The Journal of the Oklahoma State Medical Association最新文献_第3页

Identifying Differences in the Prevalence of Psychological Symptoms between Underweight, Normal Weight, Overweight, and Obese Children in Primary Care. 确定初级保健中体重不足、体重正常、体重超重和肥胖儿童心理症状发生率的差异。

The Journal of the Oklahoma State Medical Association Pub Date : 2018-10-01

Erin M Hawks, Marilyn L Sampilo, Ashley Weedn, Stephen R Gillaspy

{"title":"Identifying Differences in the Prevalence of Psychological Symptoms between Underweight, Normal Weight, Overweight, and Obese Children in Primary Care.","authors":"Erin M Hawks, Marilyn L Sampilo, Ashley Weedn, Stephen R Gillaspy","doi":"","DOIUrl":"","url":null,"abstract":"Background: The prevalence of childhood obesity continues to be a major public health problem. Nearly one-third of children in the United States can be classified as overweight or obese, which is particularly concerning given that obesity is associated with a number of physical and mental health problems. Past studies have examined childhood obesity and psychological symptoms using samples of referred children who have already been identified as overweight or obese, leaving out children who are classified as underweight or healthy weight. This study aims to bridge this gap in the literature by evaluating differences in psychological symptoms among children who fall within all weight ranges within primary care.Methods: Data was obtained from a systematic chart review using EMR (Electronic Medical Record) for children ages 6 to 16 years from two primary care health clinics. Differences between weight groups regarding reported internalizing and externalizing symptoms were evaluated utilizing data from the Pediatric Behavioral Health Screen (PBHS).Results: Significant overall psychological symptoms (internalizing and externalizing) were endorsed for 13.2% of the sample (p > .01). Chi-Square analyses determined that the relationship between internalizing symptoms and weight category were significant. Specifically, children who were classified as overweight or obese were more likely to report significant internalizing symptoms than underweight or healthy weight children.Conclusions: Children who fall into the overweight and obese weight categories may need to be screened for psychological symptoms and referred for mental health services following overweight/obese classification in primary care.","PeriodicalId":75127,"journal":{"name":"The Journal of the Oklahoma State Medical Association","volume":"111 8","pages":"802-805"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615746/pdf/nihms-1038205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37404250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Community Based Efforts to Address Infant Mortality and Disparities in Oklahoma. 以社区为基础的努力解决俄克拉何马州婴儿死亡率和差异。

The Journal of the Oklahoma State Medical Association Pub Date : 2018-10-01

Kathryn M L Konrad, Marny Dunlap, Paul H Patrick, Chad Michael Smith, Kelli McNeal, James Dorn

{"title":"Community Based Efforts to Address Infant Mortality and Disparities in Oklahoma.","authors":"Kathryn M L Konrad, Marny Dunlap, Paul H Patrick, Chad Michael Smith, Kelli McNeal, James Dorn","doi":"","DOIUrl":"","url":null,"abstract":"Importance: Oklahoma's infant mortality remains among the highest in the nation.1 Infant mortality rates are highest within the African American community.2 Physician and community partner efforts to decrease infant mortality are discussed to encourage more involvement in addressing infant mortality. The purpose of this article is to describe both provider and community-based efforts to combat infant mortality, particularly those focused on infant mortality disparities.Observations: The leading causes of infant deaths are prematurity, congenital malformations and/or chromosomal anomalies, and unclassified deaths such as Sudden Infant Death Syndrome or accidents. Prematurity accounts for the highest number of infant deaths. Efforts in Oklahoma focus on prematurity and SIDS prevention. Fetal Infant Mortality Review programs in Oklahoma and Tulsa Counties focus on local issues contributing to infant mortality and promote community engagement. In central Oklahoma, an Infant Mortality Alliance (IMA) was formed including over 180 stakeholders focusing on healthcare access, community and faith engagement, and health disparities. In the year following the IMA's initial work, the non-Hispanic African American infant mortality rate in Oklahoma County decreased by 18.8%.12.Conclusions and relevance: Infant mortality is multifactorial and requires multiple strategies to combat. To address infant mortality and disparities, all aspects of the community must be involved. No individual alone can improve infant mortality. Physicians providing prenatal care make an impact by implementing recommended guidelines for progesterone therapy. Physicians seeing infants can encourage safe sleep practices among their families and local hospitals. While progress has been made addressing Oklahoma's infant mortality, much work remains.","PeriodicalId":75127,"journal":{"name":"The Journal of the Oklahoma State Medical Association","volume":"111 8","pages":"762-766"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594563/pdf/nihms-1019345.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37366385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

THE OPIOID-EXPOSED NEONATE: A REVIEW OF THE OKLAHOMA EXPERIENCE. 暴露于阿片类药物的新生儿：回顾俄克拉荷马州的经验。

The Journal of the Oklahoma State Medical Association Pub Date : 2018-10-01

Kimberly D Ernst, Abhishek Makkar

引用次数: 0

Implementation of Reach Out and Read by Health Departments Increases Rural Access. 卫生部门实施的“接触和阅读”增加了农村人口的可及性。

The Journal of the Oklahoma State Medical Association Pub Date : 2018-10-01

Alexandria Caldwell, M Townsend Cooper, Marny Dunlap

{"title":"Implementation of Reach Out and Read by Health Departments Increases Rural Access.","authors":"Alexandria Caldwell, M Townsend Cooper, Marny Dunlap","doi":"","DOIUrl":"","url":null,"abstract":"Background: Reach Out and Read is an evidence based early literacy program used in primary care practices. In 2014, the program expanded to County Health Departments in Oklahoma.Objective: To evaluate how implementation of the program in Health Departments affects access for at risk children.Methods: Oklahoma program sites were classified as either Health Department or practice, geocoded, and mapped to census tract, census block group, and county subdivision maps. Sites were classified as rural or urban, and census data was used to classify sites as high or low poverty prevalence and education level. Sites were compared to determine their accessibility to at risk children as defined by living in rural areas, high poverty, and low educational level.Results: There were 18 Health Department and 67 practice sites. Health Department sites were more likely to be in rural areas: 13 of 18 sites versus 16 of 67 practices (p<0.001). They were less likely to be in areas of high poverty: 10 of 18 versus 61 of 67 practices (p<0.001), and they were not more likely to be in areas of lower education, with 8 of 18 sites in low education areas versus 34 of 67 practices (p=0.8342).Conclusions: Implementation of Reach Out and Read in Health Departments in Oklahoma increased the number of rural program sites. Health Department locations were less likely to be in areas of poverty and lower education. Use of the program in Health Departments is an effective way to expand the program to serve rural children.","PeriodicalId":75127,"journal":{"name":"The Journal of the Oklahoma State Medical Association","volume":"111 8","pages":"796-800"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615744/pdf/nihms-1038212.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37404249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overview of Pediatric Nonalcoholic Fatty Liver Disease: A Guide for General Practitioners. 小儿非酒精性脂肪肝概述：全科医生指南》。

The Journal of the Oklahoma State Medical Association Pub Date : 2018-10-01

Asiya K Shakir, Upma Suneja, Kevin R Short, Sirish Palle

{"title":"Overview of Pediatric Nonalcoholic Fatty Liver Disease: A Guide for General Practitioners.","authors":"Asiya K Shakir, Upma Suneja, Kevin R Short, Sirish Palle","doi":"","DOIUrl":"","url":null,"abstract":"Importance: Nonalcoholic fatty liver disease (NAFLD) is rapidly evolving into one of the most common pediatric liver diseases and currently is the most common cause for liver transplantation in young adults. Therefore, early recognition of risk factors, disease prevention, and diagnosis during childhood is paramount for effective management.Objective: The primary objective of this review is to discuss updated recommendations for screening, diagnosis and management of NAFLD. The secondary objective is to review the extent and impact of pediatric NAFLD in Oklahoma through our center's participation in a multi-center prospective study.Evidence review: We reviewed updated guidelines from the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), the approach used in our clinic and data from a multi-center collaboration on NAFLD, known as TARGET-NASH.Findings: Our review highlights that obese and Hispanic children are at greatest risk for developing NAFLD. Screening with ALT should be considered between ages 9-11 years for children with BMI more than the 95th percentile. Liver biopsy is the gold standard for diagnosis of NAFLD and currently lifestyle modification is the only effective therapy for management of NAFLD.Conclusion and relevance: All obese children, especially those who are Hispanics or have a family history of NAFLD should be considered for screening with serum ALT between the ages of 9 and 11 years. Children with ALT values that are elevated more than twice the upper limit of normal for more than 3 months must be referred to pediatric hepatology for timely evaluation.","PeriodicalId":75127,"journal":{"name":"The Journal of the Oklahoma State Medical Association","volume":"111 8","pages":"806-811"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625810/pdf/nihms-1038256.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37419858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In adults with osteoarthritis of the knee, is conservative management more effective than intra-articular corticosteroid injections in relieving pain? 对于成年膝关节骨关节炎患者，保守治疗是否比关节内皮质类固醇注射更能有效缓解疼痛?

The Journal of the Oklahoma State Medical Association Pub Date : 2018-08-01

Daniel F Jones, Jeffrey D Hodgden, Cheyn D Onarecker

引用次数: 0

Question: In men with risk factors for coronary artery disease, does initiating lipid screening earlier than 35 years of age reduce cardiovascular events? 问题：在有冠状动脉疾病危险因素的男性中，早于35岁开始进行脂质筛查会减少心血管事件吗？

The Journal of the Oklahoma State Medical Association Pub Date : 2018-03-01

Joshua Smith, Phillip McGhee, Nathan Nguyen, Philip Palmer

引用次数: 0

Clinical Question: In women with preterm labor, do repeated courses of prenatal corticosteroids improve neonatal outcomes compared to a single course? 临床问题:对于早产妇女，与单一疗程相比，重复的产前皮质类固醇疗程是否能改善新生儿结局?

The Journal of the Oklahoma State Medical Association Pub Date : 2018-01-01

Melanie Hutchinson, Jeffrey Dean Hodgden

引用次数: 0

In patients suspected of cognitive decline, what is the most accurate in-office screening instrument to determine if there is dementia needing further evaluation and management? 在怀疑认知能力下降的患者中，确定是否存在需要进一步评估和管理的痴呆的最准确的办公室筛查工具是什么?

The Journal of the Oklahoma State Medical Association Pub Date : 2017-09-01

Jamie Quitoriano, Robert M Hamm

引用次数: 0

Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women. SSRIs和SNRIs是否能降低更年期妇女潮热的频率和/或严重程度?

The Journal of the Oklahoma State Medical Association Pub Date : 2017-05-01

Chris Stubbs, Lisa Mattingly, Steven A Crawford, Elizabeth A Wickersham, Jessica L Brockhaus, Laine H McCarthy

{"title":"Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women.","authors":"Chris Stubbs, Lisa Mattingly, Steven A Crawford, Elizabeth A Wickersham, Jessica L Brockhaus, Laine H McCarthy","doi":"","DOIUrl":"","url":null,"abstract":"Clinical question: In menopausal women who experience regular hot flashes, does treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) reduce the frequency and/or severity of hot flashes?Answer: Yes. Review of the literature suggests that treatment with SSRIs or SNRIs reduces the frequency and severity of hot flashes in menopausal and post-menopausal women. Studies demonstrated that paroxetine (Paxil), citalopram (Celexa) and escitolapram (Lexapro) were the most effective SSRIs, and venlafaxine (Effexor) was the most effective first line SNRI, with desvenlafaxine as a second option. The most common side effects reported for both SSRIs and SNRIs are nausea and constipation, with most resolving within the first week of treatment. SNRIs have been associated with increased blood pressure in some patients and should be used with caution in women with hypertension. Women with a history of breast cancer and taking tamoxifen should avoid SSRIs, which have been shown to interfere with tamoxifen metabolism. SNRIs are the safest drugs for this population. Treatment choice should be patient-specific and begin with the lowest dose available.Level of evidence for the answer: A.Search terms: SSRI, SNRI, hot flashes, vasomotor symptoms, menopause.Search conducted: August 2014, February 2016 and August 2016.Inclusion criteria: menopausal, perimenopausal or postmenopausal women 18 years of age or older with frequent and/or severe vasomotor symptoms, meta-analyses, systematic reviews, randomized controlled trials, cohort studies.Exclusion criteria: pre-menopause, anxiety, depression, panic disorder, bipolar disorder, co-morbid conditions.","PeriodicalId":75127,"journal":{"name":"The Journal of the Oklahoma State Medical Association","volume":"110 5","pages":"272-274"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5482277/pdf/nihms828836.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35119710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0