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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study of the natural presentation, course, and treatment of low back pain in the primary care setting was undertaken. One hundred and forty-four charts listing low back pain as a problem were reviewed at a family practice center for a period of one year. A profile of the patient evaluated by the primary care physician emerged, revealing a high incidence of associated weight problems (70 percent), psychologic problems (33 percent), and hypertension (19 percent). The rate of actual or suspected disc disease (1.4 percent) was much lower than that reported in series from referral centers. This study of low back pain in the primary care setting illustrates the usefulness of outpatient study in defining a problem category, recognizing disease as a symptom complex, suggesting modalities of treatment, and designing a curriculum for the primary care physician.
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PMID:Low back pain in the primary care setting. 16 43

A 65-year-old female suffering from lumbago, headache, and hypertension had been treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and antihypertensive drugs. On June 13, 1990, 2 weeks after the commencement of loxoprofen administration, she developed cough and low grade fever. She was treated with antibiotics and NSAIDs without improvement. Laboratory data showed marked eosinophilia (2200/mm3), elevation of IgE (3090 IU/ml), and liver dysfunction. Her chest X-ray revealed no active lesion, but the percentage of eosinophils in BALF was elevated (38%). Because drug-induced eosinophilic pneumonia was suspected, all drugs were discontinued. Her symptoms improved and the abnormalities of laboratory data normalized. The lymphocyte stimulation test was weakly positive with three NSAIDs (loxoprofen, pranoprofen, and alminoprofen). The challenge test by loxoprofen reproduced eosinophilia and liver dysfunction, suggesting that she had loxoprofen-induced eosinophilic pneumonia. To our knowledge, this is the first reported case of loxoprofen-induced lung injury.
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PMID:[A case of loxoprofen-induced pulmonary eosinophilia]. 163 61

The working conditions of municipal employees of Botucatu (State of S. Paulo, Brazil) are described with a view to identifying the most frequent and serious occupational risks. Office workers (clerks) were not included in this study. The morbidities registered in the municipal outpatient service (from July 17 through December 4, 1987) and in the occupational accident register for the period 1984-1987 were evaluated. The activities of the majority of the employees were found to be carried out manually with no technological assistance, likely to generate "occupational accidents" (OA) and related to inadequate (antiergonomic) positions. The coefficient of severity of the OA has increased so rapidly that in 1987 it was 1.85 times higher than in 1984. The analysis of the external sources and the nature of the lesions caused by the OA were closely related to the description of the activities and the risk factors observed. The most frequent ailments registered in the outpatient service were: arterial hypertension, lumbago, the common cold, chronic alcoholism, acute gastroenterecolitis and "personal difficulties". An occupational health program for the municipal workers in Botucatu is proposed.
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PMID:[Evaluation of working conditions of municipal employees engaged in manual labor]. 178 71

Twenty consecutive, chronic low back pain patients admitted to our pain treatment unit completed the Attributional Style Questionnaire (an instrument that detects a cognitive style that is correlated with, and that predicts, depression) and the Beck Depression Inventory. An age, sex, and education-matched group of normal subjects, a group of patients with asymptomatic essential hypertension, and a group of patients with end-stage renal disease receiving dialysis treatment served as controls. The majority of the chronic-pain and renal-dialysis patients had elevated depression scores, whereas none of the normal subjects or hypertensive patients were outside the nondepressed range. The Attributional Style scores of the pain and renal dialysis patients were significantly deviant from the normal control group, but no more so than those of the patients with hypertension. The results of this study suggest that individuals with a chronic medical condition, either symptomatic (chronic low back pain or renal disease) or asymptomatic (essential hypertension) in nature, develop an attributional style characteristic of depression. These data neither lend support nor refute the thesis that chronic pain syndromes are a variant of, or a masked, depression. Rather, this research implies that a more important question is what identifiable risk factors (for example, attributional style) predispose patients with chronic pain to develop a depressive illness.
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PMID:Chronic low back pain, depression, and attributional style. 215 7

Twenty cases of ependymomas of the intradural filum terminale in adults have been reviewed. Their pathology was quite uniform, of a myxopapillary type, similar to the low grade ependymoma described by Kernohan, which represent about 23% of the tumours of cauda equina. Mean age of the patients was 35.7 years. Mean time between the first symptom and the diagnosis was 46 months. Clinical symptoms were often non specific, with low back pain and radiculalgias. At the time of operation, clinical signs were essentially motor deficits usually moderate (11 cases), sphincter disturbances (10 cases), and sensory loss (9 cases). In 3 patients with rapid worsening, an intratumoral haemorrhage was found. In 2 other cases, intracranial hypertension was the main symptom: in the first, it was related to hydrocephalus probably caused by spinal subarachnoid haemorrhage; in the second, there was no ventricular dilatation. In this series, neuroradiological examinations had consisted mainly in myelographies. C.T. scan has been performed in 3 patients; in only one case it has allowed to visualize a presacral extension. One patient had preoperative M.R.I.: the association of an expansive lesion with upper cyst in conus medullaris and presence of blood in the sacral area permitted the diagnosis of ependymoma of the filum terminalis. The average size of the tumours was 8 cm. Total removal has been possible in 15 cases (and in 2 of the 5 giant tumours), subtotal removal in 2 cases, and partial removal in 3 cases. In 4 patients where existed an intraspinal cord extension above the conus, it has been resected completely, except for one case with recurrence. Patients with a total removal had a good functional recovery (13/15). No recurrence has been observed in this group. In conclusion, with M.R.I., one may hope an earlier diagnosis, condition of radical surgery. So, radiotherapy which is not without risk, could be avoided.
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PMID:[Ependymoma of the intradural filum terminale in adults. 20 cases]. 216 65

A comprehensive approach to worker's health problems involves integration of occupational health services within community health programs. This comprehensive health care concept is basic to the work of the Occupational Health Unit (OHU), in Botswana which was set up in 1982 as a collaborative effort of the WHO Regional Office for Africa and the Ministry of Health using a family nurse practitioner (FNP) for clinical assessment in the place of employment. Botswana has an acute health personnel shortage. Traditionally, nurses have provided primary health care (PHC). In 1980, a 1-year postbasic FNP program was set up at the Botswana National Health Institute (NHI) to prepare registered nurse-midwives (NMs) to treat and diagnose common problems. Family nurse practice includes health assessment, the provision of health education, and counseling. The OHU participates in training nurses who attend the NHI. An instructional unit has been set up for occupational health in which nurses receive field experience. There is a high degree of understanding and acceptance of FNPs by Botswana's physicians. 65 FNPs serve the PHC system--some in remote and some in periurban health facilities. The national manpower development plan says that an additional 20 nurse practitioners should be trained per year. A survey of the health status of industrial workers in Gaborone, the capital of Botswana, was undertaken. It was conducted at places of employment in 30 urban and periurban industries. On-site physical examinations of the workers took place. Diagnosis was based on symptoms and signs. Health problems were managed according to the 1986 "Botswana national drug catalogue and treatment guide." 1007 workers--796 men and 211 women-- were examined. 166 health problems were detected. There were 157 sexually transmitted diseases; 148 low back pain problems; 105 cases of high blood pressure, and 96 workers had eye problems. The health problems affecting Gaborone workers are mostly the same as the PHC problems in the general population. Suspected occupational health and work-related conditions were managed in consultation with the doctor specialist in the OHU. The FNP also provided health education and counseling. One model is to use a centrally located FNP attached to an occupational health team as a source of education and other support for district nurse practitioners and allied health personnel. A team of FNPs could also be used.
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PMID:Nurses bring primary health care to industrial workers. 220 30

We presented a 47 year old lady in whom, during the investigation for unstable arterial hypertension and lumbar pain, ultrasonography and computed tomography showed a polycystic mass retroperitoneally in the level of the pancreas. During operation a chylous lymphangioma of the pancreas was found and was almost entirely excised. The remaining mass was opened and left to drain into abdominal cavity. The recovery was uneventful. Hystology confirmed chylous limphangioma. The patient stayed symptom-free with normal clinical, ultrasonographic and laboratory data for more than a year after surgery. Lumbar pain disappeared and blood pressure became normal.
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PMID:[Chylous lymphangioma of the pancreas (case report)]. 248 76

This comparative descriptive study investigated differences in perceived body space and self-esteem in adult males with and without chronic low back pain. Results indicated that no significant differences existed between the two groups. Ancillary findings indicated that adult males with chronic low back pain were more depressed than adult males with hypertension. Those with continuous chronic pain demonstrated higher depression scores and lower self-esteem scores than did those experiencing intermittent chronic pain.
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PMID:Perceived body space and self-esteem in adult males with and without chronic low back pain. 252 43

An autopsy case report of leiomyosarcoma of the thoracic aorta is presented. The patient was a 75-year-old Japanese woman who complained of hypertension, melena and lumbago. The autopsy revealed severe occlusion of the thoracic aorta due to the tumor. Histologically the tumor consisted of fascicular proliferation of atypical fusiform cells. Metastases were seen in the bilateral adrenal glands, pancreatic tail and bones (vertebrae and femur). At the distal portion of the aortic tumor, there was a secondary dissecting aneurysm.
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PMID:Leiomyosarcoma of the thoracic aorta associated with dissecting aneurysm. 260 59

Of 101 patients with benign intracranial hypertension not related to vasculitis, neck stiffness occurred in 31, tinnitus in 27, distal extremity paresthesias in 22, joint pains in 13, low back pain in 5, and gait "ataxia" in 4. Symptoms resolved promptly upon lowering the intracranial pressure by lumbar puncture, and were probably directly caused by intracranial hypertension. Awareness of these "minor" symptoms of increased intracranial pressure can facilitate diagnosis and management.
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PMID:The minor symptoms of increased intracranial pressure: 101 patients with benign intracranial hypertension. 297 Jun


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