First, Do No (Self) Harm

When a doctor in your hospital system kills himself, the entire medical staff receives a mass email informing everyone of “Dr. So-and-So’s sudden unexpected death”. Thoughts and prayers for his family and loved ones. Perhaps a link to your Employee Assistance Program is provided, for those who may need counseling or grief assistance.  This is followed later that day with another email detailing the schedule for the final arrangements. Calling hours. Funeral. Directions to the church.Not everyone will have known the physician. So most scan the email and then go about their day. But then you pass people in the halls; residents, peers, nurses who knew him, worked with him, laughed with him, and so you see the smudged mascara, the middle distance gazes, the shattered disbelief of those who now believe in ghosts. Your eyes meet and neither of you know what to say. What the hell? What happened? And the other will say,didn ’t you hear? Shot himself. In his own backyard. Called EMS just before doing it. Jesus you say. Jesus. I wondered if he had children. Another way of asking, was he loved? And it ’s absurd and unkind and naive and ignorant. Was he loved. Or more gently, did he leave behind someone he ought not to have? I had known this particular doctor. Not particularly well, we weren ’t friends or anything. I didn &r...
Source: Buckeye Surgeon - Category: Surgery Authors: Source Type: blogs

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This article reviews implications of cannabis use for defendants' eligibility and participation in problem-solving courts, with a focus on adult drug courts and mental health courts. This article also examines a range of policies, such as abstinence-based, tolerance-based, and adaptive approaches, that problem-solving courts may consider implementing. Further research is needed to characterize existing problem-solving court policies toward cannabis use and to develop evidence-based practices that courts may follow. PMID: 31533992 [PubMed - as supplied by publisher]
Source: Journal of the American Academy of Psychiatry and the Law - Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research
Authors: Moon JR, Lee CK, Hong SN, Im JP, Ye BD, Cha JM, Jung SA, Lee KM, Park DI, Jeen YT, Park YS, Cheon JH, Kim H, Seo B, Kim Y, Kim HJ, MOSAIK study group of the Korean Association for the Study of Intestinal Diseases (KASID) Abstract Background/Aims: Limited data are available regarding psychosocial distress at the time of diagnosis of ulcerative colitis (UC). We investigated the psychosocial burden and factors related to poor health-related quality of life (HRQL) among patients newly diagnosed with moderate-to-severe UC who were affiliated with the nationwide prospective cohort study. Methods: Within the ...
Source: Gut and Liver - Category: Gastroenterology Tags: Gut Liver Source Type: research
The goal of this proposed initiative is to identify feasible approaches to telehealth-supplied suicide prevention practices, and how this consultation affects patient suicide-related outcomes that include intentional and non-intentional injuries and mortality, and suicide related-health utilization patterns.
Source: National Institute of Mental Health - Category: Psychiatry Authors: Source Type: news
CONCLUSION: The incidence of rhinoscleroma in Egypt is decreasing and its clinical and histopathological patterns are changing to less advanced forms. This may be explained by the improvement in socioeconomic conditions and methods of treatment. PMID: 31533871 [PubMed - as supplied by publisher]
Source: Journal of Laryngology and Otology - Category: ENT & OMF Tags: J Laryngol Otol Source Type: research
Authors: Shoar S, Naderan M, Mahmoodzadeh H, Shoar N, Lotfi D Abstract Introduction: Night Eating Syndrome (NES) refers to an abnormal eating behavior which presents as evening hyperphagia consuming>25% calorie intake and/or nocturnal awaking with food ingestion which occurs ≥2 times per week. Although the syndrome has been described more than seven decades ago, the literature has been growing slowly on its etiology, diagnosis, and treatment. Areas covered: The proposed treatment options for NES are all at a case-study level. Moreover, our understanding of its etiology, comorbidities, and diagnosis is still p...
Source: Expert Review of Endocrinology and Metabolism - Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research
Conclusion: This study confirmed the association of vitamin D deficiency with hypothyroidism, thyroid autoimmunity, increased volume, nodularity, and vascularity of thyroid gland in hypothyroid patients as well as increased HOMA-IR. It proved the association between HOMA-IR and thyroid autoimmunity. The study proved no association between VDR polymorphisms (Fok1 and Apa1) with either vitamin D levels or TSH levels. PMID: 31534663 [PubMed]
Source: Journal of Thyroid Research - Category: Endocrinology Tags: J Thyroid Res Source Type: research
Authors: Nakamura H, Utsunomiya A, Ishida Y, Horita T Abstract A 48-year-old man was brought to our emergency room with acute abdominal pain and systemic edema, indicating acute circulatory failure with lactic acidosis. Furosemide treatment paradoxically worsened the systemic edema and induced confusion. He had no drinking history but hardly ate legumes or meats containing thiamine. Administration of fursultiamine dramatically improved the symptoms and subsequently caused pulmonary edema. Thiamine deficiency may occur in nondrinkers with an unbalanced diet. In this condition, diuretic therapy can worsen the symptom...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conclusion The present study showed that high plasma glucose levels and severe liver fibrosis stage influence insulin secretion levels in Japanese patients with NAFLD. Conservation of delayed insulin secretion levels was confirmed in patients with severe liver fibrosis. PMID: 31534089 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Hosoda T, Uehara Y, Naito T Abstract Patients with HIV infection represent a high-risk group for medication overdose because of the high frequency of complicating psychiatric disorders. Raltegravir is well-known for its low frequency of adverse effects. We herein report a 42-year-old Japanese man with HIV infection who was hospitalized 6 hours after overdosing with 24,000 mg of raltegravir in a suicide attempt. No serious adverse events occurred, although the plasma concentration of raltegravir at 18 hours after the overdose was 79,871.1 ng/mL. Raltegravir may be well-indicated for HIV patients at risk of ...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
We describe the case of a 52-year-old female outpatient who developed OIC while receiving oxycodone for pain due to cancer with multiple bone metastases. Although she did not have brain metastasis, opioid withdrawal syndrome (OWS) developed after taking naldemedine orally. Her Clinical Opiate-Withdrawal Score (COWS) was 19 (moderate symptoms). However, she recovered from OWS on intravenous fentanyl and a continuous infusion of oxycodone. She did not develop OWS thereafter and was discharged two days after recovery. PMID: 31534081 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
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