What do you think of this elderly man with " possible seizure " ?
Written by Pendell Meyers(with really great and thorough explanation of this finding by Ken Grauer).At my hospital, patients with any symptoms which could be vaguely interpreted as a possible stroke during the triage process are brought to the high acuity area and a provider is asked to do a " neuro check " , which involves a quick H and P and exam to determine if we should activate our stroke protocol.A man in his 70s was brought to me for a neuro check, and the triage providers commented that they were worried about a possible seizure as well. The patient was alert and oriented with normal vitals at triage. He stated that the last thing he remembers was sitting at his desk working on some paperwork, then he remembers being on the ground looking up at paramedics. His wife heard a noise and found him on the floor next to his desk. He could not recall feeling anything unusual prior to the event, was in good health earlier that day, and felt completely normal at the time of my evaluation with no complaints. Of note, he had an identical episode last week for which he did not seek medical attention.So I asked for an ECG as syncope was high in the differential.Here is his initial ECG:What do you think?Interpretation: Sinus rhythm with extreme 1st degree AV block (PR interval roughly 500 msec!)There is a narrow, regular QRS which could arguably meet morphology criteria for LAFB. The ST segments and T-waves are normal, but they are followed immediately by another wave that...
Do you guys think there is enough volume to support an outpatient interventional cancer pain &cancer rehab practice? I will be starting my PM&R residency training at one of the top programs in the country after this academic year (am an prelim medicine intern right now). And I ultimately want to help cancer survivors. I think with the continuing improvements with cancer treatments (most recently with immunotherapy), cancer will be/is a chronic disease with debilitating side effects that... cancer pain only practice
Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain:A Systematic Review and Meta-analysis | Anesthesiology | ASA Publications In this new meta-analysis in this months’ Anesthesiology, the use of these drugs is very much called into question. Will this change your practice?
Publication date: September 2020Source: Social Science &Medicine, Volume 261Author(s): Vani A. Mathur, Theresa Morris, Kelly McNamara
Publication date: Available online 3 August 2020Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Salvador Israel Macías-Hernández, Jessica Rossela García-Morales, Cristina Hernández-Díaz, Irene Tapia-Ferrusco, Oscar Benjamín Velez-Gutiérrez, Tania Inés Nava-Bringas
CONCLUSIONS: To avoid running-related injuries, runners should be careful when increasing weekly mileage. Moreover, runners with previous exercise experience may need to approach running more cautiously. Setting goals and pursuing longer-distance running events may be motivating, but at the same time, can increase the risk of running-related injuries. PMID: 32744044 [PubMed - as supplied by publisher]
Authors: Sakamoto T, Ishio Y, Ishida Y, Mogi K, Kikusui T Abstract Deprivation of maternal care has been associated with higher pain sensitivity in offspring. In the present study, we hypothesized that the maternal licking/grooming behavior was an important factor for the development of the pain regulatory system. To test this hypothesis, we used male F2 offspring of early-weaned (EW) F1 mother mice that exhibit lower frequency of licking/grooming behavior. The formalin test revealed that F2 offspring of EW F1 dams showed significantly higher pain behavior than F2 offspring of normally-weaned (NW) F1 dams. We found...
Publication date: Available online 3 August 2020Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Nermine Ramadan Mahmoud, Essam Mohamed Ashour
Condition: Musculoskeletal Pain Intervention: Behavioral: Emotion- and Relationship-Focused Therapeutic Interview Sponsor: Mark A. Lumley Not yet recruiting
Condition: Low Back Pain Interventions: Other: dry needling; Other: sham dry needling Sponsor: University of Haifa Not yet recruiting
Condition: Opioid Use Intervention: Sponsor: Hospital for Special Surgery, New York Active, not recruiting
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