David Impastato, MD, Author at Physical Medicine and Rehabilitation Qbank Review

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So far David Impastato, MD has created 29 blog entries.

Gabapentin – Worsening the opioid crisis?

Gabapentin - Worsening the opioid crisis? PM&R News • April 2018 Another one bites the dust! Opioid related deaths are increasing substantially throughout the United States. A lot of resources are being put into studying this increase and how to improve pain control without opioids. Gabapentin has been a common drug used to treat pain while trying to decrease opioid burden due to its’ safe side effect profile. A recent study, took a look at the co-use of gabapentin while on opioids and the risk of opioid related overdose. The study looked at individuals who died of an opioid related cause and compared [...]

Gabapentin – Worsening the opioid crisis?David Impastato, MD2018-04-25T03:50:53+00:00

ABPMR Part I Study Plan

Part I Study Plan PM&R News • April 2018 Part I is around the corner and there is no better time than now to put together your study plan! The upcoming months are going to be busy and stressful with moving for a new job/fellowship, preparing for that job/fellowship, and trying to cram in as much studying for Part I as possible. First off, take every opportunity to learn from your patients over the next 4 months as there is no better way to learn than from patient experience. Secondly, examine your SAE results to determine areas you are weak in so you [...]

ABPMR Part I Study PlanDavid Impastato, MD2018-06-18T02:32:01+00:00

“I just want to walk normally!”

Can you improve his gait? PM&R News • March 2018 A 63-year-old male comes from his rural home to your big city practice with a chief complaint of "I just want to walk normally again!". You learn that he had a traumatic tractor accident 5 years ago which resulted in a left below the knee amputation. He was fitted with a transtibial prosthesis but has never really been happy since it was fitted. He received a polycentric hydraulic swing/stance control device but has loss of balance often with heel contact of the prosthetic limb. He often feels he is walking on a tight [...]

“I just want to walk normally!”David Impastato, MD2018-03-15T19:21:55+00:00

How are you annual eval’ing?

How are you annual eval'ing? PM&R News • March 2018 The annual evaluation for patients with spinal cord injury (SCI) was a groundbreaking service that led to the decrease in mortality for these patients. Gone are the days where the leading cause of death in long term spinal cord injury was kidney disease, however, are the recommendations perfected yet? In this study by Skelton et al, they evaluate whether routine urine testing at the annual evaluation leads to unnecessary antibiotic use. As physiatrists, we have learned through our training not to treat asymptomatic bacteriuria but all providers are not as familiar with the [...]

How are you annual eval’ing?David Impastato, MD2018-03-07T04:16:24+00:00

Electrodiagnostic Screening for Critical Ilness Disorders

Electrodiagnostic Screening for CIM/CIP? PM&R News • February 2018 Research continues to be performed looking into the causes and treatments of critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). It was not long ago that we thought these two diagnoses were independent of each other. Now we are finding out they often occur together and can be found in up to 50% of severely critical ill patients. With this research, new studies have shown screening electrodiagnostic studies to best assist in diagnosing these entities. To review, critical illness polyneuropathy usually shows a sensory-motor axonal polyneuropathy and clinically the patient can have difficulty [...]

Electrodiagnostic Screening for Critical Ilness DisordersDavid Impastato, MD2018-02-18T03:45:56+00:00