An estimated 60% to 80% of the population suffer from backache at least once in his life (see here). In most cases, the pain is localized to the lower back, corresponding to the lumbar vertebrae. These disorders are particularly common in rheumatology consultation, but also the firm of generalist. Their socio-economic cost is significant because these low back pain account for approximately 20% of work stoppages and 7% of accidents, with suites often difficult.

The emotional suffering that connects the spine to the individual is linked to two major concerns: the paralysis or cancer that doctors fail to diagnose. These fears are rarely expressed and often underpinned by the knowledge of an exemplary case in the entourage.

The management of back pain takes time to listen to the grievances of the patient, Gary Stone explains, experience and careful consideration. The origin of spinal pain is even more difficult to establish that there is no parallelism between the intensity of pain and radiologic appearance.

The inter-vertebral disk is a cartilage which has a particular role with some damper device more rigid, the annulus, and a central part hydrated, the nucleus. Constraints and duplication of effort will cause cracks with migration of the nucleus: the herniated disk.

At age 40, it is associated with lesions of osteoarthritis more or less extensive and characterized by destruction of cartilage with bone formation, osteophytes.

The herniated disk is not visible on plain radio-graphs that are especially useful for not missing a tumor lesion, cancerous, or ankylosing spondylitis disco-vertebral infection. Modern imaging, CT or MRI can demonstrate the existence of anatomical herniated disk, but allows no conclusion on its clinical consequences automatic.

Neural structures

Back pain can radiate, depending on the location of the hernia, behind the thigh and leg is sciatica, or the front of the thigh is the femoral nerve neuralgia. You should know that over 80% of cases the pain resolves spontaneously within a period which can reach six months.

Rare are the cases where surgery is needed immediately. It can be a pain to extreme violence, resistant to major analgesics, especially with functional impairment or progressive neurological complications. They involve varying degrees of sphincter dysfunction and lower limb paralysis that depend on the headquarters of the herniated disk. Urinary problems are immediately consider intervention. The paralysis may be initially supported medically unless there is a gradual worsening.

Whatever the technique used, surgery aims to decompress the neural structures in the spinal canal. In a young patient, some have proposed that the disk curettage by the establishment of an inter-vertebral disk prosthesis. The advantage of this technique is still under discussion.

Surgery for herniated disk is not a panacea. It can be complicated by nosocomial discitis. The paralysis does not resolve more quickly after surgery with rehabilitation alone. The pain may persist unchanged or even increased. Mention was used as an explanation of the phenomena of scarring. It is now believed that these lesions of nerve roots, often lifelong, by vascular thrombosis. For surgeons, the excessive attention and the contemplative attitude of some rheumatologists favor these root lesions.

Wednesday evening, in front of the two rooms of the met Congress in the imposing House of Representatives, in the presence of the members of his office, diplomatic body and of his woman Michelle all of clothed rose, Barack Obama did forehead.  Reaffirming with clarity and passion in a speech of 45 particularly moving minutes, his authority and his total engagement to the leading service of one of the missions of his mandate: to give a cover health (EHR) to the body of the Americans.  “We did not come here to be afraid of the future.  We came here to forge it”, it launched under applause nourish camp democrat, that got up more than 25 time to acclaim it standing, while the Republicans generally remained sit without applauding.  “For hundred years and the era of Theodore Roosevelt, many presidents attempted to reform the Senate… I am resolved to be the last one!”, followed the president.  “I will not accept the status-qua.  Not this time, not today”, hammered Barack Obama after noting that the Congress was in agreement very close of the goal, since an agreement existed on 80% of the project.  “Everyone knows that it is necessary a reformation”, said the president.

The whole camp democrat awaited with impatience this presidential intervention, after a particularly eventful summer marked by the violent attacks of the Republicans and the decrease of the popularity of the president.  It will not have been disappointed.  Far to be cut down by a months of politically testing August, Obama appeared smiling, offensive and decided to use his political capital to defend a cause, that, if she fails, could be justified in his young presidency.  It was not afraid of to reaffirm its support for the public idea of an option of assurance “for those that would have need of electronic health record“, without nevertheless some to do the center of his project.  “The public option is only a means and we must remain open to other ideas to accomplish our ultimate goal”, it said to the address of the liberal democrats.  Replying to those that the too accused to have abandoned the debate to the Congress, leaving the confusion to install itself, Obama recalled that its essential goals were “to propose stability to those that have an assurance” but live in the fear to lose it and to give an assurance to those that not some have pass…

Revenant on dramatic cases of cancerous deaths in order not to have been able to pay, it repeated that The new law would forbid to the underwriters to refuse a cover because of medical antecedents.  The boss of the State also promised to reduce the astronomical costs of the system of health, that take the country to the “precipice” … Promising to protect the small businesses, that have not currently the means to endow itself with a cover disease too costly.  “I will not sign a project of law that adds the least penny to our deficit.  The economies will be done in the existing system, it insisted, judging that the increase of the cost of the private assurances and the bad management of Medicare (medical billing software), the assurance of State that covers the elderly personages, were responsible the bulk of the deficit” This question of the financing of the reformation, remains without any doubts the principal serious lever on which the Republicans again could play.

Obama also was anxious to rectify all the “lies” hurled on his reformation by its conservative opponents, disinformation on his supposed intention to create courts of the death for elderly persons to the false rumor according to which the cover disease would spread itself to the illegal immigrants.  “I will not lose my time with the calculators that think that it is better politics of to kill this plan rather than to improve it”, it warned.  Warning clearly seems to indicate that the Democrats will forge ahead with an ambitious plan if the Republicans choose the obstruction.

Barack Obama some did not less continue to preach the compromise and to stretch the hand, asserting that his door would be “always open” and announcing that it had the intention to include a very good idea of the republican senator Mc Cain, his former opponent to the presidential one, in the plan health.  This one smiled and greeted the president of the hand.  The speech finished by a moving grade when the president evoked a letter of the senator Ted Kennedy, that the latter had sent him some days before his death.  It there explained that the reformation of health, fights of his life of which it hoped that it results at last, was “a moral question”.  It is the character of the nation” that is in game, wrote the senator.

Recognizing that “the individualism of the Americans, their wild skepticism for any excessive government” is “a basic trait” and remarkable of the American people, Obama underlined that the extraordinary empathy of Ted Kennedy for its similar ones was not “something of republican or of democrat, but equally a part of this character” national.  It underlined that in 1935 during the big crisis, or in 1965, during the vote of the Medicare insurance for the retired, the Congress had met in the adversity to vote historic social laws, understanding that “an insufficiency of maybe government sometimes as dangerous as an excess of government”.  A manner to call, without illusion but with force its opponents, to the historic compromise.

The transition between the worlds can not be easy. Government, industry and doctors concerned with health problems, like the president and Congress are in the public sphere? Unfortunately we do not ask a little more than wait to see the details.

Bottom line: the convenience of patients should come first with Electronic Medical Records. Some may even say it is crucial. The three main issues for patients, apparently, costs, confidentiality and accessibility curves. The big question is: Who pays? It is clear that a large part of the purchase price for the implementation of EHR softwares doubles the expenses of healthcare. This can cause anxiety for some patients long-term costs of electronic health records.

However, patients pay for these services, although it can handle to total expenditure on health-care, it was considered a majority of respondents are willing to pay for electronic services. Half of those polled said that $ 5 a month is required. Knowing that patients high enough for them is support for this portfolio over considerable effort to wash recommendations on electronic medical records.

Another important aspect of confidential documents. A recent survey of patients attitudes towards the use of EHR – Beth Israel medical center in Boston facility was very revealing. Distress that patients are willing to part of the privacy interests of co-ordination of service. It is a promising result of doctors and companies such as FSD. Under strict confidentiality can open the door for patients to see a number of simple healthcare. Patients enjoy freedom and the necessary treatment outside these hours. It is also one of the greatest benefits for patients, provide access to health information.

Asking for health care has a major role in the health service support functions through 2007 survey found that three out of four U.S. consumers of electronic medical records would be an advantage as it curves and patient data of patients are dameliorer. Since the patient is likely to play their own records of growing interest to the media, so we still have much to do. Ultimately, patients are generally in favor of ladoption. This suggests that the transition to common electronic devices to be less controversial, because the patient what was expected.