scholarly journals Orthopnea and fever in an elderly woman

2017 ◽  
Vol 11 (4) ◽  
pp. 399
Author(s):  
Claudio Tana ◽  
Silvio Di Carlo ◽  
Mauro Silingardi ◽  
Maria Adele Giamberardino ◽  
Francesco Cipollone ◽  
...  

Orthopnea is a sensation of shortness of breath, which occurs in recumbent position and is usually improved by standing or sitting. The authors report a case of an 81-year-old woman presented to the Emergency Department with a two-week history of orthopnea, fever and low back pain resistant to analgesics. Radiological findings confirm the presence of a diafragmatic hernia, and clinicians should pay attention to any history of trauma, because their absence in symptomatic adult patients directs towards a congenital cause. A surgical repair should be promptly obtained to avoid further general and respiratory deterioration.

Author(s):  
Sweekriti Sharma ◽  
Adrian C. Traeger ◽  
Gustavo C. Machado ◽  
Christina Abdel Shaheed ◽  
Caitlin Jones ◽  
...  

2019 ◽  
Vol 22 (11) ◽  
pp. 1206-1212 ◽  
Author(s):  
Eduardo Martinez-Valdes ◽  
Fiona Wilson ◽  
Neil Fleming ◽  
Sarah-Jane McDonnell ◽  
Alex Horgan ◽  
...  

2020 ◽  
Vol 29 (4) ◽  
pp. 400-404 ◽  
Author(s):  
Whitney Williams ◽  
Noelle M. Selkow

Context: Decreased hamstring flexibility can lead to a plethora of musculoskeletal injuries, including low back pain, hamstring strains, and patellofemoral pain. Lack of flexibility may be the result of myofascial adhesions. The fascia connected to the hamstrings is part of the superficial back line that runs from the cranium to the plantar aspect of the foot. Any disruption along this chain may limit the flexibility of the hamstring. Objective: To investigate if self-myofascial release (SMR) of the plantar surface of the foot in addition to the hamstring group was more effective at improving the flexibility of the hamstrings when compared with either intervention alone. Design: Cross-over study. Setting: Athletic training facility. Participants: Fifteen college students (5 males and 10 females; age: 20.9 [1.4] y, height: 173.1 [10.3] cm, mass: 80.0 [24.9] kg) who were not older than 30, with no history of low back pain or injury within the past 6 months, no history of leg pain or injury within the past 6 months, no current signs or symptoms of cervical or lumbar radicular pain, no current complaint of numbness or tingling in the lower-extremity, and no history of surgery in the lower-extremity or legs. Interventions: Each participant received each intervention separated by at least 96 hours in a randomized order: hamstring foam rolling, lacrosse ball on the plantar surface of the foot, and a combination of both. Main Outcome Measures: The sit-and-reach test evaluated hamstring flexibility of each participant before and immediately after each intervention. Results: There were no significant differences found among the SMR techniques on sit-and-reach distance (F2,41 = 2.7, P = .08, ). However, at least 20% of participants in each intervention improved sit-and-reach distance by 2.5 cm. Conclusions: SMR may improve sit-and-reach distance, but one technique of SMR does not seem to be superior to another.


2017 ◽  
Vol 13 (24) ◽  
pp. 267
Author(s):  
Kodjo Kakpovi ◽  
Komi Cyrille Tagbor ◽  
Eyram Fianyo ◽  
Agbeko Komlan Doleagbenou ◽  
Kokou Mensah Guinhouya ◽  
...  

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains.


2020 ◽  
Vol 10 (3) ◽  
pp. 70-77
Author(s):  
Larissa Faria Borges ◽  
Ligia Loiola Cisneros ◽  
Danielle Aquino Silva ◽  
Amabile Borges Dario ◽  
Manuela Ferreira ◽  
...  

Objective: To describe the demographic profile and the management of patients with low back pain (LBP) complaints presenting to the Emergency Department (ED) of a Brazilian public hospital. Methods: Retrospective, cross-sectional study using a convenience sample of patients with LBP triaged at the studied ED through the Manchester Triage System along a year. Data were extracted from electronic medical records. LBP presentations were classified as non-traumatic, traumatic, and non-spinal related pain according to the signs and symptoms reported. Data included patients’ demographic profile, pain severity and management (e.g., imaging exams, medication prescription and hospitalization). Results: Data from 2016 patients was analyzed. Most were middle-aged adults (mean age = 40.5years, SD 15.7), female (n = 1043, 51.7%) and presented moderate pain intensity (score range 4 to 7 on the Visual Analogue Scale, n=1,471; 74.1%). Non-traumatic pain (n = 1,016; 50.4%) was the main cause of care-seeking. A total of 36.9% (n = 743) underwent imaging exams and 42.2% (n = 850) received medication. Patients with non-spinal related pain were three times more likely to receive opioid medication (OR = 2.96; 95%CI 2.30 to 3.79). Conclusion: Non-traumatic LBP (i.e., no history of trauma or red flags) was the main cause of LBP care-seeking in a Brazilian ED. Most patients were treated conservatively and without hospitalization. Opioids prescription and imaging exams, although performed on a smaller scale, were still used for of the management of this type of LBP.


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