The Ochsner journal
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Background: Carotid webs are luminal, shelf-like protrusions at the carotid bulb. Considered to be a variant of fibromuscular dysplasia, carotid webs have been observed principally in African American females. The association between carotid webs and recurrent ischemic strokes continues to be established as patients without traditional stroke risk factors are found to have carotid webs as the only possible cause of symptomatic deficits. ⋯ Follow-up digital subtraction angiography at 3 months showed obliteration of the right carotid artery web and satisfactory integration of the stent into the vessel wall. She was reassessed at 1 year and reported no neurologic symptoms. Conclusion: Although carotid webs are most commonly treated with endarterectomy, they may be amenable to stent therapy with favorable clinical outcomes as shown with this patient.
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The Ochsner journal · Jan 2019
Medical Scribes in the Emergency Department: The Scribes' Point of View.
Background: Studies report the benefit of medical scribes in the emergency department on patient throughput, clinical documentation, patient outcomes, and provider and patient satisfaction. However, studies are silent on the benefits of being a scribe for premedical and medical students. Methods: The senior author interviewed 8 scribes who were applying for medical school and 9 medical students who had been scribes prior to medical school. ⋯ The scribes recognized their value in the areas of process and finance. They also recognized that many doctors, particularly those working in academic health centers, derived satisfaction from the training and mentoring that they offered. Conclusion: Scribes perceive the role of a scribe to be highly valuable in terms of their career decision making and future medical education.
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The Ochsner journal · Jan 2019
Sexual Harassment in the House of Medicine and Correlations to Burnout: A Cross-Sectional Survey.
Background: Burnout is a major problem among physicians in the United States. Women physicians experience higher rates of both burnout and sexual harassment than their male counterparts. Some studies from Asia and Europe have shown a correlation between sexual harassment at work and burnout in women physicians, but no studies on this topic have been done in the United States. ⋯ Conclusion: This study found that reports of burnout and gender harassment from colleagues were significantly correlated. The results also align with previous findings of high rates of sexual harassment in medical school and residency. More research should be done in this area, especially focusing on women in training, women of color, and sexual and gender minority individuals.
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The Ochsner journal · Jan 2019
Case ReportsEndoscopic Retrieval vs Observation in Cylindrical Battery Ingestion.
Background: Battery ingestion, particularly in the pediatric population, has become more common since the development of button batteries. Consequently, formal recommendations regarding the management of this battery type have been developed. Larger cylindrical battery ingestion is less common, with fewer cases reported. ⋯ The second battery passed spontaneously via the rectum after administration of laxatives and supportive care. Conclusion: Our case and review of the literature demonstrate that nonsurgical, conservative management with close clinical monitoring is possible in a hospital setting after cylindrical battery ingestion. Cases with concerning clinical symptoms or a history of damage to the battery casing warrant endoscopic or surgical intervention.
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The Ochsner journal · Jan 2019
ReviewSphenopalatine Ganglion Block and Radiofrequency Ablation: Technical Notes and Efficacy.
Background: Sphenopalatine ganglion (SPG) blockade or lesioning can offer significant pain relief for cluster headaches (CHs) and a variety of other pain syndromes involving the head and face. Methods: We reviewed the literature on the efficacy of SPG block and radiofrequency ablation (RFA) using PubMed and Google Scholar. Results: The infrazygomatic technique can be used to directly access the SPG for injection of local anesthetic or lesioning using RFA. ⋯ SPG blockade efficacy is supported by randomized controlled studies but SPG RFA is not. Conclusion: Targeting the SPG is a promising treatment option for refractory CHs. RFA and neuromodulation have the potential to offer long-term significant pain relief, but more randomized studies are needed to demonstrate their efficacy.