Spokane Medical Research

Urinary Tract Infections

Filed under: Health — Tags: , , — Rudolph @

We have a 5-month-old daughter who was diagnosed with a urinary tract infection at 2 months. At that time she was hospitalized and was treated with antibiotics. Since then, she has had another UTI, and received a renal scan and a voiding test. She has been on Septra for 6 months.

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The Behavior Chain

Filed under: Diet Food — Tags: , , — Rudolph @

After completing, weight was prepared for the second step—breaking the behavior into smaller parts. Although Sammy’s specific problem-behavior was eating candy bars, we used the behavior chain to see how eating candy bars consisted of many different events. Sammy was able to do this by describing the specific events, thoughts, and feelings he experienced before, during, and after eating candy bars. Sammy’s Behavior Chain is illustrated at the bottom of the page.

The behavior chain helped Sammy to make a specific plan. The idea behind the behavior chain is to look for places where a link can be broken. There may be many places where the chain can be broken, but it is best to choose a link that is realistic and more easily accomplished. For example, John could go to the store and not buy candy bars or he could buy one and save it for after dinner when he could enjoy it (rather than eating it quickly while driving). Although these are possible, they seem difficult given that John is already hungry. After reviewing his options, Sammy decided to break the behavior chain by eating an afternoon snack at a regular time each day. This would prevent him from being hungry on his way home and decrease the likelihood of impulse buying.

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Ankle Injury

Filed under: Muscle Relaxant — Tags: , , — Rudolph @

Ankle and foot injuries are common reasons for emergency department visits. When patients come to the emergency department with these injuries, they usually want an X-ray to make sure nothing is broken. Too many ankle and foot X-rays are ordered. Many times the physician can reliably determine, without an x-ray, but by a good patient history and physical exam, if a broken bone may be present.

The best studies on how to decide which ankle injuries may have a broken bone, and hence need an X-ray, were done by Dr. Stiell and others in Ottawa, Canada. Their well-known guidelines are called the “Ottawa Ankle Rules.” They are simple, and you can use them to help decide if you need to be seen for an ankle or foot injury. It’s helpful to know that the lateral malleolus is the bony bump on the outside of the ankle, and the medial malleolus is the bony bump on the inside.

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