Eating disorders (EDs) and obesity (OB) are both chronic health problems that often emerge during childhood and adolescence. Both conditions are difficult to treat and may pose serious medical and behavioral health effects. In the following review article, prevalence and common health consequences of both EDs and OB in youth are presented, followed by a summary of literature describing the interaction between the two conditions. Best practice prevention strategies and specific physician action steps are then out-lined. These include (1) discouraging restricting diet behavior and using behavioral strategies to encourage nourishing eating habits (including 5-2-1-0 plan), (2) promoting positive body image, (3) eating frequent family meals, (4) encouraging and modeling positive body talk and (5) addressing weight stigma and bullying related to weight.
{"title":"Evidence-Based Strategies to Prevent Eating Disorders and Obesity in Children","authors":"Jessica L. Luzier, Jamie Jeffrey","doi":"10.21885/wvmj.2020.7","DOIUrl":"https://doi.org/10.21885/wvmj.2020.7","url":null,"abstract":"Eating disorders (EDs) and obesity (OB) are both chronic health problems that often emerge during childhood and adolescence. Both conditions are difficult to treat and may pose serious medical and behavioral health effects. In the following review article, prevalence and common health consequences of both EDs and OB in youth are presented, followed by a summary of literature describing the interaction between the two conditions. Best practice prevention strategies and specific physician action steps are then out-lined. These include (1) discouraging restricting diet behavior and using behavioral strategies to encourage nourishing eating habits (including 5-2-1-0 plan), (2) promoting positive body image, (3) eating frequent family meals, (4) encouraging and modeling positive body talk and (5) addressing weight stigma and bullying related to weight.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83866473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SARS CoV 2 Pandemic and Depression","authors":"Ayne Amjad, Christina Mullins","doi":"10.21885/wvmj.2020.9","DOIUrl":"https://doi.org/10.21885/wvmj.2020.9","url":null,"abstract":"","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"235 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89151859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary care practitioners have long been encouraged to screen adult patients for depression, as reflected by national guidelines from the United States Preventive Services Task Force (USPSTF) and recent federal initiatives aimed at bolstering screening rates. The Patient Health Questionnaire-2, or PHQ-2, is a simple, commonly used tool for depression screening. However, results can be skewed due to variability in the way in which questions are delivered. This study, conducted in seven West Virginia primary care centers from August 2016 to October 2017, evaluated delivery of the PHQ-2 via face-to-face administration by clinical staff compared to a scripted, video-based delivery using a tablet computer, here called the electronic PHQ-2 or ePHQ-2. This observational study finds a significant, increased difference in positive screening results when administered face-to-face by clinical staff compared to a scripted, tablet-based delivery (X2 (1, N = 655) = 5.32, p = 0.02). Given this important difference between groups, this study highlights the need for further exploration into the fidelity of PHQ-2 delivery and acceptance of such technology among patients and health care providers.
从美国预防服务工作组(USPSTF)的国家指导方针和最近旨在提高筛查率的联邦倡议中可以看出，初级保健从业人员长期以来一直被鼓励筛查成年抑郁症患者。患者健康问卷-2(简称PHQ-2)是一种简单、常用的抑郁症筛查工具。然而，由于提问方式的变化，结果可能会有所偏差。这项研究于2016年8月至2017年10月在西弗吉尼亚州的七个初级保健中心进行，评估了通过临床工作人员面对面给药的PHQ-2与使用平板电脑(这里称为电子PHQ-2或ePHQ-2)的脚本化、基于视频的给药方式的比较。这项观察性研究发现，与基于脚本的片剂给药相比，由临床人员面对面给药的阳性筛查结果差异显著增加(X2 (1, N = 655) = 5.32, p = 0.02)。鉴于两组之间的这一重要差异，本研究强调需要进一步探索PHQ-2输送的保真度以及患者和医疗保健提供者对这种技术的接受程度。
{"title":"A Comparison of Face-to-Face Versus Tablet-Based Delivery of the Patient Health Questionnaire-2 Screening for Depression in Primary Care","authors":"M. Weimer, M. A. Maurer, A. Baus","doi":"10.21885/wvmj.2020.4","DOIUrl":"https://doi.org/10.21885/wvmj.2020.4","url":null,"abstract":"Primary care practitioners have long been encouraged to screen adult patients for depression, as reflected by national guidelines from the United States Preventive Services Task Force (USPSTF) and recent federal initiatives aimed at bolstering screening rates. The Patient Health Questionnaire-2, or PHQ-2, is a simple, commonly used tool for depression screening. However, results can be skewed due to variability in the way in which questions are delivered. This study, conducted in seven West Virginia primary care centers from August 2016 to October 2017, evaluated delivery of the PHQ-2 via face-to-face administration by clinical staff compared to a scripted, video-based delivery using a tablet computer, here called the electronic PHQ-2 or ePHQ-2. This observational study finds a significant, increased difference in positive screening results when administered face-to-face by clinical staff compared to a scripted, tablet-based delivery (X2 (1, N = 655) = 5.32, p = 0.02). Given this important difference between groups, this study highlights the need for further exploration into the fidelity of PHQ-2 delivery and acceptance of such technology among patients and health care providers.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86593628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Morise, Jennifer Tennant, S. Holmes, Danyel H Tacker
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have demonstrated significant lowering of low-density lipoprotein (LDL) cholesterol in patients with atherosclerotic cardiovascular disease (ASCVD) and familial hypercholesterolemia (FH). We retrospectively reviewed data concerning use of PCSK9 inhibitors from patients in our university-based adult lipid clinic. Data collected included clinical pre-treatment variables and pre-and post-treatment non-fasting lipid profiles. Of 165 candidates, 163 were approved for PCSK9 inhibition (90% ASCVD and 10% FH). A majority of patients (72%) had statin intolerance. Treatment was provided and assessed in 141 patients. After three doses of medications, LDL cholesterol fell from 170 + 58 mg/dL to 76 + 45 mg/dL (55%, P<0.001). There were no differences in efficacy according to sex, elevated lipoprotein(a), and the PCS-K9 inhibitor utilized. Continued efficacy was evaluated in 101 patients with LDL decreasing further from initial follow-up to long-term follow-up over an average of 14 months (74 ± 44 mg/dL to 68 ± 41 mg/dL). Permanent discontinuation of PCS-K9 inhibitor because of side effects occurred in 11% of patients. When strict adherence to guidelines was applied, >95% approval rate was obtained, and there was similar efficacy in LDL lowering to what has been previously reported irrespective of statin intolerance.
{"title":"Initial Clinical Experience with PCSK9 Inhibitors to Lower LDL Cholesterol in a University Lipid Clinic Setting","authors":"A. Morise, Jennifer Tennant, S. Holmes, Danyel H Tacker","doi":"10.21885/wvmj.2020.2","DOIUrl":"https://doi.org/10.21885/wvmj.2020.2","url":null,"abstract":"Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have demonstrated significant lowering of low-density lipoprotein (LDL) cholesterol in patients with atherosclerotic cardiovascular disease (ASCVD) and familial hypercholesterolemia (FH). We retrospectively reviewed data concerning use of PCSK9 inhibitors from patients in our university-based adult lipid clinic. Data collected included clinical pre-treatment variables and pre-and post-treatment non-fasting lipid profiles. Of 165 candidates, 163 were approved for PCSK9 inhibition (90% ASCVD and 10% FH). A majority of patients (72%) had statin intolerance. Treatment was provided and assessed in 141 patients. After three doses of medications, LDL cholesterol fell from 170 + 58 mg/dL to 76 + 45 mg/dL (55%, P<0.001). There were no differences in efficacy according to sex, elevated lipoprotein(a), and the PCS-K9 inhibitor utilized. Continued efficacy was evaluated in 101 patients with LDL decreasing further from initial follow-up to long-term follow-up over an average of 14 months (74 ± 44 mg/dL to 68 ± 41 mg/dL). Permanent discontinuation of PCS-K9 inhibitor because of side effects occurred in 11% of patients. When strict adherence to guidelines was applied, >95% approval rate was obtained, and there was similar efficacy in LDL lowering to what has been previously reported irrespective of statin intolerance.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74632403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Though inter-facility acute care patient transfers from resource-limited rural hospitals are necessary, it is desirable to minimize them for several reasons. Some transfers might be potentially avoidable with appropriate pre-transfer teleconsultation. We conducted a retrospective record review of adult patient transfers to our rural academic medical center for medical-surgical services or critical care to estimate the frequency of potentially avoidable patient transfers and to identify any re-quested specialty that was more often associated withpotentially avoidable patient transfers. Excluded were patients transferred via trauma network or for obstetrics care. Transfers were judged potentially avoidable if resulting in live discharge within 48 hours without procedures or intensive care. We studied patient demographics and transferring facility characteristics.We examined 1,180 transfers between June 2016 and January 2017 and judged 21.6% (N=255) potentially avoidable. Transfers for Neurology consultation were 2.5 times (95% CI 1.2 -5.0) more likely to be avoidable relative to transfers for General Surgery. Neurology was the only specialty associated with a greater likelihood of potentially avoidable transfers than the comparator specialty.A significant proportion of inter-facility patient transfers to our facility are potentially avoidable. Neurology-related transfers might warrant pre-transfer teleconsultation.
虽然从资源有限的农村医院转送急诊病人是必要的，但出于几个原因，最好尽量减少这种情况。通过适当的转会前远程咨询，有些转会是可以避免的。我们对转到我们农村学术医疗中心接受内科外科服务或重症监护的成人患者进行了回顾性记录审查，以估计潜在可避免的患者转院频率，并确定任何与潜在可避免的患者转院更频繁相关的要求专科。排除通过创伤网络或产科护理转院的患者。如果在48小时内没有手术或重症监护的情况下出院，则认为转移可能是可以避免的。我们研究了患者人口统计学和转院设施的特点。我们研究了2016年6月至2017年1月期间的1180次转会，并判断21.6% (N=255)是可以避免的。神经内科会诊的转院是普通外科转院的2.5倍(95% CI 1.2 -5.0)。与比较专科相比，神经内科是唯一具有更大潜在可避免转移可能性的专科。很大一部分跨机构的病人转移到我们的机构是可以避免的。神经相关的转移可能需要转移前远程会诊。
{"title":"Potentially Avoidable Acute Care Patient Transfers to a Rural Academic Medical Center","authors":"D. Nair, M. Gibbs, T. Gress, Shawndra Barker","doi":"10.21885/wvmj.2020.3","DOIUrl":"https://doi.org/10.21885/wvmj.2020.3","url":null,"abstract":"Though inter-facility acute care patient transfers from resource-limited rural hospitals are necessary, it is desirable to minimize them for several reasons. Some transfers might be potentially avoidable with appropriate pre-transfer teleconsultation. We conducted a retrospective record review of adult patient transfers to our rural academic medical center for medical-surgical services or critical care to estimate the frequency of potentially avoidable patient transfers and to identify any re-quested specialty that was more often associated withpotentially avoidable patient transfers. Excluded were patients transferred via trauma network or for obstetrics care. Transfers were judged potentially avoidable if resulting in live discharge within 48 hours without procedures or intensive care. We studied patient demographics and transferring facility characteristics.We examined 1,180 transfers between June 2016 and January 2017 and judged 21.6% (N=255) potentially avoidable. Transfers for Neurology consultation were 2.5 times (95% CI 1.2 -5.0) more likely to be avoidable relative to transfers for General Surgery. Neurology was the only specialty associated with a greater likelihood of potentially avoidable transfers than the comparator specialty.A significant proportion of inter-facility patient transfers to our facility are potentially avoidable. Neurology-related transfers might warrant pre-transfer teleconsultation.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75394184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ankyloglossia is a common congenital anomaly, characterized by limited tongue mobility because of anatomical restriction by the lingual frenulum. The reduced tongue mobility has been associated with breastfeeding difficulty. Consensus on the functional effect of ankyloglossia is lacking and a small minority of pediatricians and otolaryngologists believe it affects feeding. A larger proportion of lactation specialists believe ankyloglossia contributes to feeding issues. Diagnostic assessment tools can guide the appropriateness of surgical correction in cases of ankyloglossia. Recent attention has been directed to the role of the maxillary frenulum in breastfeeding difficulty. We will review current literature on both topics with the aim to clarify when pediatric patients should be referred for appropriate surgical intervention.
{"title":"Oral frenula in newborns: When should you refer for evaluation and intervention?","authors":"T. Buchanan, Phillip R. Purnell, M. Carr","doi":"10.21885/wvmj.2020.1","DOIUrl":"https://doi.org/10.21885/wvmj.2020.1","url":null,"abstract":"Ankyloglossia is a common congenital anomaly, characterized by limited tongue mobility because of anatomical restriction by the lingual frenulum. The reduced tongue mobility has been associated with breastfeeding difficulty. Consensus on the functional effect of ankyloglossia is lacking and a small minority of pediatricians and otolaryngologists believe it affects feeding. A larger proportion of lactation specialists believe ankyloglossia contributes to feeding issues. Diagnostic assessment tools can guide the appropriateness of surgical correction in cases of ankyloglossia. Recent attention has been directed to the role of the maxillary frenulum in breastfeeding difficulty. We will review current literature on both topics with the aim to clarify when pediatric patients should be referred for appropriate surgical intervention.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90764745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-27DOI: 10.31525/ct1-nct04107909
R. Kusminsky, E. Tiley, T. Witsberger, J. Boland
In recent months, the technique of Laparoscopic Laser Cholecystectomy (LLC) was introduced at our institution. A small series is presented here involving 14 patients, seven of whom underwent LLC and seven in which a "mini-lap" cholecystectomy was performed. Symptomatic cholelithiasis was the indication for surgery in all cases, and operative cholangiograms were employed in 12 patients. Comparisons are made regarding length of hospitalization, recovery time and operative time. An improved recovery period is indeed demonstrated with LLC allowing return to normal activities and employment much sooner than with an open cholecystectomy. We suggest that, though some prudence and caution is advised, this appears to be a safe and feasible adjunct in the treatment of cholelithiasis.
{"title":"Laparoscopic cholecystectomy.","authors":"R. Kusminsky, E. Tiley, T. Witsberger, J. Boland","doi":"10.31525/ct1-nct04107909","DOIUrl":"https://doi.org/10.31525/ct1-nct04107909","url":null,"abstract":"In recent months, the technique of Laparoscopic Laser Cholecystectomy (LLC) was introduced at our institution. A small series is presented here involving 14 patients, seven of whom underwent LLC and seven in which a \"mini-lap\" cholecystectomy was performed. Symptomatic cholelithiasis was the indication for surgery in all cases, and operative cholangiograms were employed in 12 patients. Comparisons are made regarding length of hospitalization, recovery time and operative time. An improved recovery period is indeed demonstrated with LLC allowing return to normal activities and employment much sooner than with an open cholecystectomy. We suggest that, though some prudence and caution is advised, this appears to be a safe and feasible adjunct in the treatment of cholelithiasis.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"6 1","pages":"336-7"},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80629217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Danielson, MD, Ann Murray, MD, Kymberly A. Gyure, MD, Amelia Adcock, MD
The diagnosis of neurolymphomatosis can be highly challenging requiring a high index of suspicion. This paper discusses a clinical case and workup for secondary neurolymphomatosis. A patient with history of diffuse large B-cell lymphoma presented as an acute, ascending, progressive neuropathy mimicking acute inflammatory demyelinating polyradiculopathy with subtle differences. No response to intravenous immunoglobulins was seen though he had transient improvement after concurrent plasmapheresis and oral steroids. Extensive work-up eventually lead to a diagnosis of neurolymphomatosis by sural nerve biopsy. The patient was sent to hospice per family preference prior to initiation of the typical current treatment of chemotherapeutic agents. Neurolymphomatosis can present as a rapidly progressive neuropathy that can be diagnostically challenging, however, data is limited regarding treatment protocols. Multiple case reports suggest encouraging results from chemotherapy combinations which include high-dose methotrexate.
{"title":"An Atypical Case of Neurolymphomatosis","authors":"Laura Danielson, MD, Ann Murray, MD, Kymberly A. Gyure, MD, Amelia Adcock, MD","doi":"10.21885/WVMJ.2019.7","DOIUrl":"https://doi.org/10.21885/WVMJ.2019.7","url":null,"abstract":"The diagnosis of neurolymphomatosis can be highly challenging requiring a high index of suspicion. This paper discusses a clinical case and workup for secondary neurolymphomatosis. A patient with history of diffuse large B-cell lymphoma presented as an acute, ascending, progressive neuropathy mimicking acute inflammatory demyelinating polyradiculopathy with subtle differences. No response to intravenous immunoglobulins was seen though he had transient improvement after concurrent plasmapheresis and oral steroids. Extensive work-up eventually lead to a diagnosis of neurolymphomatosis by sural nerve biopsy. The patient was sent to hospice per family preference prior to initiation of the typical current treatment of chemotherapeutic agents. Neurolymphomatosis can present as a rapidly progressive neuropathy that can be diagnostically challenging, however, data is limited regarding treatment protocols. Multiple case reports suggest encouraging results from chemotherapy combinations which include high-dose methotrexate.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83578316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In most health care fields, outcomes are becoming increasingly scrutinized and may play a role in "pay for performance;" therefore, selecting the most appropriate outcomes measures for the populations being studied or treated has evolved into a key aspect of outcomes monitoring. One way to assess patient goals is to administer a "patient generated index" (PGI). The philosophical underpinning of the PGI is that the person living the life is the best judge of the quality of that life. The PGI has been utilized in low back pain, as well as in adult spinal deformity surgery, however, it has not been previously utilized in an Appalachian population. The PGI was administered by means of self-report to 80 new patients with back pain who presented for assessment in the neurosurgery clinic. Participants completed an acceptability survey and written comments as well as compliance were analyzed. Findings indicate that the PGI in its earliest form did not meet acceptable levels for use in this Appalachian subspecialist clinic setting. This study contributes to the growing body of knowledge on patient reported outcomes and more specifically, the importance of utilizing patient generated responses to map improvements in quality of life for patients over time.
{"title":"Using the \"Patient Generated Index\" in Spine Surgery in an Appalachian Population.","authors":"Patricia Dekeseredy, Robert Marsh, Cara L Sedney","doi":"10.21885/wvmj.2019.10","DOIUrl":"https://doi.org/10.21885/wvmj.2019.10","url":null,"abstract":"<p><p>In most health care fields, outcomes are becoming increasingly scrutinized and may play a role in \"pay for performance;\" therefore, selecting the most appropriate outcomes measures for the populations being studied or treated has evolved into a key aspect of outcomes monitoring. One way to assess patient goals is to administer a \"patient generated index\" (PGI). The philosophical underpinning of the PGI is that the person living the life is the best judge of the quality of that life. The PGI has been utilized in low back pain, as well as in adult spinal deformity surgery, however, it has not been previously utilized in an Appalachian population. The PGI was administered by means of self-report to 80 new patients with back pain who presented for assessment in the neurosurgery clinic. Participants completed an acceptability survey and written comments as well as compliance were analyzed. Findings indicate that the PGI in its earliest form did not meet acceptable levels for use in this Appalachian subspecialist clinic setting. This study contributes to the growing body of knowledge on patient reported outcomes and more specifically, the importance of utilizing patient generated responses to map improvements in quality of life for patients over time.</p>","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"115 3","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457017/pdf/nihms-1872762.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10165040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Davis, Troy Wallace, Christine Gilkerson, E. Saunders
Drug induced angioedema can be allergic or non-allergic depending on the specific mediators leading to the reaction. Allergic angioedema is due to histamine release and has a rapid onset including an urticarial rash that responds to antihistamines and glucocorticoids. Non-allergic angioedema is likely due to increases in bradykinin, and has a much slower onset without an urticarial rash; it only resolves with discontinuation of the offending medication. Mirabegron, a beta 3-adrenergic receptor agonist, is widely prescribed medication for urinary urge incontinence and overactive bladder. This case report presents a patient with angioedema following the use of mirabegron for urinary incontinence whose angioedema symptom had been previous misattributed. The history, clinical examination, and diagnostic parameters led to the diagnosis of mirabegron induced angioedema and she was successfully treated with discontinuation of the medication. Though rare, angioedema is a side effect of mirabegron and can be life-threatening. Therefore thorough history taking and a high index of suspicion are crucial to correlate relevant exposure and onset of symptoms and should be considered in all patients on the medication who have a consistent presentation.
{"title":"Drug-induced Angioedema: A Rare Side Effect of Mirabegron","authors":"H. Davis, Troy Wallace, Christine Gilkerson, E. Saunders","doi":"10.21885/wvmj.2019.5","DOIUrl":"https://doi.org/10.21885/wvmj.2019.5","url":null,"abstract":"Drug induced angioedema can be allergic or non-allergic depending on the specific mediators leading to the reaction. Allergic angioedema is due to histamine release and has a rapid onset including an urticarial rash that responds to antihistamines and glucocorticoids. Non-allergic angioedema is likely due to increases in bradykinin, and has a much slower onset without an urticarial rash; it only resolves with discontinuation of the offending medication. Mirabegron, a beta 3-adrenergic receptor agonist, is widely prescribed medication for urinary urge incontinence and overactive bladder. This case report presents a patient with angioedema following the use of mirabegron for urinary incontinence whose angioedema symptom had been previous misattributed. The history, clinical examination, and diagnostic parameters led to the diagnosis of mirabegron induced angioedema and she was successfully treated with discontinuation of the medication. Though rare, angioedema is a side effect of mirabegron and can be life-threatening. Therefore thorough history taking and a high index of suspicion are crucial to correlate relevant exposure and onset of symptoms and should be considered in all patients on the medication who have a consistent presentation.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82097975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：