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Lead for "Brazilian Gold"

Brazilian gold, first discovered in the late 17th century, has played an important and lasting role in shaping the social, cultural, and economic realities of eastern South America. The initial discovery of gold in the area that is modern-day Brazil led to the longest lasting gold rush in world history, bringing hundreds of thousands of non-indigenous Portuguese and slaves to the area as well as environmental destruction and pollution. The effects from mass migration to the region in the pursuit of riches are some of the biggest formative components of Brazilian culture today. However, along with the opportunity for economic prosperity that gold has offered to some, extensive mining and the processes that accompany purification of the valuable mineral have wreaked havoc on the delicate ecosystem of the Amazon, with large swaths of rainforest leveled and dangerously high levels of mercury deposited in the Amazon River. Despite the negatives, Brazilian gold is still highly sought after and mined by modern day Brazilian "garimpieros," partly due the the recent resurgence of gold prices making the dangerous and polluting line of work highly profitable.

Sources for the article "Back pain"

WP Section:

The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible, to restore the individual's ability to function in everyday activities, to help the patient cope with residual pain, to assess for side-effects of therapy, and to facilitate the patient's passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain to a manageable level to progress with rehabilitation, which then can lead to long-term pain relief. Also, for some people the goal is to use non-surgical therapies to manage the pain and avoid major surgery, while for others surgery may be the quickest way to feel better.

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The goal of treatment of chronic LBP is to reduce pain, maintain function and prevent future exacerbation. Numerous evidence-based clinical practice guidelines for the management of chronic LBP have been published (Chou et al., 2007; National Institute for Health and Clinical Excellence, 2009; Koes et al., 2010; German Medical Association, National Association of Statutory Health Insurance Physicians, and Association of Scientiﬁc Medical Societies, 2013). Available guidelines typically advise a multimodal approach to the management of chronic LBP, combining pharmacological therapies for symptomatic relief with nonpharmacological approaches, such as physical activity and psychosocial/behavioural interventions. Choice of treatment should be individualized according to the nature and severity of symptoms, the presence of comorbid conditions (e.g. depression or sleep disorders), potential for adverse effects and drug interactions, risks of misuse and abuse, and cost. However, these guidelines typically do not include speciﬁc recommendations for the treatment of neuropathic components of chronic LBP.

WP Section:

Back pain in pregnancy may be severe enough to cause significant pain and disability and pre-dispose patients to back pain in a following pregnancy.

Biomechanical factors of pregnancy that are shown to be associated with low back pain of pregnancy include abdominal sagittal and transverse diameter and the depth of lumbar lordosis. Typical factors aggravating the back pain of pregnancy include standing, sitting, forward bending, lifting, and walking. Back pain in pregnancy may also be characterized by pain radiating into the thigh and buttocks, night-time pain severe enough to wake the patient, pain that is increased during the night-time, or pain that is increased during the day-time.

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Low back pain (LBP) is a common complaint amongst women during pregnancy, having a great impact on their quality of life.

It is described as deep, stabbing, unilateral or bilateral, recurrent or continuous pain, presenting between the posterior iliac crest and the gluteal fold, possibly radiating to the posterolateral thigh, to the knee and calf, but not to the foot.

One of the most frequent mechanisms suggested, is associated with the mechanical factors, due to weight gaining during pregnancy, to the increase of the abdominal sagittal diameter and the consequent shifting of the body gravity center anteriorly, increasing the stress on the lower back 3,8,9,11. Studies suggest that an anterior shift is associated with pubic symphysis problems8. Postural changes may be implemented to balance this anterior shift, causing lordosis and increasing stress on the lower back.

In addition, a biomechanical process suggests that the abdominal muscles of the pregnant woman stretch to accommodate the enlarging uterus, causing muscle fatigue and resulting to an extra load on the spine, which is charged with the task of supporting the majority of the increased weight of the torso.

Another theory suggests that LBP during pregnancy, which worsens at night, may be the consequence of the expanding uterus putting pressure on the vena cava causing venous congestion in the pelvis and the lumbar spine.

Pregnant women should be educated on how they can maintain a proper posture, while doing everyday activities, so that their back is not overloaded and misaligned.

The education of the pregnant woman is very important, so that she learns how to stand, walk or bend without causing an extra stress on the spine or muscle fatigue. Women are also encouraged to take a midday rest to relieve their muscles and to avoid prolonged walking or standing.