This is a case report of an 85-year old patient who presented with abdominal pain, nausea and vomiting associated with altered liver function test. The plain X-rays and CT scan showed pneumobilia with an ectopic gallstone. The patient was diagnosed with Bouveret syndrome and managed surgically. The report is followed by a discussion about Bouveret syndrome.
Purpose: To identify prognostic factors in the literature that may predict a poor recovery from acute occupational low back pain (LBP). Methods: Four international databases (Medline, CINAHL, EMBASE, and PsycINFO) were reviewed, searching all articles indexed up to November 2007 with the term low back pain combined with the terms prognostic, prospective, or cohort. Following application of inclusion criteria, 10 articles were found to be appropriate for data extraction. Each article was critically appraised by two independent reviewers. Statistical pooling was performed on any factor evaluated in at least three independent cohorts. Results: Seven cohorts were identified, with a total sample size of 2,484 subjects. Only three factors were followed in at least three cohorts and were therefore suitable for statistical pooling: female gender (OR ¼ 1.28, 95% CI: 1.03-1.58); pain radiation (OR ¼ 1.37, 95% CI: 0.79-2.39); and previous history of back pain (OR ¼ 0.91, 95% CI: 0.52-1.60). There was significant heterogeneity within the female gender factor; compensation of subjects for study participation appeared to moderate its effect. Conclusion: After statistical pooling, only female gender achieved statistical significance as a prognostic factor for prolonged recovery. Further research is necessary to determine prognostic factors for non-recovery in acute LBP.Key Words: chronic disability, chronic pain, higher-order analysis, occupational low back pain, prognosis Agnello A, Brown T, Desroches S, Welling U, Walton D. Can we identify people at risk of non-recovery after acute occupational low back pain? results of a review and higher-order analysis. Physiother Can. 2010;62:9-16. RÉ SUMÉObjectif : Identifier, dans la litté rature, les facteurs pronostiques susceptibles d'indiquer un piè tre ré tablissement d'une lombalgie professionnelle aiguë . Mé thode : Examen de quatre bases de donné es internationales : Medline, CINAHL, EMBASE et PsycINFO, dans le but de rechercher tous les articles ré pertorié s depuis novembre 2007 avec le mot « lombalgie » combiné à « pronostic », « prospective » ou « cohorte ». À la suite de l'application du critè re d'inclusion, dix articles ont é té jugé s approprié s pour faire l'objet d'une extraction de donné es. Chaque article a ensuite é té critiqué par deux ré viseurs indé pendants. Une mise en commun statistique a é té ré alisé e pour tous les facteurs ayant é té é valué s au sein d'au moins trois cohortes indé pendantes. Ré sultats : Sept cohortes ont é té identifié es, pour un é chantillon comptant au total 2 484 sujets. Seuls trois facteurs ont fait l'objet d'un suivi dans au moins trois cohortes et pouvaient, par consé quent, faire l'objet d'une mise en commun statistique. Les facteurs ayant fait l'objet d'un suivi sont : les sujets de sexe fé minin (RO ¼ 1,28, CI 95 %, 1,03 à 1,58), le degré de radiation de la douleur (RO ¼ 1,37, 0,79 à 2.39) et les anté cé dents de lombalgie (RO ¼ 0,91, 0,52 à 1.60). On a constaté une hé té rogé né ité considé rable chez les sujets de sex...
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