Tendons are designed to take tensile load, but excessive load can cause overuse tendinopathy. Overuse tendinopathy results in extensive changes to the cells and extracellular matrix, resulting in activated cells, increase in large proteoglycans and a breakdown of the collagen structure. Within these pathological changes, there are areas of fibrocartilaginous metaplasia, and mechanotransduction ...

Overuse injuries of the ankle and foot are common in the general and athletic populations. The wide spectrum of overuse injuries includes ligamentous injuries, soft tissue and osseous impingement, osteochondral lesions, tendon injuries, and stress fractures. Some conditions such as impingement syndromes and stress fractures may be missed on initial physical examination, and patients with such i...

You cannot dispute the warning of England’s chief medical officer, Sally Davies, that antibiotic resistance is one of modern health’s greatest threats. Also beyond dispute is her analysis of its causes—the lack of new drugs combined with massive overuse of existing antibiotics. What physicians and policy makers generally overlook, however, is the critical role played by the ongoing overuse of a...

Citation: Su M, Yu S. Medication-Overuse Headache: The Same Thing to Substance Abuse? J Headache Pain Manag. 2016, 2:1. Medication-Overuse Headache (MOH) is one of the most common chronic headache disorders characterized by overuse of kinds of acute headache medications. Many studies have found that MOH shares some common clinical and biological features with substance abuse, however, the compl...

Current strategies for addressing health care costs stress physician performance measurement and commonly use an efficiency index (EI). During seven years of conducting individual practitioner pay-for-performance (P4P), we found that using EIs hindered our work on reducing overuse of services. This paper offers an alternative approach through the identification of variation in key cost drivers....

Many Veterans Affairs physicians are familiar with the steady stream of reminders generated by our electronic medical record system to order laboratory and screening tests. These reminders help clinicians meet guidelines and performance targets for screening and prevention. However, the article by Virani and colleagues demonstrating substantial overuse of repeated lipid testing in a Veterans Af...

When x-rays were first discovered, the harmful effects of radiation had to be manifest in the early users before they were known. Today, radiation protection and safety have been established and the effects of radiation, as well as its risks, are known. Even so, medical radiation, in particular the growth in the use of computed tomography (CT), has resulted in soaring radiation doses received b...