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Smoking as a Marker of Comorbid Vulnerability Among Persons with Probable Posttraumatic Stress Disorder Who Engage in Hazardous Drinking
No full textBackground: Persons with posttraumatic stress disorder (PTSD) compared to those without evince high rates of hazardous drinking, or patterns of alcohol consumption that increase the risk for harmful consequences. One potential marker of vulnerability for PTSD-hazardous drinking comorbidity may be smoking behavior. Individuals with PTSD have a higher prevalence of smoking and smoke at higher rates. Smokers, compared to nonsmokers, are more apt to engage in hazardous alcohol use. Notably, there is a need to expand research on smoking in the context of PTSD and hazardous drinking to inform treatment of these morbidities. Objective: The present cross-sectional investigation sought to examine smoking status as a marker of risk among persons with probable PTSD who engage in hazardous drinking (N = 647; M = 38.90 years, SD = 10.71; 51.2% female). Results: Results indicated that trauma-exposed smokers, compared to non-smokers, evinced greater severity of PTSD symptoms, depression, emotion regulation difficulties, hazardous drinking, and substance use problems, with small effect sizes. No statistically significant group differences were found for anxiety symptom severity. Secondary analyses among only smokers supported an interrelation between cigarette dependence and each of the criterion variables that demonstrated statistically significant group differences. Specifically, cigarette dependence was statistically significantly and incrementally related to PTSD symptom severity, depression, emotion regulation difficulties, more severe hazardous drinking, and a greater degree of substance use problems. Conclusions: Overall, the current investigation found that smoking status among persons with probable PTSD who engaged in hazardous drinking was associated with numerous indicators of mental health and substance use vulnerability
Management of hip fracture patients on direct oral anticoagulants: a survey of orthopaedic trauma surgeons, systematic review, and meta-analysis
Get PDFOBJECTIVES: This systematic review examined the literature regarding management of fracture patients who take direct oral anticoagulant (DOAC) medications, with a focus on delay in surgical treatment, and need for transfusions. In addition, a survey of orthopaedic trauma surgeons was conducted to gain insight on current practices. DATA SOURCES: A review of PubMed, Cochrane, Embase, and Scopus databases was performed from inception through March 2024, including English language publications. STUDY SELECTION: Studies were included if they reported time to surgery and transfusion rates among fracture patents who were taking DOAC medications. Additional data points were collected on an if-reported basis, including mortality, venous thromboembolism, and bleeding complications. DATA EXTRACTION: In all, 4546 abstracts were screened. Full-text review was conducted on 86 publications, and 25 articles were included in the final analysis. Each article was independently screened by 2 reviewers, with disputes settled by a third reviewer. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) tool. DATA SYNTHESIS: Descriptive statistics are reported for overall study findings. Meta-analysis was performed for the variables time to surgery and transfusion rate. CONCLUSIONS: Our findings indicate that fracture patients taking DOACs experience longer delays before surgery but have equivalent transfusion rates compared with nonanticoagulated patients. Survey results indicate that surgeons do not delay operating on emergent or percutaneous cases, regardless of anticoagulant medications. In circumstances when they do delay, they are more likely to do so for patients taking DOAC medications. LEVEL OF EVIDENCE: Level III, systematic review and meta-analysis of Level II and III articles
A Delicate Situation by C. Leslie
No full text10 x 15 Mixed Media Paint on Paperhttps://digitalscholar.lsuhsc.edu/art_med/1044/thumbnail.jp
Time by L. Birke
No full text14 x 18 Charcoalhttps://digitalscholar.lsuhsc.edu/art_med/1034/thumbnail.jp
Untitled (cream) by K. E. Sclafani
No full text6 x 4 Glazed Ceramichttps://digitalscholar.lsuhsc.edu/art_med/1031/thumbnail.jp
Ladybug by O. Mipro
No full text11 x 9 Mixed Media Painting: Wood, Glass and Fiberhttps://digitalscholar.lsuhsc.edu/art_med/1024/thumbnail.jp
Pigeons by K. Taylor
No full text12 x 12 Acrylic on Canvashttps://digitalscholar.lsuhsc.edu/art_med/1015/thumbnail.jp
Glomeru-love by E. Stevens
No full text15 x 10 Mixed Media Fiber and Paper Paintinghttps://digitalscholar.lsuhsc.edu/art_med/1013/thumbnail.jp
Efficacy of Transcutaneous Electrical Nerve Stimulation in Management of Cancer Pain: a Meta Analysis
No full textPurpose of Review: The present investigation assesses efficacy of transcutaneous electrical nerve stimulation (TENS) on relief of cancer or chemotherapy-related pain. Patients with cancer experience a relatively high prevalence of pain that is reportedly undertreated. Therefore, this analysis is pertinent to determine if TENS is a useful complementary therapy considering its increase in accessibility and minimal side effect profile. Recent Findings: A systematic search for eligible studies from PubMed, Google Scholar, Cochrane, and Embase was performed. The present investigation elucidated any significant differences between change in numeric rating scale of average and maximum pain scores between a TENS and non-TENS group. A nonsignificant difference was reported between TENS and non-TENS, with a mean difference of − 0.393 (95% CI − 1.780, 0.993; P = 0.578). For change in maximum pain reported, a nonsignificant difference was also found, with a mean difference of 0.128 (95% CI − 1.158, 1.414; P = 0.845). Conclusion: Related to various limitations of this meta-analysis, no definitive conclusions could be concluded regarding efficacy of TENS in the treatment of cancer or chemotherapy-related pain. Additional randomized primary studies with standardized treatment protocols and pain measurements are needed for future meta-analysis and recommendations for clinical practice
Social, Racial, and Economic Disparities Affecting Outcomes of Hypertensive Adolescents
Get PDFEssential hypertension is one of the most common conditions managed in pediatric cardiology and can result in lasting deleterious effects on the cardiovascular system. Pediatric hypertension is so prevalent in the United States that it is often referred to as a public health challenge. Social determinants of health (SDH) are the cultural, economic, educational, healthcare accessibility, and political influences in the environment in which an individual is born or lives, all of which can affect that individual\u27s overall health. This study investigated the impact of social determinants such as rurality, food insecurity, transportation challenges, minority status, income, and race on cardiovascular outcomes in adolescent patients with essential hypertension. This study utilizes multiple validated tools including those from the United States Census and the United States Department of Agriculture (USDA). Using these tools, the patients were scored on their social vulnerability based on home address. These scores were then compared with their echocardiographic data, focusing on measures of end-organ damage known to occur in the setting of hypertension, including but not limited to indexed left ventricular (LV) mass. LV mass is an independent risk factor for future adverse cardiovascular events. In this study, more social vulnerability and low income were associated with a greater indexed LV mass (r = 0.18, p = 0.008). African American race was associated with a higher left atrial (LA) volume (p = 0.03). These findings substantiate that adolescents with essential hypertension are not only impacted by biological factors but also a combination of intersecting social constructs. The results of this study provide both a deeper understanding of the challenges these patients face and the opportunity to develop real-life interventions that can optimize clinical outcomes