Presenting Complaint: Social Injustice

By ANISH KOKA, MD Bobby It took some doing, but I had finally made it to Bobby’s home. It was a rowhome tucked into one of those little side streets in the city that non-city folks wouldn’t dream of driving down. As I step in, I’m met by the usual set up – wooden steps that hug the right side of the wall leading up to the second floor.  Bobby certainly hasn’t made it up to the second floor in some time. At the moment she is sitting in her hospital bed in the living room. The bed is the focal point to a room stuffed to the gills with all manners of stuff. At least three quarters of the stuff seems to be food. Cinnamon buns, Doritos, donut holes, chocolate frosted Donuts, crackers, Twinkies. The junk food aisle at Wawa would be embarrassed by the riches on display here. Bobby weighs in at four hundred pounds, 5 foot 5 inches. She has a tracheostomy from multiple prior episodes of respiratory failure that have required ventilatory support. I’m here at the request of a devoted primary care physician that still makes home calls. I’ve looked through the last number of hospital stays. The last few discharge summaries are carbon copies of each other. Hypoxemic respiratory failure related to pulmonary edema complicated further by morbid obesity. Time on the vent. Antibiotics. Diuretics. Home. Return to the hospital 2 weeks later. The last echocardiogram done was 3 admissions ago. A poor study. Not much could be seen due to &ls...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients Physicians Anish Koka social injustice Source Type: blogs

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Source: Social Work in Health Care - Category: International Medicine & Public Health Authors: Source Type: research
ConclusionsThis is the largest series to date reporting>30-day follow-up for patients undergoing venous ablation procedures while receiving anticoagulation and the longest follow-up reported of any series. Durability, safety, and efficacy of vein ablation in patients receiving anticoagulation are comparable to those in control patients. Anticoagulation should not be considered a contraindication to endothermal ablation of the GSV or SSV for symptomatic venous reflux.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Publication date: Available online 25 January 2020Source: Best Practice &Research Clinical RheumatologyAuthor(s): Ayşe A. KüçükdeveciAbstractThe goals in the management of established rheumatoid arthritis (RA) are to control pain and disease activity, prevent further joint damage, and enhance functioning and quality of life. Despite the fact that aggressive and the early use of biological and nonbiological disease-modifying antirheumatic drugs have been associated with substantial gains in clinical, radiological, and disability outcomes, a considerable proportion of patients still report significant p...
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research
Publication date: Available online 24 January 2020Source: Journal of Environmental PsychologyAuthor(s): Dario Krpan, Nanne HoutsmaAbstractResearch suggests that consuming vegetarian foods is one of the key lifestyle changes that could reduce greenhouse gas emissions. However, transforming dietary habits to counter climate change has received little attention to date compared to other green behaviors. In three large pre-registered online studies conducted on 11,066 US participants, the present research tested whether reframing the name of the vegetarian food category impacts the choice of dishes from this category in the co...
Source: Journal of Environmental Psychology - Category: Psychiatry & Psychology Source Type: research
Publication date: Available online 25 January 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Jiadela Teliewubai, Ximin Fan, Hongwei Ji, Rusitanmujiang Maimaitiaili, Jiamin Tang, Song Zhao, Shikai Yu, Chen Chi, Yawei Xu, Yi ZhangAbstractBackground and AimsMetabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort.Methods and results3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associatio...
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
ConclusionThe plasma cholesteryl ester fraction after a diet high in dairy was characterized by higher 15:0 levels. Concentrations of 14:0 were only higher when comparing the FA profile after a diet high in dairy when compared to a diet high in meat.Clinical trial registrationClinicalTrials.gov, NCT01314040.
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
ConclusionsThere was an improvement in informing patients of overweight/obesity status. However, less than a quarter of young adults with overweight were notified in recent surveys, compromising the opportunities of preventing overweight from becoming obesity in early adulthood.Graphical abstract
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
Publication date: Available online 24 January 2020Source: Brain, Behavior, and ImmunityAuthor(s): Maria Grazia Morgese, Stefania Schiavone, Angela Bruna Maffione, Paolo Tucci, Luigia TrabaceAbstractDepression is one of the most common psychiatric diseases and the prevalence of depressive symptoms in women is almost twice compared to men, although the reasons of this gender difference are not fully understood yet. Recently, soluble amyloid beta (Aβ)1-42 peptide has been receiving great importance in the development of depression, also considering that depression is highly comorbid with Alzheimer’s disease and oth...
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Publication date: Available online 25 January 2020Source: Microbial PathogenesisAuthor(s): Samia Ayari, Shiv Shankar, Peter Follett, Farah Hossain, Monique LacroixAbstractThe checkerboard method was used to study the potential interactions between eight essential oils (Basil, Cinnamon, Eucalyptus, Mandarin, Oregano, Peppermint, Tea tree, and Thyme) when used as antibacterial agents against Bacillus cereus LSPQ 2872 and Paenibacillus amylolyticus ATCC 9995. The minimum inhibitory concentration (MIC) of each essential oil (EO) and the fractional inhibitory concentration (FIC) index for the binary combinations of essential oi...
Source: Microbial Pathogenesis - Category: Infectious Diseases Source Type: research
Publication date: Available online 24 January 2020Source: Microbial PathogenesisAuthor(s): Mani Divya, Marimuthu Govindarajan, Sivashanmugam Karthikeyan, Elumalai Preetham, Naiyf S. Alharbi, Shine Kadaikunnan, Jamal M. Khaled, Taghreed N. Almanaa, Baskaralingam VaseeharanAbstractβ-Glucan-binding protein (βGBP) is important for the rational expansion of molecular biology. Here, zinc oxide nanoparticle (ZnONP) was synthesized using βGBP from the crab Scylla serrata (Ss-βGBP-ZnONP). Ss-βGBP-ZnONP was observed as a 100 kDa band on sodium dodecyl sulfate polyacrylamide gel and characterized with UV&nd...
Source: Microbial Pathogenesis - Category: Infectious Diseases Source Type: research
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