Articles: back-pain.
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In the past decade, more and more behavioral health providers have begun consultation practices in primary-care settings. Their availability makes multidisciplinary care a reality and the possibility of improved outcomes for patients with chronic pain more feasible. ⋯ This article presents two cases to illustrate the questions that arise in delivery of primary-care behavioral health services to patients with chronic pain. Relevant professional ethical guidelines for psychologists, social workers, and physicians are examined and recommendations for addressing the gaps in extant guides are offered.
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Urolithiasis refers to renal or ureteral calculi referred to in lay terminology as a kidney stone. Utolithiasis is a potential emergency often resulting in acute abdominal, low back, flank or groin pain. Chiropractors may encounter patients when they are in acute pain or after they have recovered from the acute phase and should be knowledgeable about the signs, symptoms, potential complications and appropriate recommendations for management. ⋯ This case describes a patient with acute right flank and lower quadrant pain which was diagnosed as an obstructing ureteric calculus. Acute management and preventive strategies in patients with visceral pathology such as renal calculi must be considered in patients with severe back and flank pain as it can progress to hydronephrosis and kidney failure.
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The Spanish version of the Pain Vigilance and Awareness Questionnaire has not been validated. ⋯ The Spanish version of the Pain Vigilance and Awareness Questionnaire is a reliable and valid instrument. Pain Acceptance and Fear Avoidance beliefs are better predictors of adjustment to pain than pain hypervigilance.
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Arthritis care & research · Mar 2013
Assessment of SpondyloArthritis International Society criteria for axial spondyloarthritis in chronic back pain patients with a high prevalence of HLA-B27.
The Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (SpA) allow SpA classification of HLA-B27-positive patients if ≥2 specific clinical SpA features are present. We investigated the performance of these clinical ASAS criteria in a population with a high prevalence of HLA-B27. ⋯ Application of the clinical ASAS classification criteria in an area with a high prevalence of HLA-B27 leads to significant increases in the prevalence of axial SpA compared to radiologic SpA among CBP patients. This increase in the prevalence of disease is likely to have significant ramifications for patient management and health care systems.
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Int J Cardiovasc Imaging · Mar 2013
Case ReportsSalmonella mycotic aneurysm: a rare cause of fever and back pain in elderly.
An 85-year-old man with history of hypertension presented with fever, cough and abdominal pain. Unfortunately fever and leukocytosis persisted despite treatment. Blood cultures obtained on admission grew Salmonella enteritidis. ⋯ The diagnosis of S. aortitis can be challenging, because the clinical course may be indolent and the symptoms are nonspecific. A high index of suspicion is required to make the diagnosis of S. aortitis, especially in patients with Salmonella bacteraemia, fever, back pain and/or abdominal pain. This case highlights the usefulness of TOE in the evaluation of diseases involving the thoracic aorta, leading to a successful intervention.