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Low back pain in the paediatric athlete.
Eur J Emerg Med. 2014 Apr 21;
Authors: Roy SL, Shaw PC, Beattie TF
Abstract
BACKGROUND: This study was designed to provide an overview of the…

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Fifteen-minute consultation: a structured approach to the management of a child or adolescent with back pain.
Arch Dis Child Educ Pract Ed. 2014 Apr 7;
Authors: Cruikshank M, Ramanan AV
Abst…

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Isolated ureteric endometriosis presenting as a ureteric tumor.
Urol Ann. 2014 Jan;6(1):94-7
Authors: Seyam R, Mokhtar A, Al Taweel W, Al Sayyah A, Tulbah A, Al Khudair W
Abstract
A 32 year ol…

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Candida albicans spondylodiscitis following an abdominal stab wound: Forensic considerations.

J Forensic Leg Med. 2014 Mar;23:1-3

Authors: Savall F, Dedouit F, Telmon N, Rougé D

Abstract
Candida albicans spondylodiscitis is a fungal infection of the spine which is still unusual in spite of the increasing frequency of predisposing factors. A 22-year-old man received an abdominal stab wound during a physical assault. Initial medical care included surgery, prolonged use of indwelling vascular catheters with administration of broad-spectrum antibiotics, and hospitalization in intensive care. Two months after the event, the victim experienced back pain in the right lumbar region and septic spondylodiscitis secondary to C. albicans was diagnosed three weeks later. This case is noteworthy because of its clinical forensic context. In France, the public prosecutor orders a medico-legal assessment after an assault for all living victims in order to establish a causal relationship between the assault and its complications. In our case, the patient presented numerous risk factors for candidemia and the forensic specialist reasonably accepted that the causal relationship was certain but indirect. We have only found one published case of spondylodiscitis after an abdominal penetrating injury and the pathogenic agent was not mentioned. We have found no case reported in a forensic context. This unusual observation shows that it may be genuinely difficult to prove the causal relationship between an abdominal penetrating injury and an unusual infectious complication such as fungal spondylodiscitis.

PMID: 24661694 [PubMed – in process]

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Type 1 Modic changes was a significant risk factor for 1 year outcome in sick-listed low back pain patients: a nested cohort study using magnetic resonance imaging of the lumbar spine.

Spine J. 2014 Feb 14;

Authors: Jensen OK, Nielsen CV, Sørensen JS, Stengaard-Pedersen K

Abstract
BACKGROUND CONTEXT: It is not clear whether Modic changes (MC) is associated with low back pain (LBP) outcome.
PURPOSE: To study associations between baseline degenerative manifestations and outcome in sick-listed LBP patients.
STUDY DESIGN: Prospective nested cohort study based on a randomised controlled trial.
PATIENT SAMPLE: Out of 325 sick-listed LBP patients, 141 patients were consecutively examined by magnetic resonance imaging (MRI) and included, and 140 patients completed the study.
OUTCOME MEASURES: Degenerative manifestations of the lumbar spine were quantified, and associations were studied in relation to the three primary outcomes 1) change of back+leg pain and 2) change of function as measured by Roland-Morris questionnaire and 3) one-year U-RTW.
METHODS: By using a previously validated MRI-protocol, a specialist in radiology, who had no access to clinical data, described the images. Associations were studied by linear and logistic regression with adjustment for previously identified prognostic factors for one-year pain and function and for unsuccessful return to work (U-RTW).
RESULTS: Clinically, 43% of the patients had radiculopathy. Degenerative changes were prevalent with altered disc contours in 84%, high intensity zones in 70% and nerve root touch or impingement in 63% of the patients. MC was identified in 60% of the patients, 18% with type 1 changes and 42% with type 2 changes, type 1 including both type 1 and type 1 in combination with type 2. Patients with type 1 changes reported more back pain and did not improve in pain or disability. They increased to include 30% of the patients with U-RTW at one year. Patients with type 2 changes did not differ significantly from patients without MC, but differed significantly from patients with type 1 changes in all three outcomes. Other degenerative manifestations were not significantly associated with any of the three outcomes.
CONCLUSIONS: The only degenerative manifestation negatively associated with outcome was type 1 MC which affected 18% of the cohort at baseline and implied an increased risk for no improvement in pain and function and for U-RTW, even after adjustment for other prognostic factors.

PMID: 24534386 [PubMed – as supplied by publisher]

Prevalence and characteristics of chronic musculoskeletal pain in Japan: A second survey of people with or without chronic pain.

J Orthop Sci. 2014 Feb 7;

Authors: Nakamura M, Nishiwaki Y, Ushida T, Toyama Y

Abstract
BACKGROUND: An epidemiological survey conducted in Japan in fiscal year 2010 revealed a high prevalence of chronic musculoskeletal pain, low patient satisfaction with treatment, a high incidence of protracted treatment lasting a year or more, and reduced quality of life. To improve the current system for treating chronic musculoskeletal pain, it is important to identify risk factors, including patient characteristics, for developing chronic pain. Thus, we sought to determine the incidence of new chronic pain in the Japanese population, as well as the persistence rate, associated factors, and current state of treatment of chronic pain, by repeating a postal survey in a nationwide representative sample group first surveyed in 2010.
METHODS: Among 11,507 participants in the 2010 epidemiological survey, 1,717 reported chronic pain and 6,283 reported no chronic pain. A repeat questionnaire, mailed to subjects in these 2 groups in fiscal year 2011, received replies from 85 % of those who reported pain and 76 % of those without pain in 2010.
RESULTS: The incidence of new chronic pain was 11.1 %. Risk factors for developing chronic pain included working in a professional, managerial, or clerical/specialist occupation, being female, having a BMI ≥25; currently using alcohol or cigarettes; and having completed an education level of vocational school or higher. Persistent chronic pain was reported by 45.2 % of respondents. Those with severe (VAS score ≥7) and constant lower-back pain lasting more than 5 years had the highest risk of the pain persisting. More than 80 % respondents with persistent chronic pain had a history of treatment, and while about 30 % were still receiving treatment at the time of the survey, the other 50 % had discontinued treatment despite the persistence of pain because of a low degree of satisfaction with treatment.
DISCUSSION: We identified risk factors related to the development of new chronic pain and the persistence of chronic pain. Countermeasures to prevent chronic pain could be especially important for the high-risk populations for understanding the pathology of chronic pain.

PMID: 24504984 [PubMed – as supplied by publisher]

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Osteogenesis imperfecta in adults.
J Clin Invest. 2014 Jan 27;:1-2
Authors: Bishop NJ, Walsh JS
Abstract
A 42-year-old premenopausal woman with osteogenesis imperfecta presents to the metabol…

Reduction mammoplasty improves body posture and decreases the perception of pain.

Can J Plast Surg. 2013;21(1):29-32

Authors: Goulart R, Detanico D, Vasconcellos RP, Schütz GR, Dos Santos SG

Abstract
Women with hypertrophic breasts often experience body pain and posture problems, which tend to be reduced or even eliminated after reduction mammoplasty. The present study aimed to analyze the effects of reduction mammoplasty on anthropometric variables, body posture and pain in women with breast hypertrophy. Eleven women (mean [± SD] age 31.3±10.4 years) participated in the present study. Anthropometric variables, body posture and pain perception were evaluated pretest, and 60 (post60) and 90 (post90) days after reduction mammoplasty. Commercially available posture analysis software was used to analyze the following variables: acromial horizontal alignment (AHA), angle between acromial and anterior superior iliac spines (A-AAIS), vertical alignment of right (R) and left (L) trunk (VAT), vertical alignment of R and L body (VAB) and horizontal alignment of R and L pelvis (HAP). Descriptive statistics and ANOVA for repeated measures were used, and effect sizes (ES) were measured; the level of significance was set at P<0.05. There were no significant differences in anthropometric variables among the assessments. Only HAP-R showed a significant decrease; however, when analyzed, ES, VAT- L and HAP- L in post60, and VAT-R, VAT-L, HAP-R, HAP-L and VAB-L in post90 showed large ES after mammoplasty (ES>0.70). There were significant reductions in pain at post60 and post90 in the neck, cervical spine, back, shoulder and arm (P<0.05). Following mammoplasty, an improvement in body posture, primarily in the alignment of shoulders, trunk and pelvis, and a decrease in pain in the upper limbs and spine, were observed.

PMID: 24431933 [PubMed]

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PM R. 2014 Jan 9;
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