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A 44-year-old man is evaluated for a 6-month history of progressive bilateral lower extremity numbness and weakness and a 4-year history of back pain. What is the diagnosis? Medscape (Source: Medscape Today Headlines)

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Opioid administration turns down a pain amplifier by reversing synaptic long-term potentiation in spinal nociceptive pathways.Authors: Ruth Drdla-Schutting, Justus Benrath, Gabriele Wunderbaldinger, Jürgen Sandkühler (Source: Science: Current Issue)

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Introduction: The On-Q® pain pump provides a continuous infusion of regional anesthesia for management of postoperative pain. Several studies have evaluated its use in adult patients, but little is known about its effectiveness in children. the objective of this study was to assess the efficacy and outcomes of pediatric patients treated with the On-Q® pump, and compare it to conventional epidural use in the postoperative period. Methods: We evaluated all patients in our hospital, from 2005-2008 who underwent a surgical procedure and received either an epidural infusion or On-Q® pump postoperatively. 192 patients met criteria, 124 epidural and 64 On-Q® (4 patients received both therapies and were excluded). Patients were sub-categorized by procedure type, abdominal, thoracic, or other (…

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Conclusions: Both SRH and HRQoL were lower among those reporting functional limitations or chronic low back pain. However, the change varied according SEP and the measure. In relative term, the negative impact of a given health condition seems to be greater on SRH and lower on HRQoL for people with higher SEP in comparison with people with low SEP. Using SRH could thus decrease socioeconomic differences. In contrast using HRQoL could increase these differences, suggesting being cautious when using these indicators for analyzing health disparities. (Source: BMC Public Health – Latest articles)

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Discussion Infantile hemangiomas (IH) are the most common soft tissue tumors in infants. They are usually considered birthmarks but are dynamic lesions. They usually begin in the first few weeks of life and rapidly grow in the first 3-5 months of life. By 5 months, most lesions will have achieved 80% of their final size. Almost all IH have cessation of growth after 9 month of age. Images of IH can be seen in the To Learn More section below. Learning Point Often no treatment is necessary for IH other than expectant monitoring. Additional treatment may be necessary depending on the patient’s age, lesion type, location, size and complication being considered. The results of a prospective cohort of 1058 children in 7 pediatric dermatology clinics found that overall 24% of patients had c…

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Popped ribs, brain injuries, blinding pain. Are the healing rewards worth the risks? (Source: NYT)

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Objective: Functional somatic symptoms, symptoms for which no organic pathologic basis can be found, are more prevalent in girls than in boys, and this difference tends to increase during adolescence. This might be explained, at least in part, by pubertal … (Source: SafetyLit: All (Unduplicated))

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Spinal manipulation therapy and exercises that patients can do at home are more effective than drugs for relieving neck pain, a new study shows. Medscape Medical News (Source: Medscape Today Headlines)

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Medication appeared least effective treatment in small study Source: HealthDay Related MedlinePlus Page: Neck Injuries and Disorders (Source: MedlinePlus Health News)

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Neck pain is very common and fortunately resolves quickly in most individuals. However, in certain cases neck pain can last longer and result in chronic pain, limited neck motion, and disability. In fact, chronic neck pain is the second leading cause of workers’ compensation claims in the United States. Treatments that can quickly reduce pain, increase motion, and improve the ability of the muscles to protect the neck may help decrease long-term disability associated with neck pain. A variety of manual therapy treatments are currently used to manage neck pain. These treatments include mobilization, which slowly and repeatedly moves the neck joints and muscles, and manipulation, which delivers a single, small, quick movement to the joints and muscles. A research report published in th…

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ConclusionMohs surgeons have a high prevalence of musculoskeletal disorders. Symptoms present early and persist throughout the careers of Mohs surgeons. The nature of the occupation leaves the surgeon vulnerable to injury. Ergonomic modifications in behavior and workplace are recommended to reduce pain and injury to surgeons. (Source: Dermatologic Surgery)

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We describe a 10-year-old girl with pain in her lower limbs and back. Spinal magnetic resonance imaging revealed an intradural extramedullary lesion at T9-T10. We decided on surgical treatment. An anatomic/pathologic examination revealed histiocytic-like cells and extensive fibrosis. Immunohistochemistry revealed positivity for CD68 protein and negativity for CD1a protein. Craniospinal magnetic resonance imaging demonstrated an extra-axial lesion in the right frontal region, a small nodule in the left middle cerebellar peduncle, and another small lesion in the right ventral pons. We performed a complete removal of the frontal lesion. The histologic examination produced results compatible with Rosai-Dorfman disease. Most lesions in intracranial Rosai-Dorfman disease mimic meningioma. The de…

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Which method of pain control effectively manages pain while also minimizing the risk of postoperative nausea and vomiting after spinal surgery? Spine (Source: Medscape Today Headlines)

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Conclusion: The relationships between flare-up and studied related factors were not proven. Clinical significance: Age, gender, visit type, treatment duration, preoperative pain and intraoperative pain have no effect on flare-up incidence. Keywords: Flare-up, Longitudinal study, Preoperative pain, Treatment duration, Visit type. How to cite this article: Udoye CI, Jafarzadeh H, Aguwa EN, Habibi M. Flare-up Incidence and Related Factors in Nigerian Adults. J Contemp Dent Pract 2011;12(2):120-123. Source of support: Nil Conflict of interest: None declared. PMID: 22186755 [PubMed - in process] (Source: J Contemp Dent Pract)

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CONCLUSIONS: Lower FS and higher pain intensity outcomes were associated in similar but not identical patterns with patients whose SCL BPPM classification of PD increased, or remained at high or intermediate levels during physical therapy. Serial assessments of change in PD during rehabilitation are recommended as a possible treatment-monitoring tool. J Orthop Sports Phys Ther 2011;41(12):969-980. doi:10.2519/jospt.2011.3814. PMID: 22146493 [PubMed - in process] (Source: Physical Therapy)

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This study undertook an economic analysis of the costs of early retirement due to back problems, with the aim of quantifying how much lower the value of accumulated wealth of individuals who exit the workforce early due to back problems is by the time they reach the traditional retirement age of 65years – compared to those who remained in the workforce. This was done using the output dataset of the microsimulation model Health&WealthMOD. It was found that over 99% of individuals who are employed full time will have accumulated some wealth at age 65years, whereas as little as 74% of those who are out of the labour force due to back problems will have done so. Those who retire from the labour force early due to back problems will have a median value of total accumulated wealth by the time …

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Magnetic resonance imaging before epidural steroid injections for lower back pain does not improve patient outcomes or guide treatment decisions. Medscape Medical News (Source: Medscape Today Headlines)

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(Ivanhoe Newswire) – Routine expensive MRI imaging doesn’t improve the treatment of patients who need steroid injections into their spinal column to relieve pain, according to this study. (Source: Medical Headlines From Ivanhoe.com)

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Conclusions:  Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson’s‐associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the elderly, in general chronic pain, posture, respiratory function and stuttering, but there is insufficient evidence to support recommendations in these areas. (Source: International Journal of Clinical Practice)

Origin: MedWorm: Back Pain

Guidelines for clinical management of patients with low back pain (LBP) encourage health care practitioners to advise staying active and returning to work. Despite this, most practitioners believe work factors can cause or exacerbate LBP, and a recommendation for a “short break from work” to allow healing is common… (Source: Health News from Medical News Today)

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