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https://www.readbyqxmd.com/read/28641572/a-child-with-hypertension-and-ambiguous-genitalia-an-uncommon-variant-of-congenital-adrenal-hyperplasia-a-case-report
#1
Vivek Pant, Suman Baral, Bishal Shrestha, Arjun Tumbapo
BACKGROUND: Deficiency in 11β-hydroxylase as a cause of congenital adrenal hyperplasia is uncommon. It should be considered in the differential diagnosis of hypertension with virilization in any prepubescent child. CASE PRESENTATION: A 12-year-old Asian boy from eastern Nepal presented with pain in his abdomen and hypertension. He was raised as a male but had absent testicles since birth and had precocious puberty. Plasma testosterone, follicle-stimulating hormone, and luteinizing hormone were below baseline level...
June 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28627924/clusters-of-financially-incentivized-chronic-pain-patients-using-the-minnesota-multiphasic-personality-inventory-2-restructured-form-mmpi-2-rf
#2
Luis E Aguerrevere, Matthew R Calamia, Kevin W Greve, Kevin J Bianchini, Kelly L Curtis, Veronica Ramirez
The Minnesota Multiphasic Personality Inventory (MMPI)-2 Restructured Form (MMPI-2-RF) has been shown to have clinical utility in the assessment of individuals with chronic pain (e.g., predicting surgical outcomes). The purpose of this study was to explore the ability of the MMPI-2-RF Validity Scales in profiling patients with chronic pain who had external financial incentive (e.g., workers' compensation claims) and determine the associations between Validity Scale response patterns and important outcomes. Cluster analysis identified 2 similarly sized clusters of patients with very different MMPI-2-RF profiles...
June 19, 2017: Psychological Assessment
https://www.readbyqxmd.com/read/28605305/attitudes-toward-medical-cannabis-legalization-among-serbian-medical-students
#3
Isidora Vujcic, Aleksandar Pavlovic, Eleonora Dubljanin, Jadranka Maksimovic, Aleksandra Nikolic, Sandra Sipetic-Grujicic
BACKGROUND: Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. OBJECTIVES: To determine medical students' attitudes toward medical cannabis legalization and to examine the factors influencing their attitudes. METHODS: Fourth-year medical students at the Faculty of Medicine, University of Belgrade, had participated in a cross-sectional study...
June 12, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28561731/pain-and-opioids-in-cancer-care-benefits-risks-and-alternatives
#4
Mike Bennett, Judith A Paice, Mark Wallace
Pain remains common in the setting of malignancy, occurring as a consequence of cancer and its treatment. Several high-quality studies confirm that more than 50% of all patients with cancer experience moderate to severe pain. The prevalence of pain in cancer survivors is estimated to be 40%, while close to two-thirds of those with advanced disease live with pain. Progress has occurred in the management of cancer pain, yet undertreatment persists. Additionally, new challenges are threatening these advances. These challenges are numerous and include educational deficits, time restraints, and limited access to all types of care...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28549263/prevalence-reasons-perceived-effects-and-correlates-of-medical-marijuana-use-a-review
#5
REVIEW
Ji-Yeun Park, Li-Tzy Wu
BACKGROUND: The use of marijuana for medical purposes is now legal in some U.S. states and other jurisdictions, such as Canada, and Israel. Despite the widespread legalization of medical marijuana globally, there is limited information on patterns and correlates of medical marijuana use (MMU). We conducted a literature review to assess prevalence, reasons, perceived effects, and correlates of MMU among adolescents and adults. METHODS: We searched peer-reviewed articles in English between January 1996 and August 2016 from several databases (PubMed, Google Scholar, Embase, CINAHL, and PsycINFO) using different combinations of keywords...
May 16, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28514026/gambling-with-life-masculinity-risk-and-danger-in-the-lives-of-unauthorized-migrant-roofers
#6
Sergio Chávez, Claire E Altman
BACKGROUND: This paper examines the occupational experiences of unauthorized immigrants employed in one of the most dangerous occupations in the United States: roofing. METHODS: We draw on 40 in-depth interviews with return migrants in Guanajuato, Mexico, to examine how the adoption of masculinity, dangerous working conditions, the labor market structure, and absence of legal status exacerbates injuries for unauthorized roofers. FINDINGS: Undocumented men return to Mexico injured with chronic pain, health complications, and trauma...
June 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28498071/assessment-of-malpractice-claims-due-to-spinal-epidural-abscess
#7
J Mason DePasse, Roy Ruttiman, Adam E M Eltorai, Mark A Palumbo, Alan H Daniels
OBJECTIVE Spinal epidural abscesses (SEAs) can be difficult to diagnose and may result in neurological compromise or even death. Delays in diagnosis or treatment may worsen the prognosis. While SEA presents a high risk for litigation, little is known about the medicolegal ramifications of this condition. An enhanced understanding of potential legal implications is important for practicing spine surgeons, emergency medicine physicians, and internists. METHODS The VerdictSearch database, a large legal-claims database, was queried for "epidural abscess"-related legal cases...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28496355/cannabis-as-a-substitute-for-prescription-drugs-a-cross-sectional-study
#8
James M Corroon, Laurie K Mischley, Michelle Sexton
BACKGROUND: The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs. METHODS: A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28465128/nursing-home-physicians-assessments-of-barriers-and-strategies-for-end-of-life-care-in-norway-and-the-netherlands
#9
Anette Fosse, Sytse Zuidema, Froukje Boersma, Kirsti Malterud, Margrethe Aase Schaufel, Sabine Ruths
OBJECTIVES: Working conditions in nursing homes (NHs) may hamper teamwork in providing quality end-of-life (EOL) care, especially the participation of NH physicians. Dutch NH physicians are specialists or trainees in elderly care medicine with NHs as the main workplace, whereas in Norway, family physicians usually work part time in NHs. Thus, we aimed at assessing and comparing NH physicians' perspectives on barriers and strategies for providing EOL care in NHs in Norway and in The Netherlands...
April 29, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28462897/radiation-oncology-resident-palliative-education
#10
Monica Krishnan, Margarita Racsa, Joshua Jones, Eva Chittenden, Kristen G Schaefer, Alex Spektor, Andrea Enzinger, Randy Wei, Tracy Balboni
PURPOSE: Although palliative care is recognized as integral to oncology care, limited data exist regarding the extent to which palliative care training is incorporated into radiation oncology residency training in the United States. We aim to characterize US radiation oncology residents' perceived palliative care educational needs and experience to guide future palliative oncology educational interventions. METHODS AND MATERIALS: An 8-person expert panel developed a survey to assess resident perceptions of generalist palliative care education within radiation oncology residency...
March 14, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28457767/clinical-and-financial-implications-of-emergency-department-visits-for-synthetic-marijuana
#11
Eric Rowley, David Benson, Aaron Tiffee, Adam Hockensmith, Henry Zeng, Glenn N Jones, Mandi W Musso
BACKGROUND: Many users believe that synthetic cannabinoids offer a safe and legal means of getting high. However, spikes in emergency department visits have been associated with use of synthetic cannabinoids. The purpose of the current study was to document emergency department visits from three large hospitals in one metropolitan area over a two month period. METHOD: This was a retrospective chart review examining 218 patients presenting to three inner city emergency departments between March and April 2014...
April 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28452611/at-zero-and-turning-in-circles-refugee-experiences-and-coping-in-durban-south-africa
#12
Charlotte A Labys, Chandré Dreyer, Jonathan K Burns
Millions of refugees are on the move globally, mostly settling in low- and middle-income (LMIC) "host" countries, where they often receive insufficient assistance and encounter a multitude of barriers. Despite a risk for developing mental illness, limited research exists on their struggles and coping strategies in these settings, especially outside of camps. Against this backdrop, our qualitative study aimed to gain a deeper understanding of refugee experiences in Durban, South Africa. We conducted semistructured individual interviews with 18 adult refugees from Zimbabwe and the Democratic Republic of Congo at a community-based support center in Durban...
January 1, 2017: Transcultural Psychiatry
https://www.readbyqxmd.com/read/28434211/health-conditions-and-motivations-for-marijuana-use-among-young-adult-medical-marijuana-patients-and-non-patient-marijuana-users
#13
Stephen E Lankenau, Janna Ataiants, Salini Mohanty, Sheree Schrager, Ellen Iverson, Carolyn F Wong
INTRODUCTION: While marijuana has been legal for medical purposes in California since 1996, little is known about the health histories of young adult medical marijuana patients who are a significant proportion of medical marijuana patients. We examined whether young adult medical marijuana patients reported health conditions and motivations for use that were consistent with medical use of marijuana in California. METHODS: Young adults (N = 366) aged 18 to 26 years were sampled in Los Angeles in 2014-2015 and segmented into medical marijuana 'patients' (n = 210), marijuana users with a current recommendation, and non-patient users or 'non-patients' (n = 156), marijuana users who never had a medical marijuana recommendation...
April 23, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28426028/-groping-in-the-dark-unheard-pain-2
#14
D J F Lambregts-van Marrewijk
For a very severely mentally disabled, deaf and blind man, it was always very difficult to carry out dental check-ups, diagnosis and treatment, even with pharmacologic support. The man cannot communicate pain. When caries and calculus were diagnosed, the man was treated under general anaesthesia. During this treatment session he was also found to have severe periodontal disease and peri-apical problems. The legal representative of the patient was unavailable for consultation on changes to the pre-prepared preliminary treatment plan...
April 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/28418411/-groping-in-the-dark-unheard-pain-2
#15
D J F Lambregts-van Marrewijk
For a very severely mentally disabled, deaf and blind man, it was always very difficult to carry out dental check-ups, diagnosis and treatment, even with pharmacologic support. The man cannot communicate pain. When caries and calculus were diagnosed, the man was treated under general anaesthesia. During this treatment session he was also found to have severe periodontal disease and peri-apical problems. The legal representative of the patient was unavailable for consultation on changes to the pre-prepared preliminary treatment plan...
April 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/28389221/welfare-law-and-ethics-in-the-veterinary-intensive-care-unit-a-discussion-of-the-different-types-of-suffering-that-patients-may-endure-in-the-veterinary-intensive-care-unit-the-legal-limits-to-that-suffering-and-the-ethics-underpinning-at-what-point-that-suffering
#16
REVIEW
Peter S Fordyce
OBJECTIVES: In UK law, allowing an animal protected under the Animal Welfare Act 2006 (AWA 2006) (as devolved) to suffer 'unnecessarily' may render the person responsible for it to prosecution. The act does not define suffering, although 'case law' suggests that suffering encompasses more than pain. Clinicians responsible for animals under their care in the intensive care unit (ICU) are likely to also be responsible in law for the welfare of those animals, and may be called upon to justify why any suffering was necessary, or more likely, why they did not act to end any suffering when it became 'unnecessary'...
March 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28384683/characterizing-18-years-of-the-death-with-dignity-act-in-oregon
#17
Charles Blanke, Michael LeBlanc, Dawn Hershman, Lee Ellis, Frank Meyskens
Importance: Numerous states have pending physician-aided dying (PAD) legislation. Little research has been done regarding use of PAD, or ways to improve the process and/or results. Objectives: To evaluate results of Oregon PAD, the longest running US program; to disseminate results; and to determine promising PAD research areas. Design, Setting, and Participants: A retrospective observational cohort study of 991 Oregon residents who had prescriptions written as part of the state's Death with Dignity Act...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28379832/comparison-of-opioid-prescribing-patterns-in-the-united-states-and-japan-primary-care-physicians-attitudes-and-perceptions
#18
Eriko Onishi, Tadashi Kobayashi, Eve Dexter, Miguel Marino, Tetsuhiro Maeno, Richard A Deyo
INTRODUCTION: Far fewer opioids are prescribed in Japan than in the United States. METHODS: We conducted an online physician survey assessing attitudes and perceptions that might influence prescribing. A Japanese version was distributed to members of the Japan Primary Care Association and an English version to members of the American Academy of Family Physicians practicing in Oregon. RESULTS: We received 461 Japanese responses and 198 from the United States, though overall response rates were low (Japan: 10...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28372506/substitution-of-medical-cannabis-for-pharmaceutical-agents-for-pain-anxiety-and-sleep
#19
Brian J Piper, Rebecca M DeKeuster, Monica L Beals, Catherine M Cobb, Corey A Burchman, Leah Perkinson, Shayne T Lynn, Stephanie D Nichols, Alexander T Abess
A prior epidemiological study identified a reduction in opioid overdose deaths in US states that legalized medical cannabis (MC). One theory to explain this phenomenon is a potential substitution effect of MC for opioids. This study evaluated whether this substitution effect of MC for opioids also applies to other psychoactive medications. New England dispensary members ( n = 1,513) completed an online survey about their medical history and MC experiences. Among respondents that regularly used opioids, over three-quarters (76...
March 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28359979/variation-in-selection-criteria-and-approaches-to-surgery-for-lumbar-spinal-stenosis-among-patients-treated-in-boston-and-norway
#20
Greger Lønne, Andrew J Schoenfeld, Thomas D Cha, Øystein P Nygaard, John Anker H Zwart, Tore Solberg
OBJECTIVES: There are no uniform guidelines regarding when to operate or the ideal surgical intervention in Lumbar Spinal Stenosis (LSS). Understanding the presence of practice-based variation between different localities is critical. We sought to compare patient-reported pre-operative pain, disability, and health-related quality of life as indications for surgery between Boston and Norway, and the use of decompression alone vs. decompression and arthrodesis. PATIENTS AND METHODS: This study included 3826 patients; 1886 from Boston and 1940 from Norway...
March 21, 2017: Clinical Neurology and Neurosurgery
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