Articles related to CASE STUDY
Clinical Challenge: Headache With Transient Drooling
Navigate the complex world of diagnosing Chiari malformation in this insightful review of a clinical case. To understand Chiari malformation, let’s explore a clinical case. A mid-30s patient with a migraine history came to the ED with a sudden posterior headache. Accompanied by transient total body numbness, loss of coordination, and an inability to swallow with drooling, these symptoms started abruptly after violent sneezing. Although neurological symptoms faded after 20 seconds, the headache persisted. Regarding vital signs and physical examination, everything was normal. The patient had a head CT ordered. Interpreting the clinical picture and CT images with care is crucial in these cases. Even though a sudden onset headache could signify a ruptured berry aneurysm, no blood was detected on the CT cuts, minimizing that concern. Remember, an LP is seldom recommended if the CT is performed within 6 hours and hemoglobin exceeds 10 g/dL. However, the clinical presentation in this case, characterized by headache and drooling, didn’t match a typical migraine. Be mindful that many patients might loosely use the term “migraine” for any severe headache. The CT cut revealed a brainstem compressed by the cerebellum, indicative of a Chiari malformation type 1. Chiari malformation, characterized by an […]
Emergency Medicine May 24th 2023
First-Time Opioid Therapy: An Interactive Case History
This case study applies the newly revised CDC Clinical Practice Guideline for Prescribing Opioids for Pain to a patient with chronic neck pain. The patient, Joanna, is a 78-year-old woman who has undergone two neck surgeries and experiences worsening pain. Her pain ranges from 6 to 7 on average and can increase up to 8. She has tried various non-pharmacologic modalities, such as heat, ice, TENS, physical therapy, and massage therapy, but insurance limitations and cost have hindered her access to these treatments. Considering Joanna’s medical history, physical therapy and topical analgesics are identified as potential options. However, due to limitations and contraindications with other medications, the only feasible options for her are low-dose acetaminophen and topical analgesics. As a result, initiating a low-dose opioid therapy is considered appropriate, in addition to low-dose acetaminophen, OTC menthol and methyl salicylate cream, and a referral to physical medicine and rehabilitation. Before initiating opioids, the patient’s risk of side effects, including overdose, addiction, constipation, and hypogonadal axis suppression, should be discussed. Joanna’s Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) score indicates a risk class of 4 out of 7, with a 15% estimated probability of an opioid-induced respiratory depression event […]
Neurology May 17th 2023
Transforming Root Canal Treatment with Dental Lasers
The article discusses the benefits of using the Waterlase iPlus all-tissue dental laser from Biolase in root canal treatments. The author, an endodontist, shares their experience with traditional root canal treatment methods and how adopting the dental laser has improved their practice. They present two cases to illustrate the difference in treatment outcomes. The first case was treated without the dental laser, using traditional tools and techniques. The second case, treated with the dental laser, showed improved results, including better disinfection, reduced side-directed tenderness, and more conservative cleaning and filling of canals. The author emphasizes that the dental laser provides enhanced dentin debris removal, better management of complex canal configurations, and improved healing times. They conclude that investing in a dental laser has greatly improved their endodontic practice and expanded treatment capabilities.
Dentistry May 15th 2023
The New England Journal of Medicine
Association of Overweight, Obesity, and Recent Weight Loss with Colorectal Cancer Risk
When body mass index (BMI) at the time of recruitment was taken into account in this case-control study, an inverse correlation between being overweight and the risk of CRC was found. However, when looking at BMI at earlier times, a clear positive association between BMI and CRC risk emerged, which was especially pronounced for BMI eight or more years ago. Recent weight loss was also strongly associated with increased CRC risk.
Oncology, Medical May 1st 2023
Digital Care Platform Helps Doc Trim Costs, Increase Patients, and Boost Revenue
Orthopedic surgeon Dr. Ahmed Siddiqi wanted to find a better approach to postoperative monitoring – one that came closer to direct, continuous visibility of patient progress during recovery – while reducing the burden on patients and the management team. His new digital care solution enabled his team to provide long-term remote patient monitoring while directly communicating with all patients. The platform’s remote therapeutic monitoring (RTM) module helps the team meet the minimum engagement and data submission requirements to be eligible for RTM coverage.
All Specialties April 26th 2023
A 19-Year-Old Is Youngest Ever to Be Diagnosed with Alzheimer’s
Only 5 to 10 percent of Alzheimer’s cases are diagnosed in people under the age of 65. However, a BCBS report shows that from 2013 to 2017, there was a 200 percent increase in Alzheimer’s diagnoses in people ages 30 to 64. This case reports the youngest patient yet diagnosed with Alzheimer’s disease.
Family Medicine/General Practice March 2nd 2023