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Mobile Doctor Services for Quick and Convenient Care

Finding a doctor is difficult enough when you need a doctor for yourself. But when you’ve got an entire family to look out for, finding a physician can seem challenging — unless you seek mobile doctor services. You’ll find a distinct advantage with mobile doctors as compared to traveling to a doctor’s office or a crowded ER, especially when you are not feeling well.

Not only do you save trouble and time when you seek mobile doctor services in San Diego, but you can also help solve medical issues in your family a lot more quickly.

Why should I seek Mobile Doctor Services?

Mobile doctors or house call doctors provide home health and immediate access to skilled and experienced doctors for healthy, acute and chronic conditions management. Leading healthcare centers, such as Pacific Medical Care in San Diego, provide mobile doctor services at your doorstep.

Quick Care

No more waiting long hours to see a doctor. With mobile doctor services, seeing a doctor has never been easier. Mobile doctor services allow access to reliable medical care that is just a call away.

Convenient Care

Getting better is easy now. The doctor will come to your home or office to treat you. Pacific Medical in San Diego also offers mobile diagnostics, radiology and lab work.

If you are looking for mobile doctor services or an internal medicine doctor in San Diego, call Pacific Medical Care at 619-333-8114 or visit www.pacificmedicalcare.net. Internal medicine doctors focus on the whole patient, no matter how simple or complex the issue. They can help to prevent health issues before they arise and also manage chronic illnesses.

Best Urgent Care San Diego has to Offer

Whether you have a sinus infection, a sore throat, or a broken bone, the emergency room is not your only option for healthcare. Today, people are using urgent care centers to treat many life-threatening illnesses. A recent study found that half of all emergency department visits could be safely handled at urgent care facilities, like Pacific Medical Care. We have the best urgent care San Diego has to offer, and this includes pediatric services. Many people call 911 and are taken right to a hospital. Instead of waiting in the emergency department, you can come to our facility, and get treated quickly and appropriately.

Best Urgent Care San DiegoWhat is Urgent Care?

Urgent care centers offer walk-in services to their people. They focus on acute injuries and illnesses. Common causes of urgent care clinics are minor sprains, colds, flu, and broken bones. At Pacific Medical Care in San Diego, we go beyond the scope of retail clinics to offer primary care services in a fast, efficient manner. The main advantage of this type of clinic is that you can receive immediate attention without the long waits associated with hospitals and traditional doctors’ offices.

In addition to doctors, Pacific Medical Care has x-ray and laboratory testing available. This means you do not have to wait to find your diagnosis out until the next day. The doctor can treat you immediately. You can receive prescriptions at our facility too, without the long pharmacy wait afterward.

 

Benefits of Urgent Care

  • Lower cost – A trip to the emergency department is quite expensive, even when you have good health insurance. If you use Pacific Medical Care, you do not have to worry about high deductibles and copays, which is associated with emergency departments. Most insurance plans cover trips to the urgent care center. The prices for services are much lower at the Pacific Medical Care, and if you don’t have the money to pay out of pocket, then your bills are less.
  • Shorter wait – With the urgent care, you can expect a shorter wait time than at a hospital emergency room. Most of us really dread the hassle of going to a doctor’s appointment to schedule a sitting in the waiting area. An estimated 70% of people who visit an urgent care facility reported a wait time of fewer than 25 minutes. Urgent care centers take less than an hour, and the benefits of visiting one of these centers mean you spend less time.
  • Close to home – Many suburban residents drive into a crowded city hospital when they are sick or in pain. This can be unbearable. However, many urgent care centers are located near cities in surrounding suburbs. You do not have to worry about driving to a crowded hospital or deal with parking issues. Instead, when you come to Pacific Medical Care, you stay close to home to receive faster treatment.
  • Extended hours – Another benefit of attending an Urgent Care Center is the extended service hours. You do not have to make it to the doctor by 3 p.m. to be seen. If you are sick with a cold, have fallen and hurt yourself, or have a child who is injured, you can bring come to the urgent care center for care. These centers are open on weekends also, so it is the ideal place to go when you have a non-life-threatening illness or injury that requires medical attention.
  • Out-of-town healthcare – People who are traveling for pleasure or business do get sick or injured. An urgent care center is the best place to go for healthcare. At Pacific Medical Care, we offer excellent medical care without the problems associated with hospitals and doctors’ offices. There are no extensive wait times, no large copays, and you get the care you need.

A Six Step Approach to Asthma Control

treat asthmaHow do I treat asthma?

Asthma is a life-long disease that occurs when the immune system responds to harmless allergens in the environment. Short-acting medications can treat attacks when they occur. But it is a progressive disease that can harm the lungs. ‘Progressive’ means that if damage builds up over time, symptoms become more frequent and severe. So for severe cases, prevention is the better than treatment.

There are two main types of asthma medications. Of course, there are new drugs out there – but these are the most widely-used:

  1. A beta-agonist:Short-acting BAs, or ‘rescue inhalers’ calm down the immune system once it starts to react. A long-acting BA works daily or weekly when other drugs aren’t enough to prevent an attack.
  2. Corticosteroids (inhaled or oral): steroids suppress the immune system to stop attacks before they happen. Unfortunately, they have strong side-effects. These include weight gain, osteoporosis (weakening of the bones), high blood pressure, and high blood sugar. That’s why patients start out on an inhaled steroid. Inhaled drugs target the lungs, and are less likely to affect the rest of the body. But severe, uncontrolled asthma may need an oral steroid.

Which medications should I take?

All these drugs can be overwhelming. But there is a system! Doctors use a “Six Step” approach that balances the benefits of asthma control against the side-effects. Mild to moderate asthma begins with Step 1. If you still have frequent attacks, you and your doctor will discuss the risk and benefits of moving to the next step.

Step 1: Rescue inhaler as needed

Step 2: Add a low-dose inhaled corticosteroid to Step 1

Step 3: Change Step 2 to a medium-dose inhaled corticosteroid

Step 4: Add a long-acting BA to Step 3

Step 5: Change step 3 to a high-dose inhaled corticosteroid

Step 6: Add an oral (pill) corticosteroid to Step 5.

 

Keeping in step: why prevention is critical

It may seem ok to ‘push through’ asthma attacks with rescue inhalers and other treatments. But inflammation builds with each one. If symptoms are not addressed, a patient on Step 6 would need:

  • rescue inhaler as needed
  • a long-acting beta agonist
  • a high-dose inhaled corticosteroid
  • An oral corticosteroid

That is a lot of medications with serious side effects. Still, the good news is that the earlier you start prevention, the less likely you are to move up steps.

Warning signs to watch for

What are the signs that your asthma is not well-controlled?

  • Asthma symptoms wake you up at night more than once per month
  • You need a rescue inhaler more than twice per week
  • Asthma interfere with normal activities
  • Your lung function declines. A doctor measures lung function using a spirometer. It gauges how well your lungs pull in and push out air, and how much air you can take in.

If you notice any of these, it’s time to schedule a check-up. You may need to move up a Step to control symptoms. The good news is that asthma can also improve. When symptoms are under control, the lungs can heal. You can discuss moving back a down to a step with fewer medications.

Asthma Attacks Can Get Worse Over Time

Allergic asthma is a chronic condition caused by inhaling allergens. Allergens are compounds in the environment that trigger an inflammatory reaction. In some people, the immune system mistakes them for an outside invader, and attacks. The air pathways swell and become narrow. While there is no cure, there are many ways to manage symptoms.

Many people think asthma is ‘under control’ as long as their rescue inhaler provides relief. Unfortunately, asthma can be a progressive disease. This means that symptoms get worse over time if inflammation builds. When attacks are frequent, symptoms become harder to control with medication. Eventually, rescue inhalers will stop working

Asthma attacks inhalerIs it time to put down your rescue inhaler?

Many people think that if they rescue inhaler relieves the symptoms, their asthma is under control. In fact, this is only a Band-Aid. The rescue inhaler does not address the underlying inflammation. With each attack, your lungs are more inflamed and more easily triggered.

The key is to prevent attacks before they happen. Doctors decide what medication to prescribe using a Step Guide. (insert link to blog post on Asthma steps). Each step adds another medication or changes the dosage. This reduces side effects while managing attacks. If you are using the rescue inhaler more than twice per week, it’s time to put it down, pick up the phone, and schedule a doctor’s appointment.

A symptom self-assessment

How controlled is your asthma? The following are signs that it is time to get re-evaluated:

  • Group 1: Well controlled – No interference with normal activity. Fewer than 2 rescue inhales per week.
  • Group 2: Not-Well Controlled – Some limitation of normal activity. More than 2 rescue inhales per week.
  • Group 3: Very poorly controlled – Extremely limited activity. Rescue inhaler used several times per day.

If you fall into the first category, then you are doing great! Keep up your medications and schedule a check-up every six months. If you are in the second group, you should see your doctor determine if you need an oral or inhaled steroid. They may change a medication or raise your dose. Visit your doctor every six weeks until you asthma symptoms fall back into the ‘well-controlled’ group.

If you are in the last group, you should consider a short-course treatment with an oral corticosteroid. This will control the attacks for a short time, so you can work on a new treatment regimen. You likely need significant changes to your medications.

Some other signs that your asthma is not well controlled:

  1. Difficulty breathing with normal activities like going up stairs or carrying groceries.
  2. Decreased stamina and fatigue while exercising
  3. Drop in peak flow meter: this is a meter provided by your doctor. As your lungs become inflamed, your peak flow will drop.
  4. Waking up a night due to coughing or wheezing

Remember prevention, not rescue treatments! To stop asthma symptoms from becoming worse, it is important to make sure you are taking the right medications.

High Blood Pressure? Check Your Kidneys

You heart contracts (“beats”) to push blood through your body. The right amount of pressure keeps blood moving. Too little pressure (hypotension) can make you light-headed or even pass out. Too much pressure (hypertension) can damage your blood vessels and organs.

Damaged Kidneys Caused by heart attackHigh blood pressure can damage your kidneys

High blood pressure means that there is too much force pushing against the walls of your blood vessels. This happens because the vessel is too narrow or because the hormones that control blood pressure are not in balance. Your kidneys produce some of these hormones.

Blood pressure is the force of blood pushing against blood vessel walls as the heart pumps out blood.

High blood pressure causes your blood vessels to stretch. The damages the tissue and leaves scars that weaken vessel walls.

In addition to producing hormones, kidneys filter waste and water from your blood. Your blood flows into the kidneys through arteries (large blood vessels). Then it divides into smaller vessels to reach the millions of microscopic filters (glomeruli) in your kidney. These filters allow waste flow out, and keep blood and important proteins in the body.

If hypertension is not managed, the high pressure damages the glomeruli filters. They become ‘leaky,’ and blood and proteins leak into the urine. Other waste products are not filtered correctly and remain in the body. If not controlled, the kidneys may stop working. This damage is irreversible and requires dialysis or a kidney transplant. Patients with kidney damage don’t have any symptoms until the damage is severe. So it’s very important for a doctor to check your kidney function.

How can I test my kidney function?

If you have hypertension, you need to make regular doctor visits to check kidney function. This involves two important tests:

  1. GFR (glomerular filtration rate): this is a blood test that measures how much waste is being filtered by the kidneys. The following numbers reflect how healthy your kidneys are:

  • Normal: GFR greater than 60
  • Kidney disease: GFR below 60
  • Kidney failure: GFR below 15
  1. ACR (Albumin-to-creatinine ratio): This is a urine test for proteins (albumin) or blood. Any amount of these in your urine, it is a sign of kidney damage.

How can I prevent kidney damage?

Anything you do to manage high blood pressure will prevent kidney damage. You can learn more about hypertension here (link to Blog#2 HTN blog). But some important steps you can take include:

  1. Medication: High blood pressure does not cause symptoms early in the disease. It is important to take any prescriptions to manage blood pressure.
  2. Quite smoking: smoking causes your blood vessels to constrict. This raises blood pressure throughout your body, increasing damage to your kidneys.
  3. Diet: eating a diet high in LDL or “bad” cholesterol can cause atherosclerosis, or blockage in your arteries. Eat low-fat foods, or healthy fats that contain HDL.(Blog#4 to learn more about good and bad cholesterol)

Manage blood sugar: If you are diabetic, it is important that you manage your blood sugar levels. Hypertension is the second leading cause of kidney damage in the United States. Damage caused by diabetes is the leading cause.

Prehypertension: Does it matter?

Prehypertension Heart AttackThe term ‘pre-disease’ can be confusing. Am I sick or not? Do I need medication or not? Why bother with a ‘diagnosis,’ if I don’t have a disease? To answer this, let’s talk about what pre-hypertension means, and how it affects your health now and in the future.

Hypertension is a disease caused by continuous, high-pressure on the walls of arteries and blood vessels. Over time, this pressure begins to weaken blood vessel walls and damage organs. It can also cause blood clots to develop, leading to a heart attack or stroke.

Hypertension has few symptoms. Most people feel completely normal until a devastating stroke occurs. As a result, doctors aim to diagnose and monitor hypertension early.  Blood pressure is measured with a BP cuff. A reading of 120/80 mmHg or lower is normal. Hypertension is diagnosed when a person’s average blood pressure is above 140/90 mmHg.

However, your doctor has told you that your average blood pressure is above 120/80 mmHg and below 140/90 mmHg. It means that you have pre-hypertension. Where does that leave you?

Mind the Gap

First off, you aren’t alone. Over 59 million American adults have prehypertension. To make things more complicated, risks vary based on genetic background. For example, a Caucasian (‘white’) person with hypertension is three times more likely to develop coronary heart disease (CHD) than an Asian person with hypertension. (Source: https://www.nature.com/nrcardio/journal/v12/n7/pdf/nrcardio.2015.17-c1.pdf)

So why have doctors made this distinction at all? The answer is based on research into treatment efficacy and risk. These are studies where scientists determine whether the positive effects of medications outweigh the negatives, which include dangerous side effects. On average, studies found that people with hypertension greatly benefit from treatments that lower their blood pressure. It can save lives and organs. In comparison, prehypertension treatment does not significantly lower the chance of developing an organ disease. The risks outweigh the benefits of the medication.

However, it is important to diagnosis prehypertension because it is an early warning sign that hypertension is on the way.

How do I know my risk?

It’s important to accurately measure your blood pressure.  A phenomenon called ‘white coat syndrome’ affects one in five people. Going to the doctor is stressful for many people. Stress temporarily raises blood pressure. As a result, these people have a high BP anytime they are in a clinical setting.

If this is you, your doctor may ask you to take readings at home. It also helps to take 4 to 5 readings throughout the day, to get an accurate idea of your average blood pressure. Your blood pressure is usually highest during the day, and lowest while you are sleeping.

I know my blood pressure. Now what?

The word ‘pre-disease’ means there is still have time for prevention. Remember, too much medication can cause more harm than benefit. But lifestyle changes to diet and exercise can strengthen the heart and arteries with little or no risk.

So if your doctor tries to prescribe you medication for prehypertension, ask more questions. What are their concerns? Is there something about you (age, race, gender) that concerns them more than the average person? If not, ask what lifestyle changes you can make before starting on a medication. Or get a second opinion from another doctor.

Remember, doctors are humans. Sometimes, a good or bad outcome with one patient can influence their decision for another. That is why medical experts created the national guidelines for hypertension. So that doctors AND patients have a starting point to make informed health decisions, together.

The Four Types of Heart Disease to Ask Your Doctor About

  1. Types of Heart DiseaseCoronary artery disease (CAD)

Coronary artery disease is the most common type of heart disease and the leading cause of ALL deaths in the United States.
CAD affects the vessels that flow into and out of the heart. When plaques build up in arteries, the muscle has to work harder to pump blood. Plaques are deposits of cholesterol (a fat-like compound) and other substances. CAD occurs when this ‘gunk’ can become large enough to restrict or block blood flow.

How does CAD lead to a heart attack? There are many tiny blood vessels that deliver oxygen and nutrients to the cardiac muscle. These provide the ‘fuel’ for the muscle to contract. If plaque blocks blood flow, the muscle weakens or may stop completely (a heart attack). Many people do not know they have the disease until they have a heart attack.

How do I treat CAD?

  • Lifestyle changes include a healthy diet, regular exercise, and not smoking
  • Your doctor can prescribe medications that lower cholesterol in the blood
  • For severe CAD, you may need surgery open your arteries
  1. Heart valve disease

Your heart and arteries have valves that control blood flow. If a valve ‘hardens’ or becomes narrow, it cannot close completely. Blood may flow in the wrong direction or back up into the heart. It then has to work harder to keep your circulation moving. As a result, the muscle grows bigger and the heart chambers that hold blood become smaller.
At first, you may not have any symptoms. In advanced disease, you may experience mild to severe chest pain, dizziness, or fluid filling in your legs. If these happen, you should call your doctor immediately.

What causes valve disease?

  • Valves weaken as you get older
  • Hypertension (high blood pressure) damages valves
  • Plaque builds up in arteries (CAD) increases the strain on valves.
  • Bacterial endocarditis is an infection of the valves
  1. Cardiomyopathy

Cardiomyopathy means damage to the muscles that make the heart contract (squeeze). When this happens, muscle is replaced with scar tissue. The heart thickens and becomes weaker. The remaining muscle has to work hard to pump blood. This may lead to valve disease, arrhythmias (see below), or heart failure.

Cardiomyopathy may be genetic, meaning you were born with the disease. If someone in your close family has cardiomyopathy, you and your children are more likely to have it. Certain medications and illnesses also damage the muscle. Some illnesses include hypertension, diabetes, or a viral infection.

How do I treat cardiomyopathy?

Your doctor can tell you if you have cardiomyopathy. You may not know until something serious occurs, like a heart attack.

Treatments include

  • Medicine
  • Surgery
  • Implant devices to make your cardiac muscles contract
  1. Arrhythmias (Irregular rhythm)

Electric impulses cause your heart to contract. Arrhythmias occur when these impulses do not follow a normal rhythm. It beats too fast, too slow, or at irregular intervals. Symptoms may be mild, like a fluttery-feeling in the chest. If combined with another problem like cardiomyopathy or valve disease, arrhythmias are life-threatening.

Severe symptoms include chest pain, difficulty breathing, dizziness or fainting. It may feel like your heart is ‘racing.’ If these occur, you should see a doctor immediately.

How do I prevent arrhythmias?

Sometimes, they are normal and don’t need treatment. But you should do everything you can to lower your risk for severe arrhythmias. This includes

* Follow lifestyle changes to prevent CAD and valve diseases

* If you have high blood pressure, ask your doctor what steps you should take to lower it

* Exercise regularly

Preventing ALL types of heart disease

Did you notice that these diseases all seem related? That is because one may lead to another, or they may BOTH be caused by the same problem (like genetics, poor diet, or smoking). The good news: lowering your risk for one illness also lowers your risk for the others! So talk to your doctor today about ways to maintain a healthy heart.

What do Internal medicine Doctors do?

Internal medicine is the medical specialty that focuses on comprehensive adult care. Doctors who practice internal medicine are also called internists. They care for a person for the duration of his or her lifetime.

Internal Medicine Doctor vs. Family Practitioner

Internal medicine doctors study adult medicine and are skilled in diagnosis and treatment of adult diseases. Internists have a wide-range of knowledge based on complex diseases. Family practitioners treat all people from age 0 through 100, and specialize in family practice.

Conditions treated by Internists

Internists treat –

  • Vascular and heart disease
  • Respiratory disease
  • Blood problems
  • Joint and rheumatologic problems
  • Kidney problems
  • Digestive problems
  • Urinary problems
  • Mental health issues
  • Neurological problems
  • Diabetes
  • Endocrine/hormonal problems
  • Infectious diseases

They also treat substance abuse, women’s health, mental health and common problems of the ears, eyes, skin, reproductive organs, and nervous system.

An internist treats a variety of acute and chronic conditions and can also coordinate many subspecialists in order to treat a certain ailment or disease.

Internal medicine doctors focus on the whole patient, solve puzzling diagnostic problems and handle severe chronic illnesses and situations.

While internists focus on general internal medicine, many have additional training to subspecialize in one of 13 different areas which include adolescent medicine, allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, infectious diseases, nephrology, oncology, pulmonology, rheumatology and sports medicine.

To know more or to schedule an appointment with internal medicine doctors in San Diego, call Pacific Medical Care at 619-333-8114 or visit www.pacificmedicalcare.net.

13 Urgent Foot and Ankle Conditions where a Podiatrist can help you

A foot doctor or podiatrist can diagnose and treat a wide range of foot and ankle problems. A mobile foot doctor can even come to our house and treat your foot condition. The following are a few symptoms in which you should consult a foot doctor.

  • Stubborn pain in the feet or ankles that doesn’t go away with rest
  • Feet blisters
  • Cracking, scaling or peeling of the foot and the heel
  • Changes in the nails or skin on your foot
  • Signs of infection, such as –
    • pain, swelling, tenderness or redness in the feet or ankles
    • discharge or pus from an area on the foot
    • stubborn foot and/or ankle symptoms that show no improvement even after two weeks of treatment with an over-the-counter product
    • infection from one area of the foot spreading to another, such as under the nail bed, skin under the nail or the nail itself
    • uncomfortably thickening toenails
    • heel pain, redness or numbness, followed by a fever
    • tingling in the heel
    • continuous pain in the heel even without putting any weight on it
    • pain doesn’t go away despite icing or over-the counter medication
    • diabetics with poor circulation who develop Athlete’s Foot

To know more or to consult a podiatrist in San Diego, call Pacific Medical Care at 619-333-8114 or visit www.pacificmedicalcare.net. Podiatrist in San Diego can prevent, diagnose and treat foot and ankle conditions. They can also treat day-to-day foot problems, such as toenail problems, corns and calluses.

What is Sciatica and How to Relieve Sciatica Pain?

Sciatica is a common cause of disability and long-term pain. The sciatic nerve supplies the buttock and lower leg (on each side of the body). When it is inflamed or irritated, it can produce substantial pain. According to a recent study, the prevalence rate is around 5% for the general population. Numerous back conditions can lead to sciatica, such as a herniated disc, degenerative disc disease, and other spinal conditions.

how to relieve sciatica painWhat is Sciatica?

Sciatica describes a collection of symptoms that occur from sciatic nerve compression. The sciatic nerve runs from the base of the spine down through both legs. When this nerve is compressed, it causes pain that often moves through the buttocks, legs, and feet. Sciatica is a form of nerve dysfunction or peripheral neuropathy. It occurs from pressure on the sciatic nerve.

Sciatic most often arises because of pressure from a herniated disc, protruding disc, or bone spur. Damage to a disc or excess bone growth is positioned along the spinal column so that it puts pressure on the nerve root. Sciatica could arise in cases of nerve entrapment, which entails pressure as the nerve passes through an opening between two vertebrae.

Symptoms and Diagnosis of Sciatica

Sciatica is diagnosed mainly based on symptoms. The known symptoms are numbness, burning, tingling, and pain in the back of the legs, buttocks, and/or soles of the feet. Sciatica may also cause leg weakness. The pain management specialist will inquire about your many symptoms when assessing sciatica. In addition, the doctor will take a medical history, inquire about surgeries, and perform a comprehensive examination.

Because sciatica can be caused by a spine disorder, the doctor will likely order some diagnostic tests. These include radiographs (x-rays), computed tomography (CT scan), and magnetic resonance imaging (MRI scan). The doctor will evaluate which treatments have worked in the past, and which have failed, before devising your treatment.

Treating Sciatica

If you suffer from sciatic nerve pain, or sciatica, the pain management specialist will try many treatments. Sometimes, a combination of therapies works best. Options include:

  • Physical therapy – The therapist works with you to learn exercises to strengthen the back, improve flexibility, and alleviate pain. Some therapies used by physical therapy include massage, ultrasound, and electrical stimulation.
  • Medications – Medications used to alleviate pain include nonsteroidal anti-inflammatory drugs, muscle relaxants, tricyclic antidepressants, and anticonvulsants. These agents all have benefits for nerve-related pain.
  • Epidural steroid injection – This involves injecting a corticosteroid medication into the epidural space around the spinal cord. The nerve root responds to the medication, which is known to lessen inflammation and pain. Sometimes, an anesthetic is added for pain relief. The epidural steroid injections are given in a series of 3-4, spaced out several weeks apart. According to many clinical studies, ESI has an efficacy rate of 90%.
  • Transcutaneous electrical stimulation (TENS) – This involves use of mild pleasant electrical current, which interferes with pain signal transmission. Electrodes are placed along the spine, and a battery-powered unit delivers the electrical current through wires that attach to the electrodes.
Resources
Abdi S, Datta S, Trescot AM, et al. (2007). Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician, 10(1):185-212.
Konstantinou K & Dunn KM (2008). Sciatica: review of epidemiological studies and prevalence estimates. Spine, 33(22) 2464-2472.

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