Archive for May, 2021

Hip Pain in Children

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This is a lecture about causes of hip pain in children. It is mainly aimed to primary care physicains (pediatricians, family medicine, and emergency medicine). However, orthopedic surgeons will also find this lecture very useful to them. Other health care providers (nurse practioners, therapist, students) will also benefit from this lecture

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Last week, I had a pediatric patient come in with fever, cough, and nasal congestion for one month.

The patient was placed on amoxicillin and finished the antibiotic course three days prior. Now, he’s coming in complaining with the inability to bear weight on his left hip.

There’s a broad differential for the child presenting with hip pain. Much of it can be narrowed down using the history and the age of the child.

I like to further break down the pain into four categories:
1. Inflammatory
2. Infectious
3. Orthopedic
4. Neoplastic

Today, I want to talk about hip pain in the pediatric patient!

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This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
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Aromatherapy: How Essential are Essential Oils?

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Aromatherapy is a method of natural healing that uses plant extracts to improve our health and well-being. In this video we provide a general overview of aromatherapy providing the different types of essential oils, their health benefits, side effects and methods of application. This video highlights the research limitations of testing the efficacy of aromatherapy, and its uncertainty to cure illnesses. This video is meant to educate and help decide if aromatherapy is suitable for you.
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This video was made my McMaster Demystifying Medicine students Shilpa Tandon, Niki Sadat Afjeh, and Shefali Verma
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Copyright McMaster University 2020
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References:

Alammar N, Wang L, Saberi B, Nanavati J, Holtmann G, Shinohara RT, Mullin GE. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019 Jan 17;19(1):21.

Aromatherapy: Do Essential Oils Really Work?. John Hopkins Medicine. (2020). Retrieved October 3, 2020, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/aromatherapy-do-essential-oils-really-work

Elshafie, H. S., & Camele, I. (2017). An overview of the biological effects of some mediterranean essential oils on human health. BioMed research international, 2017.

Gali-Muhtasib, H. U., & Affara, N. I. (2000). Chemopreventive effects of sage oil on skin papillomas in mice. Phytomedicine : international journal of phytotherapy and phytopharmacology, 7(2), 129–136.

Hamidpour, M., Hamidpour, R., Hamidpour, S., & Shahlari, M. (2014). Chemistry, pharmacology, and medicinal property of sage (Salvia) to prevent and cure illnesses such as obesity, diabetes, depression, dementia, lupus, autism, heart disease, and cancer. Journal of traditional and complementary medicine, 4(2), 82-88.

Kulisic, T., Radonic, A., Katalinic, V., & Milos, M. (2004). Use of different methods for testing antioxidative activity of oregano essential oil. Food chemistry, 85(4), 633-640.
Lodhia, M. H., Bhatt, K. R., & Thaker, V. S. (2009). Antibacterial activity of essential oils from palmarosa, evening primrose, lavender and tuberose. Indian Journal of Pharmaceutical Sciences, 71(2), 134.

Lee, M. S., Choi, J., Posadzki, P., & Ernst, E. (2012). Aromatherapy for health care: an overview of systematic reviews. Maturitas, 71(3), 257–260.

Malcolm, B. J., & Tallian, K. (2017). Essential oil of lavender in anxiety disorders: Ready for prime time?. Mental Health Clinician, 7(4), 147-155.

Masaoka, Y., Takayama, M., Yajima, H., Kawase, A., Takakura, N., & Homma, I. (2013). Analgesia Is Enhanced by Providing Information regarding Good Outcomes Associated with an Odor: Placebo Effects in Aromatherapy?. Evidence-based complementary and alternative medicine : eCAM, 2013, 921802.

Michalak, M. (2018). Aromatherapy and methods of applying essential oils. Arch Physiother Glob Res, 22(2), 25-31.
NCI Dictionary of Cancer Terms. (n.d.). Retrieved October 23, 2020, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/aromatherapy
What are the benefits of aromatherapy?. Mayo Clinic. (June 6, 2020). Retrieved October 4, 2020 from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/aromatherapy/faq-20058566

Pain while sitting: a simple exercise to help your hip muscles

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Do you have hip pain while sitting for short or long periods of time? Matt shows a simple set of isometric exercises that you can use to put some more blood into your hip muscles and to retrain your muscles to keep your hips feeling a little more comfortable. This is one exercise in the FAI Fix.

In general, starting off with 2-3 sets of 5-10 should be fine, but as with any exercise, your mileage may vary!

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For the comprehensive self-help program targeting FAI-like hip issues, check out http://uprighthealth.com/the-fai-fix
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1) FAI bone shapes are common as anatomic variants and are not indicative of a disease.
•Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study. Link: http://europepmc.org/abstract/MED/25736918
•The prevalence of cam-type deformity of the hip joint: a survey of 4151 subjects of the Copenhagen Osteoarthritis study. Link: www.ncbi.nlm.nih.gov/pubmed/18415788

2) Cam and pincer impingement do not lead to arthritis.
•Predictors of progression of osteoarthritis in femoroacetabular impingement: a radiological study with a minimum of ten years follow-up. Link: http://www.ncbi.nlm.nih.gov/pubmed/19190047
•Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study. Link: http://www.ncbi.nlm.nih.gov/pubmed/23850552

3) Labral tears and other joint pathologies exist in high numbers in individuals without any pain or hip symptoms.
•Identification of acetabularlabral pathological changes in asymptomatic volunteers using optimized, noncontrast 1.5-T magnetic resonance imaging. Link: http://www.ncbi.nlm.nih.gov/pubmed/22422932
•The prevalence of acetabularlabral tears and associated pathology in a young asymptomatic population. Link: http://www.bjj.boneandjoint.org.uk/content/97-B/5/623.long

4) Surgery for FAI often fails to meet patient expectations.
Fulfilment of patient-rated expectations predicts the outcome of surgery for femoroacetabular impingement. Link: http://www.oarsijournal.com/article/S1063-4584(12)00988-0/abstract

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More FAI videos: https://www.youtube.com/playlist?list=PLfKNSz5BBcBH4lL9pn4XUX9ef0OyZPFtj

For more relevant material:
1) diagnostic criteria for FAI make no sense: http://uprighthealth.com/?p=7558
2) unreliability of x-rays and anterior hip impingement tests: http://uprighthealth.com/?p=7703
3) CAM impingement and supposed causation of arthritis: http://uprighthealth.com/?p=7784
4) What is arthritis really? http://uprighthealth.com/?p=7946
5) Prevalence of FAI in CT scans of young asymptomatic population: http://www.ajronline.org/doi/full/10.2214/AJR.12.8546
6) Is a Positive Femoroacetabular Impingement Test a Common Finding in Healthy Young Adults?: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676610/
7) Does FAI cause arthritis? This 2010 study gives a resounding NO: http://www.bjj.boneandjoint.org.uk/content/93-B/5/580.short
8) Does pincer impingement lead to arthritis? This study also says NO: http://www.ncbi.nlm.nih.gov/pubmed/23850552

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Understanding C. diff infection

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Clostridioides difficile (also known as Clostridium difficile or C. diff) is an infection caused by a type
of bacteria that make substances (toxins) that harm the gut. C. diff most often occurs in people who are on antibiotics or have been taking them recently. It is also common in patients who have been in a hospital or long-term care facility for some time. People ages 65 and older are at increased risk, as well. Learn more at https://gastro.org/practice-guidance/gi-patient-center/topic/clostridium-difficile-c-diff/.