Conservative management of low back pain

Back pain is prevalent worldwide, but back pain disability has reached epidemic proportions in many industrialised societies. Few patients have serious medical pathology or direct neurological involvement requiring surgery. Although the causes remain unclear, physical stress and its consequences on discs, facet joints and supporting soft tissues at work or leisure are important, sometimes aggravated by adverse psychosocial factors. Modern management emphasises the role of self-care, beginning in primary care with the first episode. Without root compression, bed rest should not exceed 48 hours. Emphasis is on encouraging a rapid return to physical fitness and other activities, including employment, acknowledging that returning to a normal life may require working through pain. Medication facilitates this. No one should remain in pain beyond six weeks without being referred to a specialist service for a physical and psychosocial assessment by appropriately trained professionals and with consultant support for investigation, pain management and rehabilitation when needed

Neck pain and disability: A cross-sectional survey of the demographic and clinical characteristics of neck pain seen in a rheumatology clinic

This hospital-based cross-sectional cohort study examines the clinical and demographic features of neck pain, disability (using the Northwick Park neck pain questionnaire) and relationships to handicap in employment. Of 173 consecutive referrals to a rheumatology clinic with neck pain, 70% had neck/arm pain without neurological involvement, 13% other conditions, 11% nerve involvement and 5% other spinal pain. 141 patients (mean age 50 years) had mechanical or degenerative neck pain, of which 13% was probably work-related and 13% was trauma-related. 44 had taken sickness absence for an average of 30 weeks. Comorbidities were frequent (lumbar pain 51%). Those in work were significantly less disabled than those not working (p = 0.001) and those off sick (p < 0.01). Those reporting sleep disturbance, tearfulness and crying were significantly more disabled (p = 0.0001) than those who did not. Neck pain in secondary care is complicated by physical and emotional comorbidities. Comprehensive management requires a biopsychosocial model of care

Changes in the quality of life in severely disabled people following provision of powered indoor/outdoor chairs

Purpose:To determine the benefits for patients who received an Electric Powered Indoor/outdoor Chair (EPIOC) and to quantify their perceived changes to their quality of life. Method: Community-based cohort study of all patients provided with an EPIOC over 4 months; and followed up about 3 months later in a community served by a regional wheelchair service in North West London (population about 3.1 million) using the EuroQol EQ-5D with visual analogue scales for each of the 5 dimensions of the EQ-5D. Results: Sixty-four wheelchair users were assessed initially and 51 completed follow up. Chair users showed no significant improvement in health state as measured by the EQ-5D after EPIOC provision. The visual analogue scales (VASs) indicated that, although perceived overall health state, independence and social life did not appear to improve, the dimensions of mobility, quality of life and pain/discomfort improved significantly on provision of an EPIOC. Conclusion: EPIOC users reported significant improvements in several important aspects of their lives; not just in mobility (as expected) but also in reduction of pain and discomfort. The use of VASs provided a more holistic set of outcome measures that demonstrate quality of life benefits beyond that of health state alone

Young people’s experiences using electric powered indoor-outdoor wheelchairs (EPIOCs): Potential for enhancing users’ development?

Purpose: To examine the experiences of severely physically disabled young people using electric powered indoor/outdoor chairs (EPIOCs). Methods: A priori interview questions examined young people’s functioning with EPIOCs, pain and discomfort with EPIOC use and accidents or injuries resulting from EPIOC use. Eighteen young people (13 males and 5 females) aged 10 -18 (mean 15) years were interviewed by telephone using a qualitative framework approach. Participants were interviewed 10 -19 (mean 14.5) months after delivery of the chair. Diagnoses included muscular dystrophy (n = 10), cerebral palsy (n = 5), and ‘other’ (n =3). Results: Many children reported positive functioning following EPIOC use, including increased independence and social activities like wheelchair football. However, EPIOC use was also associated with pain and discomfort, as well as perceived lack of safety, and minor accidents. Most young people and their families were fairly satisfied with the service and provision of their wheelchairs. Conclusions: The findings suggest that disabled children’s development may benefit from the use of electric powered indoor/outdoor wheelchairs, although the advantages may come at certain costs to young people’s perceived and real safety. Recommendations to powered wheelchair providers include the demonstrated need for additional driving training as these young people mature

Using geographical information systems for management of back-pain data

This is the post-print version of the Article. The official published version can be accessed from the link below - Copyright @ 2002 MCB UP LtdIn the medical world, statistical visualisation has largely been confined to the realm of relatively simple geographical applications. This remains the case, even though hospitals have been collecting spatial data relating to patients. In particular, hospitals have a wealth of back pain information, which includes pain drawings, usually detailing the spatial distribution and type of pain suffered by back-pain patients. Proposes several technological solutions, which permit data within back-pain datasets to be digitally linked to the pain drawings in order to provide methods of computer-based data management and analysis. In particular, proposes the use of geographical information systems (GIS), up till now a tool used mainly in the geographic and cartographic domains, to provide novel and powerful ways of visualising and managing back-pain data. A comparative evaluation of the proposed solutions shows that, although adding complexity and cost, the GIS-based solution is the one most appropriate for visualisation and analysis of back-pain datasets

Describing race, ethnicity, and culture in medical research. Self defined ethnicity is unhelpful

This article has been made available through the Brunel Open Access Publishing Fund and is available from the specified link - 1996 Copyright BMJ Publishing Group

Synthesis and characterization of alpha-zirconium (IV) hydrogenphosphate containing metallic copper clusters.

SYNTHESIS AND CHARACTERIZATION OF alpha-ZIRCONIUM (IV) HYDROGENPHOSPHATE CONTAINING METALLIC COPPER CLUSTERS. The alpha-zirconium (IV) hydroggeriphosphate (alpha-ZrP) has received great attention in the last years due to its properties like ion exchange, intercalation, ionic conductivity and catalytic activity. This work reports a method to produce metallic copper clusters on alpha-ZrP to be used as catalysts in petrochemical processes. It was found that the solids were non-crystalline regardless of the uptake of copper and the reduction. The specific surface area increased as a consequence of the increase of the interlayer distance to accept the copper ions between the layers. During the reduction, big clusters of copper (0,5-11mu) with different sizes and shapes were produced.281464

Content of Lipids, Fatty Acids, Carbohydrates, and Proteins in Continental Cyanobacteria: A Systematic Analysis and Database Application

The lipid, fatty acid, protein, and carbohydrate contents in cyanobacterial strains and biomass can vary by orders of magnitude. Many publications (thousands of peer-reviewed articles) require more work to extract their precise concentration values (i.e., different units, inaccurate data), which makes them not easily exploitable. For this purpose, tables have been compiled from the literature data, including lipids, fatty acids, proteins, and carbohydrates composition and quantities in cyanobacteria. A lot of data (323) were collected after careful a literature search, according to selected criteria in order to distinguish separately cyanobacteria, and according to categories of genus and species and generate average values of the contents of these cell components. These data are exploited in a first systematic analysis of the content in types of strains. Our database can be a powerful tool for biologists, chemists, and environmental agencies to determine the potential concentration of high-value chemical building blocks directly from low-value bloom biomass, cell cultures, or debris in the sediment, offering the potential to minimize environmental waste and add value to the agro-industrial residues. The database can also support strategies for food manufacturers to develop new products with optimized properties for veterinarian applications

The pain experiences of powered wheelchair users

Copyright © 2012 Informa UK, Ltd. This is the author's accepted manuscript. The final published article is available from the link below.Purpose: To explore the experience of pain and discomfort in users of electric-powered indoor/outdoor wheelchairs (EPIOCs) provided by a National Health Service. Methods: EPIOC users receiving their chair between February and November 2002 (N=74) were invited to participate in a telephone questionnaire/interview and 64 (aged 1081 years) agreed. Both specific and open-ended questions examined the presence of pain/discomfort, its severity, minimizing and aggravating factors, particularly in relation to the EPIOC and its use. Results: Most EPIOC users described experiences of pain with 17% reporting severe pain. Over half felt their pain was influenced by the wheelchair and few (25%) considered their chair eased their symptoms. The most common strategy for pain relief was taking medication. Other self-help strategies included changing position, exercise and complementary therapies. Respondents emphasized the provision of backrests, armrests, footrests and cushions which might alleviate or exacerbate pain, highlighting the importance of appropriate assessment for this high dependency group. Conclusions: Users related pain to their underlying medical condition, their wheelchair or a combination of the two. User feedback is essential to ensure that the EPIOC meets health needs with minimal pain. This becomes more important as the health condition of users changes over time

ANTIMYCOBACTERIAL AND CYTOTOXICITY ACTIVITIES OF FREE AND LIPOSOME-ENCAPSULATED 3-(4 '-BROMO[1,1 '-BIPHENYL-4-YL)-3-(4-BROMO-PHENYL)-N,N-DIMETHYL-2-PROPEN-1-AMINE

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The antimycobacterial activity of 3-(4'-bromo[1,1'-bipheny1-4-yl)-3-(4-bromo-phenyl-N,N-dimethyl-2-propen-1-amine (BBAP), free or incorporated in preformed liposomes, on extracellular M. tuberculosis H37Rv was 8 and 25 mu M (MIC), respectively. Extracellular antimycobacterial activity was not significantly improved by entrapment of BBAP in liposomes, but there was a 6.1-fold reduction of BBAP cytotoxicity on J774 macrophages. Liposomal BBAP or its free form showed IC(50) values of 165 and 27 mu M, resulting in a selectivity index (SI=IC(50)/MIC) of 3.4 and 6.6, respectively. Free BBAP in concentrations from 10 to 80 mu M were quite effective in eliminating intracellular M. tuberculosis while liposomal formulation was less effective at these concentrations.334871874Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq