Biomedical subjects
Publications and source records attributed to M Campello.
This article reviews the evidence for using modalities and/or exercise treatment in patients with nonspecific low back pain. Poor evidence of efficacy exists for the use of modalities in this patient group. Exercises are beneficial for patients with subacute and chronic nonspecific low back pain. Further studies are needed for type, frequency, duration, and intensity of exercises.
The purpose of this chapter is to promote a model to prevent chronicity and disability from non-specific low back pain (NSLBP). Delayed recovery is defined in this chapter as the period between 4 and 8 weeks after onset of NSLBP during which a patient has not yet returned to work. The recognition of predictors associated with delayed recovery at onset of the problem helps health care providers in their treatment plan. An algorithm can be useful for health care providers and employers in guiding the employee back to work. A multidisciplinary return to work programme is an essential part of the algorithm.
BACKGROUND: Despite the recent multidisciplinary achievements, surgery for posterior circulation aneurysms remains challenging. Sac dimensions and fundus projection are highly variable and independent factors, which can determine, the operative field being deep and restricted, in some case the failure of the procedure. Other factors the surgeon must cope with are the relationships between aneurysm and surrounding arteries, cranial nerves (oculomotor nerve mainly) and bone structures. Due to the esiguity of the operative field a complete dissection of the sac can be achieved frequently only after the clipping when, by the way, the clip position must be verified in order to avoid perforants closure. Aim of this paper is to perform a retrospective study regarding patients harbouring a posterior circulation aneurysm treated in a public health environment. METHODS: Our experience resides on 78 consecutive cases (whose 37 of the basilar artery and 37 with other localizations) successfully clipped by the same surgeon (senior author: RS); 4 additional aneurysms were only explored (whose 3 originated from the basilar artery). The clinical charts of the basilar apex cases were reviewed, the angiographic and intraoperative findings were correlated to the GOS (Glasgow Outcome Scale). RESULTS: The fundus projection in the basilar apex cases was the main risk factor accounting for a 50% mortality rate in the antero-posterior direction cases. CONCLUSIONS: Posterior circulation aneurysms are intimidating vascular malformations even nowadays; in the future improvements in the endovascular technique could provide an effective alternative to an open surgery approach.
Health care providers often prescribe exercises as treatment for nonspecific low back pain. However, the effectiveness of this treatment is poorly documented in the literature. While the evidence suggests that exercise in general is beneficial, there is a lack of knowledge about the types, frequency and duration of exercises that should be prescribed and at what stage of injury they are most helpful. In addition, few studies have dealt with exercise treatment alone rather than in combination with other treatments, making it hard to decipher the unique contribution of exercise. Inadequate study designs also make conclusions difficult. Conversely, the literature clearly shows that inactivity has detrimental effects (i.e. delayed return to normal activity, and negative physiological and psychological effects) for low back pain patients.
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