Adult Services, Behavioral and Mental Health

Opioid use disorder treatment in the primary care setting

The landscape of opioid use disorder (OUD) treatment is evolving, with recent Drug Enforcement Administration regulation changes enabling physicians to treat patients without obtaining the X-waiver. This shift underscores the pivotal role primary care providers can play in addressing treatment gaps and offering care for patients with OUD. Understanding opioid use disorder: Definitions and diagnosis…

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Neuroscience, Pediatric Services

Pediatric migraine: A clinical guide for practitioners

Migraine affects 37 million men, women and children in the United States and ranks among the top 10 most disabling medical conditions, according to the World Health Organization. More than 90% of patients report that migraine interferes with education, career and social activities – making early recognition and treatment in pediatric populations particularly crucial. Paul…

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Adult Services, Neuroscience

Detecting early signs of Parkinson’s disease in a clinical setting

Early recognition of Parkinson’s disease requires health care providers to look beyond the classic tremor. Parkinson’s disease affects approximately 1 million people in the United States, with 90,000 new diagnoses each year. Despite its prevalence, early recognition remains challenging for health care providers. Parkinson’s disease is the most common neurodegenerative movement disorder, characterized by abnormal…

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Adult Services, Provider Wellness

Helping patients make lasting lifestyle changes

By focusing on small steps, physicians can help patients make meaningful, lasting improvements to lifestyle habits that contribute to chronic disease. Time constraints and patient resistance can make conversations about activity, diet, stress reduction and other improvements feel secondary. Even small, incremental lifestyle changes can lead to significant long-term improvements in health outcomes. The Small…

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Cardiovascular, Case Study, Pediatric Services

Case study: First in the region to place Impella RP Flex temporary ventricle support

The patient An 18-year-old male with a history of heart transplantation for cardiomyopathy after a durable ventricular assist device presented with progressive cardiac allograft vasculopathy (CAV) and severe diastolic graft failure. The patient presented to the cardiac intensive care unit after a recovered cardiac arrest in extremis with impending multiorgan failure. He initially underwent placement…

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Case Study, Neuroscience, Pediatric Services

Case study: Pediatric migraine patient with anxiety

Provider Team The patient The patient is a now 13-year-old girl with a history of anxiety and headaches dating back to approximately age 7, although she did not present to neurology until age 9. At that time, she was reporting approximately 15 out of 30 headache days per month and was meeting criteria for chronic…

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Neuroscience, Pediatric Services

Pediatric migraine management: Evidence-based approaches for clinicians

Pediatric migraine management requires a nuanced approach that differs significantly from adult protocols. While migraine affects up to 10% of children and adolescents, treatment decisions must account for developmental considerations, family dynamics and the substantial placebo effect observed in younger patients. This evidence-based guide synthesizes current best practices for clinicians managing pediatric migraine, from initial…

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Cardiovascular, Gastroenterology, Pediatric Services

Navigating the confluence: Gastrointestinal considerations in pediatric congenital heart disease within the medical home

Myocarditis represents a significant cause of morbidity and mortality in pediatric patients, yet its clinical presentation can be deceptively subtle. As inflammation of the heart muscle and conduction system, myocarditis affects the heart’s ability to contract effectively and maintain normal rhythm, potentially leading to sudden cardiac death even in previously healthy children. Epidemiology and risk…

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Adult Services, Gastroenterology, Oncology/Hematology

New guidelines aim to improve colonoscopy quality and cancer detection

Recent advances in colonoscopy techniques are helping physicians detect more colon cancers while reducing complications, according to updated medical guidelines that emphasize quality indicators and improved detection methods. William B. Evans III, M.D., gastroenterologist with Norton Gastroenterology Consultants of Louisville, presented the findings at a continuing medical education session, outlining key changes in how physicians…

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