Holistic care means addressing the patient as a person; providing high-quality care by focusing on individual needs. Our goal is to implement a survey that quantifies the patients' physical, mental, and spiritual health to enable improvements in client-centered therapy in lower-limb amputees. For this, we worked with a 43-year-old Hispanic male with a medical history of insulin-dependent diabetes complicated by sequential lower limb amputations. The second amputation cost him his job and left him homeless. The patient was hospitalized after developing severe depression, to the point that he had command auditory hallucinations to kill himself. He was discharged back into the community after a three-week hospitalization. However, he was readmitted to the hospital a week later due to a resurgence of suicidal ideation. Our team engaged the patient using the "Holistic Health and Wellness Survey" of Raymond W. Smith, which we used to assess and address various domains of his mental, spiritual, and physical health. We were able to create obtainable goals for the patient for each category on which he scored low in the health and wellness survey. The patient's overall health and attitude improved substantially through his client-centered therapy, which addressed his quantified health needs; and he began to take an active role in developing short-and longterm goals that he found attainable as he adjusted to life as a double-amputee.This case illustrates the potential for improving client-centered therapy in lower-limb amputees. We believe that providers may benefit from implementing this health and wellness survey to better assess how to provide client-centered care for their patients.
BACKGROUND YouTube is a popular American video-sharing platform that has been accessible to the public since 2005. Previous studies have shown that YouTube is potentially beneficial to medical education, but the quality of videos still need to be determined. OBJECTIVE The goal of this study is to understand the quality of the YouTube videos by evaluating the characteristics of physicians and the total number of views on videos regarding fibromyalgia. METHODS The term “fibromyalgia” was searched on the YouTube search engine by relevance, the default setting. Information from the first 100 videos was analyzed. A search was performed on Scopus to determine the h-index and fibromyalgia-related publication for any physician who was featured in the videos. RESULTS Of the top 100 videos, there were 64 academic videos, 18 vlogs, 5 interview videos, and 13 miscellaneous videos. Out of the 64 academic videos, 30 physicians, 7 Doctors of Philosophy (Ph.D.), 5 physical therapists, and 5 chiropractors were identified. The majority of physicians have adequate academic affiliation such as h-index and academic publications. CONCLUSIONS Residents and medical students will encounter a large number of academic videos on fibromyalgia on YouTube. This study suggests that many videos were posted for academic purposes and that the quality of the videos can be ensured to some degree. However, developing a better systemic evaluation of the quality of YouTube content is still necessary.
BACKGROUND YouTube is a popular American video-sharing platform that has been accessible to the public since 2005. Previous studies have shown that YouTube is potentially beneficial to medical education, but the quality of videos still need to be determined. OBJECTIVE The goal of this study is to understand the quality of the YouTube videos by evaluating the characteristics of physicians and the total number of views on videos regarding fibromyalgia. METHODS The term “fibromyalgia” was searched on the YouTube search engine by relevance, the default setting. Information from the first 100 videos were analyzed. A search was performed on Scopus to determine the h-index and fibromyalgia-related publication for any physician who was featured in the videos. RESULTS Of the top 100 videos, there were 64 academic videos, 18 vlogs, 5 interview videos, and 13 miscellaneous videos. Out of the 64 academic videos, 30 physicians, 7 Doctors of Philosophy (Ph.D.), 5 physical therapists, and 5 chiropractors were identified. The majority physicians have an adequate academic affiliation such as h-index and academic publications. CONCLUSIONS Residents and medical students will encounter a large number of academic videos on fibromyalgia on YouTube. This study suggests that many videos were posted for academic purposes and that the quality of the videos can be ensured to some degree. However, developing a better systemic evaluation of the quality of YouTube content is still necessary.
BACKGROUND YouTube is a popular platform with many videos which have potential educational value for medical students. Due to the lack of peer review, other surrogates are necessary to determine the content quality of such educational videos. Few studies have analyzed the research background of the physicians associated with the production of YouTube videos for medical education. The research background of those physicians may be a reflection of the content quality of these educational videos. OBJECTIVE This study identifies physicians associated with the production of educational YouTube videos about shingles and analyzes the physicians based on their research background. METHODS Using the YouTube search engine with default settings, the term “shingles” was searched on May 8, 2020. A cross-sectional study was performed using the first 50 search results. A search on Scopus for each identified physician was performed and data regarding their research background was recorded. RESULTS Of the 50 YouTube videos, 35 (70%) were categorized as academic. From the academic videos, 24 (71%) featured physicians totaling 25 physicians overall. Five physicians (20%) had at least 1 shingles-related publication. Eight physicians (32%) had an h-index >10. Twenty-one physicians (84%) held an academic affiliation. CONCLUSIONS These results ensure to a certain degree the quality of the content in academic videos on YouTube for medical education. However, more evaluation is needed for this growing platform.
Patient: Female, 31-year-old Final Diagnosis: Central diabetes insipidus Symptoms: Polydipsia • polyuria Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: Nephrogenic diabetes insipidus is a well-known adverse effect of lithium use. Albeit rare, there have also been documented cases of central diabetes insipidus (CDI) associated with lithium use. Case Report: A 31-year-old woman with a past medical history of bipolar disorder, managed with lithium 300 mg by mouth every day for 3 years, was assessed for a 1-year history of polyuria with accompanying polydipsia. During her initial hospital stay, her estimated urine output was more than 4 L per day. Initial labs showed elevated serum sodium (149 mmol/L; reference range 135–145), elevated serum osmolality (304 mOsm/kg; reference range 275–295), urine osmolality of 99 mOsm/kg (reference range 50–1200), and urine specific gravity (1.005; reference range 1.005–1.030). Lithium was at a subtherapeutic level of 0.05 mEq/L (reference range 0.6–1.2). Magnetic resonance imaging of the brain revealed no abnormalities of the pituitary gland. Two different occasions of desmopressin administration resulted in >50% increase in urine osmolality, confirming the diagnosis of CDI. Common causes of CDI, including trauma, tumors, and familial CDI, were ruled out and chronic lithium use was determined as the most probable cause for the patient’s CDI. Conclusions: CDI in the background of chronic lithium use is rarely reported. We present this case to consider CDI as a differential diagnosis when evaluating polyuria and hypernatremia in patients with long-term lithium use. These presentations warrant the consideration of both types of diabetes insipidus in the differential diagnoses.
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