Efficacy, effectiveness, and safety of herpes zoster vaccines in adults aged 50 and older: systematic review and network meta-analysis  Systematic review and meta-analysis of  RCTs adults aged 50 and older. Over 2 million patients were included in the study The 27 studies were published between 1998 and 2017: nine in North America (33%), five in Europe (19%), two in Asia (7%), and 11 across several geographical regions (41%) (table 2, also see appendix S7). Twenty three of the trials were conducted across multiple study centers (74%) and 22 studies used a randomized controlled trial study design (81%). The average study …

During my site evaluation, I presented two H&Ps, a journal article and drug cards. One patient I presented came to the clinic following up on a wrist and hand injury. The patient sustained the injury while working as an American Airlines Agent, and has unfortunately been out of work since June. She received steroid injections for continued pain with no relief. My site evaluator and I discussed her case in detail and other examples of worker’s compensation related scenarios. My journal article discussed the herpes zoster vaccine and compared the effectiveness and safety of the live attenuated vaccine versus the …

During this rotation, I was able to strengthen my musculoskeletal knowledge and how to approach those injuries as a PA. My rotation site was located at CitiMed in JFK, and this clinic mostly saw patients with work-related injuries, injuries outside of work, DOT physicals and employment physicals. This clinic also employed Pain Management MD/PAs, orthopedics MD/PAs, Physical Therapists, chiropractors and acupuncturists, which was great to work in collaboration with. Each day, I was assigned my own room where I was able to conduct thorough histories and physicals on my own patients. Afterwards, I would present the patient to my preceptor …

During my first site visit, I presented a patient who was admitted to the psychiatric ER for suicidal ideations. This young woman was an overwhelmed individual who found it difficult to adjust to situations surrounding COVID, a loss of a job, and breakup with a long-term boyfriend. I found this case particularly interesting because I was able to understand how she was feeling and could even relate some of my feelings and worries surrounding all these unknowns. The PA and I discussed the importance of talk therapy and staying in touch with loved ones during this time, and how it …

Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial This study examined if brain activity is associated with treatment response to CBT (cognitive behavioral therapy) in adolescents and adults with OCD. This was compared to a control group (stress management therapy).  This was a RCT of 87 participants. 42 were assigned to CBT and 45 were assigned to SMT. Patients were required to have an early age at symptom onset (<15 years) and moderate or greater levels of symptoms at baseline – score >16 on either the standard or the Children’s version of …

tally (1)

H&P 1 CC: Suicidal Ideations and Depression HPI 31 y/o female with no PMH and no past psych history brought in by EMS for questionable suicide attempt with cyclobenzaprine. EMS was called by the patient’s work counselor who was told she took 8-10 pills of cyclobenzaprine on Sunday so she could “sleep for a long time” because she “didn’t want to deal with life”. Prior to taking pills, she states she was coming home from a work trip and felt anxious and heart palpitations, which prompted her to call her counselor 2 days later on Tuesday. Pt stated she has …

Overall, this rotation was a great learning experience. This rotation definitely presented as a challenge at first. I found it particularly difficult to interview patients who were acutely psychotic and not in touch with reality since it was hard to follow their thought process. Although this was challenging at first, it became easier to establish a rapport with them after being stabilized in the Psychiatric ER. My perspective on psychiatric patients changed as a result of this rotation. There is sometimes a negative stigma that occurs with patients who have mental health issues. However, you realize that all these patients …

obgynTYPHON

H&P 1 CC: vaginal bleeding x6 weeks. HPI AL is a 43 y/o female G4P3013 with a history of abnormal uterine bleeding presenting today with vaginal bleeding. Patient underwent vaginal myomectomy 6/15/2020 for an aborting leiomyoma. Procedure was complicated by heavy vaginal bleeding 2 days later which prompted her to go to the ER and received 3UPRBC. A total vaginal hysterectomy was discussed with the patient prior as a possible treatment option. States she has had mild spotting daily since after the transfusion using 2 pads per day and takes iron three times daily. Denies any pain, passage of clots, …