Articles: back-pain.
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Equine veterinary journal · Feb 2009
Osteoarthritis of the thoracolumbar synovial intervertebral articulations: clinical and radiographic features in 77 horses with poor performance and back pain.
Back pain is well recognised as a cause of poor performance in horses, but the role of lesions of the thoracolumbar synovial intervertebral articulations (facet joints) has not been well documented. ⋯ Osteoarthritis of the thoracolumbar facet joints probably contributes to back pain, but further investigation of the prevalence of osteoarthritis in horses without clinical signs of back pain is merited.
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The multimodal therapy has proved to be useful for the treatment of patients with chronic back pain. The aim of this methodical study was to test whether specific effects for the individual can be inferred from general effects of the entire sample, in order to define criteria for the success of treatment. These could be helpful when deciding to which patients the multimodal therapy can best be applied. ⋯ Taking into account principles of classical test theory this study showed that sufficient systematic coherence of the data must be proven before changes can be calculated. As long as neither an adequate systematic nor useful criteria can be found, there seems to be no reason to exclude any patient from multimodal therapy using pre-selection criteria.
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Data on the efficacy of the Dachau multidisciplinary treatment program for chronic pain is presented. The treatment is administered in a primary care day clinic and the treatment period is 5 weeks plus 5 booster days 6 months later. The program is characterized by high treatment intensity (122.5 h over 5 weeks) and is aimed at patients where outpatient pain therapy proved to be insufficient. The treatment plan is applicable to different types of chronic pain and the main treatment objective is functional restoration. ⋯ The Dachau multidisciplinary treatment for chronic pain achieved significant improvements which remained stable for 6 months after treatment.
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Randomized Controlled Trial Multicenter Study Comparative Study
The efficacy of prostaglandin E1 derivative in patients with lumbar spinal stenosis.
Randomized controlled trial. ⋯ In this study, limaprost was found to be efficacious on most outcome measures, such as HRQOL, symptoms and subjective satisfaction, in LSS patents with cauda equina symptoms.
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GMS Health Technol Assess · Jan 2009
Human papillomavirus (HPV) vaccination for the prevention of HPV 16/18 induced cervical cancer and its precursors.
Essential precondition for the development of cervical cancer is a persistent human papillomavirus (HPV) infection. The majority - approximately 70% - of cervical carcinomas is caused by two high-risk HPV types (16 and 18). Recently, two vaccines have been approved to the German market with the potential to induce protection against HPV 16 and HPV 18 among additional low-risk virus types. ⋯ Implementation of HPV vaccination might lead to a reduction of cervical cancer in immunized women. However, uptake of immunization should be accompanied by further studies in order to assess long-term effectiveness and safety aiming at an optimization of possible implementation processes. High numbers of participants are of particular importance regarding immunization. This has to be backed up by programs to optimize early detection - as this affects even those women who already underwent immunization. Since cost-effectiveness evidence might be significantly affected by the unclear duration of protective benefits, a final verdict on the vaccination's cost-effectiveness in the German setting is not possible. Hence, risk-sharing-agreements between third-party payers and manufacturers would pose an option to balance the consequences of uncertainty towards the duration of protection on cost-effectiveness.