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PubMedDate not supplied

[Backache from exertion in health personnel of the Istituti Ortopedici Rizzoli in Bologna. A case-control study of the injury phenomenon in the 10-year period of 1987-1996].

Low-back (lumbosacral) injuries are known as one of more important occupational health problems in health care workers, because of high prevalence and impact of socioeconomic costs. To investigate the risk of low-back pain in hospital workers into the Istituti Ortopedici Rizzoli in Bologna (Italy), a retrospective study was carried out. The adapted study design was the matched (1:1 for age) case-control, enlisting the first injuries occurred in the hospital staff like cases, and personnel in force, matched for age and year of happened case, like controls. Information about diagnoses and occupational data was obtained from the current informative systems. Comparison with a control group suggests the validity of the work-relatedness of low-back pain in nursing and health aides (OR: 21.67; LC: 4.69-196.56), in nurses (OR: 20.21; LC: 4.81-177.95), in therapists (OR: 16.36; LC: 2.80-163.54) and in X-ray technicians (OR: 13.64; LC: 2.25-138.99). The risk of occupational injury is not homogeneously allocated into the hospital, and significatively prevails in the orthopaedic wards, in the plaster-rooms, in the operating blocks and in the sterilization plants. Specific manual handling were associated with an increased risk of back pain, while some non occupational factors like cigarette smoking, previous trauma leading to hospital admission, and number of children in female, were resulted weakly associated.

Adult↗
PubMed2000

[Backache].

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Back Pain↗
PubMed2000

[1: Clinical aspects, laboratory diagnosis and therapy. Low backache--when is sacroiliitis the cause?].

Despite the availability of modern imaging modalities, early diagnosis of sacroiliitis remains a challenge. The patient's history and the results of the clinical examination form the basis for establishing a working diagnosis, which then needs to be confirmed by laboratory tests and diagnostic imaging. Common causes of sacroiliitis are inflammatory diseases of the spine, in particular seronegative spondyloarthropathies; infectious sacroiliitis is much less common. Besides serological testing (HLA-B27), imaging techniques are essential for diagnosing early forms of sacroiliitis. The treatment of the condition initially involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). In patients with infectious sacroiliitis, antibiotics are the treatment of choice. Local application of steroids, or physiotherapy, can be helpful. The value of disease-modifying drugs (DMARDs) (sulfasalazine, methotrexate) has not been verified, and is questionable. New approaches such as anti-tumor necrosis factor alpha (anti-TNF alpha) need to be tested in controlled studies.

Arthritis↗
PubMedDate not supplied

[Backache as the initial symptom of adrenomyeloneuropathy].

INTRODUCTION: Adrenoleukodystrophy is a paroxysmal disorder, with recessive linking to the X chromosome, characterized biochemically by the accumulation of extra-long-chain fatty acids. Six phenotypes are distinguished: pre-symptomatic, infantile, adolescent and adult cerebral forms, adrenomyeloneuropathy and isolated Addison's disease. We describe a patient with adrenomyeloneuropathy in whom the presenting symptom was lumbago. CLINICAL CASE: A 23 year old man with no significant previous clinical history complained of having lumbago for over two years. On examination he had pyramidal signs and reduced epicritic sensitivity of the legs. Laboratory investigations showed adrenal failure, increased plasma extra-long-chain fatty acids concentration, mononuclear cells and fibroblasts. On MR there was a hyperintense lesion of the genu of the corpus callosum. SSEP were pathological while the electroneurogram showed bilateral increase in latency of the F wave. The patient was diagnosed as having adrenomyeloneuropathy and treatment started with hydrocortisone, a diet low in extra-long-chain fatty acids and 'Lorenzo's oil'. The lumbago gradually disappeared while the plasma extra-long-chain fatty acids concentration dropped. The oil was stopped because of moderate thrombocytopenia, and treatment was started with lovastatin 40 mg/day. Two years later the patient has no lumbago and is neurologically stable. CONCLUSIONS: The lumbago associated with adrenomyeloneuropathy is probably due to demyelination of the spinal tracts. Although lumbago is usually a benign condition, a careful history and examination is necessary in all such cases.

Adrenoleukodystrophy↗