Curēus
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Background Opioid analgesics, also known as narcotics, are medicinal drugs used primarily for the management of pain secondary to any type of cancer, severe injury or surgery. Due to the ease of availability, opioids are commonly abused. In 2015, reported deaths exceeded 33,000 Americans from opioid overdose. A survey in 2013 revealed nearly 1.6 million Pakistanis abusing prescription opioids for non-medical needs. ⋯ Adaptation of medical school curricula and appropriate training can equip doctors for better management of patients requiring opioids. This includes the screening of patients using standard risk assessment tools for opioid abuse leading to a more controlled opioid prescription practice. Dissemination of these tools will boost doctors' confidence and may help in reducing morbidity and mortality from opioid abuse.
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Objectives This study sought to assess: 1) pervasiveness of vaping or electronic cigarette (e-cigarette) use, 2) General understanding of information on vaping or e-cigarette use, 3) Prevalence and respondent awareness of smoking/vaping prevention programs, and 4) Awareness of the harmful effects of e-cigarettes. Methods This was a cross-sectional survey of 101 young adults (ages 18-24) in the United States designed to assess the prevalence and knowledge of vaping. Ten questions tested this knowledge and prevalence, some directly (for example, "Which of the following have you used? Select all that apply") and some indirectly (Which of the following pictures corresponds with that of an e-cigarette?). ⋯ Most (87.4%) of the people were able to identify an e-cigarette when shown a picture of e-cigarettes versus two computer flash-drives and a cigarette. However, 78.2% of respondents were aware of at least one of the effects of nicotine in humans, which corresponds with the number of respondents who were familiar with any of the provided e-cigarette brands (as 71.7% of respondents to question six knew of the six provided brands of e-cigarettes) and the respondents with parents who smoke (as about 75% of respondents said that neither parent smokes). Thirty-eight percent of respondents had used either traditional tobacco products (such as cigarettes, cigars, or chewing tobacco) or e-cigarettes before, with 13% of respondents having used both tobacco and e-cigarettes.
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Background Depression and psychosis are common comorbidities that significantly affects the quality of life and disease outcomes in Parkinson's disease (PD) patients. Objective The aim of this study was to analyze and discern the differences in the hospitalization outcomes, comorbidities, and utilization of deep brain stimulation (DBS) in PD patients with comorbid depression and comorbid psychosis. Methods We used the Nationwide Inpatient Sample (2010-2014) and identified PD as a primary diagnosis (N = 62,783), and depression (N = 11,358) and psychosis (N = 2,475) as co-diagnosis using the International Classification of Diseases, Ninth Revision (ICD-9) codes. ⋯ Utilization of DBS was lower in PD patients with psychosis versus with depression (3.9% vs. 24.3%; P < 0.001). Conclusion Psychiatric comorbidities are prevalent in PD patients and are associated with more disease severity, impaired quality of life, and increased use of healthcare resources (higher LOS and cost). They should be considered an integral part of the disease, and a multidisciplinary approach to managing this disease is crucial to improve the health-related quality of life of PD patients.
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The future physician will face a career challenged by a number of significant changes in healthcare, including changes in demographics and disease, an increasing focus on population health and value-based care, and changes in healthcare funding. National organizations have called for medical schools to better prepare students for these challenges, and to incorporate more public health education in medical school. While many medical schools have responded, the topics covered, the timing in the curriculum, and the importance of these topics for graduation vary widely. Florida has been a site of growth in medical education in the last 10 years. Given that new medical schools were developed during a period of increased emphasis on the need for public health education, a survey was developed to assess the state of public health education in medical schools accredited by the Liaison Committee for Medical Education (LCME) in the state of Florida. ⋯ Given the importance of public health content in medical schools, survey methodology using established competencies to assess public health curricula could be used in the US to provide an up-to-date assessment of the strengths and opportunities for improvement in this area.
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Depressed skull fracture, also referred to as a "ping-pong ball" or "pond" fracture in neonates, is a common sign of traumatic brain injury in paediatric patients. The main causes of depressed skull fractures include labour and obstetric trauma in newborns and direct head trauma in older children. Skull depression rarely resolves spontaneously, and the surgical options include open cranioplasty and percutaneous microscrew elevation, among others. ⋯ Here, we present a case-based review along with an illustrative case of depressed skull fracture reduced using the suction cup method via negative pressure. In addition, a Systematic Literature Review was performed to evaluate the safety of applying this procedure. The suction cup method is a feasible method to reduce depressed skull fracture in children, with minimum complications and no apparent long-term impairments.