 0.71 (P < 0.02); sharp, 0.50 +/- 0.53 (P < 0.033); and tender, 0.88 +/- 0.83 (P < 0.021). They also demonstrated a significant decrease in the present pain intensity of 0.63 +/- 0.52 (P < 0.011). Participants demonstrated a nonsignificant decrease of 0.813 +/- 0.998 (P < 0.55) on the visual analog scale. Pressure algometry was nonsignificant with a difference of 0.062 +/- 1.17 (P < 0.885). CONCLUSION: Static magnetic fields may decrease the sensory dimensions and intensity of myofascial shoulder pain in persons with SCI.