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Author: V. Dimov, M.D., Cleveland ClinicReviewer: A. Aneja, M.D., Cleveland Clinic78 yo AAM with a PMH of DM2, CRI, HTN is admitted to the hospital with CC: confusion for several hours. Blood glucose was 40.He was given one amp. of D50 by the EMS and was admitted for a D10W drip and evaluation.Meds:Lasix, Glyburide, Avandia, ASA, PepcidPhysical exam:VS 36.5-80-14-153/83Chest, CVS, abdomen: WNLNeuro: AAO x 3, nonfocalLabwork: At baseline, BUN 25, Cr 2.3Final diagnosis:Hypoglycemia due to the combination of oral DM medications and CRI (low creatinine clearance).What happened?Patient had no further symptoms, his BS was stable, his PO meds were adjusted (Glyburide was stopped), and he was D/C’d home within 24 hours.Why are we presenting this case?During his hospital stay the nurse noted some c…

CONCLUSIONS: FPs in the CHR need to increase their comfort level toward opioids in general to adequately manage CNCP. Their lack of comfort may reflect a lack of education or fear of regulatory scrutiny. PMID: 15605133 [PubMed - indexed for MEDLINE] (Source: Pain Research and Management)

Authors: Meyerson J, Gelkopf M An out-of-body experience (OBE) is a unique dissociative event in which the person feels separated from his/her body. Studies and anecdotal reports have observed that this experience tends to appear spontaneously in stressful and hypnogogic situations. It often contributes to the person’s later having a new perspective of himself and his conception of the world, and may influence his functioning and behavior. Despite its potential as a powerful therapeutic lever in hypnotherapy, little has been written about applying OBE in this milieu. The current article describes three individuals who were contending with different therapeutic issues (i.e., symbiotic involvement, somatization, and cessation of therapy) for whom spontaneous OBE was used therapeutically …