PubMed · 9069738
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J Maklebust, D Margolis. Ready or not.. https://pubmed.ncbi.nlm.nih.gov/9069738/
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STUDY DESIGN: An amalgamated review of the current state of knowledge about psychosocial factors in low back pain (LBP), as presented at the plenary session at the Fourth International Forum on LBP Research in Primary Care (March 16-18, 2000, Israel). OBJECTIVES: To outline evidence-based theories that have lead to the identification of yellow flags (psychosocial risk factors for developing long-term disability) for nonspecific LBP. To discuss the role of clinicians in primary care in detecting and addressing these psychosocial factors and to outline future directions for research to clarify this role. SUMMARY OF BACKGROUND DATA: It is widely accepted that psychological and social factors play an important role in LBP; however, it is currently unclear which specific factors merit intervention to reduce the burden of disease. METHOD: The review is an integration based on the plenary session presented at the Fourth International Forum on LBP Research in Primary Care. The presentations included original research studies, a systematic review, and theoretical descriptions of models of risk and treatment. RESULTS: There is good evidence to support the role of psychological risk factors at early stages of LBP in the development of long-term disability. There are evidence-based theories and models that provide directions for future interventions. CONCLUSION: In the treatment of psychological factors, the role of clinicians in primary care remains unclear. Further evidence is needed to identify specific psychological risk factors, primary care tools for their identification need developing, and interventions at different stages of LBP by different professionals need to be tested.
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Microscopic colitis is an umbrella term for a newly described group of colitides, belonging to the inflammatory bowel diseases, which are only diagnosable by microscopic evaluation of a macroscopically normal colon mucosa. Collagenous colitis and lymphocytic colitis are the most common of these colitides. Microscopic colitis is characterised clinically by chronic non-bloody watery diarrhoea. Crampy abdominal pain, nocturnal diarrhoea, urgency, and initial weight loss are usual. Concomitant diseases of autoimmune origin and arthralgia are commonly seen. Treatment of microscopic colitis follows the guidelines for treatment of other inflammatory bowel diseases, but a substantial part of the patients with microscopic colitis enter spontaneous remission after some years. A minor part, however, have very troublesome symptoms and are almost refractory to treatment. Microscopic colitis has apparently no malignant potential.