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Approach to Diagnosis and Treatment of Spondylolysis in Adolescent Athletes
No full textSpondylolysis is a common cause of low back pain (LBP) in adolescent athletes. While spondylolysis has a relatively low prevalence in the general population, adolescent athletes are at an increased risk due to repetitive activity and forces on the spine. The key to managing the condition is early detection and treatment, but many athletes and providers may be unaware of early signs. Additionally, spondylolysis is unique in that patients may present with minimal symptoms, but necessitate a lengthy treatment process. It can be difficult for providers to determine when to intervene, and there is a lack of standardized protocol for these patients. A vital aspect of treatment is rest from sports, which may have several mental health implications that are often overlooked. This presentation addresses the gaps in current research by underscoring the importance of integrating mental health care into the treatment process. The aim is to outline a holistic approach that prioritizes both physical recovery as well as mental well-being of the patient
Long Term Effects of Hormonal Contraception
No full textThe CME article “Long term effects of Hormonal Contraception” reviews meta-analyses, peer-reviewed clinical studies, and current clinical guidelines regarding long-term systemic effects of hormonal contraceptive use. Hormonal contraceptives are commonly prescribed for pregnancy prevention and other medical indications, such as dysmenorrhea, acne, polycystic ovarian syndrome and heavy menstrual bleeding. Emerging data on hormonal contraception has found protective benefits and potentially harmful effects. The article collaborates findings on the associations between hormonal contraceptive use and risks involved, including venous thromboembolism (VTE), various cancers, inflammatory bowel disease, bone mineral density changes and folate deficiency. The results of some clinical studies remain controversial, which emphasizes the need for further research. This CME encourages providers to use current evidence-based research when prescribing hormonal contraceptives
Prophylactic Measures for Ischemic Stroke Prevention in At-Risk Populations
No full textAbstract:
Stroke is a leading cause of death in the United States, impacting approximately 795,000 individuals annually.1 According to the CDC, the financial burden of strokes on the U.S. healthcare system exceeds $56.5 billion each year.1 Given the significant mortality rate and economic costs associated with stroke, reducing its prevalence must remain a priority. This CME article will explore both pharmacological and non-pharmacological strategies for preventing ischemic stroke, particularly in vulnerable populations. These groups include individuals with comorbid medical conditions and those impacted by Social Determinants of Health (SDOH). Current modalities will be analyzed via evidence-based medicine, to gain insight into the effect of stroke prevention on patient outcomes. Additionally, risk assessment tools will be examined for their efficacy in early stroke detection. The purpose of this article is to equip healthcare professionals with the resources to prevent ischemic stroke in at-risk patient populations
Exploring Barriers in Low Back Pain Management: Patient and Provider Perspectives
No full textLow back pain (LBP) remains one of the leading causes of disability and one of the common complaints seen worldwide. Despite established guidelines to manage acute LBP, significant barriers persist for both patients and providers, contributing to suboptimal care. Through a review of current literature and analysis of provider and patient perspectives, this capstone project explores the various challenges in LBP management, such as access limitations, misaligned expectations or limited patient education, and systemic constraints. It concludes with specific recommendations for a multidisciplinary, system-level approach to improve outcomes through prioritizing patient education, care coordination, and policy reform
Emerging Treatments for Psoriasis
No full textPsoriasis is a chronic, immune-mediated, inflammatory condition that affects people of all ages, races, and genders. There are currently many different treatment options for psoriasis that have been around for years including topical moisturizers, topical corticosteroids, vitamin D analogs, oral methotrexate, oral retinoids, biologics, and phototherapy. Many newer treatment options have been introduced within the last 2 years, including Bimekizumab, Roflumilast, and Deucravacitinib. These emerging treatments will be discussed at length throughout this presentation
The Effects of Diet and Exercise During the Menstrual Cycle on Energy Levels and Other Premenstrual Symptoms
Full text linkA woman experiences hormonal fluctuations throughout the menstrual cycle (MC) that may have many effects on her daily life such as energy levels, mood, appetite, strength, and physical symptoms. However, a majority of studies are completed on men and then generalized to women creating a large gap in research. Therefore, this analysis on changes in the physiologic function during the MC aides to close this gap in research to improve the treatment of women with MC related symptoms and help women understand their body’s fluctuating nutritional and energy needs. Overall, there is evidence that the female body has differing dietary requirements and exercise levels during different phases of the MC due to fluctuations in estrogen and progesterone. Therefore, developing a diet and exercise program for women experiencing negative hormone-related symptoms such as during the premenstrual and menstrual phases may be a successful first step for healthcare providers
Diagnosis, Treatment and Complications of Fecal Impaction in Children and Adolescents
No full textFecal impaction is a condition that can lead to serious complications such as stercoral perforation and peritonitis. The condition is known to be particularly dangerous in the elderly due to more frequent hospitalizations, medication use, and dehydration. However, children and adolescents can also develop fecal impaction, from both functional constipation and genetic causes. In these children, it is important for providers to be able to recognize conditions that would put patients at risk for developing fecal impaction, as well as to be aware of methods to prevent impaction from occurring. While these methods of diagnosis and treatment have been outlined extensively for adult and elderly patients, there are less comprehensive guides to managing fecal impaction in pediatrics. In order to provide proper support for these patients and prevent serious complications, this article aims to contribute a guideline of how to care for children and adolescents with fecal impaction
CYSTINURIA: Approach to early diagnosis, management, and advances in treatment options
Full text linkCystinuria is an autosomal recessive disease that affects the transport of amino acids in the proximal tubules of the nephron. It typically presents around 12 years old and accounts for approximately 6-8% of kidney stones in pediatric patients. It is important for all providers to have a basic understanding of the diagnostics and management options surrounding this genetic mutation. Long term complications as a result of poor management or late diagnosis include recurrent UTIs, hypertension, ureteral scarring, chronic kidney disease, poor quality of life, and ultimately renal failure. This CME will be a succinct summary of the algorithm family medicine, ER, and urgent care providers can follow in order to provide the most up to date treatment options while striving to maintain the highest quality of life for these patients
Hyperemesis Gravidarum: Bridging Gaps In Care
No full textHyperemesis gravidarum (HG) affects approximately 0.3–3% of pregnancies globally, leading to severe nausea and vomiting that can result in significant physical, mental, and social consequences. It is one of the leading causes of hospitalization in early pregnancy, contributing to dehydration, electrolyte imbalances, and weight loss. Despite its prevalence, clinical practice guidelines emphasize individualized care while highlighting substantial gaps in high-quality research needed to address treatment limitations and improve outcomes. This poster explores the current landscape of hyperemesis gravidarum management, highlighting the limitations of existing therapies, the need for personalized care approaches, and the potential for future research to improve patient outcomes
ADJUSTING TO THE RISING PREVALENCE OF COLORECTAL CANCER AMONGST YOUNG ADULTS
Full text linkColorectal Cancer (CRC) is the second most prevalent cause of cancer-related death, with the highest incidence in middle-age and elderly populations [1]. However in America, there is a rising incidence rate of colorectal cancer amongst individuals under 45 years of age, leading to early-onset colorectal cancer (EOCRC [2]). From all cancers studied from 2010-2019, gastrointestinal cancers had an increase in incidence rate of 14.80%, making it the fastest-growing among all early-onset cancers [2]. Patients with EOCRC have a higher likelihood of misdiagnosis and metastasis, leading to higher rates of mortality [1]. Additionally, many patients suffering from EOCRC are uninsured minority groups and are more likely to present with stage IV when compared to their older counterparts [3]. Although patients who suffer from EOCRC only make up 5% of all GC cases [2], this group of individuals suffer from poor outcomes due to preventable factors such as patient education, diet, and misdiagnosis, ultimately increasing the disease burden in the United States [3]. Social drivers of health such as geographic location, income, and healthcare access are also linked to poorer EOCRC outcomes [16]. Healthcare providers must be made aware of the diagnosis criteria and risk factors to better educate and treat their patients with, or at the risk of EOCRC