All posts by doctorswithoutwaitingrooms

EMPOWERING PATIENTS THROUGH EDUCATION AND TELEMEDICINE

Neurology: What Are Cluster Headaches? (BMJ)

The prevalence of cluster headache is about one in 500. In people coming to a headache clinic, the prevalence is about 10%.

Cluster headaches are excruciating and incapacitating, and affect quality of life. Prompt diagnosis and treatment can make a big difference to the outcome – so it is vital that we get the diagnosis and management of this condition right.

In this BMJ Best Practice podcast on cluster headache, Kieran Walsh talks with Professor Amaal Starling, Associate Professor of Neurology at the Department of Neurology in the Mayo Clinic.

Further resources: clusterbusters.org/.

Sleep & Aging : What Can Be Expected? (Yale Medicine)

Yale Medicine (March 12, 2023) – As we age, are melatonin starts rising at an earlier hour in the night, thus we may tend to go to sleep earlier than when we were younger. We still require the same number of hours of sleep (7-9 hours on average), so we may also rise earlier. Our sleep is more likely to be disturbed by medical conditions, medications, or substance use.

Diverticulitis: Diagnosis And Testing (Mayo Clinic)

Mayo Clinic – Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms.

Your doctor will start with a physical examination, which will include checking your abdomen for tenderness. Women generally have a pelvic examination as well to rule out pelvic disease.

After that, the following tests are likely:

  • Blood and urine tests, to check for signs of infection.
  • A pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain.
  • A liver enzyme test, to rule out liver-related causes of abdominal pain.
  • A stool test, to rule out infection in people who have diarrhea.
  • A CT scan, which can identify inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment.

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Kidney Failure Reviews: The History Of Dialysis

Cleveland Clinic (March 9, 2023) – Nephrologist Sevag Demirjian, MD takes you through the history of dialysis and explain discoveries and innovations along the way.

What is dialysis?

Dialysis is a treatment for people whose kidneys are failing. When you have kidney failure, your kidneys don’t filter blood the way they should. As a result, wastes and toxins build up in your bloodstream. Dialysis does the work of your kidneys, removing waste products and excess fluid from the blood.

Who needs dialysis?

People who have kidney failure, or end-stage renal disease (ESRD), may need dialysis. Injuries and conditions like high blood pressurediabetes and lupus can damage kidneys, leading to kidney disease.

Some people develop kidney problems for no known reason. Kidney failure can be a long-term condition, or it can come on suddenly (acute) after a severe illness or injury. This type of kidney failure may go away as you recover.

There are five stages of kidney disease. In stage 5 kidney disease, healthcare providers consider you to be in end-stage renal disease (ESRD) or kidney failure. At this point, kidneys are carrying out around 10% to 15% of their normal function. You may need dialysis or a kidney transplant to stay alive. Some people undergo dialysis while waiting for a transplant.

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Reviews: Poor Nutrition Is #1 Cause Of Early Death

According to Stephen Kopecky, MD, a preventive cardiologist at the Mayo Clinic, “nutrition is now the number one cause of early death and early disease in our country and the world.” Moreover, he says that while having genes for disease will increase your risk by 30% to 40%, having a bad lifestyle for disease will increase your risk by 300% to 400%.

WebMD (March 7, 2023) – About 20 years ago, Kopecky says, the cause of death worldwide changed from infection to non-infection (like non-communicable diseases). “In those last 20 years, that’s grown in terms of what kills us and what gets us sick,” he says. “The three big non-communicable diseases are heart disease, cancer, and rapidly rising is Alzheimer’s. But there’s also diabetes, obesity, and high blood pressure — all those things are also related to diet.”

Forty-eight-year-old James, of Fredericksburg, VA, knows this all too well. James asked that his last name not be printed, to protect his privacy. For the last 30 years, he’s been managing type 1 diabetes and complications of insulin resistance, along with high blood pressure, high cholesterol, thyroid disease, and low testosterone. As a former Division 1 college athlete, James exercised regularly and ate what he believed to be a responsible diet.

Chronic Kidney Disease: New Medication Review

Mayo Clinic (March 6, 2023) – About 15% of adults in the U.S. are estimated to have chronic kidney disease — that’s about 37 million people.

What if those people could be treated with medication that could slow the progression of their disease, and help avoid the need for dialysis and kidney transplantation altogether?

Dr. Naim Issa, a Mayo Clinic transplant nephrologist says there is a class of medications to help people with chronic kidney disease that does just that. He says Mayo Clinic has been incorporating these medications to help patients for the last few years.

March 9 is World Kidney Day, a day aimed at raising awareness about the importance of the kidneys.

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Review: Psoriatic Arthritis Flare-Up Signs & Symptoms

“A psoriatic arthritis flare-up is a temporary worsening of symptoms of arthritis, which includes swelling, pain and stiffness in your joints,” explains Dr. Sapkota. “It can also include swelling of the whole toes or fingers due to the swelling of the ligaments around the joint. And sometimes, psoriasis, a skin rash, can worsen at the same time as your joints.”

Mayo Clinic – Symptoms of psoriatic arthritis flare-ups

It can be hard to predict when you may have a flare-up — and the degree of pain and discomfort can vary from person to person.

Psoriatic arthritis flare-up symptoms include:

  • Joint pain.
  • Joint swelling.
  • Joint tenderness.
  • Fatigue.
  • Difficulty moving.

How long do psoriatic arthritis flare-ups last?

A typical psoriatic arthritis flare-up can last anywhere from a few days to a week. It depends on the individual.

And it can vary on when you get them. You may experience flare-ups often, while others may not have them as frequently.

Bottom line? Psoriatic arthritis flare-ups can be unpredictable.

What triggers psoriatic arthritis flare-ups?

Causes of psoriatic arthritis flare-ups can include:

  • Stress and anxiety.
  • Obesity.
  • Smoking.
  • Alcohol.
  • Lack of activity.
  • Lack of sleep.
  • Diet.
  • Skipping psoriatic arthritis medication.
  • Certain medications like beta-blockers.

Lung Infections: Signs & Symptoms Of Pneumonia

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

Mayo Clinic – Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.

Symptoms

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.

Signs and symptoms of pneumonia may include:

  • Chest pain when you breathe or cough
  • Confusion or changes in mental awareness (in adults age 65 and older)
  • Cough, which may produce phlegm
  • Fatigue
  • Fever, sweating and shaking chills
  • Lower than normal body temperature (in adults older than age 65 and people with weak immune systems)
  • Nausea, vomiting or diarrhea
  • Shortness of breath

Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

When to see a doctor

See your doctor if you have difficulty breathing, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if you’re coughing up pus.

It’s especially important that people in these high-risk groups see a doctor:

  • Adults older than age 65
  • Children younger than age 2 with signs and symptoms
  • People with an underlying health condition or weakened immune system
  • People receiving chemotherapy or taking medication that suppresses the immune system

For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a life-threatening condition.

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