Thoracic outlet syndrome comprises a group of disorders that result in compression of the brachial plexus and subclavian vessels exiting the thoracic outlet. Symptoms include pain, paresthesia, pallor, and weakness depending upon the compromised structures. While consensus in diagnostic criteria has not yet been established, a thorough patient history, physical exam, and appropriate imaging studies are helpful in diagnosis. General first-line therapy for thoracic outlet syndrome is a conservative treatment, and may include physical therapy, lifestyle modifications, NSAIDs, and injection therapy of botulinum toxin A or steroids. Patients who have failed conservative therapy are considered for surgical decompression. This article aims to review the epidemiology, etiology, relevant anatomy, clinical presentations, diagnosis, and management of thoracic outlet syndrome.
Health Psychology Research ConclusionExisting studies provide promising results. However, additional high-quality data on vitamin D supplementation is needed before recommendations for pain management can be made. Vitamin D supplementation is inexpensive, has minimal side effects, and can benefit FM patients regardless of its efficacy in pain control. Additionally, high-quality studies are warranted to fully elucidate the potential of vitamin D to manage chronic pain in FM.
This a comprehensive review of the literature regarding the use of Valbenazine in treating tardive dyskinesia. A primarily oral movement disorder induced by chronic exposure to certain classes of medications, tardive dyskinesia is often resistant to many therapeutic approaches. This review presents the background, evidence, and indications for the use of Valbenazine as a treatment option for this condition. Recent FindingsTardive dyskinesia is a disorder arising from long-term exposure to medications that blocked dopamine receptors, primarily antipsychotics. It is characterized by abnormal movements of the oral-buccal-lingual structures as well as associated pain and hypertrophy. Simply stopping the use of the dopamine blocking agents effectively alleviates the symptoms but is not always reliable hence the need for another therapeutic approach.Valbenazine is thought to function as a highly selective inhibitor of the VMAT2 vesicular monoamine transporter resulting in decreased availability of dopamine in the presynaptic cleft. This leads to decreased dopaminergic activation of the striatal motor pathway. The FDA approved Valbenazine in 2017 to treat tardive dyskinesia in adults and needs to be evaluated with existing therapeutic approaches.
Introduction Medical student mental health and wellness has been an increasingly hot topic over the past decade. Much of the research, however, has remained focused more on anxiety and depression and less on other less common but just as detrimental mental health disorders such as PTSD, bipolar disorder, OCD and others. In addition to the more traditional psychological stresses medical students experience, they also experience physical consequences of their training, often with sleep patterns suffering most initially. Methods The questionnaire consists of thirty-five questions, compromising of demographic questions, questions relating to USMLE exams and education, the STOP-Bang Questionnaire, Epworth Sleepiness Scale, Fatigue Severity Scale and PTSD DSM-V Questionnaire. This survey was sent out between March and April of 2020 and was distributed to all medical students and residents with an LSU Health Shreveport email address via RedCAP, an encrypted electronic survey tool. Results A total of 78 participants responded to our survey, with 91.1% identifying as medical students and the rest as residents. 64.1%, identified as female, 34.6% identified as male and 1.3% declined to answer. While 43% of our participants found their educational experience emotionally traumatizing, 75% of them felt that preparing and/or taking USMLE exams was emotionally traumatizing. In regards the portions of our questionnaire that served as sleep disorder screening questions, the average score for the STOP-Bang was 1.48 (SD +/- 1.15) the average score for the ESS was 6.85 (SD +/- 4.72) and the average score for the FSS was 32.04 (SD +/- 11.99). It should be noted that, while the average score of the PTSD screening portion was 20.34 (SD +/- 17.47), 18 participants scored above 38, the minimum score needed to qualify for a PTSD diagnosis. Conclusion These results suggest some correlations that warrant further future study. It is worrisome that while less than half of our participants stated their educational experience as harrowing, 75% stated preparing for and/or taking these required exams was emotionally traumatizing. The possible connections suggested here between USMLE exams and an increase in fatigue, lack of motivation and PTSD symptoms urge us to look more closely at the impact of the USMLE. Support (if any):
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.