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Approach to Early Recognition and Treatment of a Leading Progressive Disease: Atrial Fibrillation
No full textAtrial fibrillation is the most common form of arrythmia affecting nearly 40 million people globally. Due to the high risk of developing blood clots, this arrythmia is the leading cause of cardiac related strokes. There are many different therapeutic approaches available to help manage and control atrial fibrillation in patients. The more conservative approaches to help manage this condition include regular exercise, improved diet, and weight management. Pharmacologic management for a stable patient includes antiarrhythmic medications and direct oral anticoagulants (DOACs) based on their CHA2DS2 score. For an unstable patient who is not hemodynamically stable or shows signs of heart failure, they will need to undergo cardioversion. More drastic approaches to manage atrial fibrillation long term include catheter ablation, the open-heart maze procedure, AV node ablation requiring a pacemaker and left atrial appendage closure via watchman device or atriclip. While managed atrial fibrillation can be mild in some cases, it can also be very debilitating. Atrial fibrillation can also go unnoticed and cause severe outcomes when it is too late to control. It is vital that these patients are managed and receive a proper diagnosis and individual treatment plan. Therefore, it is important to be up to date on the current advanced research and studies in this field and update best practices accordingly to provide the best level of patient care
Approach to Diagnosis and Treatment of Menopause
No full textMenopause is a significant transitional event in every woman’s life defined by the cessation of menstruation. The transition period into menopause is characterized by a range of symptoms relating to the decline in reproductive hormone activity. This process can induce vasomotor symptoms, vaginal atrophy and dryness leading to sexual dysfunction, mood changes and greater fracture risk. These symptoms have a large effect on daily life, and many women seek medical treatment to improve their day to day experience during the perimenopausal period. Traditional path of treatment consists of hormone replacement therapy (HRT) with estrogen and progesterone, however many patients are interested in natural supplements due to the risks associated with HRT. This capstone will explore the diagnosis and treatment of menopause, comparing conventional and alternative treatment efficacies with the goal of promoting the health and wellness of the typical perimenopausal woman
Diagnosis, Management, and New Findings of MIS-C
No full textMultisystem inflammatory syndrome in children (MIS-C) is a new condition that emerged amongst the devastating COVID-19 pandemic. It is defined as a hyperreactive immune response involving multiple organs in febrile patients. MIS-C is often life-threatening and requires intensive care for acutely ill patients. As of date, clear diagnostic criteria and uniform treatment regimens have yet to be defined or laid out for providers. It has been frequently misdiagnosed for other related conditions that have overlapping symptoms with MIS-C. A thorough history and physical examination, combined with appropriate lab and imaging selection, can aid providers in reaching the MIS-C diagnosis. Proper aggressive and appropriate treatment of MIS-C is paramount in preventing disease progression and improving patient outcomes. This article reviews the key background information, presentation, and diagnostics, management, and recent findings of MIS-C so that providers can develop a solid foundation of the condition and confidently distinguish it from other related ailments
The Role of Probiotics in Managing Antibiotic-Associated Diarrhea
No full textThis CME paper will provide healthcare providers with suggestions for clinical practice when it comes to preventing and managing antibiotic-associated diarrhea (AAD) in their respective patient populations. Antibiotics can alter the gut microbiome in many ways and cause what is known as dysbiosis, or the disruption of the healthy gut flora. In certain cases, opportunistic bacteria such as Clostridioides difficile can cause severe illness in the presence of dysbiosis. It is important for a clinician to understand the role of probiotic supplementation in mitigating the risk of AAD and allowing for faster patient recovery. This paper will cover the pathophysiology of AAD, the selection process of appropriate probiotic sources, actionable clinical guidelines for providers, and other effective approaches that should be considered
Managing weight loss medications in obese adults
No full textObesity is a chronic, multifactorial disease that currently affects over 40% of adults in the U.S. and continues to rise globally. It significantly increases the risk for serious health conditions such as type 2 diabetes, cardiovascular disease, certain cancers, and it can drastically reduce overall quality of life. Despite significant advances in the understanding of obesity as a chronic disease, it has proven difficult to manage effectively. While lifestyle modifications such as diet and exercise are still considered the cornerstone of managing obesity, it has fallen short in sustaining weight loss. In response, weight loss medications have emerged as a valuable adjunct tool to augment lasting weight reduction. Due to the growing prevalence of obesity placing additional demands on healthcare systems and the evolving interest in anti-obesity medications, this topic holds significant relevance for healthcare providers. In this presentation, I will identify appropriate candidates for pharmacological weight loss treatment, review these FDA approved anti-obesity meds and discuss overall management of these medications, addressing clinical considerations
The Success of the Clinton, Bush, and Trump Administrations In Securitizing Mexican and Central American Immigration Through Border Policies
Get PDFU.S. political discourse has framed immigration from Mexico and Central America as a security threat, driven by political, economic, and racial motivations. American presidential administrations are able to further racialize and criminalize immigrants coming from the Global South through rhetoric in legislation and executive orders that frame migration as a national security issue. Administrations focus on this narrative to indicate that the security threat is harmful to the interests of Americans. Although few migrants do present security threats to the US, the rhetoric used by various presidential administrations generalize these populations as a political tactic to further control and militarize the border. This narrative is known in scholarly literature and political discourse as the securitization theory. Based on the securitization theory, this article analyzes the use of a militarized global separation apparatus to justify specifically excluding Mexican and Central American immigrants from the category of ‘vulnerable’ displaced people. Specifically, this project answers to what extent the Clinton, Bush, and Trump presidential administrations and their respective Congresses criminalized Mexican and Central American immigration through their border policies and executive orders. To answer this question, one immigration policy from each of these administrations will be examined to further conceptualize how they used criminalized political rhetoric to justify their securitized and militarized border patrol enforcement policies on the Southern border
Increasing Safety Practices in Prescribing Opioid Pain Medication
Get PDFSince the 1990’s, the prescription rate of opioid pain medication in the United States has risen rapidly, putting the country in what is now referred to as an “opioid epidemic” or “opioid crisis”. High rates of opioid prescriptions can be attributed to their high efficacy rates, although these medications come with significant adverse effects. This brings about significant challenges for prescribers and policymakers in terms of opioid prescribing practices. Research shows that in order to combat the opioid epidemic, there is a need for reform in the current methods of safe and effective prescribing and preventing misuse. Specific points of focus include closer monitoring of opioid prescriptions and a unification of varying policies regarding opioid prescribing. A more focused education on opioid prescribing specifically for mid-level providers may be beneficial as well. Finally, a conscious effort to move away from the common practices of pain management and a shift towards other non-opioid medication options is important to educate prescribers in an attempt to change the norm of pharmacologic pain management
Power Dynamics and Oppression: Analyzing Structural Control in Suzanne Collins’s The Hunger Games
Get PDFThe Hunger Games is a popular novel universe that describes a totalitarian dictatorship through the lens of the oppressed. Through the book, the viewer is given insight into how Panem operates the way it does even though the majority of its citizens are oppressed by the minority in a much more obvious manner. However, within modern society, the tactics used by the oppressors are much more ambiguous and distorted. This essay will explore the structures put in place by the Capitol in tandem with modern examples to mirror each other and increase awareness of the the tactics governments use both in the modern and fictional world to remain in power
Vitiligo: Pathogenesis, Psychosocial Impact, and New Therapeutic Targets
No full textVitiligo is a skin condition characterized by the destruction of melanocytes resulting in a loss of skin pigmentation. The skin condition affects 0.5-2% of people worldwide, with an equal prevalence amongst children and adults of both genders. Vitiligo can reduce one’s quality of life due to the psychosocial burden and negative perceptions towards skin condition. The depigmentation disorder is divided into two main categories: non-segmental, affecting the body symmetrically and segmental, which is localized to one or more segments of the skin. While the exact etiology of the condition is still being explored, there is now a consensus that vitiligo is an autoimmune condition with inciting factors such as metabolic abnormalities, genetics, oxidative stress, and environmental hazards. Various therapeutic interventions are still being explored and there has yet been a superior mainstay of effective therapy. In this paper, I analyze the pathogenesis of vitiligo while exploring advancements in treatment for the skin condition