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75 year old dialysis patient with nausea, vomiting and lightheadedness
Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal
disease was sent to the ED after dialysis for three days of nausea, vomiting,
loose stool, lightheadedness and fatigue. RR18 sat 99% HR 90 BP 90/60, afebrile. Below is the 15 lead ECG. What do you think? There ’s normal sinus rhythm, normal conduction, normal axis,
normal R wave progression and normal voltages. There’s subtle inferior ST
elevation with straightening of the ST segment, reciprocal ST depression and T
wave inversion in aVL, and ST depression in V2. This is diagnostic of
infero-posterior OMI, but it is falsely n...
Source: Dr. Smith's ECG Blog - August 19, 2023 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Virtual Reality for the Treatment of Postoperative Pain After Laparoscopic Hysterectomy for Benign Indications: a Randomized Controlled Trial
The primary objective of this study was to determine if immediate post-operative use of virtual reality impacts pain scores or opioid consumption following hysterectomy.Study Design: A randomized controlled trial was performed at a university associated tertiary referral hospital in the United States among patients undergoing laparoscopic hysterectomy for benign indications. Prior to surgery, participants were randomized to use a VR program versus routine care postoperatively in the post anesthesia care unit.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - August 18, 2023 Category: OBGYN Authors: Mariana McCune, Stephanie Tufano, Manrit Gill, Kaitlyn Oelkers, Nicole Segaline, Janet Foote, Andrea Aguirre, Nichole D. Mahnert Tags: Full length article Source Type: research
Retrospective chart review suggests patients referred to therapy following digit and partial thumb amputations have decreased pain and improved function
Inclusion criteria 18 years of age or older, a diagnosis of a thumb or digit amputation, received occupational therapy services at a level I trauma center in the Southwestern United States and had pre- and -post-therapy scores in the medical records on the QuickDASH1 and or/visual analog (VAS)/numeric pain scales (NPS).2 Patient data, from 134 charts spanning a 3-year period between 2018 and 2021, were reviewed. Charts were identified using a broker in a health science center data warehouse to locate electronic medical records with ICD9/ICD10 codes corresponding to amputation.
Source: Journal of Hand Therapy - August 16, 2023 Category: Rehabilitation Authors: Patricia Siegel, Maxwell Richardson, Joseph Flores, Janet L. Poole Tags: Technical Note Source Type: research
We Can Prevent Overdose Deaths If We Change How We Think About Them
I’ve been living in recovery from opioid use disorder for eight and a half years, and this might be a weird thing to say about addiction, but I feel lucky—like I dodged a bullet. I was addicted to opioids in Florida throughout the early 2000s, during the heyday of pill mills that flooded the streets with powerful pharmaceuticals like OxyContin. I say I’m lucky because this was just before the drug supply turned into a toxic sludge of potent fentanyl analogues, mysterious tranquilizers, and deadly counterfeit pills. Sometimes I wonder what it would be like if I were using today. The chances of my survival ...
Source: TIME: Health - August 15, 2023 Category: Consumer Health News Authors: Ryan Hampton Tags: Uncategorized freelance Source Type: news
The Association Between Racialized Discrimination in Health Care and Pain Among Black Patients With Mental Health Diagnoses
Chronic pain is a costly and debilitating problem in the United States, and its burdens are exacerbated among socially disadvantaged and stigmatized groups. In a cross-sectional study of Black Veterans with chronic pain at the Atlanta VA Health Care System (N = 380), we used path analysis to explore the roles of racialized discrimination in health care settings, pain self-efficacy, and pain-related fear avoidance beliefs as potential mediators of pain outcomes among Black Veterans with and without an electronic health record-documented mental health diagnosis.
Source: The Journal of Pain - August 15, 2023 Category: Materials Science Authors: Patrick J. Hammett, Johanne Eliacin, Michael Saenger, Kelli D. Allen, Laura A. Meis, Sarah L. Krein, Brent C. Taylor, Mariah Branson, Steven S. Fu, Diana J. Burgess Tags: Original Reports Source Type: research
Evaluation and Medical Management of Chronic Pelvic Pain
Semin intervent Radiol 2023; 40: 372-378 DOI: 10.1055/s-0043-1770715Chronic pelvic pain (CPP) is a challenging condition affecting an estimated 15% of females in the United States. Multiorgan system dysfunction results in the complex clinical pain presentation. Similar to other chronic pain syndromes, CPP is influenced by biopsychosocial factors and requires a multimodal approach for optimal pain management. This review summarizes the clinical evaluation and medical management of CPP with a comprehensive approach. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme...
Source: Seminars in Interventional Radiology - August 10, 2023 Category: Radiology Authors: Carey, Erin T. McClurg, Asha B. Tags: Review Article Source Type: research
The 5-Steps to Relieve Tinnitus
My patient T.K. was a wreck. He looked like he hadn’t slept in a week. I asked him what was going on.
“It’s nothing you can fix, doc,” he said. “I’ve been to three specialists, and they all told me the same thing…
“I’ve got tinnitus, and I just have to live with it.”
Luckily, I was able to help him.
Tinnitus is an aggravating, nerve-racking, and unseen condition.
The constant ringing in your ears robs you of sleep, makes you miserable as it drowns out your hearing, and, over time, makes you more prone to illness. Tinnitus also shatters your focus and concentration.
Sadly, up to 25% of the U.S. populatio...
Source: Al Sears, MD Natural Remedies - August 9, 2023 Category: Complementary Medicine Authors: Jacob Tags: Anti-Aging Source Type: news
Influence of Body Mass Index on the Evaluation and Management of Pediatric Abdominal Pain in the Emergency Department
Introduction:Childhood obesity is a serious concern in the United States, with over one third of the pediatric population classi fied as obese. Abdominal pain is one of the most common chief complaints among pediatric emergency department (ED) visits. We hypothesized that overweight and obese children being evaluated in the ED for abdominal pain would have higher resource utilization than their normal and underweight peers.Methods:This was a retrospective review of pediatric patients<18 years who presented with abdominal pain to the ED of a tertiary care center from January 1, 2014 –September 3, 2020. Patients were e...
Source: Western Journal of Emergency Medicine - August 8, 2023 Category: Emergency Medicine Authors: Theiler, Carly A. Source Type: research
Use of real-world evidence in neuroscience-related new drug and biologics license applications for novel therapeutics
Clin Pharmacol Ther. 2023 Aug 7. doi: 10.1002/cpt.3018. Online ahead of print.ABSTRACTThe US Food and Drug Administration (FDA) is evaluating the potential use of real-world evidence (RWE) in regulatory decision-making. Some groups have evaluated the use of RWE in regulatory submissions in the United States and abroad, reporting that reliance on RWE to support new product approvals is relatively common. Confusion regarding the use of RWE in drug-approval decisions may arise, however, based on different application of the terms real-world data (RWD) and RWE. We evaluated RWE in NDAs and BLAs from January 2019 to June 2021 f...
Source: Clinical Pharmacology and Therapeutics - August 7, 2023 Category: Drugs & Pharmacology Authors: Bartholt Bloomfield-Clagett Motiur Rahman Kimberly Smith John Concato Source Type: research
Global Status and Future Trends of Fascia and Pain Research in 2013-2022: Bibliometric Analysis Based on CiteSpace and VOSviewer
CONCLUSION: This analysis identifies the most influential authors, institutions, and countries in the field of fascial and pain research and provides a reference for assessing their academic impact. The analysis of keywords and co-cited literature is useful for analyzing research hotspots and their evolution, as well as for predicting future trends.PMID:37538250 | PMC:PMC10394092 | DOI:10.2147/JPR.S412161
Source: Cell Research - August 4, 2023 Category: Cytology Authors: Yikuan Du Xiaolin Cai Bijun Xu Yuqing Wu Mianhai Chen Jinjin Wang Bing Yuan Weichui Zhang Jinfeng Zhu Chun Yang Source Type: research
Determinants of Health and Outcomes in Medicare Recipients with Heart Disease: A Population Study
Heart disease (HD) is a primary cause of mortality and morbidity in the United States. While there is a growing body of evidence demonstrating the contribution of social determinants of health (SDoH) to HD outcomes, the impact of combined or individual SDoH on health-related quality of life (HRQoL) in patients with HD is not well understood.
Source: Journal of Pain and Symptom Management - August 4, 2023 Category: Palliative Care Authors: Kelley M Anderson, Edilma Yearwood, William S Weintraub, Yi Xia, Rebecca Scally, Hunter Groninger, Anirudh Rao, Jaeil Ahn Tags: Original Article Source Type: research
Outpatient opioid prescribing by Alzheimer ’s diagnosis among older adults with pain in United States
To examine opioid prescribing practices for pain in older adults with and without Alzheimer ’s Disease and Related Dementias (ADRD).
Source: BMC Geriatrics - August 1, 2023 Category: Geriatrics Authors: Yinan Huang, Rajender R Aparasu and Tyler J Varisco Tags: Research Source Type: research
Improving the Autism Pathway in a Pediatric Perianesthesia Unit
According to the CDC (2018), 1 in 44 children in the United States has been diagnosed with autism spectrum disorder (ASD). Nearly a decade ago, our pediatric hospital implemented a special pathway through the perianesthesia continuum to address the unique needs of these patients. This autism pathway aims to individualize the process to decrease stress for this patient population. The Recovery Center Clinical Practice Council (CPC) recently identified an opportunity to update this pathway to better assess and treat pain in patients with communication challenges.
Source: Journal of PeriAnesthesia Nursing - August 1, 2023 Category: Nursing Authors: Team Leader: Lucinda Sapikowski, Team Members: Sandra Contreras, Dawn Flynn, Michelle Skarstan, Felicia Uliano, Jamie Valencia Source Type: research
Fight Aging! Newsletter, July 31st 2023
In conclusion, an SBP level below 130 mmHg was found to be associated with longevity among older women. The longer SBP was controlled at a level between 110 and 130 mmHg, the higher the survival probability to age 90. Preventing age-related rises in SBP and increasing the time with controlled BP levels constitute important measures for achieving longevity.
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Source: Fight Aging! - July 30, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Cases of Tick-Borne Illnesses Are on the Rise. Some Experts Believe Climate Change is the Cause
(NEW YORK) — In 2022, doctors recorded the first confirmed case of tick-borne encephalitis virus acquired in the United Kingdom.
It began with a bike ride.
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A 50-year-old man was mountain biking in the North Yorkshire Moors, a national park in England known for its vast expanses of woodland and purple heather. At some point on his ride, at least one black-legged tick burrowed into his skin. Five days later, the mountain biker developed symptoms commonly associated with a viral infection — fatigue, muscle pain, fever.
At first, he seemed to be on the mend, bu...
Source: TIME: Health - July 28, 2023 Category: Consumer Health News Authors: ZOYA TEIRSTEIN / Grist/AP Tags: Uncategorized climate change healthscienceclimate wire Source Type: news
