Clinics in occupational and environmental medicine
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Clin Occup Environ Med · Jan 2006
ReviewUse of medications in the treatment of acute low back pain.
The prescription of medications continues to be one of the mainstays of treatment of acute low back pain episodes. The goals of the pharmacologic treatment for acute low back are reduction of pain and return of normal function. Often, nociception is a result of secondary inflammation and muscle spasm after acute injury of a structure of the spine, which may include muscle, tendon, ligament, disc, or bone. An understanding of the appropriate use of medications to address the underlying pain generator and the current evidence for using these medications is essential for any physician who sees and treats patients with acute low back pain.
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Clin Occup Environ Med · Jan 2006
ReviewLumbar spine injection and interventional procedures in the management of low back pain.
Lumbar spine injections play a role in the evaluation and treatment of low back pain and lumbar radiculopathy. These injection procedures have been demonstrated to be effective in determining the pain generator for low back pain. ⋯ Current evidence validates that these injections provide temporary relief of low back and radicular leg pain up to several months, if not longer. This duration of pain relief creates an opportunity to maximize rehabilitation efforts while symptoms are minimal.
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Clin Occup Environ Med · Jan 2006
ReviewExposure to airborne particulate matter in the ambient, indoor, and occupational environments.
Exposure to airborne particulate matter results in various adverse health effects. Unlike other pollutants, such as ozone, sulfur dioxide, carbon monoxide, and oxides of nitrogen, for which there is significant exposure, particulate matter exposure is much more complex because it is not a single chemical species or even a limited number of chemical species. ⋯ People are exposed to particles in the ambient environment, in indoor spaces, and in the occupational environment. This article reviews the information available on the concentrations of particulate matter and its composition in these general environmental categories.
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High-pressure injection injuries of the hand represent one of the most serious surgical emergencies of the upper extremity. It is imperative to understand the mechanism of injury and the parts that take place for this injury to occur (material, pressure, site of injury). Prompt recognition and treatment may alter the final outcome.
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Work-related upper extremity burns often occur. The cause directs the course of action. Thermal burns should be assessed for system alterations, and depth of burn should be determined. ⋯ Some chemical burns, such as those that involve phenols and metal fragments, require specific topical applications before water lavage. Hydrofluoric acid burns can cause life-threatening electrolyte abnormalities with a small, highly concentrated acid burn. The goal with any extremity burn is to provide the patient with a multidisciplinary team approach to achieve a functional, usable extremity.