How often have you caught patients in a lie perpetuated for years?

Recently saw a 50 something year old gentleman with supposed sickle cell disease who still had both native hips, no heart failure, no strokes, no CKD, or any other medical co-morbidities. I found all of that to be beyond abnormal given the low life expectancy and the typical disease burden of someone living that long with SCD. He is apparently a regular at our hospital presenting to the ER at least 5-6x/month and being admitted 1-2x/month and has been doing this for the last 3 years. He was... How often have you caught patients in a lie perpetuated for years?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Emergency Medicine Source Type: forums

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Conclusion: Kampo medicines may cause various adverse events. The present results provide valuable information regarding adverse events associated with Kampo medicines from the viewpoint of patient safety. PMID: 31118950 [PubMed]
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Publication date: Available online 25 May 2019Source: Annals of Physical and Rehabilitation MedicineAuthor(s): Sung Ho Jang, Han Do Lee
Source: Annals of Physical and Rehabilitation Medicine - Category: Rehabilitation Source Type: research
This study aimed to explore the effect of winter temperatures on the risk factors, etiology, coagulation, and degree of neurological impairment in patients with ischemic stroke using temperature and rainfall data from the Guangzhou Meteorological Bureau during the winter months of December, January, and February. MATERIAL AND METHODS We divided 112 patients with ischemic stroke into low-temperature and non-low-temperature groups. The low-temperature group experienced an average daily winter temperature of 13°C on admission. Neurological deficits were scored and monitored using the National Institutes of Health Stroke S...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
ConclusionsEndovascular treatment for TBAD with ARSA was feasible and safe with a satisfactory midterm follow-up outcome.
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: Available online 24 May 2019Source: The LancetAuthor(s): Natan M Bornstein, Jeffrey L Saver, Hans Christoph Diener, Philip B Gorelick, Ashfaq Shuaib, Yoram Solberg, Lisa Thackeray, Milan Savic, Tamar Janelidze, Natia Zarqua, David Yarnitsky, Carlos A Molina, Ashfaq Shuaib, Michael Hill, Daniel Vaclavik, David Skoloudik, Jan Fiksa, Grethe Andersen, Pekka Jakala, Turgut TatlisumakSummaryBackgroundSphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood–brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potentia...
Source: The Lancet - Category: General Medicine Source Type: research
This article reviews relationships between mild to moderate essential hypertension and chronic kidney disease with a focus on the role of APOL1 in development of hypertension. Available evidence strongly supports that APOL1 renal-risk variants associate with glomerulosclerosis in African Americans, which then causes secondary hypertension, not with essential hypertension per se.
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
mi JM Abstract BACKGROUND AND OBJECTIVES: Thrombotic microangiopathies constitute a diagnostic and therapeutic challenge. Secondary thrombotic microangiopathies are less characterized than primary thrombotic microangiopathies (thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome). The relative frequencies and outcomes of secondary and primary thrombotic microangiopathies are unknown. DESIGN, SETTING, PARTICIPANTS, &MEASUREMENTS: We conducted a retrospective study in a four-hospital institution in 564 consecutive patients with adjudicated thrombotic microangiopathies during the 20...
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
This ECG was recorded on a middle-aged male with sickle cell disease and diffuse pain.Sinus rhythmLeft ventricular hypertrophy (LVH)Diffuse significant ST depression with ST Elevation in aVRComputerized QT = 494 ms, QTc = 538 msWhat else?What do you think?Here is a Previous ECG for comparison:Baseline LVHOnly minimal ST depressionDiffuse ST depression with ST Elevation in aVRKnotts et al. found that such ECG findings only represented left main ACS in 14% of such ECGs: Only 23% of patients with the aVR STE pattern had any LM disease (fewer if defined as  ≥ 50% stenosis). Only 28% of patients had ACS o...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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