The cadmium concentration of renal tissue from 82 patients who had died at the age of 45-65 years has been determined by atomic absorption spectrophotometry; 43 were normotensive and 39 hypertensive. Renal cadmium concentration was higher in normotensives than in hypertensives. When smoking habits were taken into account, renal cadmium concentration was found to be 82% higher in normotensives than in hypertensives. Other workers have found the opposite relationship. It is proposed that this discrepancy might reflect either that variations due to age were not taken into account in previous investigations or that a difference exists between soft-water areas and hard-water areas such as the one studied.
OBJECTIVE: To compare physical characteristics of the cervical musculature, including maximal isometric strength of the flexors and extensors, relative isometric endurance of the extensors and the active range of motion (ROM) in extension in a group of patients seeking treatment for chronic neck pain and a group of age-matched healthy people. SETTING: Department of Medical Orthopedics, National University Hospital, Denmark. METHODS: One hundred and nineteen chronic neck-pain patients underwent physical testing for active ROM in extension, maximal isometric torque in extension and flexion and relative isometric endurance in extension before entering a clinical controlled trial studying the treatment of chronic neck pain. Their results were then compared with those of 80 age-matched healthy people. RESULTS: The reliability study demonstrated good within-day and day-to-day reproducibility for active ROM. Active ROM was significantly reduced in female patients, but not in all male age groups. Patients exhibited clinically and statistically significant reductions in maximal isometric torque in both the flexors and extensors of the cervical spine, with the greatest reduction seen in the extensor muscle group. Most patient groups demonstrated a significant reduction in relative isometric endurance of the extensors. CONCLUSIONS: In agreement with most low-back comparisons between patients and age-matched healthy people, the greatest relative muscular deficiencies seem to be in the extensor muscle group. Additionally, most patients exhibit a significant decrease in active ROM during extension. The clinical utility of physical measurements has not been firmly established.
OBJECTIVE: To review the literature pertaining to neck/shoulder pain and its treatment primarily through rehabilitation. A discussion regarding the theoretical basis for clinical rehabilitation is presented. DATA SOURCE: A Medline literature search was performed. English and Scandinavian language articles were reviewed. Key words included neck/shoulder pain, neck pain, rehabilitation and exercise. STUDY SELECTION: The studies included used rehabilitation of the cervical musculature as the main treatment therapy on patients suffering from neck/shoulder pain as defined by the Standardized Nordic Questionnaires. DATA SYNTHESIS: The relatively new concept of neck/shoulder rehabilitation seems to result in pain reduction, restoration of functional values and psychological benefit for patients suffering from chronic, recurrent, post-traumatic or postoperative neck/shoulder pain. Successful protocols seem to be dependent upon sufficient dosage, duration and a relative disregard of pain. Side effects seem to be rare. CONCLUSIONS: Rehabilitation of patients with neck/shoulder pain offers great promise; sufficient documentation exists to warrant serious consideration from all practitioners in the primary health sector. Future studies will be necessary to further clarify which rehabilitative procedures are most suitable for different patient types.