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

Three patients, men aged 62, 57 and 44 years, had suffered for 6-24 months from low back pain, which after an acute moment had worsened with pain radiating to one leg. In all 3 patients, a neurological cause was considered first, but investigations revealed that they had a large abdominal aortic aneurysm (AAA) resulting in emergency surgery. The oldest man died from late complications; the younger men made a good recovery. An AAA should be considered in patients with low back pain and risk factors such as male gender, older age, cigarette smoking, hypertension and previous manifestations of vascular disease. Making the diagnosis as early as possible can be lifesaving.
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PMID:[Back pain? Don't forget the abdomen]. 1521 60

Anecdotal evidence indicates a difference between doctors' health seeking behaviours for their patients and for themselves. This difference remains untested. This study aimed to assess any differences between the first-line treatment options GPs would accept for themselves and those they would advise their patients. A postal questionnaire was completed by 286 GPs based in two west London Health Authorities (response rate 51.4%) asking them to score the treatment options of 6 common symptoms for both themselves and their patients in terms of over the counter (OTC) remedies, prescriptions, referrals and complementary therapies. The results showed that GPs differentiated between themselves and their patients in terms of OTC remedies for indigestion and depression, prescriptions for indigestion, hypertension, depression and 'tired all the time' (TATT); referrals for indigestion, hypertension, low back pain and TATT; and complementary therapy for depression. GPs may be prepared to cross the boundary be treated the same as their patients if the symptoms are relatively uncontroversial. Stigmatised problems and those with clinical guidelines, however, seem to result in a 'do as I say not as I do' approach to health care.
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PMID:Do GPs practice what they preach? A questionnaire study of GPs' treatments for themselves and their patients. 1559 Feb 31

Hemodialysis procedure has potential complications and nurses must be able to intervent on them. Considering this context, this article aims to describe the most frequent hemodialysis-related complications as well as nursing-related interventions. This bibliographic review consists in LILACS, BDENF and MEDLINE search using pertinent descriptors. Results demonstrated that major complications are: hypotension, hypertension, cramps, nausea and vomiting, headache, chest and low back pain, scratching, fever and shriving. For these complications there are specific nursing interventions that can be delivered. It was concluded that nurse's role is essential for monitoring, identification, and intervention in such complications and that this role also is a differential to obtain quality in hemodialysis procedure. However, there is a need to perform more research in nursing area to better define the nurse's role.
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PMID:[Nursing interventions for the most frequent complications during hemodialysis procedure: literature review]. 1668 8

Caudal block with a local anesthetic through the hiatus sacralis has been performed in patients with chronic low back pain, lower limb pain, anal pain, and pelvic pain due to spinal canal stenosis, lumbar disc herniation, lumbar spondylolisthesis, postherpetic neuralgia, peripheral vascular disease, complex regional pain syndrome and so on. We prepar- ed an information and consent sheet on caudal block in The University of Tokyo Hospital. In the information sheet, we included disease, purpose, methods, outcome, accidental complications of caudal block, other treatments, progress on unperformed case, questions and answers, influence of rejection, and doctor's name. We experienced some cases of boring pain, deterioration of low back pain and lower limb pain, headache, nausea, hypertension, hypotension, and tachycardia as accidental complications of caudal block. In describing some accidental complications, we included boring pain, high intracranial pressure, dural puncture, nerve injury, infection, hemorrhage, embolism, allergy, and heart, lung, brain, liver, and kidney failures. Further, we could refer to the accidental complications of epidural block. However, the rate of each accidental complication has not been known in detail. We should survey the outcome and accidental complication of caudal block prospectively in multiple facilities and provide the patients with useful information.
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PMID:[Information and consent sheet of caudal block in the University of Tokyo Hospital]. 1678 90

A 42-year-old, non-obese man with a three-month history of headache, pulsatile tinnitus, transient visual obscurations, and scintillations later developed low back pain with right lower extremity radiation. Brain MRI and magnetic resonance venography were normal, but spine MRI revealed a mass in the cauda equina. Neuro-ophthalmologic examination disclosed bilateral optic disc edema with normal visual function. During spine surgery, cerebrospinal fluid, released under high pressure despite prior hyperventilation, contained a glucose level of 51 mg/dl and a protein level of 1840 mg/dl. Histologic and immunohistochemical features of the lesion were compatible with a capillary hemangioma. Although spinal cord tumors have been associated with papilledema, this is the first report of a capillary hemangioma of the cauda equina in this context. If papilledema is present, spinal cord imaging should be performed when lumbar puncture discloses unexplained protein elevation and in cases that lack clinical features typical of idiopathic intracranial hypertension.
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PMID:Capillary hemangioma of the cauda equina presenting with radiculopathy and papilledema. 1684 8

A 69-year-old man (163 cm, 72 kg) with hypertension and lumbar spondylosis deformans was diagnosed as having prostate cancer and subsequently underwent perineal prostatectomy under sevoflurane anesthesia combined with epidural anesthesia using mepivacaine in the exaggerated lithotomy position. Supplemental intravenous fentanyl was also given. The patient's systolic blood pressure ranged between 80 and 120 mmHg throughout the 255-minute procedure. On emergence from the anesthesia, the patient was free from pain and epidural infusion with 0.2% ropivacaine, fentanyl 2 microg x ml(-1) and droperidol 12.5 microg x ml(-1) at a rate of 5 ml x hr(-1) was started. Shortly thereafter, the patient began to complain of severe low back pain, which required intramuscular pentazocine injection as a rescue analgesic for 5 days postoperatively. On the 6th postoperative day, creatine kinase, which had apparently passed its peak, was 4,795 IU x l(-1). MRI on the 8th day demonstrated the presence of hemorrhage in the bilateral erector spinae muscles. On day 16, CT scan also confirmed partial necrotizing changes in the bilateral gluteal and erector spinae muscles. We believe that the low back pain was due to rhabdomyolysis secondary to ischemia of the lumbar and pelvic muscles resulting from lengthy compression during surgery. The recognition and early diagnosis of rhabdomyolysis following prolonged time in the exaggerated lithotomy position are the key to prevent potentially fatal sequelae.
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PMID:[Rhabdomyolysis accompanying low back pain following prolonged urological surgery in the exaggerated lithotomy position: a case report]. 1705 83

This descriptive cross-sectional survey was conducted among all the female traders in Sango market, Ibadan in, April 2003. The aim of the study was to identify the common health problems of women traders in Sango and their work conditions. The most commonly reported health problems were muscular and joint pains by 105 (37.4%), 95 (33.8%) had symptoms suggestive of malaria and 66 (23.5%) had chronic low back pain. The prevalence of muscular and joint pain was highest among respondents aged > 60yrs (p=0.023), and among those who spent eight to ten hours per day in the market (p=0.200). On examination 56 (19.9%) were hypertensive, 88 (31.3%) and 97 (16.7%) were overweight and obese respectively. The prevalence of hypertension was associated with increasing age and obesity (p=0.000). The common health problems among these female traders were muscular and joint pain, symptoms suggestive of malaria, chronic low back pain and hypertension. It is recommended that appropriate health interventions be instituted to address these problems.
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PMID:Work conditions and health problems of female traders in Ibadan, Nigeria. 1787 91

(1) Paracetamol is the first-choice analgesic for joint pain. Nonsteroidal antiinflammatory drugs (NSAIDs), especially ibuprofen, are second-line options. Cox-2 inhibitors are no more effective than traditional NSAIDs and have no tangible advantages in terms of gastrointestinal tolerability. In contrast, they expose patients to an increased risk of cardiovascular adverse effects. (2) Etoricoxib is marketed in some European countries to relieve symptoms of osteoarthritis, rheumatoid arthritis, and gout attacks. (3) Many clinical trials have tested etoricoxib in these indications, as well as in ankylosing spondylitis, low back pain, and various types of acute pain. Etoricoxib was no more effective than other NSAIDs such as ibuprofen, naproxen or diclofenac in these situations. (4) Comparative trials showed a higher overall mortality rate with etoricoxib than with naproxen. A combined analysis of long-term comparative trials including 5441 patients, mainly versus naproxen, showed that etoricoxib does not reduce the risk of perforation, ulcer or severe gastrointestinal haemorrhage. Similarly, it does not reduce the risk of mild gastrointestinal events in at-risk patients: those with a history of gastrointestinal disorders, aspirin use, etc. (5) Three trials including a total of 34 701 patients (MEDAL programme) compared cardiovascular thrombotic events associated with etoricoxib and diclofenac. Overall, the cardiovascular risks appear to be similar but the thrombotic risk may be slightly higher with diclofenac than with other conventional NSAIDs. (6) Etoricoxib provoked arterial hypertension, oedema and heart failure during clinical trials. Serious skin reactions were reported both during clinical trials and after marketing, but their precise incidence is not known. Etoricoxib is partly metabolised by the cytochrome P450 isoenzyme CYP 3A4 and increases the bioavailability of ethinylestradiol. (7) When a NSAID is considered, drugs with which we have the most experience should be chosen, such as ibuprofen, and used at the lowest acceptable dose regimen (daily dose and length of treatment). Etoricoxib should be avoided.
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PMID:Etoricoxib: new drug. Avoid using cox-2 inhibitors for pain. 1808 59

Salmonella tiphymurium infection frequently causes gastroenteritis but some cases have a predilection for damaged blood vessels, especially those affected by atherosclerosis. The abdominal aorta is the most frequent location. Salmonella aortitis with mycotic aneurysm formation is a rare but serious condition, due to the high risk of rupture. We report the clinical case of a 61 year old man with a history of diabetes and hypertension, who was previously admitted with Salmonella gastroenteritis for which he had been treated with proper antibiotics. He was readmitted with fever, nausea and low back pain. Salmonella thyphimurium was isolated in blood cultures. The investigation revealed a pseudoaneurysm formation on the abdominal aorta. He was submitted to surgical vascular grafting with aneurysm resection and antibiotic therapy before and after surgery, with excellent clinical outcome. Bacteremia due to Salmonella Typhymurium must always raise the suspicion of focalization, especially a vascular infection. Particular attention should be given to predisposing factors, such as pre-existent atherosclerosis and age. The advised treatment of mycotic aneurysm due to a Salmonella agent must be a combined medical and surgical therapy.
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PMID:[Salmonella typhimurium aortitis]. 1816 78

The Author examined in The Time of Twelve Months (October 2006/October 2007) a sample of 371 Workers exposed at different Types of Risck Factors (See Tab. I) with the Aim of to Express one Judgment of Fitness at The Specific Task and PreVenction and Therapie of the Professionals Diseases. The 74.52% of the Workers to Obtain one Judgment of Fitness Absolute and the 25.48% one Judgment of Fitness with Specific Limitation. The Casistic to understanding a Number of 316 Male (85.17%) and 55 Female (14. 83%). The Middle Age of the Sample it's 38. 17 Year with DS:9.77, and it's therefore juvenile, middle. To come Explained in the Tab. III the Percentage of Internistic Diseases obtained in The Fitness with Limitation. The Symptoms of Phatologie most attend aren't: The Arterial Hypertension (29.17%), following to Low Back Pain/Artrhosis (15.63%) afterwards the Ear Deafness for Noise (14.58%) and The sharp or Chronic Bronchitis (12.50%). The Subject Workers aren't dependent to Questionnnaire about the Job Satisfaction (JCQ di Karasek R) about the Stress (Pisa Stress Questionnaire of CA Pruneti at 32 Items) and about the Alexithimic Characteristic (Test Tas-20). The Outcomes aren't explained in Tab. IV. It's Already explain, that Judments of Not Fitness absoluted to have Heart repercussion about the Psychosomatic Health of the Workers and of Your Family System with one increased Psychosocial Risck and Inability, and therefore Judgment of Fitness at Work with specific Limitation aren't to indicate for adaptation the Worker at the best Work and Task.
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PMID:[Compliance to regular health surveillance in workers with different work related risk factors]. 1840 80


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