Soft tissue disorders

Clinical use Etofenamate (Coletta et al., 1988) is a nonsteroidal anti-inflammatory drug which is used for the treatment of joint, musculoskeletal and soft tissue disorders. Etofenamate is used mainly as a topical formulation (500-1300 mg/day) and is also available for intramuscular injection (1 g/day). 

Clinical use Lonazolac (Riedel et al., 1981) is a nonsteroidal anti-inflammatory drug used for the treatment of acute inflammatory pain conditions of joint and soft-tissue disorders as well as posttraumatic and postoperative pain. It is used as its calcium salt and is given by oral (600 mg/day, initial dose up to 900 mg/day) or rectal administration (800 mg/day). 

Clinical use Naproxen (Todd and Clissold, 1990) is a nonsteroidal anti-inflammatory drug used for the treatment of mild to moderate pain and inflammatory pain conditions such as rheumatoid arthritis, osteoarthritis, soft tissue disorders, postoperative pain and dysmenorrhoea. It is also used to treat migraine. Naproxen shows balanced inhibition of both COX isoenzymes in a cellular assay and a preference for COX-1 in a whole blood assay and in an enzyme assay using recombinant human enzymes. 

The separation of nonsteroidal anti-inflammatory drugs (NSAIDs) has recently attracted considerable interest. Nonsteroidal anti-inflammatory drugs are agents that, in addition to having anti-inflammatory action, also have analgesic, antipyretic, and platelet-inhibitory properties. They are used primarily in the treatment of chronic arthritic conditions and certain soft tissue disorders associated with pain and inflammation. 

It is a non-steroidal antiinflammatory drug (NSAID) and used mainly as its sodium salt for the relief of pain and inflammation in various conditions, such as musculoskeletal and joint disorders viz., rheumatoid, arthritis, osteoarthritis and ankylosing spondolytis peri-articular disorders, for instance bursitis and tendenitis soft-tissue disorders, such as sprains and strains and other painful conditions, namely renal colic, acute gout, dysmenorrhoea, and following certain surgical procedures. 

A work-related musculoskeletal disorder is an injury to the muscles, tendons, and/ or nerves of the upper body either caused or aggravated by work. Other names used to describe work-related musculoskeletal disorders include repetitive motion injuries, repetitive strain injuries, cumulative trauma disorders, soft tissue disorders, and overuse syndromes. Work-related musculoskeletal injuries (MSIs) affecting the upper body and limbs are now recognized as one of the leading causes of worker pain and disability. 

Sommerich, C.M., Mcglothlin, ID. Marras, W.S. 1993. Occupational risk factors assodated with soft tissue disorders of the shoulder a review of recent investigations in the literature. Ergonomics, 36, 697-717. 

Soft-tissue disorders arising from the posterior hip essentially include traumatic injury at the insertion of the hamstring muscles, sciatic neuropathies and ischiogluteal bursitis. The coexisting involvement of the hamstrings insertion at the ischium and the adjacent sciatic nerve is a common condition observed in athletes who present with pain near the ischial tuberosity. It is commonly referred to as... 

Soft-tissue disorders arising from the medial knee essentially comprise traumatic injuries of the medial collateral ligament and pes anserinus tendinopathy and bursitis. 

A variety of soft-tissue disorders involve the ankle. They are reviewed here by location. 

Other Calcium Disorders. In addition to hypocalcemia, tremors, osteoporosis, and muscle spasms (tetary), calcium deficiency can lead to rickets, osteomalacia, and possibly heart disease. These, as well as Paget s disease, can also result from faulty utilization of calcium. Calcium excess can lead to excess secretion of calcitonin, possible calcification of soft tissues, and kidney stones when combined with magnesium deficiency. 

Before giving a nonnarcotic analgesic to a patient, the nurse assesses the type, onset, and location of the pain. It is important to determine if this problem is different in any way from previous episodes of pain or discomfort. If the patient is receiving a nonnarcotic analgesic for an arthritic or musculoskeletal disorder or soft tissue inflammation, the nurse should examine the joints or areas involved. The appearance of the skin over the joint or affected area or any limitation of motion is documented. The nurse evaluates the patient s ability to carry out activities of daily living. This important information is used to develop a care plan, as well as to evaluate the response to drug therapy. 

The musculoskeletal system consists of the muscles, bones, joints, tendons, and ligaments. Disorders related to the musculoskeletal system often are classified by etiology. Acute soft-tissue injuries include strains and sprains of muscles and ligaments. Repeated movements in sports, exercise, work, or activities of daily living may lead to repetitive strain injury, where cumulative damage occurs to the muscles, ligaments, or tendons.1-3 While tendonitis and bursitis can arise from acute injury, more commonly these conditions occur as a result of chronic stress.3,4 Other forms of chronic musculoskeletal pain, such as pain from rheumatoid arthritis (see Chap. 54) or osteoarthritis (see Chap. 55), are discussed elsewhere in this text. 

Inflammation is a common pathway in soft-tissue injury of musculoskeletal disorders. Inflammatory processes lead to two outcomes swelling and pain. Inflammatory processes... 

Trabectedin is licensed for the treatment of advanced soft-tissue sarcoma when treatment with anthracyclines and ifosfamide has failed or is contraindicated. It is administered by intravenous infusion. Trabectedin may cause hepatobiliary disorders and for this reason hepatic function should be evaluated before starting treatment and during treatment. Dexamethasone is administered intravenously with trabectedin for its anti-emetic and hepatoprotective effects. As with other antineoplastic drugs, trabectedin causes nausea and vomiting and bone-marrow suppression as side-effects. 

Rheumatic disease is defined as disease of connective tissue and medical disorders of the musculoskeletal system . The medical discipline concerned with these diseases is referred to as rheumatology. The majority of rheumatic diseases are soft tissue rheumatism and nonspecific low back pain (LBP), autoimmune inflammatory rheumatic diseases, osteoarthritis (OA), osteoporosis, crystal-deposition disease and infectious arthritis. 

Soft tissue rheumatism can be one of the many manifestations of an underlying specific autoimmune disease. Secondary fibromyalgia and enthesitis are the consequences of long-term inadequately treated autoimmune diseases. When no specific underlying causes can be detected, the disorder is called nonspecific soft tissue rheumatism. The major manifestations of soft tissue rheumatism are non-specific... 

Imipenem-cilastatin is one of the drugs of first choice for the empirical therapy of many polymicrobial pulmonary, intraabdominal, and soft tissue infections. The notable adverse effect of imipenem-cilastatin is seizures affecting 1% of patients. Risk factors for seizures are old age, head trauma, previous seizure disorder, cerebrovascular accident, and renal failure. Among patients with a history of penicillin allergy, 10% are cross-sensitive to imipenem-cilastatin. 

Clinical use Acetylsalicylic acid is the prototype of a nonsteroidal anti-inflammatory drug and is used in a large number of inflammatory and pain indications including musculoskeletal, soft tissue and joint disorders, headache, dysmenorrhoea and fever (Symposium on new perspectives on aspirin therapy 1983, various authors). Furthermore, acetylsalicylic acid is used as an antiplatelet drug in the acute treatment of myocardial infarction in combination with thrombolytics and for the prevention of myocardial infarction and stroke (Patrono, 1994). 

Clinical use Diclofenac (Todd and Sorkin, 1988) is a nonsteroidal anti-inflammatory drug with balanced COX-1 and COX-2 inhibition. It is commonly used for a variety of inflammatory and pain conditions such as musculoskeletal and joint disorders, periarticular disorders, soft tissue... 

Clinical use Salicylamide has analgesic and antipyretic effects and is used in multidrug combinations for the treatment of a variety of mild pain conditions including musculoskeletal, soft tissue and joint disorders. 

The average adult contains more that 1 kg of calcium, this being the most prevalent metallic element. The major proportion is contained within the bone (99%) the remainder being in teeth and soft tissues [20]. Plasma calcium represents only a minute fraction (0.03%) of total body calcium yet alteration in the concentration of this fraction can usually accurately reflect underlying disorders of calcium metabolism which are of great importance in clinical medicine. 

Prolonged exposure to high concentrations of metals and their accnmulation in the soft tissues cause many kinds of health disorders ... 

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