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Obesity, Weight Loss, and Low Back Pain: An Overview for Primary Care Providers—Part 1

Obesity, Weight Loss, and Low Back Pain: An Overview for Primary Care Providers—Part 1

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

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Teaser: 

1,2Darren M. Roffey PhD; 1Simon Dagenais DC, PhD, MSc; 3Ted Findlay DO, CCFP; 4,5Travis E. Marion MD, MSc; 6Greg McIntosh MSc; 1,2,4,5Eugene K. Wai MD, MSc, FRCSC

1University of Ottawa Spine Program, The Ottawa Hospital, Ottawa, ON, 2Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON,

3
Department of Family Medicine, University of Calgary, Calgary, AB, 4Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, 5Department of Surgery, Faculty of Medicine, University of Ottawa, ON, 6CBI Health Group, Toronto, ON,

Abstract

Recognizing that the increasing incidence of obesity coincides with the rising prevalence of LBP, there is growing interest in establishing the relationship between over-weight and back pain. It is likely that any association is multi-factorial and that the connection is not as mechanistically simple as previously believed. Systemic inflammation associated with obesity may be an important contributor. Proposed treatment options vary from cognitive behavioural therapy to bariatric surgery with none yet fully proven. Despite the ambiguity, it appears prudent for primary care providers treating obese patients with LBP to recommend weight loss and exercise.

Key Words: Obesity, low back pain, inflammation, intervertebral disc, multi-factorial, causality, association.

Diagnosis and Treatment of Pericarditis in the Aged

Diagnosis and Treatment of Pericarditis in the Aged

Teaser: 


Kristopher S. Cunningham, MD, PhD, University Health Network, University of Toronto, Department of Pathology, Toronto, ON.
Sharmi Shafi, BSc, University of Toronto, Toronto, ON.
Mellitta Mezony, MD, FRCPC, Mount Sinai Hospital, Department of Cardiology, Toronto, ON.
Molly Thangaroopan, MD, FRCPC, University Health Network, University of Toronto, Department of Cardiology, Toronto, ON.
Jagdish Butany, MBBS, MS, FRCPC, University Health Network, University of Toronto, Department of Pathology, Toronto, ON.

Pericardial inflammation is a familiar but uncommon cause of chest pain. The classic triad of retrosternal chest pain, pericardial friction rub, and serial ECG changes facilitates diagnosis of pericarditis, the etiology most often being idiopathic in nature. Because older adults more frequently contend with multiple conditions that may require cardiovascular surgical intervention, receive numerous medications, or result in an immunocompromised state, other important causes of pericarditis need to b e considered. This article considers pericarditis in the older population and emphasizes diagnosis and management of this condition. Situations common to this age group that require special attention to the appropriate treatment are also discussed.

Key words: pericarditis, pericardium, heart, inflammation, tamponade.