How successful is nonsurgical treatment of obesity? Evidence suggests that nonsurgical treatment (diet/behavior modification, exercise programs, and psychological support) for morbid obesity has a > 90% long-term failure rate. Pharmacologic therapy for morbid obesity, although improving, has been hampered by serious side effects, lack of insurance coverage, and, overall, disappointing results.
How common is obesity? Obesity is simply defined as the excess of body fat. The degree of body fat relative to weight is calculated by the body mass index (BMI; kg/m 2 ). Overweight is a BMI 25.0 to 29.9 kg/m 2 ; obesity is a BMI ≥ 30 kg/m 2 ; morbid obesity is a BMI ≥ 40 kg/m 2 . Increasing …
What causes of abnormal mental status are particularly life threatening? The list includes epidural hematoma, cerebral edema, brain neoplasms, cerebral infarctions, CSF shunt malfunction, meningitis, encephalitis, toxic ingestions, carbon monoxide poisoning, hypotension, hypoxia, and sepsis. Sources Nelson DS: Coma and altered level of consciousness. In Fleisher G, Ludwig S, Henretig FM (eds): Textbook of Pediatric …
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What subtle signs may represent seizure activity as the cause of AMS? Suspect seizure if the patient is dazed or confused and exhibits staring, swallowing, eye blinking, lip quivering, nystagmus, and automatisms (motor actions performed without conscious intent). The degree of neurologic impairment can fluctuate over time. Sources Benson PJ, Klein EJ: New-onset absence status …
Can children presenting with abnormal mental status just be observed? The only common situation when a child with AMS can be observed is when they are in the postictal period from a recent seizure. Otherwise, children presenting with AMS due to trauma, illness, known toxic ingestions, or undefined reasons almost always need laboratory or radiographic …
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Clues to Causes of Altered Mental Status DPT Dehydration, poisoning, trauma OPV Occult trauma, postictal or postanoxia, ventriculoperitoneal shunt HIB Hypoxia or hyperthermia, intussusception, brain masses MMR Meningitis or encephalitis, metabolic, Reye’s syndrome + other rarities Sources Schunk JE: The pediatric patient with altered level of consciousness: Remember your “immunizations.” J Emerg Nurs 1992;18:419-421.
What scales are in use to quantify altered mental status? The level of consciousness of a neurologically impaired patient may initially be evaluated by using a simple AVPU scale, representing four major levels of alertness: alert (A), responsive to verbal stimuli (V), responsive to painful stimuli (P), and unresponsive (U). A more widely used measurement …