Clinical findings in a population with back pain Relation to one-year outcome and long-term sick leave

Objectives - To review the care by general practitioners (GPs), district nurses and assistant nurses of patients receiving home nursing. Design - Retrospective data from questionnaires, records and official statistics. Statistical comparisons. Setting - Primary health care from October 1995 to October 1996. Subjects - One-third (158) of all patients receiving home nursing in a suburban area were sampled; 73% (116) participated. All patients of comparable age in one practice served as a control group. Main outcome measures - Number of and reasons for visits and other contacts. Nature of care. Relation between patient problems and care given. Results - Most patients were seen by the nurses two to five times a month. They met their GPs less often than other patients. More measures were undertaken without direct contact between GP and patient. The most common measures concerned medication and the assessment of symptoms. Patients with cognitive problems seemed to get less active GP care. Conclusion - GPs played an active role in the care of patients receiving home nursing even though they seldom met them. Many patients were regularly assessed by the nurses, which might have diminished the need for doctor visits. The care of patients with cognitive problems needs further study.     

Recurrent disc herniation in a man with ankylosing spondylitis

Summary Disc herniation in patients with Bechterew disease is rare; even rarer are recurrent disc herniations, a condition which we have not found described before. The patient was operated on with an excellent result.