CLINICAL СASE: 41-YEAR MAN WITH NEUROLOGICAL SIGNS AND BACK PAIN AFTER PHYSICAL EXERCISES AND UNUSUAL IMAGING APPEARANCES

2021 ◽  
Vol 74 (7) ◽  
pp. 1770-1772
Author(s):  
Nataliya P. Yavorska ◽  
Andrii M. Netliukh ◽  
Roksolana I. Klymkiv ◽  
Andrii V. Kulmatytskyi ◽  
Nataliya V. Matolinets
Keyword(s):  
Physical Activity ◽  
Back Pain ◽  
Age Groups ◽  
Supporting Evidence ◽  
Neurological Signs ◽  
Good Outcome ◽  
Results Of Treatment ◽  
Physical Exercises ◽  
Strenuous Physical Activity

The aim was to describe the uncommon cause of back pain with successful treatment, precise diagnostic and good outcome. Lower back pain is prevalent among all the age groups and can derive from many potential anatomic sources. Here is presented the case of atypical course of back pain and neurological signs with point on importance of astute visualizations technics. This clinical case of 41-year old male patient who got back pain and neurological signs after intensive physical exercises and had no adequate response for anti-inflammatory and analgesic drugs demonstrated the importance of appropriate visualization and considering non-standard causes of these symptoms. This allowed to prescribe effective treatment with good outcome during follow-up period. This could be the supporting evidence for including such additional visualization in protocols for non-typical back pain after strenuous physical activity. Back pain is common condition with a variety of causes. It is important to consider them in case of inadequate results of treatment and use non-conventional investigation if appropriate, which improves the outcome. This could be the supporting evidence for including such additional visualization in protocols for non-typical back pain after strenuous physical activity.

scholarly journals Is chronic low back pain a risk factor for diabetes? The Nord-Trøndelag Health Study

2018 ◽  
Vol 6 (1) ◽  
pp. e000569 ◽  
Author(s):  
Ingrid Heuch ◽  
Ivar Heuch ◽  
Knut Hagen ◽  
Elin Pettersen Sørgjerd ◽  
Bjørn Olav Åsvold ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Linear Models ◽  
Age Groups ◽  
Health Study ◽  
Low Back ◽  
Cross Sectional ◽  
Increased Risk

ObjectiveThe purpose of this study was to examine the risk of diabetes associated with the presence or absence of chronic low back pain, considering both cross-sectional and cohort data.Research design and methodsAnalyses were based on the Norwegian HUNT2 and HUNT3 surveys of Nord-Trøndelag County. The prevalence of diabetes was compared in groups with and without chronic low back pain among 45 157 participants aged 30–69 years. Associations between low back pain at baseline and risk of diabetes were examined in an 11-year follow-up of 30 380 individuals with no baseline diagnosis of diabetes. The comorbidity between diabetes and low back pain was assessed at the end of follow-up. All analyses were carried out considering generalized linear models incorporating adjustment for other relevant risk factors.ResultsCross-sectional analyses did not reveal any association between low back pain and diabetes. With adjustment for age, body mass index, physical activity and smoking, the cohort study of women showed a significant association between low back pain at baseline and risk of diabetes (RR 1.30; 95%  CI 1.09 to 1.54, p=0.003). The association differed between age groups (p=0.015), with a stronger association in relatively young women. In men, no association was found in the whole age range (RR 1.02; 95%  CI 0.86 to 1.21, p=0.82). No association was observed between diabetes and chronic low back pain at the end of follow-up.ConclusionAmong younger women, those with chronic low back pain may have an increased risk of diabetes.

scholarly journals Follow-Up of a Case of Dopamine-Mediated Yawning-Fatigue-Syndrome Responsive to Opioids, Successful Desensitization via Graded Activity Treatment

2021 ◽  
Vol 13 (1) ◽  
pp. 79-84
Author(s):  
Payam Dibaj ◽  
Dagmar Seeger ◽  
Jutta Gärtner ◽  
Frank Petzke
Keyword(s):  
Physical Activity ◽  
Receptor Agonist ◽  
Lumbar Disc ◽  
Opioid Medication ◽  
Effort Level ◽  
Fatigue Syndrome ◽  
Physical Exercises ◽  
Opioid Receptor Agonist ◽  
Graded Activity

A 60-year-old man suffering from recurrent attacks of yawning-fatigue-syndrome, triggered by mild exercise of his right leg since a temporary lumbar disc herniation 9 years ago, was initially treated with the oral µ-opioid-receptor agonist tilidine before each bout of exercise (see Dibaj et al. 2019 JAMA Neurology 2019;77:254). During the first few months, this treatment continuously prolonged the time without exercise-triggered yawning and fatigue. In the next few months of treatment, exercise was increased in a graded manner to alleviate the yawning-fatigue-syndrome. The number of repetitions of the physical exercises was gradually increased without taking the opioid beforehand. After several months, almost the same effort level without medication could be achieved by graded activity as before under the influence of opioid medication. Graded physical activity can thus disrupt complex pathophysiological mechanisms leading to yawning and fatigue.

scholarly journals Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lena W. Holm ◽  
Clara Onell ◽  
Martin Carlseus ◽  
Robin Ekwurtzel ◽  
Olle Holmertz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Back Pain ◽  
Pain Intensity ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Important Improvement ◽  
Minimal Clinically Important Improvement

Abstract Background Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs). Methods Analyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location. Results Participants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49). Conclusions Persons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain. Trial registration Registration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776

scholarly journals Healthy Moves to Improve Lifestyle Behaviors of Cancer Survivors and Their Spouses: Feasibility and Preliminary Results of Intervention Efficacy

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4460
Author(s):  
Cindy L. Carmack ◽  
Nathan H. Parker ◽  
Wendy Demark-Wahnefried ◽  
Laura Shely ◽  
George Baum ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Cancer Survivors ◽  
Exercise Intervention ◽  
Primary Source ◽  
Lifestyle Behaviors ◽  
Chair Stand ◽  
Intervention Efficacy ◽  
Strenuous Physical Activity

Spouses offer a primary source of support and may provide critical assistance for behavior change. A diet-exercise intervention previously found efficacious in improving cancer survivors’ lifestyle behaviors was adapted to utilize a couples-based approach. The aims were to test the feasibility of this couples-based (CB) intervention and compare its efficacy to the same program delivered to the survivor-only (SO). Twenty-two survivor-spouse couples completed baseline assessments and were randomized to the CB or SO interventions. The study surpassed feasibility benchmarks; 91% of survivors and 86% of spouses completed a 6-month follow-up. Survivors and spouses attended 94% and 91% of sessions, respectively. The SO survivors showed significant improvements on the 30-s chair stand and arm curl tests, weight, and fruit and vegetable (F and V) consumption. The CB survivors showed significant improvements on the 6-min walk and 2-min step tests, body weight, and fat and F and V consumption. Improvement in the 30-s chair stand and arm curl tests was significantly better for SO survivors. The SO spouses showed no significant changes in outcome measures, but the CB spouses showed significant improvements in moderate-to-strenuous physical activity, weight, and fat and F and V consumption. Weight loss was significantly greater in CB spouses compared to SO spouses. Findings demonstrate feasibility, warranting further investigation of CB approaches to promote lifestyle change among cancer survivors and spouses.

Abstract 169: A Comprehensive Multicenter Evaluation of the Impact of Age on Stroke Thrombectomy Outcomes - Insights From the STAR Collaboration

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Reda M Chalhoub ◽  
Ali M Alawieh ◽  
Mohammad Anadani ◽  
Maya Eid ◽  
Adam Arthur ◽  
...  
Keyword(s):  
Age Groups ◽  
Star Collaboration ◽  
The Elderly ◽  
Complication Rates ◽  
Good Outcome ◽  
Poor Outcome ◽  
Age Dependent ◽  
Poor Outcomes ◽  
The Impact

Introduction: Elderly patients, octogenarians and nonagenarians, were excluded or under-represented in the majority of stroke endovascular thrombectomy (ET) trials. There is conflicting data on the outcomes of ET in the elderly. We evaluated age-dependent outcomes of ET for stroke in a large dataset from the Stroke Thrombectomy and Aneurysm Registry (STAR). Methods: Patients undergoing ET for acute ischemic stroke at 12 comprehensive stroke centers in the US and Europe between 01/2013 and 12/2018 were reviewed. Data was collected retrospectively from patient charts, procedure notes, and patient follow-up in neurology clinics. The primary endpoint was the modified Rankin score (mRS) at 90-days which was dichotomized into good outcome (mRS 0-2) or poor outcome (mRS 3-6). Results: Of 3,850 patients reviewed, 2,827 had 90-day follow-up (mean age 69±14), and were divided into 6 age groups: 20-49 (G1, 10%), 50-59 (G2, 10%), 60-69 (G3, 23%), 70-79 (G4, 27%), 80-89 (G5, 21%), 90 or more (G6, 4%). When adjusted for confounding variables, age was an independent predictor of poor outcome (OR=1.4, p<0.001) and mortality (OR=1.5, p<0.0001). When used as categorical variable, adjusted OR (aOR) for good outcomes were significantly lower in groups G2-G6 compared to G1 (p<0.01, figure), and OR for mortality were significantly higher in G2-G6 compared to G1 (p<0.01, figure). An age increment of 10 years was associated with 23% higher odds of symptomatic hemorrhage, and 50% higher odds of mRS 5-6. The impact of procedure time on good outcome (mRS 0-2) was also age-dependent with aOR=0.84 (p<0.05) in G1,2 compared to aOR=0.65 (p<0.05) in G5,6. Conclusions: Age is a major predictor of functional recovery after ET, and this study demonstrates a clear age-dependent increase in rate of mortality and poor outcomes after ET with exponentially worse outcomes above 80 years of age. Complication rates were not age-dependent. Further studies are required to optimize patient selection for ET in the elderly.

scholarly journals P772 Trends and risk factors of elderly-onset Crohn’s disease: A nationwide cohort study in South Korea

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S612-S613
Author(s):  
J M Moon ◽  
E A Kang ◽  
K Han ◽  
S W Hong ◽  
H Soh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Health Insurance ◽  
Alcohol Consumption ◽  
National Health Insurance ◽  
National Health ◽  
Age Groups ◽  
Middle Aged ◽  
Aged Group

Abstract Background The incidence of inflammatory bowel disease (IBD) is increasing in Asia. Numerous risk factors associated with IBD development have been investigated. This study aimed to demonstrate the risk factors of Crohn’s disease (CD) diagnosed in persons aged &gt;40 years in South Korea and to specify any differences between age groups by using the National Health Insurance Service (NHIS) database. Methods Using the National Health Insurance Service (NHIS) database, a total of 14,060,821 persons aged &gt;40 years who underwent national health screening in 2009 were followed up until December 2017. Patients with newly diagnosed CD were enrolled and compared with non-CD cohort. CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration programme codes from the NHIS database. The mean follow-up periods were 7.39 years. Age and sex were adjusted for in the multivariate analysis model. Results During the follow-up, 1337 (1.33/100,000) patients developed CD. Men in the middle-aged group (40–64 years) had a higher risk than women (adjusted HR [aHR] 1.46, 95% CI 1.29–1.66); however, this difference tended to disappear as the age of onset increases. In the middle-aged group, patients with a history of smoking (adjusted hazard ratio [aHR] 1.29, 95% confidence interval [CI] 1.06–1.58) and anemia (aHR 1.99, 95% CI 1.67–2.36) had a significantly higher CD risk. In the elderly group (age, ³65 years), ex-smoking and anemia also increased the CD risk (aHR 1.58 [95% CI 1.16–2.18] and 1.91 [95% CI 1.53–2.38], respectively). Especially in the middle-aged group, those with chronic kidney disease (CKD) had a statistically elevated CD risk (aHR 1.38, 95% CI 1.06–1.79). Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups. (Middle-aged: aHR 0.76 [95%CI 0.65–0.87] and aHR 0.38 [95%CI 0.27–0.53], respectively) (elderly-group: aHR 0.57 [95%CI 0.42–0.77] and aHR 0.52 [95%CI 0.32-.83], respectively) For regular physical activity and dyslipidemia, negative correlation between CD incidences was proved only in the middle-aged group (aHR 0.85 [95%CI 0.74–0.96] and aHR 0. [95%CI 0.75 [95% CI 0.63–0.89], respectively). Conclusion This study demonstrated four risk factors (ex-smoking, anemia, CKD, and lower BMI) and three possible protective factors (alcohol consumption, physical activity, and dyslipidemia) for CD in Asians age &gt;40 years. Individuals with potential risk factors need more cautious monitoring for CD.

scholarly journals Long-term incidence of cardiovascular outcomes in the middle-aged and elderly with different patterns of physical activity: Tehran lipid and glucose study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Parisa Naseri ◽  
Parisa Amiri ◽  
Hasti Masihay-Akbar ◽  
Sara Jalali-Farahani ◽  
Davood Khalili ◽  
...  
Keyword(s):  
Physical Activity ◽  
Eastern Mediterranean ◽  
Age Groups ◽  
Developed Countries ◽  
Cardiovascular Outcomes ◽  
Guideline Recommendation ◽  
Mediterranean Population ◽  
Middle Aged ◽  
Men And Women

Abstract Background Following the global upward trend of cardiovascular diseases (CVD/CHD), much attention has been paid to lifestyle behaviors such as physical activity (PA). However, most of previous studies were conducted in developed countries and with just one measurement of physical activity. The aim of the current study is to assess the effect of changes in the PA on the incidence of CVD/CHD in middle-aged and older men and women in an Eastern-Mediterranean population, over a decade follow-up. Methods This study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) including 4073 (57% women) participants without CVD/CHD at baseline. The participants were followed up for an average period of 12 years. The Iranian version of Modified Activity Questionnaire (MAQ) was used to measure PA at baseline and at the closest follow-up to the outcome. Subsequently, participants were categorized as “compliers”, “non-compliers”, “adopters” and “relapsers”, based on their adherence to the PA guideline recommendations. All analysis has been conducted in two separate age groups including middle-aged and elderly in both men and women. The effect of PA patterns on incidence of CVD/CHD was investigated using Cox proportional hazard model. Variables including marital status, job status, education, smoking, and family history of CVD/CHD were adjusted in the models. Results Adherence to guideline recommendation increased from 63.5 to 66.6% between the two measurements. At the second measurement of PA, the percentages of compliers, non-compliers, adopters and relapsers were 48.4, 18.3, 18.2, and 15.1%, respectively. In fully adjusted models, HRs of CVD and CHD for men aged 40–60 years in the complier group were 0.58 (95% CI: 0.38–0.87, P = 0.008) and 0.58 (95% CI: 0.38–0.89, P = 0.01), respectively. HRs of CVD and CHD for men aged 40–60 years in adopter group were 0.61 (95% CI: 0.38–0.96, P = 0.03) and 0.60 (95% CI: 0.37–0.97, P = 0.04) respectively. The corresponding values were not significant in women. Conclusions Adhering to established PA recommendations have a protective effect on the incidence of CVD/CHD among middle-aged men; findings which need to be considered in reducing cardiovascular outcomes in this population.

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