The Journal of the Oklahoma State Medical Association最新文献

We present a case of priapism in a homeless patient with a psychiatric history of major depression, PTSD, polysubstance abuse (alcohol and cocaine) and past psychotropic medication use who was admitted to a local hospital for suicidal ideation. Priapism is a serious urological and a medical emergency which has often been associated with psychotropic medications (including the antidepressant trazodone), use of marijuana and alcohol, and other factors. This clinical case highlights the additive risks of medications and comorbid conditions in contributing to onset of priapism, emphasizing the importance of any pre-existing medical illness, diagnoses, and comorbid mental illnesses. Moreover, clinicians should consider potential side effects of all medications used and their drug interactions as they manage patients who develop this condition.

CONTEXT: Observed disconnect between patient knowledge and choice of anesthesiologist. OBJECTIVES: Assess opportunities to improve perceptions about anesthesiology as a profession, and for patient education on the scope of anesthesia practice. DESIGN: Prospective Study. SETTING: Academic institution and tertiary care hospital in Oklahoma, USA. PARTICIPANTS: 238 patients with a scheduled procedure involving general anesthesia were approached and consented before surgery. Minors, in-patients, pregnant women, prisoners, and non-native English speakers were excluded. Post-procedure, 156 of the consented patients were administered a verbal, eight-question survey in the post-operative are of the hospital. The other 82 patients who had originally consented to the study were excluded for various reasons detailed in the case report. INTERVENTIONS: Study was conducted through surveys over a seven-week period on random patients who consented to answer the survey questions. Main outcome measures: Study confirmed the hypothesis, but also brought out secondary findings. RESULTS: Of the 156 patients surveyed, 19 (12%) knew their anesthesiologist's name, and only 15 (9.6%) said that they knew anything about the anesthesiologist's practice or qualifications. T-test analysis comparing satisfaction with the whole hospital environment to other satisfaction questions showed satisfaction with surgeon, nursing staff, and anesthesiologist were all significantly higher than satisfaction with whole hospital environment (p < 0.05). All T-tests performed were two-tailed tests. CONCLUSIONS: Study indicates that patients know little about their anesthesiologists, and are unlikely to select their own anesthesiologist. Improving patients' knowledge about the anesthesiologists' roles and competencies might be accomplished by providing a list of names and specific practice competencies, or by having an online site of practice information easily accessible.

Throughout the healthcare industry fears of taking blood pressure in arm of patients who have undergone breast cancer surgery have been propagated for decades and continue to be recommended by multiple medical societies and healthcare organizations. However, these precautions are not well based on evidence-based medicine and may have a more historical and traditional basis. The purpose of this study was to review current evidence-based research as well as current guidelines regarding ipsilateral arm blood pressure measurements in women who have undergone breast surgery for cancer including lymph node removal.