The Journal of the American Osteopathic Association
-
J Am Osteopath Assoc · Mar 2011
Review Meta AnalysisGetting to know human papillomavirus (HPV) and the HPV vaccines.
More than 100 types of human papillomavirus (HPV), of which more than 40 are transmitted sexually, affect men and women. The worldwide prevalence of cervical HPV infection is approximately 10%. The most common HPV types worldwide are 16 and 18, which are the main causative viruses for cervical cancer and are both preventable by vaccination. ⋯ The Advisory Committee on Immunization Practices does not recommend routine use of the quadrivalent vaccine in males. The vaccines have been demonstrated to be highly effective in preventing cervical dysplasia, vulvar cancer, and genital warts related to HPV types 6, 11, 16, and 18; they are most effective, however, in vaccinees who have never been infected with HPV. Based on a review of the literature, the authors argue that it may be appropriate to routinely vaccinate both males and females to prevent the spread of HPV types 6, 11, 16, and 18.
-
J Am Osteopath Assoc · Mar 2011
Case ReportsCannabinoid hyperemesis syndrome as the underlying cause of intractable nausea and vomiting.
Recently, reports have suggested that chronic cannabis abuse can result in cyclical vomiting, or cannabinoid hyperemesis syndrome. With the increasing prevalence of cannabis use in the United States, this syndrome may be encountered in the emergency department. The authors describe a case of a 30-year-old man who presented to the emergency department with diffuse abdominal pain, nausea, and intractable vomiting. ⋯ The patient was admitted to the hospital and underwent pharmaceutical treatment. However, hot showers continued to be the mainstay of the patient's symptomatic relief. Four days after presentation, the patient's symptoms resolved and he was discharged from the hospital.
-
J Am Osteopath Assoc · Jan 2011
Implementation of a stroke alert protocol in the emergency department: a pilot study.
Although tissue plasminogen activator (tPA) is an effective treatment for stroke patients, it typically must be administered within 3 hours of symptom onset to substantially reduce morbidity and mortality. Because of this limited treatment window, it is essential for healthcare professionals to properly identify and quickly triage stroke patients. ⋯ By coupling a formal stroke protocol with a limited education program, door-to-treatment time of stroke patients was reduced.
-
J Am Osteopath Assoc · Nov 2010
Randomized Controlled TrialMindfulness-based stress reduction for failed back surgery syndrome: a randomized controlled trial.
Previous studies on the effect of mindfulness-based stress reduction (MBSR) therapy on chronic pain syndromes have been hampered by study design. ⋯ The results suggest that MBSR can be a useful clinical intervention for patients with FBSS.
-
J Am Osteopath Assoc · Oct 2010
Case ReportsPotential for pregabalin abuse or diversion after past drug-seeking behavior.
Pregabalin, primarily used to manage neuropathic pain and fibromyalgia, is categorized as a Schedule V drug (ie, lowest potential for abuse) in the US Drug Enforcement Administration's Controlled Substances Act. Because pregabalin is not recognized as a drug with high-abuse potential, data on pregabalin abuse and addiction are lacking. The authors report a case of a 35-year-old woman with a history of opioid-seeking behavior who was prescribed pregabalin for pain control. ⋯ Over a 28-day period, the patient received a total of 88,500 mg of pregabalin. After learning of the other prescriptions, the patient's physician became suspicious of pregabalin abuse or diversion. In accordance with state medical board guidelines, the patient was discharged from the practice and referred to a local detoxification center.