骨骼肌肉系统

章节摘录

版权页：   插图：    Interesting facts  NSAIDs and cardiovascular risk  Over the past 30 years,the main toxicity concern of NSAIDs has been the upper gastrointestinal toxicity system.However,since 2000 there has been increasing interest in the cardiovascular risk of NSAIDs,particularly the COX-2 selective inhibitor Rofecoxib（Vioxx）.This culminated in its international withdrawal from the market.The cardiovascular risk of NSAIDs,whether COX-2-selective or not remains under a cloud. Corticosteroids  The corticosteroids（or glucocorticoids）are hormones produced by the adrenal glands.They have potent antiinflammatory and immunosuppressive properties.Their effect in RA,when used at high doses,is dramatic.Corticosteroid analogues have been produced synthetically by chemical modification of the natural hormone cortisol.This has resulted in a range of compounds with varying potencies and differential toxicities.By far the most commonly used compound is prednisone,which is four to five times as potent as cortisol and has less mineralocorticoid activity,resulting in less fluid retention. Prednisone is administered orally and acts rapidly to reduce inflammation,resulting in a lessening of joint swelling,pain and stiffness in RA.They bind to cytoplasmic cortisol receptors and are transported into the nucleus where they interfere with RNA processing of protein molecules.Corticosteroids act on a wide variety of target cells including leukocytes.They inlubit leukocyte chemotaxis（directed motion towards a stimulus）,preventing circulating polymorphs,monocytes and lymphocytes from reaching sites of inflammation.They reduce vascular permeability and inhibit the production of cytokines and arachidonic and metabolites,such as prostaglandins and leukotrienes. Despite clinical efficacy,corticosteroids are toxic if used at high doses for prolonged periods.Corticosteroids  Case 1.1 Rheumatoid arthritis: 4 Case note: Corticosteroid treatment  Despite 2 weeks of complete rest and a course of naproxen,Mrs Gale has only partly improved,remains in pain and cannot funaion effectively.After a telephone call by her general practitioner to a theumatologist,she is advised to commence oral prednisone lomg per day as a morning dose.

内容概要

作者：（英国）萨姆布鲁克（Philip Sambrook） （英国）Leslie Schrieber （英国）Thomas Taylor （英国）Andrew Ellis

书籍目录

1 RHEUMATOID ARTHRITIS AND THE HAND  Introduction  Essential anatomy and physiology  Essentialimmunology  Pathology  Aetiopathogenesis of theumatoid arthritis  Treatment of theumatoid arthritis  Prognosis 2 SOFT TISSUE RHEUMATIC DISEASE INVOLVING THE SHOULDER AND ELBOW  Introduction  Anatomy of the shoulder  Pathophysiology of rotator cuff disease  Clirucal aspects of shoulder pain  Investigahons  Treatment  Rehabilitation and outcome  Anatomy of the elbow  Lateralepicondylitis 3 NERVE COMPRESSION SYNDROMES  Introduchon  Peripheral nerve anatomy  Pathophysiology and classification of nerve injury  Electrophysiology  Carpal tunnel syndrome  Treatment of carpal tunnel syndrome  Cubital tunnel syndrome 4 BACK PAIN  Introduction  Normal lumbar spine anatomy  Funchon of the lumbar spine  Pain from the lumbar spine  Epidemiology of low back pain  Treatment of low back pain 5 BONE STRUCTURE AND FUNCTION IN NORMAL AND DISEASE STATES  Introduction  Normal skeletal structure and function  Metabolic bone disease  Osteoporosis： pathophysiology and risk factors  Epidenuology of fractured hip  Essential anatomy of the hip  Surgical management of hip fractures  Medical management of osteoporotic hip fracture 6 ARTICULAR CARTILAGE IN HEALTH AND DISEASE  Introduction  Anatomy  Biochemistry  Pathophysiology of osteoarthritis  Clinical features of osteoarthritis  Essential anatomy of the knee joint  Epidemiology of osteoarthritis  Management of osteoarthritis 7 CRYSTAL ARTHROPATHIES AND THE ANKLE  Introduction  Differential diagnosis of acute monarthritis of the ankle  Essential anatomy  Investigations and diagnosis  Pathophysiology of gouty arthritis  Treatment of acute gout  Treatment of chronic gout  Chondrocalcinosis  Treatment of calcium crystal assoaated arthritis 8 DISORDERS OF SKELETAL MUSCLE  Introduction  Anatomy of skeletal muscle  Investigations  Muscle diseases  Acquired muscle diseases  Inherited muscle disorders  Muscle disorders in which pain is the main feature  Fibromyalgia 9 AUTOIMMUNITY AND THE MUSCULOSKELETAL SYSTEM  Introduction  Immunology  Serological manifestations of autoimmunity  Clinical features and epidemiology  Pathology  Aetiology  Treatment  Variants of SLE 10 TRAUMA AND THE MUSCULOSKELETAL SYSTEM  Introduction  Pathophysiology  Functional anatomy of the knee joint  Diagnosis of fracture  Management of fractures 11 INFECTION AND THE MUSCULOSKELETAL SYSTEM  Introduction  General principles of musculoskeletal infection  Host defences against infection  Blood supply of bone  Acute infection of bone and joints  Antibiotic therapy  Chronic infections of bones and joints  Glossary  Index 

编辑推荐

《"以器官系统为中心"原版英文教材:骨骼肌肉系统(第2版)》的原版英文教材为“以器官系统为中心”，由北京大学医学出版社出版发行。

作者简介

《"以器官系统为中心"原版英文教材:骨骼肌肉系统(第2版)》每一章节都是围绕着一个临床病例展开，通过对病人问题的呈现以及解决过程引出对相关知识的探究，从而使与器官系统结构、功能以及疾病相关的重要的基础医学知识得到了完善的整合。

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