Rhode Island medical journal (2013)最新文献

Immune checkpoint inhibitors are increasingly used in the treatment of a number of malignancies and carry a known risk of immune-related adverse events (irAEs). IrAEs cover a broad range of affected organ systems and presenting symptoms. While the gastrointestinal system is a commonly affected system, isolated gastritis is an uncommon diagnosis. We present a patient with isolated ICI-related gastritis presenting with concomitant intussusception caused by the anti-programmed cell death-1 antibody, pembrolizumab.

The treatment for Functional Neurological Disorder (FND) is complex and often includes a multidisciplinary approach. One core intervention is the psychological approach through therapy, typically drawing on evidence-based practices and incorporating biopsychosocial themes. This article highlights components of the psychological approach that are integral to treatment. While therapeutic concepts are explained in the context of treatment at the Hasbro Children's Partial Hospital Program, they are applicable to any setting. This article will review the importance of psychoeducation and the importance of language and messaging when talking with patients and families. Additionally, key concepts of emotional expression and distress tolerance, which are central to psychological treatment, are discussed. Finally, this article highlights the role of the family and the integral part it plays in the treatment for FND.

Functional neurological disorder (FND) is a common diagnosis of varied neuropsychiatric symptoms presenting to pediatric healthcare settings, including primary, urgent and subspecialty care. A key diagnostic shift appearing in the DSM-V is that FND is no longer a diagnosis of exclusion; rather, a rule-in diagnosis based on suggestive elements of symptom presentation. This article reviews diagnostic criteria, clarifying features, risks, and prognostic factors. This is the first in a series of six articles on FND and will introduce an FND case that will be examined in each subsequent article in the context of their more specific subject matter.

Functional Neurological Disorder (FND) is a common condition encountered by rehabilitation therapists (physical therapists-PT, occupational therapists-OT, and speech and language pathologists-SLP) in pediatric practice. In an effort to bridge the knowledge and experience gap, PT, OT and SLP experts have published consensus recommendations for the rehab therapist's treatment of FND1-3 with additional research emphasizing a psychologically informed4,5 and wellness approach.6 This article highlights the unique role of each rehab discipline in treating FND, reviews functional diagnoses specific to PT, OT and SLP, and introduces a unique stepwise or ladder approach to treatment that can be utilized in the inpatient or outpatient setting.

Functional Neurological Disorder (FND) can significantly impact school functioning. Symptoms may affect children and adolescents academically, socially, psychologically, and impact school attendance. This article reviews the importance of being able to continue in school despite FND symptoms and recommendations to support this. It will provide a guideline for communication and collaboration with schools and describe the type of information that is helpful to share with school teams. This article will also discuss various accommodations that can be helpful in the school setting. Finally, other resources, such as IEPs and 504 Plans as well as additional sources of information and support are briefly reviewed.

Early adversity is a major contributor to psychiatric conditions and poor physical health that burden individuals and groups across Rhode Island, the United States, and globally. We established a Center of Biomedical Research Excellence (COBRE) for Stress, Trauma, and Resilience (STAR) at The Miriam Hospital to identify mechanisms linking early adversity and health, to curtail detrimental consequences of stress and trauma, and promote resilience. The STAR COBRE is a vibrant regional and national hub for transformative research to elucidate and mitigate the lasting imprint of stress and trauma across the lifespan. We have a focus on reducing health inequities among historically marginalized families including those living in poverty and from underrepresented racial and ethnic communities. A cornerstone of the STAR COBRE is fostering an inclusive community to support the advancement of a diverse group of early career researchers to emerge as leading independent investigators conducting cutting-edge STAR research.

Background: Micromobility devices like e-scooters have become popular for short trips. Providence, Rhode Island, introduced these devices in 2018. We examine non-fatal injury trends and ED care costs for micromobility-related injuries in Rhode Island (RI) from 2016 to 2021.

Methods: Data were obtained from the Healthcare Cost and Utilization Project (HCUP) and the RI State ED Databases (SEDD). Using ICD-10 codes, we identified micromobility-related injuries. The analysis spanned two waves: pre-implementation (2016-2018) and post- implementation (2019-2021). Poisson regression was performed on age-adjusted rates of micromobility injuries to evaluate change over time.

Results: From 2016 to 2021, micromobility-related ED visits rose 600%. Bicycle injuries decreased by 20%, while pedestrian and motor vehicle injuries increased by 9% and 13%, respectively.

Conclusion: The dramatic rise in micromobility- related injuries reflects their growing usage and the associated risks. Micromobility offers benefits and challenges for cities. Safety measures are crucial for their safe, sustainable use.

Traumatic injury remains a significant public health problem, with the burden highest in low-middle income countries (LMICs) and rural areas.1,2 The far-western region of Nepal, which has the lowest human development index in the country, has a high burden of traumatic injuries.3-5 One hospital in the far-western district of Achham, Bayalpata Hospital, cares for the majority of patients with traumatic injuries - most of whom arrive without any pre-hospital care. The absence of a professionalized pre-hospital program, such as an established Emergency Medical Services (EMS) system, necessitates creative strategies to address this gap.6,7 In this context, implementing a trauma-training program for community health responders (CHRs) offers a promising solution, leveraging local resources to improve early-stage trauma care.