Rhode Island medical journal (2013)最新文献

Cardiac Positron Emission Tomography (PET) can be used for the assessment of myocardial perfusion. Compared to other cardiac imaging techniques, notably Single Photon Emission Computer Tomography (SPECT), cardiac PET offers superior image resolution, higher accuracy, quantitative measures of myocardial perfusion, lower radiation exposure, and shorter image acquisition time. However, PET tends to be costlier and less widely available than SPECT due to the specialized equipment needed for generating the necessary radiotracers. Despite these challenges, PET has emerged as the preferred imaging modality for evaluating coronary artery disease due to its exceptional accuracy and broad applicability. Enhancing access to PET is anticipated to significantly improve the diagnosis and treatment of patients with cardiac conditions that might otherwise remain inadequately assessed.

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality worldwide. This review explores the evolving evidence base surrounding ASCVD prevention, particularly regarding nontraditional biomarkers, risk scores, and cardiovascular imaging modalities. Additionally, this review examines cardiovascular risk scores, including the PREVENT and MESA-CHD scores, which incorporate both traditional and nontraditional factors, thereby aspiring to offer a more equitable and precise risk assessment. Advances in cardiovascular imaging techniques, such as coronary artery calcium scoring and cardiac magnetic resonance imaging, are also discussed for their utility and potential. By integrating these advanced markers and imaging modalities, primary care clinicians can better identify and manage patients at risk, ultimately improving outcomes and reducing the burden of cardiovascular disease.

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.