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Considerations in the Management of Juvenile Absence Epilepsy in Pregnancy and in Females of Childbearing Age
No full textJAE is an epilepsy syndrome that typically requires lifelong AED treatment, and valproic acid or lamotrigine is considered first line to manage the spectrum of associated seizures. In females with JAE who become pregnant, there exist risks both from having uncontrolled seizures and from taking AEDs during the pregnancy. Valproic acid carries the highest risks to the fetus but is the most effective in controlling the seizure types seen with JAE. Folic acid supplementation has shown to mitigate some but not all of the fetal risks from valproic acid. Limited guidance from professional organizations exists for management of females of childbearing age and pregnant females with JAE. Adequate counseling should be provided to all females of childbearing age with JAE regarding pregnancy, contraceptives, folic acid supplementation, and the risks and benefits of different AEDs. A shared decision-making approach should be used to optimize outcomes for these patients
Rashes; Dangerous or Benign
No full textCertain rashes can be difficult to clinically diagnose early in their disease progression. Poor sensitivity and specificity with diagnostics also contribute to delayed or misdiagnosis. This ultimately can result in high mortality rates and poor patient outcomes. A provider must overcome those obstacles by ensuring a thorough, systematic approach is taken in regard to understanding patient history, and identifying any red flags and risk factors associated with the rash. In addition, this article outlines physical exam findings that are specific towards diagnosing certain rashes, as well as findings that warrant a more serious work-up and possibly, hospital admission
The Manifestation of Intra Gender Oppression in Margaret Atwood’s The Handmaid’s Tale as Results From Intentional Patriarchal Power Structures
Get PDFMargaret Atwood’s The Handmaid’s Tale has long been studied for its cautionary warnings about sexist ideologies that exist between men and women; seldom has it been analyzed for instances of intra gender oppression. Intra gender oppression, which this thesis seeks to define and highlight through the novel’s context, offers artificial forms of power to those in oppressed classes, enough to attract women themselves to participate in the indoctrination and policing of their own sex. This essay will highlight the ways in which Atwood’s dystopia parallels sexist beliefs held by societies past and present
Re-examining the Ethical Considerations in Liver Transplants
Get PDFLiver transplantation is one of the most debated topics in healthcare. It is important to understand the step processes involved prior to transplant as well as the treatment in follow-up, and how ethical decisions are made in who will make the transplant list. Alcoholism is also a common medical condition that plagues many people, and these people are often the recipients of liver transplants. When considering who is eligible for a transplant, healthcare professionals should not only consider medical history such as lab work, imaging, MELD scores, Child-Pugh scores, and post-op complications, but also social implications such as willingness to quit, social support, and medical compliance. It is not only an ethical dilemma of who should receive a liver transplant but when, by weighing the pros and cons of waiting a 6-month long alcohol abstinence period or proceeding quickly prior to 6 months. How and why decisions are made for liver transplants for alcoholic liver disease patients will affect the care and outlook healthcare professionals offer to patients, therefore, the significance of educating the public on this dilemma will provide a better informed and empathetic approach to healthcare
Polycystic Ovary Syndrome: Diagnosis & Treatment
No full textPolycystic ovary syndrome is a condition which is encountered in many different facets of medicine. Diagnosis is often missed or delayed, requiring clinicians to keep it on their differential lists. Over the years, many different treatments have been offered. This article will cover the basics for clinicians to properly recognize, diagnose and treat PCOS in women with the most uptodate, evidence based medicine
Nonsurgical Treatment of Knee Osteoarthritis: Platelet Rich Plasma vs Viscosupplementation
No full textOsteoarthritis (OA) is a chronic degenerative disease that causes functional impairment and pain to a large population of people worldwide. While multiple joints can be affected by OA, weight-bearing joints are the most common. Particularly, the knee joint makes up approximately 41% of all OA cases.There are currently many ways to treat the symptoms of knee OA including pharmacological agents, intra-articular injections, and surgical procedures. The goals of these treatment options are to alleviate pain and improve the functionality of the knee. Various research is currently being conducted to find a more effective treatment option to delay the need for surgical interventions, as such practices can result in more medical complications. This presentation focuses on the non-surgical treatment for knee OA and will compare the clinical outcomes of Viscosupplementation with hyaluronic acid and platelet-rich plasma (PRP), which is a recently developed treatment option for OA
Outcomes of Bariatric Surgery
No full textThis presentation includes the different types of bariatric surgeries, the definition of each one of them, with their benefits, risks and complications
Applications of Psilocybin in the Treatment of Psychiatric Disorders
No full textPsilocybin is a natural chemical compound that can be found within a myriad of mushroom species such as the genera Psilocybe, Inocybe, Pluteus, Gymnopilus, and Pholiotina. It has been used for centuries for its hallucinogenic properties both recreationally and for religious rituals dating back to the Aztec Indians. In modern day, it has been theorized to produce psychoactive effects on the brain, making it a potential psychopharmaceutical modality to help amplify the effects of psychotherapy in the treatment of a myriad of psychological pathologies such as major depressive disorder (MDD), obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and more. This article seeks to summarize the proposed mechanism of action of psilocybin on the brain, discuss the psychosocial factors that go into psilocybin treatment and analyze the current research being done to investigate this promising new treatment for various mental health disorders
Analgesia in Intrauterine Device Insertion
No full textSeveral articles have been published on potential analgesia techniques in intrauterine device insertions; however, none have explored the connection between the lack of treatment of women’s pain and the biases in medicine that have existed for hundreds of years. This paper explores why there has not been any official guidelines for analgesia, as well as what clinicians can do to alter these unequal practices, starting with pain control in this widely-performed gynecologic procedure. The article delves into current provider objections to the practice, sociological reasons for trivializing women’s pain, and recent studies that showcase the under treatment of women’s pain in multiple fields of medicine. Furthermore, methods of pain control for intrauterine device insertion are discussed, with topical Lidocaine 2.5%/Prilocaine 2.5% cream possessing the most evidence of efficacy in clinical trials. With this information, clinicians may better recognize the disparities in treatment between women and men and actively change their practices to account for it
CME: Vitamins, Antidepressants, and the Placebo Effect - How to Help Your Patients
Get PDFDepression affects roughly 280 million people globally. The disease puts patients at increased risk for stroke, cardiovascular disease, hypertension, and diabetes. The psychosocial causes of depression are well-known, but the biochemical causes are multifactorial. Theories range from homocysteine excess, calcium modulation at the neuron, inflammation, cortisol elevation, and disruption of the HPA axis. At the center, however, is serotonin, norepinephrine, and dopamine. Pharmacologic treatment directly aims at modulation of serotonin, norepinephrine, and dopamine. First-line treatment is a combination of SSRIs/SNRIs with cognitive behavioral therapy. If patients do not see improvement with the above therapy other agents such as bupropion, mirtazapine, and tricyclic antidepressants can be added. These adjunct treatments, however, come with a host of side effects and combined with the mainstay treatment of SSRIs and SNRIs may lead to adverse patient outcomes. This study aims to explore the effects of vitamin D, magnesium, and vitamin B12 on the theorized biochemical causes of depression and formulating treatment plans that incorporate them