We sought to determine if opioid exposure may have a detrimental effect on the course of infection (CDI). We compared opioid exposure in patients with well-defined severe CDI and non-severe CDI. Following exclusions, 403 records were reviewed.
View Article and Find Full Text PDFBackground: Eosinophilic esophagitis, once considered a rare disorder, has been increasingly recognized as a leading cause of dysphagia and food impaction in children and adults over the last few decades. It predominantly occurs in young men with a history of atopy. Dysphagia and food impaction are the most common presentations.
View Article and Find Full Text PDFBackground And Aim: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide, with dramatic efficacy for upper gastrointestinal acid-related disorders. In recent years, however, the safety of long-term PPI use has been questioned. One issue based on scant and conflicting literature is the possibility of PPI-related hypomagnesemia.
View Article and Find Full Text PDFOur purpose, by modification of standard bedside tilt-testing, was to search for lesser known but important initial orthostatic hypotension (IOH), occurring transiently within the first 30 seconds of standing, heretofore only detectable with sophisticated continuous photoplethysmographic monitoring systems, not readily available in most medical facilities. In screened outpatients over 60 years of age, supine blood pressure (BP) parameters were recorded. To achieve readiness for immediate BP after standing, the cuff was re-inflated prior to standing, rather than after.
View Article and Find Full Text PDFUnlabelled: Concerns have been raised regarding potential adverse effects and high costs of proton pump inhibitors (PPIs). Our objective was to assess issues of PPI utilization and expense in a large outpatient clinic population.
Methods: Two hundred-fifty-nine outpatient records were reviewed regarding PPI prescribing and indications during 2009.
Niacin is an effective lipid-lowering agent which occasionally may cause hepatic failure. Liver enzymes are periodically tested during niacin therapy to assess for hepatic injury. We report a case of suppressed synthesis of hepatically derived coagulation factors and other liver proteins in a patient on niacin with no elevation of hepatic aminotransferases.
View Article and Find Full Text PDFPurpose: To determine if endoscopic Helicobacter pylori and peptic ulcer disease prevalence has changed over an 11-year period in a rural region.
Methods: Current endoscopic records were reviewed and compared with similar data obtained over a time period 11 years earlier at the same institution with regard to H. pylori status, endoscopic findings, microscopic pathologic findings, and medication use.
Though it is our ethical imperative to minimize discomfort, physicians often struggle to manage pain effectively, mainly due to time constraints, lack of training, and fear of litigation regarding over-prescribing of controlled substances. In addition, physicians also now must face potential litigation for under treatment of persistent pain. This dilemma often leaves the physician with a sense of insecurity and stress.
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