Uro-lymphatic fistula associated with urolithiasis: A case report.

Uro-lymphatic fistulas are rare, and involve communication between the renal collecting system and the lymphatic system. The disorder is usually caused by the obstruction of lymphatic vessels due to several diseases, leading to chyluria. Here, we report the case of a patient with a uro-lymphatic fistula, considered to be associated with urolithiasis.

Effects of a Remotely Delivered Cognitive Behavioral Coaching Program on the Self-Rated Functional Disability of Participants with Low Back Pain.

Purpose: A remotely delivered cognitive behavioral coaching (CBC) program was offered as a service benefit for commercial health plan members with low back pain (LBP). This study describes changes in self-rated functional disability in a sample of plan members participating in the program (N=423).

Methods: Independent measures included demographics, length of program enrollment, total CBC sessions, and baseline self-reported patient activation and presenteeism levels.

Knowledge of Palliative Care in Ecuador.

Palliative care is a holistic approach to care for people with chronic, advanced, and life-threatening illnesses. It improves the quality of life of patients and their caregivers. However, there is still limited access to palliative care in many countries.

Lumbar fusion surgery for degenerative conditions is associated with significant resource and narcotic use 2 years postoperatively in the commercially insured: a medical and pharmacy claims study.

Background: Chronic back pain is one of the costliest and most complex medical conditions to manage, involving physiological, psychological, mechanical, social, and environmental factors. An increasing trend of lumbar fusion (LF) surgery for chronic back pain continues despite conflicting evidence for pain relief or improved long-term outcomes. Our goal was to assess medical and pharmacy utilization (including continued use of pain medication) over a 2-year period among patients receiving LF to relieve back pain for degenerative conditions without instability.

Mobile-Web app to self-manage low back pain: randomized controlled trial.

Background: Nonspecific low back pain (NLBP) is the diagnosis for individuals with back pain that has no underlying medical cause (eg, tumor, infection, fracture, herniated disc, spinal stenosis). The American College of Physicians (ACP) and American Pain Society (APS) recommend multidisciplinary treatments for NLBP that lasts more than 4 weeks. This approach, however, is impractical for many physicians to implement, and relatively few providers offer NLBP treatment that meets the joint ACP-APS guidelines.