Thursday, August 17, 2017

What You Should Know about an Abdominal Paracentesis


  A physician specializing in internal medicine, Dr. Rex Mahnensmith has been caring for patients for 40 years. In his practice, Dr. Rex Mahnensmith has performed numerous procedures, including abdominal paracentesis. 

Abdominal paracentesis, also known as an abdominal tap, is a procedure performed to remove excess fluids from a patient’s abdominal cavity. The fluid, usually referred to as ascites, should not normally be in the abdomen. It may be caused by cirrhosis of the liver, kidney disease, bowel damage, an infection, or pancreatitis. Left unchecked, the fluid can cause pain, bloating, and breathing problems. 

An abdominal paracentesis can be performed in a hospital emergency room, a doctor's office, or in an operating room. It is a relatively short procedure, depending on the amount of fluid being removed. Before the procedure is performed, a patient should inform the doctor of any pre-existing allergies or medication being taken, especially anti-inflammatory or blood thinning medication. A blood test may be performed prior to the procedure. 

During the procedure, the patient lies on a bed facing upward. The doctor starts by shaving and cleaning the abdominal area before applying a local anesthetic to numb the pain. The doctor will then make an incision in the skin and insert a needle one or two inches into the opening. The fluid is then removed through the syringe. After the fluid has been removed, the wound is stitched and dressed.

Wednesday, July 12, 2017

Diabetes Drug Shows Potential in Chronic Kidney Disease




As an internal medicine physician at StayWell Health Center in Waterbury, Connecticut, Dr. Rex Mahnensmith draws on a background that includes fellowship training in nephrology. Also a former chief of nephrology at Miriam Hospital, Dr. Rex Mahnensmith continues to focus on the needs of patients with chronic kidney disease.

On June 12, 2017, pharmaceutical companies Eli Lilly and Boehringer Ingelheim (BI) officially announced their intent to investigate their existing product Jardiance as a potential treatment for chronic kidney disease. Jardiance is currently in use as a sodium-glucose co-transporter-2 (SGLT2) inhibitor, used to lower blood glucose levels in patients with type 2 diabetes.

The announcement follows data from a 2015 cardiovascular outcomes trial that indicated the potential of Jardiance to reduce the risk of cardiovascular fatalities by 38 percent. In 2016, Eli Lilly and BI released a new analysis of the same study that showed Jardiance's ability to reduce two key measures of kidney problems. 

The drug effectively reduced the progression of microalbuminuria, defined as excessively high levels of the protein albumin in the patient's urine. It also reduced doubling of the waste product creatinine, a process indicative of kidney decline, by approximately 44 percent. Furthermore, and perhaps most notably, the drug reduced the incidence of dialysis and other renal replacement therapies by 55 percent.

The June 12 announcement came with additional data to support the potential of Jardiance to slow the decline of kidney function, even in patients at high risk of kidney disease. Following this evidence, Eli Lilly and BI will start a large clinical outcomes trial that will involve approximately 5,000 patients with chronic kidney disease.

Lifestyle Recommendations for Prediabetic Patients

Primary care physician Dr. Rex Mahnensmith has provided patient-centered treatment and preventative care at hospitals and medical centers...