2548 research outputs found
Sort by
Examining the Mental Health Impact: Investigating the Association between Suicide and Long Covid Syndrome
Get PDFSince its emergence in late 2019, Covid-19 has had many devastating economic, social, mental, and physical health consequences and caused millions of deaths worldwide over the course of the pandemic. While most cases are mild and symptoms resolve within a couple of weeks, some Covid patients\u27 symptoms can last for multiple weeks, months, or even years after contracting the virus, and these long-lasting symptoms have been identified as Long-Covid. Psychiatric symptoms have been associated with Long-Covid in addition to physical symptoms, and impaired cognitive functioning, sleep abnormalities, depression, anxiety, PTSD, and psychosis have been observed in Long-Covid patients. Given the ties between suicide and mental health, particularly during the Covid-19 pandemic, suicide should be a concern for patients with Long-Covid; however, there are limited studies focused on this issue. This review aims to elucidate the connection between Long-Covid and suicide risk and provide a helpful resource to providers treating Long-Covid patients
A purified reconstituted bilayer matrix shows improved outcomes in treatment of non-healing diabetic foot ulcers when compared to the standard of care: Final results and analysis of a prospective, randomized, controlled, multi-centre clinical trial.
No full textAs the incidence of diabetic foot ulcers (DFU) increases, better treatments that improve healing should reduce complications of these ulcers including infections and amputations. We conducted a randomized controlled trial comparing outcomes between a novel purified reconstituted bilayer membrane (PRBM) to the standard of care (SOC) in the treatment of non-healing DFUs. This study included 105 patients who were randomized to either of two treatment groups (n = 54 PRBM; n = 51 SOC) in the intent to treat (ITT) group and 80 who completed the study per protocol (PP) (n = 47 PRBM; n = 33 SOC). The primary endpoint was the percentage of wounds closed after 12 weeks. Secondary outcomes included percent area reduction, time to healing, quality of life, and cost to closure. The DFUs that had been treated with PRBM healed at a higher rate than those treated with SOC (ITT: 83% vs. 45%, p = 0.00004, PP: 92% vs. 67%, p = 0.005). Wounds treated with PRBM also healed significantly faster than those treated with SOC with a mean of 42 versus 62 days for SOC (p = 0.00074) and achieved a mean wound area reduction within 12 weeks of 94% versus 51% for SOC (p = 0.0023). There were no adverse events or serious adverse events that were related to either the PRBM or the SOC. In comparison to the SOC, DFUs healed faster when treated with PRBM. Thus, the use of this PRBM is an effective option for the treatment of chronic DFUs
Distal Versus Proximal Radial Arterial Access for Percutaneous Coronary Angiography and Intervention: Updated Meta-Analysis of Randomized Controlled Trials.
No full textRadial artery occlusion (RAO) is a major impediment to reintervention in patients who underwent proximal transradial access (p-TRA) for coronary catheterization. Distal transradial access (d-TRA) at the level of snuffbox distal to the radial artery bifurcation is a novel alternative to p-TRA. We conducted an updated meta-analysis of all available randomized controlled trials (RCTs) to compare the incidence of RAO between p-TRA and d-TRA, along with access site-related complications. PubMed, Web of Science, and Google Scholar were searched for RCTs published since 2017 to October 2023 comparing d-TRA and p-TRA for coronary angiography and/or intervention. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals were calculated using the random-effects model for procedural and clinical outcomes for the 2 approaches. A total of 18 RCTs with 8,205 patients (d-TRA n = 4,096, p-TRA n = 4,109) were included. The risk of RAO (RR 0.31, 0.21 to 0.46, p ≤0.001) and time to hemostasis (minutes) (MD -51.18, -70.62 to -31.73,
The Current State of Neonatal Neurodevelopmental Follow-Up Programs in North America: A Children\u27s Hospitals Neonatal Consortium Report.
No full textOBJECTIVE: To determine neonatal neurodevelopmental follow-up (NDFU) practices across academic centers.
STUDY DESIGN: Cross-sectional survey that addressed center specific neonatal NDFU practices within the Children\u27s Hospitals Neonatal Consortium.
RESULT: Survey response rate was 76% and 97% of respondents had a formal NDFU program. Programs were commonly staffed by neonatologists (80%), physical therapists (77%), and nurse practitioners (74%). Median gestational age at birth identified for follow-up was ≤32 weeks (range 26-36). Median duration was 3 years (range 2-18). Ninety-seven percent of sites used Bayley Scales of Infant and Toddler Development, but instruments used varied across ages. Scores were recorded in discrete electronic data fields at 43% of sites. Social determinants of health data were collected by 63%. Care coordination and telehealth services were not universally available.
CONCLUSION: NDFU clinics are almost universal within CHNC centers. Commonalities and variances in practice highlight opportunities for data sharing and development of best practices
A Rare Case of Brodie\u27s Abscess in the Tibial Diaphysis Masquerading as a Vaso-occlusive Sickle Crisis.
No full textWe present the case of a 19-year-old male with a history of sickle cell anemia who presented to the hospital with worsening lower extremity pain. Given his acute presentation and history of recurrent pain crises, he was admitted to the hospital for management of a suspected acute pain crisis. However, due to continued pain, imaging was obtained which revealed a different diagnosis for the cause of his symptoms. MRI of the left lower leg revealed heterogenous T1 and T2 hyperintense signals within the proximal tibial diaphysis measuring 6.6 × 1.6 × 2.2 cm with a thick rim of peripheral irregular enhancement with surrounding periosteal reaction and soft tissue edema, concerning for osteomyelitis and developing Brodie\u27s abscess. The patient underwent tibia irrigation and debridement with the placement of vancomycin and tobramycin beads. Perioperatively, no purulence was noted within the soft tissues, and no organisms were grown on tissue cultures. The patient\u27s pain improved and he was discharged home with a plan to complete six weeks of intravenous antibiotics. This case represents the need to differentiate Brodie\u27s abscess from a sickle cell crisis. Clinicians should also be aware that patients with sick cell disease are prone to Brodie\u27s abscess and it should be a differential for symptoms of relenting bone pain
A Case of \u27Neptune\u27s Fix Elixir\u27: The Dangerous Consequences of Unregulated Use of Tianeptine in Over-the-Counter Products.
No full textTianeptine is an atypical tricyclic antidepressant approved for the treatment of major depressive disorder in some European, Asian, and Latin countries. Along with its serotonergic properties, tianeptine also acts as a full agonist at the mu-opioid receptor, creating sensations of euphoric highs and significant risks of addiction and withdrawal. For this reason, along with increased reports of adverse effects and fatalities, tianeptine has not been approved in the US. Despite this, tianeptine continues to be accessible through unregulated online stores and small retailers under street names such as Zaza, Tia, Tianna, \u27gas-station dope\u27, and a product not mentioned in the literature previously: Neptune\u27s Fix Elixir. In this report, we discuss the case of a 34-year-old male who presented to the ED via EMS after being found unresponsive secondary to the ingestion of Neptune\u27s Fix Elixir, whose main active ingredient is tianeptine
Unveiling Ureaplasma: A Case Report of a Rare Culprit in Pyelonephritis.
No full textUreaplasma species, typically considered commensal organisms of the human urogenital tract, have been implicated in various urinary tract infections (UTIs), including the rare and challenging presentation of pyelonephritis. This case report describes a unique instance of pyelonephritis induced by Ureaplasma, characterized by a negative routine urine culture and a lack of response to empirical antibiotic treatment, highlighting the complexities associated with diagnosing and managing infections caused by atypical pathogens. A 50-year-old female presented to the emergency department with symptoms suggestive of UTI, including fever, vomiting, and dysuria. However, initial urine analysis was notable for pyuria while routine bacterial culture returned negative results, creating a diagnostic dilemma. Empirical treatment with third-generation cephalosporin was initiated. However, the patient\u27s condition failed to improve, raising concerns about antibiotic resistance or atypical pathogens. Subsequent molecular diagnostics, precisely polymerase chain reaction (PCR), identified Ureaplasma urealyticum as the causative agent. This prompted a change in the treatment regimen to doxycycline, to which the patient showed significant clinical improvement. Physicians should be aware of Ureaplasma as a potential cause of pyelonephritis, especially in cases of culture-negative UTIs and when patients do not respond to standard empirical treatment. This case emphasizes the importance of considering atypical pathogens in differential diagnosis and the role of molecular diagnostic techniques in guiding appropriate management
