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Rhode Island Medical Journal

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https://www.readbyqxmd.com/read/28459921/disparities-in-secondhand-smoke-exposure-among-nonsmoking-adults-in-rhode-island-tobacco-control-s-pro-equity-approach
#1
Elsa Larson, Benvinda Santos
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459920/chronic-venous-insufficiency-novel-management-strategies-for-an-under-diagnosed-disease-process
#2
Omar N Hyder, Peter A Soukas
Chronic venous insufficiency is an often-missed diagnosis that results in a variety of clinical manifestations that may severely compromise quality of life. Prompt recognition is important to provide symptomatic relief and prevent disease progression. Most patients can be treated with a comprehensive plan of conservative measures. However, it is important for providers to recognize those patients who require referral to a vascular specialist for more invasive therapies. Over the past 2 decades, a variety of endovenous strategies have demonstrated effective and lasting results in treatment of severe symptomatic venous insufficiency...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459919/the-arm-is-not-the-leg-pathophysiology-diagnosis-and-management-of-upper-extremity-deep-vein-thrombosis
#3
Adam M Noyes, John Dickey
Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459918/pulmonary-embolism-in-2017-increasing-options-for-increasing-incidence
#4
William Prabhu, Peter A Soukas
Scope of the problem - An increasing burden of disease Acute pulmonary embolism (PE) is a problem encountered by a majority of medical and surgical specialties in their scope of practice. Acute PE is currently the 3rd leading cause of cardiovascular death in the United States, resulting in 100,000 deaths annually as estimated by the Centers for Disease Control (CDC (1). There is a paucity of data and a broad range of estimates for both incidence and morbidity due to acute PE. The mortality of all patients presenting with acute PE is estimated between 10-30% at 90 days utilizing current treatment regimens (2)...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459917/minimally-invasive-closure-of-the-left-atrial-appendage-a-non-pharmacologic-approach-to-prevention-of-stroke-in-patients-with-atrial-fibrillation
#5
Brian D McCauley, Antony F Chu
Atrial Fibrillation's (AF) role in the pathogenesis of thromboembolic stroke has been well established, with estimates from trials of approximately 15-20% of all strokes in the U.S. Research shows more than 90% of atrial thrombi originate from the left atrial appendage (LAA). Traditionally, oral anticoagulants (OACs) have been the keystone of management for AF in reducing the risk of thromboembolic stroke. However, OACs also pose a non-negligible risk of bleeding with between 30-50% of eligible patients not receiving OACs due to absolute contraindications or perceived increased bleeding risk...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459916/direct-oral-anticoagulants-doacs-current-status-among-distinct-patient-subgroups
#6
Peter Riley, Abhishek Maan, Kenneth S Korr
The landscape of anticoagulant therapy for atrial fibrillation and deep-vein thrombosis has evolved considerably in the last decade with the advent of Novel or Direct-Acting Oral Antiocoagulants (DOACs). The initial phase III randomized controlled trials established the individual DOACs as viable alternatives to warfarin for thromboprophylaxis but generalizations to the larger population were limited by the small number of protocol subjects with renal insufficiency, congestive heart failure, advanced age and other comorbidities...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459915/the-evolving-landscape-of-thromboembolic-disease-diagnostic-and-management-strategies
#7
Kenneth S Korr
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459914/providing-non-emergency-healthcare-for-undocumented-immigrants-raises-issues
#8
Herbert Rakatansky
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28459913/malingering
#9
Joseph H Friedman
No abstract text is available yet for this article.
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375419/development-and-use-of-a-new-opioid-overdose-surveillance-system-2016
#10
Meghan McCormick, Jennifer Koziol, Kelly Sanchez
No abstract text is available yet for this article.
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375418/unexpected-serious-cardiac-arrhythmias-in-the-setting-of-loperamide-abuse
#11
Somwail Rasla, Amy St Amand, Marina K Garas, Amr El Meligy, Taro Minami
Loperamide (Imodium) is a non-prescription opioid receptor agonist available over-the-counter for the treatment of diarrhea. When ingested in excessive doses, loperamide can penetrate the blood-brain barrier and is reported to produce euphoria, central nervous system and respiratory depression, and cardiotoxicity. There is an emerging trend in its use among drug abusers for its euphoric effects or for self-treatment of opioid withdrawal. We report a case of ventricular dysrhythmias associated with loperamide abuse in a 28-year-old man who substituted loperamide for the opioids that he used to abuse...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375417/igg4-aortitis-a-case-report
#12
Shivali Marketkar, Mark LeGolvan
IgG4 aortitis is one of the entities seen in the spectrum of IgG4-related disease (IgG4-RD). It is characterized by serologic (elevated serum IgG4) and histologic features including a lymphoplasmacytic infiltrate with increased numbers of IgG4-positive plasma cells, storiform fibrosis and obliterative phlebitis. Some studies have described a correlation between infections and IgG4 aortitis. We describe a patient with an aneurysm of the infrarenal descending abdominal aorta with features of IgG4-RD, as well as culture evidence of Streptococcus sanguis...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375416/assault-injury-and-homicide-death-profile-in-rhode-island-2004-2014
#13
Yongwen Jiang, Megan L Ranney, Jordan Seaberry, Lynne-Marie Shea, Brian Sullivan, Samara Viner-Brown
Community violence, including assault and homicide, is a public health problem. We provide a profile of assault-related injury and homicide death in Rhode Island to better understand assault/homicide. The 2014 emergency department (ED) visit data, hospital discharge (HD) data, and 2004-2014 Rhode Island Violent Death Reporting System (RIVDRS) data were used for this study. Most assault injuries and homicide deaths were among persons who were 25-44 years old, male, black and Hispanic, living in urban regions, self-pay or public insurance user, and never married...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375415/improving-the-perception-of-outpatient-practice-a-second-continuity-experience-for-internal-medicine-residents
#14
Jennifer Jeremiah, Kelly McGarry, Joao Filipe Goncalves Monteiro
BACKGROUND: The challenges trainees experience in the traditional medical clinic are felt to be one deterrent to choosing a primary care career. OBJECTIVE: We examined whether participation in a second outpatient continuity experience (Second Site) affects trainee perception of primary care practice. METHODS: 241 current and former graduates of the Brown Alpert Medical School Internal Medicine training programs were surveyed about their experiences with Second Site...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375414/proceedings-from-bridging-health-disparities-to-address-the-opioid-epidemic-a-symposium-at-the-warren-alpert-medical-school-of-brown-university
#15
Luba Dumenco, Kristina Monteiro, Michael Mello, Sally Collins, Don Operario, Karen Scanlan, Richard Dollase, Paul George
OBJECTIVE/BACKGROUND: In response to the unprecedented rates of illicit drug use, including opioid addiction and overdose in Rhode Island, local healthcare institutions, led by the Warren Alpert Medical School (AMS) of Brown University, collaborated to present "Bridging Health Disparities to Address the Opioid Epidemic." This symposium sought to educate a wide array of healthcare providers and professionals around opioid use disorder, including the state of the opioid crisis in Rhode Island, national efforts around opioid misuse and how providers can work together to stem the opioid crisis in the state...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375413/medical-bureau-mid-century-switchboard-connected-patients-and-physicians
#16
Herbert Rakatansky
No abstract text is available yet for this article.
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28375412/voting-aliens-donald-trump-and-me
#17
Joseph H Friedman
No abstract text is available yet for this article.
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28246659/subjective-cognitive-decline-and-associated-health-problems-among-rhode-island-adults
#18
Tracy L Jackson, Tara Cooper
No abstract text is available yet for this article.
March 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28246658/a-review-of-anatomical-placement-of-corticosteroid-injections-for-uncommon-hand-wrist-and-elbow-pathologies
#19
Gregory R Waryasz, Robert Tambone, Todd R Borenstein, Joseph A Gil, Manuel DaSilva
Corticosteroid injections are a common nonsurgical treatment of intersection syndrome, flexor carpi radialis tendonitis, flexor carpi ulnaris tendonitis, and medial epicondylitis. The benefits of corticosteroid injections for these conditions have been well studied and documented in the medical literature. Patients with less common upper extremity complaints usually first present to their primary care provider. A correct anatomical diagnosis will help with early definitive treatment, as the injection must be in the proper location for maximal benefit to the patient...
March 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28246657/quality-improvement-processes-in-obesity-surgery-lead-to-higher-quality-and-value-lower-costs
#20
Holli Brousseau, Dieter Pohl
In the era of changes in the evaluation of medical services and performance, the Centers for Medicare and Medicaid Services (CMS) has determined that the key components are quality, value, and clinical practice improvement (MACRA). Weight Loss Surgery, also called Bariatric or Obesity Surgery, has been at the forefront of quality improvement and quality reporting through the Center of Excellence Program since 2005. As a result, weight loss surgery is now as safe as gallbladder surgery.1 Even within this culture of quality and safety, improvements are still possible, as described in this article...
March 1, 2017: Rhode Island Medical Journal
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