PubMed · 7378246
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R K Mirakhur, J W Dundee, J D Connolly. 1980. Anticholinergic premedication.. https://doi.org/10.1093/bja%2F52.4.467
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STUDY DESIGN: A systematic review of the epidemiologic literature. OBJECTIVE: To establish if body weight is truly associated with low back pain (LBP) and whether the link may be causal. SUMMARY OF BACKGROUND DATA: Because obesity and LBP are prevalent in western society, it is of interest to establish whether obesity can induce LBP. METHODS: Fifty-six original research reports, reporting on 65 studies published between 1965 and 1997, were systematically reviewed for the frequency of positive associations between body weight and LBP. In addition, the presence of positive findings was examined in relation to several study characteristics. Based on these results, only studies emanating from the general population with a sample size exceeding 3000 were included in the additional search for causality using some of the classical Bradford-Hill criteria. The review was carried out by the author, blindly at 2 months' interval. RESULTS: Thirty-two percent of all the studies report a statistically significant positive weak association between body weight and LBP. Studies that fulfilled the post hoc criteria never report a rate ratio above 2, but there is possibly a positive biological gradient. These studies had no information on temporality or reversibility and there was no obvious consistency of findings. CONCLUSIONS: Due to lack of evidence, body weight should be considered a possible weak risk indicator, but there is insufficient data to assess if it is a true cause of LBP.
Endoscopic techniques are used more frequently to harvest the saphenous vein for cardiac and peripheral vascular procedures. To identify the saphenous vein through an initial small access incision can be difficult. We describe the use of a portable intraoperative ultrasound system to expeditiously identify the saphenous vein during endoscopic harvesting, particularly in obese patients.
Debate continues concerning the treatment of infants with end-stage renal disease. We evaluated progress and outcome of 20 infants with a mean age of 0.34 year (range, 0.02-1 year) in a long-term peritoneal dialysis program at a single center. Mean weight at the start of dialysis was 4.8 kg (range, 1.7-11.4 kg), and the duration of dialysis was 17.3 months (range, 1-59 months). Eleven infants received renal transplants, 4 were switched to hemodialysis and then received transplants, 4 died, and 1 continues to receive peritoneal dialysis. There was significant co-morbidity in 6 infants who died or required hemodialysis. Catheter interventions were frequent, with 12 infants requiring at least one replacement. There were 1.1 episodes of peritonitis per patient-year; 70% of infants had 0 to 1 episode. Mean weight standard deviation score (SDS) was -1.6 at the start, -0.3 at 1 year (P =.0008), and 0.3 at 2 years (P =.0008). Height SDSs were -1.8 at the start, -1.1 at 1 year (P =.046), and -0. 8 at 2 years (P =.06). Head circumference SDSs were -1.9 at the start, -1.3 at 6 months (P =.003), and -0.9 at 1 year (P =.015). Fourteen of 16 survivors are achieving normal developmental milestones or attend mainstream school. Peritoneal dialysis in infancy is a demanding treatment, but outcome for growth, development, and transplantation justifies this intensive approach. When parents are counseled, the importance of non-renal co-morbidity must be emphasized.