Case Report of Lethal Toxin Lurking in an Edible Plant.
Case Report of Lethal Toxin Lurking in an Edible Plant. J Popul Ther Clin Pharmacol. 2019 Oct 22;26(3):e14-e18 Authors: Patel P, Konala VM, Adapa S, Gayam V, Sahasranam P, Bose S, Golez CD, Naramala S Abstract Cyanide is notoriously known to the public for more than a century now as a weapon of mass destruction (Zyklon B gas - hydrogen cyanide used by Nazis), an agent for chemical warfare during World War I (hydrogen cyanide) and very infamous "Suicide Pill" used in the past by military and espionage organizations during World War II (potassium cyanide). During the modern industrial era, cyanide poisoning is commonly associated with the industrial exposure and domestic fires. But there is little awareness about potentially fatal consequences of cyanide poisoning from common food sources. Here, we present the case report of a 79-year-old female with acute cyanide poisoning from improperly prepared cassava leaves. Symptoms from ingested toxin may start a few hours after exposure, which include headache, confusion, ataxia, seizures, palpitations, nausea, vomiting, abdominal pain, flushing, and itching of the skin. Patients may develop hypotension, cardiac arrhythmias, renal failure, hepatic necrosis, rhabdomyolysis, and metabolic acidosis; a multisystem manifestation of hypoxia at the cellular level. Multiple treatment strategies are available to treat cyanide poisoning, including sodium nitrite, sodium thiosulfate, and hydroxycobalamine. This is o...
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.
Hyperkalemia, defined as a concentration of potassium greater than 5.5 mEq/L in adults, is commonly found on labwork in the subacute nursing facility, often seen in the setting of kidney disease as a result of impaired excretion of potassium in the urine. Treatment is focused upon inducing potassium loss, often through use of loop diuretics such as furosemide. Sodium polystyrene sulfate (SPS) is often used; however, it carries with it significant associated risks and potential complications.
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.
Up to 38% of individuals with advanced dementia experience clinical depression. Although studies demonstrate lower rates of clinical depression as dementia advances, this may be attributed to the difficulty of assessment at this stage. Clinical interviews are thorough in assessing depression, though they are time- and resource-contingent. As such, healthcare providers often turn to screening tools or scales. However, conventional tools for assessing depression have problems with validity in this population.
There has been a growing emphasis towards emotional well-being in the care of older adults. This is especially important with regards to residents in a nursing home, where they can often feel marginalized or depressed. The aim of this study is to evaluate the effectiveness of pet-therapy in improving the mood and well-being in this subset of the population.
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.
Nursing home (NH) residents are at increased risk for malnutrition compared to community-dwelling older adults. Poor nutrition is associated with depression, functional decline, and higher 1-year mortality. Communal dining environments create a social dining atmosphere that increases the amount of food being consumed.
Parkinson ’s disease (PD) is a multifaceted condition that impacts a wide range of functions, including speech. The effect of loss of communication ability creates a cascade of effects which includes decreased participation in social events, social isolation, and potentially depression. If improvements in v oice occur, the cascade can be diverted. A physiological basis, as well as research evidence, supports use of singing to improve voice of those with PD. The implementation of a choir for those with PD has the potential to provide a socially engaging intervention, which is cost effective.
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.