Co-occurrence of chronic pain disorders in adolescents suggests early pain programming and possible timing for intervention
Over the last decade, much effort has been put into exploring the relationship and causality between multiple chronic diagnoses in adults, especially female adults. This research often includes endometriosis and many studies have shown increased prevalence of fibromyalgia, interstitial cystitis, irritable bowel syndrome, and migraines in patients with endometriosis compared to their counterparts without endometriosis (1). These studies have all been conducted in adult populations with a mean age usually in the 30-40 year range.
Atypical chest pain is of diverse origin. Typically, we initially consider cardiac etiology. When pain appears non-cardiac, there is a tendency to underestimate the illness, especially if the patient has neuropsychiatric illness. Our resident with dementia and anxiety disorder had chest pain; the diagnosis was unexpected.
West Nile Virus (WNV) infection is the most common mosquito-borne illness in the United States. Most cases are asymptomatic or with mild symptoms. Older adults are more likely to have central nervous system (CNS) involvement, and a higher risk for mortality.
Chronic pain is common among older adults, as is the use of medications to treat these symptoms. Aging physiology, in combination with a higher likelihood of medication use and declining renal function, makes older adults more susceptible to adverse drug effects. As such, monitoring for side effects and changes in renal function is important to avoid drug toxicity, especially during acute illness when medication errors and acute changes in renal function are more likely to occur among older adults.
Many patients are discharged to post-acute care facilities (PACFs) following surgery. These patients have either had major surgery and require close monitoring and intensive rehabilitation, or have significant medical co-morbidities. Currently they are transported, sometimes at considerable cost, to the surgeon ’s office for post-surgery visits (PSVs). These trips can be painful and uncomfortable. A staff member from the PACF may need to accompany the patient. During PSVs surgeons observe the patient's incision(s), and assess potential complications following surgery, pain, and functional recovery.
Chronic pain is among the most common reasons for seeking medical attention. In the United States, 1 in 5 adults had chronic pain in 2016 and it is estimated to cost over $500 billion annually in direct medical costs and disability. It is a prevalent problem among residents in the nursing home. Non-pharmacologic therapies are the most preferred treatment for chronic pain as pharmacological therapies, such as opioids, have proven to be less effective and associated with numerous side effects among older adults.
I love my work as a post-acute and long-term care geriatrician, and as a hospice and palliative medicine specialist. I freely admit that. Yes, there are plenty of headaches, including administrative and regulatory burdens, and there ’s the unfortunate reality that lots of the patients I become fond of die. But I believe that most of Caring’s readers feel the same way. In fact, I believe most people who choose to devote their life’s work to providing care to the vulnerable, dependent, and ill patients we look after love th eir work and consider it a calling — including arguably the most important mem...
Publication date: Available online 26 February 2020Source: NeuroImage: ClinicalAuthor(s): J.A. Kim, R.B. Bosma, K.S. Hemington, A. Rogachov, N.R. Osborne, J.C. Cheng, J. Oh, B.T. Dunkley, K.D. Davis
Publication date: Available online 26 February 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): John Davitt, Megan Wasson, Paul Magtibay
This study comprised 9191 subjects with endometriosis, and 27 573 subjects randomly selected as controls. We individually followed‐up each subject (n = 36 764) for a 3‐year period to identify subjects subsequently diagnosed with BPS/IC. A Cox proportional hazards regression model was employed to estimate the risk of subsequent BPS/IC following a diagnosis of endometriosis. ResultsIncidences of BPS/IC during the 3‐year follow‐up period was 0.2% and 0.05% for subjects with and without endometriosis, respectively. The hazard ratio for developing BPS/IC over a 3‐year period for subjects wi...
Discussion Appendicitis results from a closed loop obstruction of a blind-ending tubular structure arising from the cecum. It is a common cause of abdominal pain. It is the most frequent condition leading to emergent abdominal surgery in pediatrics. The combination of obstruction, edema, bacterial overgrowth, increased inflammatory process and increased intraluminal pressure leads to abdominal pain and possibly perforation. Appendicitis occurs in all age groups but is rare in neonates. The peak age is 6-10 years old. Pelvic inflammatory disease (PID) is an inflammatory disease of the uterus, fallopian tubes and adjacent p...