As our elderly population represents an increasing percentage of the overall population, more healthcare resources are spent treating this population. One of the overlooked issues is substance use in this population and its complications. This population is often not forthcoming with psychoactive medical issues, yet many of them came into adulthood in a time when substance use was widespread. This article will discuss the epidemiology of this population, a case of substance-induced persecutory delusion and the availability of screening methods and treatment options.
{"title":"Substance-Induced Psychosis in the Geriatric Population: Overview on Screening and Treatment","authors":"Chloe Yeung, Joshua Raven, Abdul Brula","doi":"10.33181/13045","DOIUrl":"https://doi.org/10.33181/13045","url":null,"abstract":"As our elderly population represents an increasing percentage of the overall population, more healthcare resources are spent treating this population. One of the overlooked issues is substance use in this population and its complications. This population is often not forthcoming with psychoactive medical issues, yet many of them came into adulthood in a time when substance use was widespread. This article will discuss the epidemiology of this population, a case of substance-induced persecutory delusion and the availability of screening methods and treatment options.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48484219","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}
Oms-Iv Asma Ghafoor, Hamza Paracha, Dovrat Goldstein
Ingrown toenails are a common condition in general medicine and dermatology, and they occur when the nail curves inward and pierces the nail fold. Symptoms include pain in the affected toe, erythema and edema. The diagnosis is made clinically and, if left untreated, ingrown toenails can lead to infections and even cellulitis and osteomyelitis. Conservative treatments involve clipping on the spicule and topical antibiotics. However, the mainstay of treatment is matricectomy to reduce the recurrence rate. The risk of ingrown toenail development can be reduced by wearing proper footwear, keeping toenails cut straight and overall foot hygiene. Ingrown toenails can affect various patient populations but are more prevalent in males, young adolescents and pregnant patients. Risk factors include obesity, diabetes, improper toenail clipping and improper footwear. This review explores the clinical manifestations of ingrown toenails, along with their diagnosis and treatment, providing a concise review for physicians to accurately identify and effectively treat patients with ingrown toenails or their resultant complications.
{"title":"Ingrown Toenail Management","authors":"Oms-Iv Asma Ghafoor, Hamza Paracha, Dovrat Goldstein","doi":"10.33181/13035","DOIUrl":"https://doi.org/10.33181/13035","url":null,"abstract":"Ingrown toenails are a common condition in general medicine and dermatology, and they occur when the nail curves inward and pierces the nail fold. Symptoms include pain in the affected toe, erythema and edema. The diagnosis is made clinically and, if left untreated, ingrown toenails can lead to infections and even cellulitis and osteomyelitis. Conservative treatments involve clipping on the spicule and topical antibiotics. However, the mainstay of treatment is matricectomy to reduce the recurrence rate. The risk of ingrown toenail development can be reduced by wearing proper footwear, keeping toenails cut straight and overall foot hygiene. Ingrown toenails can affect various patient populations but are more prevalent in males, young adolescents and pregnant patients. Risk factors include obesity, diabetes, improper toenail clipping and improper footwear. This review explores the clinical manifestations of ingrown toenails, along with their diagnosis and treatment, providing a concise review for physicians to accurately identify and effectively treat patients with ingrown toenails or their resultant complications.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"31-34"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49582914","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":"The Rule of Three","authors":"DO David Abend","doi":"10.33181/13031","DOIUrl":"https://doi.org/10.33181/13031","url":null,"abstract":"","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"10-11"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42087541","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}
Perceived discrimination in medical settings remains prevalent within the U.S. health care system. However, the details of these experiences and their associations with perceived quality of care are not well understood. This study evaluates any potential difference in African Americans' systemic health care discrimination and Latinx perceived by African American and Latinx patients and physicians. The New England physician alumni from the University of New England College of Osteopathic Medicine were sent surveys. Two hundred fifty-one practicing physicians' responses to the 2018 study address their beliefs toward African Americans and Latinx' racism within the health care system. High scores indicate more significant perceived discrimination among these groups. Physicians have lower discriminatory belief scores across gender, patient racial distribution and specialty.
{"title":"Physician Beliefs Concerning Structural and Institutional Racism in Health Care","authors":"DO William Ciurylo, Carol A. Brenner, D. Thieme","doi":"10.33181/13032","DOIUrl":"https://doi.org/10.33181/13032","url":null,"abstract":"Perceived discrimination in medical settings remains prevalent within the U.S. health care system. However, the details of these experiences and their associations with perceived quality of care are not well understood. This study evaluates any potential difference in African Americans' systemic health care discrimination and Latinx perceived by African American and Latinx patients and physicians. The New England physician alumni from the University of New England College of Osteopathic Medicine were sent surveys. Two hundred fifty-one practicing physicians' responses to the 2018 study address their beliefs toward African Americans and Latinx' racism within the health care system. High scores indicate more significant perceived discrimination among these groups. Physicians have lower discriminatory belief scores across gender, patient racial distribution and specialty.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42677874","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}
Evidence confirms that children and adolescents can experience the whole spectrum of mood disorders and suffer from the significant morbidity and mortality associated with them. Effective treatment often relies on physicians developing advanced communication skills with their patients. Enhanced communication will help decipher the etiology of the patient’s depression and, in addition to serotonin-regulating medications, will optimize treatment. Osteopathic medicine offers an effective treatment model through osteopathic manipulative treatment (OMT) because of the inseparability of physical and mental health. Osteopathic medicine takes a holistic view in which somatic, visceral and psychological dysfunction are united. Thus, physicians who incorporate OMT into their practice will help treat psychopathologies, such as depression and its accompanying somatic dysfunctions. This paper discusses the epidemiology of depression, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) depression criteria, screening algorithms, current treatment protocols, osteopathic considerations to treating depression, and lastly, OMT and its role in treatment.
{"title":"The Osteopathic Approach to Treating Depression in Children and Adolescents","authors":"Oms-Iii Ravi Chinsky, Domin Chan","doi":"10.33181/13033","DOIUrl":"https://doi.org/10.33181/13033","url":null,"abstract":"Evidence confirms that children and adolescents can experience the whole spectrum of mood disorders and suffer from the significant morbidity and mortality associated with them. Effective treatment often relies on physicians developing advanced communication skills with their patients. Enhanced communication will help decipher the etiology of the patient’s depression and, in addition to serotonin-regulating medications, will optimize treatment. Osteopathic medicine offers an effective treatment model through osteopathic manipulative treatment (OMT) because of the inseparability of physical and mental health. Osteopathic medicine takes a holistic view in which somatic, visceral and psychological dysfunction are united. Thus, physicians who incorporate OMT into their practice will help treat psychopathologies, such as depression and its accompanying somatic dysfunctions. This paper discusses the epidemiology of depression, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) depression criteria, screening algorithms, current treatment protocols, osteopathic considerations to treating depression, and lastly, OMT and its role in treatment.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41869432","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}
Do Pgy Christine Feng, DO Pavel Kibrik, C. Castañeda, Face Gurdeep Singh
Introduction: Inhibitors of programmed cell death receptor (PD-1) and its ligand (PD-L1), such as nivolumab and pembrolizumab, confer anti-autoimmune activities and are therefore approved for anti-cancer therapy. Their mode of action removes autoimmunity checkpoints, thus increasing the risk of immune-related adverse events. Case Presentation: This report describes a clinical case of life-threatening diabetic ketoacidosis (DKA) in a patient after long-term nivolumab administration to treat primary central nervous system lymphoma (PCNSL). The patient presented to the emergency department (ED) with symptoms of fatigue, along with nausea and vomiting for two days; laboratory testing revealed significant hyperglycemia (glucose 673 mg/dL), elevated anion gap (>27), metabolic acidosis, ketonemia, glucosuria and ketonuria, findings of which were consistent with DKA. Given no personal history of diabetes mellitus or other autoimmune conditions and additional tests ruling out alternative causes, the patient was suspected of having newly-onset DKA secondary to nivolumab treatment. Management & Outcome: The patient was treated with fluids, electrolytes replenishments and insulin drip, which closed the anion gap and normalized electrolytes. She was transitioned to subcutaneous insulin. The patient recovered well and was discharged on Metformin and longacting insulin, with close follow-up with endocrinology and oncology. Discussion: Autoimmune endocrinopathies induced by checkpoint inhibitors for cancer treatment have been reported in the past. Newly-onset hyperglycemia and DKA are common autoimmunemediated side effects of checkpoint inhibitor uses in patients without prior history of diabetes mellitus. Clinicians should be aware to prevent this potentially life-threatening condition.
{"title":"New-Onset Diabetic Ketoacidosis Secondary to Nivolumab Therapy in a Patient with Primary Central Nervous System Lymphoma","authors":"Do Pgy Christine Feng, DO Pavel Kibrik, C. Castañeda, Face Gurdeep Singh","doi":"10.33181/13037","DOIUrl":"https://doi.org/10.33181/13037","url":null,"abstract":"Introduction: Inhibitors of programmed cell death receptor (PD-1) and its ligand (PD-L1), such as nivolumab and pembrolizumab, confer anti-autoimmune activities and are therefore approved for anti-cancer therapy. Their mode of action removes autoimmunity checkpoints, thus increasing the risk of immune-related adverse events. \u0000Case Presentation: This report describes a clinical case of life-threatening diabetic ketoacidosis (DKA) in a patient after long-term nivolumab administration to treat primary central nervous system lymphoma (PCNSL). The patient presented to the emergency department (ED) with symptoms of fatigue, along with nausea and vomiting for two days; laboratory testing revealed significant hyperglycemia (glucose 673 mg/dL), elevated anion gap (>27), metabolic acidosis, ketonemia, glucosuria and ketonuria, findings of which were consistent with DKA. Given no personal history of diabetes mellitus or other autoimmune conditions and additional tests ruling out alternative causes, the patient was suspected of having newly-onset DKA secondary to nivolumab treatment. \u0000Management & Outcome: The patient was treated with fluids, electrolytes replenishments and insulin drip, which closed the anion gap and normalized electrolytes. She was transitioned to subcutaneous insulin. The patient recovered well and was discharged on Metformin and longacting insulin, with close follow-up with endocrinology and oncology. \u0000Discussion: Autoimmune endocrinopathies induced by checkpoint inhibitors for cancer treatment have been reported in the past. Newly-onset hyperglycemia and DKA are common autoimmunemediated side effects of checkpoint inhibitor uses in patients without prior history of diabetes mellitus. Clinicians should be aware to prevent this potentially life-threatening condition.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"40-43"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42114612","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}
Do Mba Facoep Lindsay Tjiattas-Saleski, Oms-Iii Erik Krueger
{"title":"Facial Rash with Eye Swelling","authors":"Do Mba Facoep Lindsay Tjiattas-Saleski, Oms-Iii Erik Krueger","doi":"10.33181/13038","DOIUrl":"https://doi.org/10.33181/13038","url":null,"abstract":"","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"44-46"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47745750","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}
Do Mms Tina Chuong, Do Mph Karen Lazarus, DO Meera Shah
OFPs and other health care professionals experience increased rates of stress, anxiety, fatigue and burnout in the face of pandemics. Historically, this has been observed with other pandemics, such as the influenza pandemic, HIV/AIDS, SARS, H1N1, Ebola virus disease and, more recently, COVID-19. Research about physician wellbeing during prior pandemics has informed recent practices and provides more guidance on how larger health care entities can provide for employees and how physicians can care for themselves. Here, we explore best practices for emotional/spiritual wellbeing, physical wellbeing, maintaining a healthy family life and wellness during a virus outbreak.
{"title":"What the Past Has Taught Us: Best Practices for OFPs to Manage Stress During a Virus Outbreak","authors":"Do Mms Tina Chuong, Do Mph Karen Lazarus, DO Meera Shah","doi":"10.33181/13034","DOIUrl":"https://doi.org/10.33181/13034","url":null,"abstract":"OFPs and other health care professionals experience increased rates of stress, anxiety, fatigue and burnout in the face of pandemics. Historically, this has been observed with other pandemics, such as the influenza pandemic, HIV/AIDS, SARS, H1N1, Ebola virus disease and, more recently, COVID-19. Research about physician wellbeing during prior pandemics has informed recent practices and provides more guidance on how larger health care entities can provide for employees and how physicians can care for themselves. Here, we explore best practices for emotional/spiritual wellbeing, physical wellbeing, maintaining a healthy family life and wellness during a virus outbreak.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"27-30"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48427321","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}
Md Faap Facop Hanna S. Sahhar, DO Karly Derwitz, DO Erica Rubin
Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020 by the World Health Organization (WHO), there has been an emergence of a new syndrome termed multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. MIS-C is defined by the presence of fever, systemic inflammation and multiorgan dysfunction in association with SARS-CoV-2 infection or COVID-19 exposure. Knowledge of this syndrome’s presentation and pathophysiology is constantly evolving as more cases are reported in the literature. This case identifies a 3-month-old patient who tested negative for SARS-CoV-2 antigen, reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies but qualified for MIS-C diagnosis. To the best of our knowledge and through extensive research at the time of diagnosing and reporting this condition to the healthcare authorities, we report the youngest pediatric patient with MIS-C diagnosis. We document this case to contribute to further understanding the variable manifestations of MIS-C and the importance of early diagnosis and treatment with intravenous immunoglobulin (IVIG).
{"title":"Multisystem Inflammatory Syndrome in Infant with Negative SARS-CoV-2 RT-PCR and Antibodies","authors":"Md Faap Facop Hanna S. Sahhar, DO Karly Derwitz, DO Erica Rubin","doi":"10.33181/13036","DOIUrl":"https://doi.org/10.33181/13036","url":null,"abstract":"Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020 by the World Health Organization (WHO), there has been an emergence of a new syndrome termed multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. MIS-C is defined by the presence of fever, systemic inflammation and multiorgan dysfunction in association with SARS-CoV-2 infection or COVID-19 exposure. Knowledge of this syndrome’s presentation and pathophysiology is constantly evolving as more cases are reported in the literature. This case identifies a 3-month-old patient who tested negative for SARS-CoV-2 antigen, reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies but qualified for MIS-C diagnosis. To the best of our knowledge and through extensive research at the time of diagnosing and reporting this condition to the healthcare authorities, we report the youngest pediatric patient with MIS-C diagnosis. We document this case to contribute to further understanding the variable manifestations of MIS-C and the importance of early diagnosis and treatment with intravenous immunoglobulin (IVIG).","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49035823","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":"A Rare Cause of Dyspnea","authors":"Vinesha Patel Do, David Do","doi":"10.33181/13026","DOIUrl":"https://doi.org/10.33181/13026","url":null,"abstract":"","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"1 1","pages":"43-45"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43708584","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}
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