A medicamentalização do mal-estar é uma realidade efetiva, atual e crescente, que se expande, inclusive, para campos diversos do médico-científico. Ao oferecerem produtos que prometem alívio ou melhoramento de estilo ou condição de vida, diversos meios de comunicação, tais como a literatura e os programas de televisão, funcionam como verdadeiros manuais de autoajuda, atendendo a uma crescente demanda de cuidado para cada sofrimento ao qual podemos estar submetidos. Devido à complexidade do fenômeno em questão, buscaremos estabelecer algumas interseções entre droga, medicina e sociedade que participam do processo de medicamentalização do mal-estar psíquico.

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Key Clinical MessageThe present case emphasizes the importance of adhering to strict indications when prescribing fluoroquinolones. Although rare, drug‐induced tendinopathy is not confined to fluoroquinolones. The patient's and physician's awareness should be increased to reduce fluoroquinolones‐associated morbidity, particularly in patients with previously described risk factors.

Study design: This is a prospective study of 2 cohorts. Objective: Compare the clinical and radiologic outcome of 2 cohorts of unstable thoracolumbar and lumbar fractures treated by open posterior fixation (OPF) with bone graft or by percutaneous fixation (PCF) without grafting. Summary of Background Data: In recent years, PCF is the most common treatment of thoracolumbar fractures. To date, no studies have analyzed clinical outcomes in terms of return to work. Material and Methods: Two cohorts of patients with unstable thoracolumbar and lumbar fractures fractures (type A2, A3, and A4) without neurological symptoms underwent OPF (n=91) or PCF (n=54) between 2010 and 2015. A conventional radiologic study was performed in the preoperative, immediate postoperative period, 1-year, and 2-year follow-up. Clinical outcomes were evaluated by Visual Analog Scale and Oswestry Disability Index scores at 1-year and 2-year follow-up. The period to return to work and the type of work were also recorded. Results: The percentages of correction were significantly higher in cases operated by OPF: fracture angle (P<0.001), kyphotic deformity (P<0.001), vertebral compression (P<0.001), and displacement (P<0.001). Cases operated by PCF experienced greater loss of correction at 2-year follow-up, especially in fracture displacement (P<0.001), deformity angle (P<0.001), kyphotic deformity (P<0.001), and in the sagittal index (P<0.001). Besides this greater loss of correction, PCF cases showed better Visual Analog Scale (P<0.001) and Oswestry Disability Index scores (P<0.001) at final follow-up. The percentage of patients returning to the same heavy work position was higher in the PCF group (P<0.001) and in a shorter period of time (P<0.001). Conclusions: The greater loss of correction of patients undergoing PCF does not reflect the clinical outcomes that were significantly better as compared to patients undergoing open fixation with grafting. It would be useful to further evaluate if the radiological changes could have a long-term clinical significance.

Key Clinical MessageThe incidence of stress injuries in older athletes is increasing, associated with a more active older population. The same principles apply for its prevention and treatment, but older athletes usually present a more adverse outcome. It is mandatory to raise awareness to this common, but frequently neglected pathology.