A Pregnancy Complication to Look out for even after Pregnancy

​BY GREGORY TAYLOR, DO, &SHERIF G. EL-ALAYLI, DOA 30-year-old G5P3 presented to the ED with bilateral lower-extremity edema and headache for three days. She presented one week after an uncomplicated full-term vaginal delivery with an unremarkable pregnancy course and no prior requirement for antihypertensive therapy. The headache was described as achy to sharp, with associated photophobia. She also noted occasional vaginal spotting, which was common a few weeks after delivery. She denied any chest pain, shortness of breath, nausea or vomiting, abdominal pain, or any other symptoms. She admitted to occasional mild cramping with minimal lochia.The patient was afebrile. Her vitals on arrival included a blood pressure of 168/94 mm Hg, heart rate of 82 bpm, respiratory rate of 18 bpm, and 100% on room air. Laboratory evaluation was notable for a hemoglobin of 11.1 g/dL, an aspartate aminotransferase of 44 U/L (13-39), alanine aminotransferase of 131 U/L (7-52), and a uric acid of 8.4 mg/dL (2.5-7.5). The clinical presentation and laboratory evaluation were concerning for postpartum preeclampsia.Hypertensive disorders of the antepartum and postpartum period (preeclampsia, eclampsia, HELLP, and cardiomyopathy) complicate up to 10 percent of all pregnancies around the world. (ACOG, 2017; http://bit.ly/2n5Pnhf.) These become common causes of maternal and perinatal morbidity and mortality. (EMRA. Jan. 31, 2018; http://bit.ly/2n56VKc.) Postpartum preeclampsia may occur w...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

Related Links:

Objective Using a feasibility analysis and matched subgroup analysis, this study investigated the implementation/safety/outcomes of a stroke recovery program (SRP) integrating modified cardiac rehabilitation for stroke survivors. Design This prospective cohort study of 783 stroke survivors were discharged from an inpatient rehabilitation facility to an outpatient setting; 136 SRP-participants completed a feasibility study and received the SRP including modified cardiac rehabilitation, 473 chose standard of care rehabilitation (nonparticipants), and a group (n = 174) were excluded. The feasibility study assessed the fo...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Objective Slow walking speed paired with increased energy cost is a strong predictor for mortality and disability in older adults but has yet to be examined in a heterogeneous sample (ie, age, sex, disease status). The aim of this study was to examine energy cost of slow and normal walking speeds among low- and normal-functioning adults. Design Adults aged 20–90 yrs were recruited for this study. Participants completed a 10-m functional walk test at a self-selected normal walking speed and were categorized as low functioning or normal functioning based on expected age- and sex-adjusted average gait speed. Partic...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Conclusions The results of the present study may be indicative for an impaired oxidative metabolism in work-related trapezius myalgia. However, additional research is necessary to confirm this hypothesis.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
This study aims to assess whether ultrasound-guided injection of platelet-rich plasma can safely and effectively treat symptoms associated with acetabular hip labral tears. Design Institutional review board approval was gained for a prospective study of eight patients (N = 8), who have previously failed conservative management, to receive ultrasound-guided injection of platelet-rich plasma at the site of hip labrum tear. We assessed pain reduction and functional ability at baseline and then 2, 6, and 8 wks after injection, using the visual analog scale and Harris Hip Score, respectively. Results Statistically signifi...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Introduction Ozone has been recently used as a safe alternative treatment in musculoskeletal disorders with fewer adverse effects than corticosteroids. The aim of this study was to compare the efficacy of a single injection of ozone with that of a corticosteroid in the treatment of shoulder impingement. Design Thirty patients with shoulder pain and clinical signs and symptoms of impingement were randomly assigned into two groups: ultrasound-guided injection with ozone or corticosteroid. Patients’ symptoms were evaluated by visual analog scale, constant score, shoulder pain and disability scale, shoulder range of...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Despite the fact that one fifth of Americans live with disability, caring for these patients is not routinely part of the undergraduate medical student curriculum. An innovative session addressing care of patients with spinal cord injury was developed for medical students and led by physiatrists, faculty experts in communications, and individuals with spinal cord injury. A mixed-method design was used in evaluating students' knowledge, skills, and attitudes following this curriculum. Quantitative evaluation was performed with a written essay question and checklist items from an objective structured clinical examination sta...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Education & Administration Source Type: research
Bone stress injury is a common overuse injury in athletes. Risk factors for bone stress injury in athletes include the female athlete triad (triad); this has not been evaluated in para athletes. The aim of this study was to identify risk factors, prevalence, and anatomical distribution of bone stress injury in para athletes. A cross-sectional online survey on health characteristics and previous fractures including bone stress injury was completed by para athletes training for the 2016 or 2018 Paralympic Games. Two hundred sixty para athletes completed the survey (659 invited, response rate = 40%). Half reported previous fr...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Brief Report Source Type: research
We describe a case of posttraumatic chronic intercostal neuralgia, in which successful pain relief was achieved via repeated injections of local anesthetic and steroid combinations in the serratus anterior plane under ultrasonographic guidance. This novel technique is easy to administer, reliable, and warrants further investigation with regard to its use for rehabilitation of patients who are experiencing posttraumatic chronic neuropathies of the chest wall.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Case Report Source Type: research
ConclusionsStructural and functional changes meta-analyzed in this paper may contribute to elucidating the central pathophysiological mechanisms involved in TN/TNP. These results may be used as biomarkers to predict the response to medication and, ideally, in the future to offer personalized treatments.
Source: NeuroImage: Clinical - Category: Radiology Source Type: research
Publication date: Available online 16 October 2019Source: Journal of the American College of RadiologyAuthor(s): Cindy Yuan, Kirti Kulkarni, Brittany Z. DashevskyAbstractObjectiveTo evaluate the impact of comorbid conditions and age on mammography use.MethodsWe used data from the 2011 to 2015 Medical Expenditure Panel Survey, which contained records for 40,752 women over the age of 40. Use was defined as a mammogram within the previous 1 or 2 years, analyzed separately. A logit model was employed to evaluate associations between use and comorbidities and age. Statistical significance was defined by a P value
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
More News: Anemia | Bilirubin | Blogging | Brain | Cardiology | Cardiomyopathy | Congestive Heart Failure | Disability | Emergency Medicine | Eyes | Headache | Heart | Heart Disease | Heart Failure | Hospitals | Hydralazine | Hypertension | Labetalol | Laboratory Medicine | Liver | Magnesium | Migraine | Neurology | OBGYN | Pain | Pain Management | Papanicolaou (Pap) Smear | Perinatology & Neonatology | Phenytoin | Pre-eclampsia | Pregnancy | Proteinuria | Residencies | Respiratory Medicine | Stroke | Study | Teaching | Teaching Hospitals | Thrombocytopenia | Universities & Medical Training | Urology & Nephrology | USA Health