Low back pain in the primary care setting.

A study of the natural presentation, course, and treatment of low back pain in the primary care setting was undertaken. One hundred and forty-four charts listing low back pain as a problem were reviewed at a family practice center for a period of one year. A profile of the patient evaluated by the primary care physician emerged, revealing a high incidence of associated weight problems (70 percent), psychologic problems (33 percent), and hypertension (19 percent). The rate of actual or suspected disc disease (1.4 percent) was much lower than that reported in series from referral centers. This study of low back pain in the primary care setting illustrates the usefulness of outpatient study in defining a problem category, recognizing disease as a symptom complex, suggesting modalities of treatment, and designing a curriculum for the primary care physician.

Primary hyperparathyroidism in the primary care setting.

A series of 36 patients with surgically proved primary hyperparathyroidism is reported. From this group a clinical profile consisting of obesity, anxiety, and/or depression in a mildly hypertensive, middleaged female was derived. Women constituted 92 percent of the patients. The serum calcium was confirmed again as the single most valuable test in the evaluation of this disorder.