RESUMEN
This JAMA Patient Page defines obesity in adults and describes the health effects of obesity, the treatment options available, and the health benefits of weight loss.
Asunto(s)
Obesidad , Adulto , Humanos , Obesidad/complicaciones , Obesidad/etiología , Obesidad/psicología , Obesidad/terapia , Terapia Conductista , Ejercicio Físico/fisiología , Pérdida de Peso/fisiología , Dieta Saludable/métodos , Fármacos Antiobesidad/uso terapéuticoRESUMEN
This JAMA Patient Page describes polymyalgia rheumatica and its signs and symptoms, diagnosis, and treatment.
Asunto(s)
Polimialgia Reumática , Humanos , Glucocorticoides/uso terapéutico , Polimialgia Reumática/diagnóstico , Polimialgia Reumática/tratamiento farmacológico , Polimialgia Reumática/epidemiología , Arteritis de Células Gigantes/epidemiología , ComorbilidadAsunto(s)
Diabetes Mellitus Tipo 2 , Agonistas Receptor de Péptidos Similares al Glucagón , Insuficiencia Cardíaca , Hipoglucemiantes , Obesidad , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Péptidos Similares al Glucagón/uso terapéutico , Péptidos Similares al Glucagón/efectos adversos , Insuficiencia Cardíaca/etiología , Hipoglucemiantes/efectos adversos , Hipoglucemiantes/uso terapéutico , Obesidad/complicaciones , Obesidad/tratamiento farmacológico , Obesidad/cirugía , Agonistas Receptor de Péptidos Similares al Glucagón/efectos adversos , Agonistas Receptor de Péptidos Similares al Glucagón/uso terapéutico , Cirugía BariátricaRESUMEN
Diabetic striatopathy (DS) is an uncommon complication of diabetes characterized by hemiballismus-hemichorea, often accompanied by reversible striatal hyperintensity on neuroimaging. Diabetes is the most common metabolic cause of hemiballismus and hemichorea. However, it is underreported as clinicians do not always consider it in the diagnosis of new movement abnormalities. The prognosis is generally excellent, and management involves glycemic control and anti-chorea medications. We present a case of a patient with bilateral chorea and ballismus and classic MRI findings of DS, though his history of diabetes and substance use confounds the clinical picture of DS.
Asunto(s)
Corea , Humanos , Corea/etiología , Corea/diagnóstico , Corea/diagnóstico por imagen , Masculino , Imagen por Resonancia Magnética , Complicaciones de la Diabetes , Persona de Mediana EdadRESUMEN
This JAMA Patient Page describes strep throat, its signs and symptoms, diagnosis, treatment, and potential complications.
Asunto(s)
Faringitis , Infecciones Estreptocócicas , Streptococcus pyogenes , Humanos , Antibacterianos/uso terapéutico , Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Faringitis/etiología , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/etiología , Penicilinas/uso terapéuticoRESUMEN
This JAMA Clinical Guidelines Synopsis summarizes the 2023 American College of Gastroenterology guidelines on management of patients with acute lower gastrointestinal bleeding.
Asunto(s)
Hemorragia Gastrointestinal , Humanos , Angiografía , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Colonoscopía , Angiografía por Tomografía Computarizada , Embolización Terapéutica , Hemorragia Gastrointestinal/complicaciones , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Guías de Práctica Clínica como Asunto , Radiografía Intervencional , Medición de RiesgoRESUMEN
OBJECTIVES: In the United States, falls are the leading cause of fatal and nonfatal injuries for geriatric patients. With a growing aging population, medical trainees must gain experience with geriatric assessments, including fall risk and prevention. To the authors' knowledge, no prior studies have explored who most often initiates fall discussions between Internal Medicine (IM) residents and geriatric (age 65 years and older) patients. Our objective was to determine who most often initiates fall discussions between IM residents and geriatric patients and the barriers to having these discussions. METHODS: This 2023 quantitative needs assessment used surveys distributed to ambulatory geriatric patients, IM residents, and attending physicians within an urban IM resident continuity clinic. We used the Stopping Elderly Accidents, Death & Injuries assessment from the Centers for Disease Control and Prevention to determine patient fall risk. RESULTS: Response rates were 46%, 51%, and 67% for patients, residents, and attendings, respectively. Of the 39 patients who were assessed, 51% were at risk of falling. Eighty-seven percent of patients have had a fall discussion with their residents, and 59% reported these were resident initiated; however, 75% of 28 residents reported initiating fall conversations rarely, and all 4 attendings said that they started these discussions most of the time while staffing patients with residents. Modifiable resident-identified barriers to discussing falls included forgetfulness and lack of knowledge regarding completing a fall risk assessment. CONCLUSIONS: Most patients have conversations about falling with their physicians, but discrepancies exist regarding who initiates them. Data from this study suggest that attendings may be instrumental in starting these conversations. Reminder systems and fall risk didactic curricula may increase resident-initiated fall discussions.