Articles: back-pain.
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J Manipulative Physiol Ther · Jun 2019
Observational StudyResearching the Appropriateness of Care in the Complementary and Integrative Health Professions Part 3: Designing Instruments With Patient Input.
The purpose of this article is to describe how we designed patient survey instruments to ensure that patient data about preferences and experience could be included in appropriateness decisions. These actions were part of a project that examined the appropriateness of spinal manipulation and mobilization for chronic low back pain and chronic neck pain. ⋯ This article documents the challenges and the efforts involved in designing data collection tools to facilitate the inclusion of patient data into appropriateness decisions.
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J Clin Psychol Med Settings · Jun 2019
Patient Activation Mediates the Association Between Psychosocial Risk Factors and Spine Surgery Results.
Although spine surgery (SS) and spinal cord stimulators (SCSs) can provide significant relief for patients with intractable pain, their effectiveness is variable. Previously, a number of pre-operative psychosocial risk factors have predicted suboptimal outcomes of these procedures. However, recent research has found that "patient activation"-the extent to which patients are engaged and active in their own health care-can predict positive surgical results. ⋯ Bootstrapped mediation analyses indicated that patient activation mediates numerous associations between psychosocial risk factors and suboptimal outcomes. That is, patients' involvement in obtaining information, decision making, and their resilience can explain why some patients do not experience adverse surgical results when pre-surgical psychosocial risk factors are present. Pre-surgical psychological evaluations should include examination of patient strengths in addition to psychosocial risk factors, so that treatments can be appropriately individualized and the most effective surgical results obtained.
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Parotid adenocarcinoma comprises 10% of all parotid cancers and does not frequently produce distant metastases. The most common site for metastases is the lung, and there have only been 2 reported cases of skeletal metastases. The purpose of this study is to report the first vertebral metastasis from a primary parotid adenocarcinoma. Patient records, imaging, and pathology from a case of vertebral metastasis of a primary parotid adenocarcinoma were reviewed. A literature review of parotid adenocarcinoma metastases was also performed and is presented. ⋯ Distant metastases from a primary parotid adenocarcinoma are rare events, especially metastases to bone. This case represents the first vertebral metastasis from a primary parotid adenocarcinoma.
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To assess inflammatory back pain (IBP) and neuropathic pain (NP) in patients with axial spondyloarthritis (axSpA) and explore their relationships with disease activity and functional status. ⋯ Though pain quality (sensory and affective pain descriptors) show differently in patients with IBP or NP, the axSpA patients with IBP or NP experience more severe pain intensity and pain interference, higher disease activity, and greater functional limitation. The presence of IBP or NP could reflect higher disease activity or greater functional limitation in patients with axSpA.