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https://www.readbyqxmd.com/read/28209549/factors-affecting-consultation-length-in-a-japanese-diabetes-practice
#1
Yusuke Kabeya, Junko Uchida, Masao Toyoda, Takeshi Katsuki, Yoichi Oikawa, Kiyoe Kato, Toshihide Kawai, Akira Shimada, Yoshihito Atsumi, Megumu Higaki
AIMS: Sufficient consultation time is important for establishing good doctor-patient relationship. We examined the factors that affect consultation length in Japanese diabetes practice. METHODS: This was a cross-sectional study performed at a diabetes clinic in central Tokyo, Japan. Regular diabetes consultations of 1197 patients with 22 physicians were analyzed. Consultation time and clinical characteristics were obtained from the electronic records. A negative binomial model, which included patient and physician characteristics, was constructed to examine the association of the variables with consultation length...
January 29, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28207998/benzodiazepine-and-z-drug-dependence-data-from-a-tertiary-care-center
#2
Lekhansh Shukla, Spandana Bokka, Tulika Shukla, Arun Kandasamy, Prabhat Chand, Vivek Benegal, Pratima Murthy
Objective: To examine the clinical characteristics and course of benzodiazepine and �Z-drug� dependence in patients presenting to a tertiary deaddiction center in southern India. Methods: Case files of 950 inpatients admitted between January 2007 and January 2014 who reported benzodiazepine or Z-drug use were reviewed. Patients (n = 170) with an ICD-10 diagnosis of mental and behavioral disorders due to the use of sedatives or hypnotics-dependence syndrome currently using substance (F13...
February 16, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28197775/individual-indicators-of-appropriate-hypnotic-level-during-propofol-anesthesia-highest-alpha-power-and-effect-site-concentrations-of-propofol-at-loss-of-response
#3
Hongling Kang, Hassan Mamdouh Hassan Mohamed, Masaki Takashina, Takahiko Mori, Yuji Fujino, Satoshi Hagihira
BACKGROUND: Electroencephalogram (EEG) waveforms vary widely among individuals, this decreases the usefulness of BIS™ monitors for assessing the effects of propofol. Practically, anesthesia is only seen as too deep when evidence of burst-suppression is seen. We designed an experiment to help towards better assessment of individual anesthetic needs. First, to mark the Ce (effect-site concentration) of propofol at loss of response to calling name and gently shaking shoulders (LOR), we defined Ce-LOR...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28193274/evaluation-of-medicines-dispensing-pattern-of-private-pharmacies-in-rajshahi-bangladesh
#4
Shuvashis Saha, Md Tawhid Hossain
BACKGROUND: In developing country like BANGLADESH, people depend more on pharmacies due to expediency, shorter waiting time, cost reduction, availability of credit and flexible opening hours. The aim of this study was to investigate medicines dispensing patterns of the pharmacies in RAJSHAHI, BANGLADESH and to identify and analyze contribution of drugsellers and quacks in irrational drug use. METHODS: This cross-sectional study was conducted during January 2016 - April, 2016 in 75 randomly selected private pharmacies including both licensed and unlicensed pharmacies of covering LAKSHMIPUR area...
February 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28190432/acute-neurotoxicology-of-drugs-of-abuse
#5
S J Traub, M D Levine
Many substances can affect the central nervous system, and may cause patients to become critically ill. Acute central neurotoxicologic syndromes associated with drugs of abuse are usually caused by an overdose of sedative-hypnotic agents (including alcohol) or opioids, withdrawal from sedative-hypnotic agents, or an overdose of anticholinergic or sympathomimetic agents. Clinical findings are often syndromic, making physical examination the most important diagnostic tool in the approach to the patient with an unknown ingestion...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186869/sedative-hypnotic-drug-withdrawal-syndrome-recognition-and-treatment
#6
Cynthia Santos, Ruben E Olmedo
Sedative-hypnotic drugs include gamma-Aminobutyric acid (GABA)ergic agents such as benzodiazepines, barbiturates, gamma-Hydroxybutyric acid [GHB], gamma-Butyrolactone [GBL], baclofen, and ethanol. Chronic use of these substances can cause tolerance, and abrupt cessation or a reduction in the quantity of the drug can precipitate a life-threatening withdrawal syndrome. Benzodiazepines, phenobarbital, propofol, and other GABA agonists or analogues can effectively control symptoms of withdrawal from GABAergic agents...
March 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28182128/co-prescription-of-opioids-with-benzodiazepine-and-other-co-medications-among-opioid-users-differential-in-opioid-doses
#7
Che Suraya Zin, Fadhilah Ismail
PURPOSE: This study investigated the patterns of opioid co-prescription with benzodiazepine and other concomitant medications among opioid users. Opioid dose in each type of co-prescription was also examined. PATIENTS AND METHODS: This cross-sectional study was conducted among opioid users receiving concomitant medications at an outpatient tertiary hospital setting in Malaysia. Opioid prescriptions (morphine, fentanyl, oxycodone, dihydrocodeine and tramadol) that were co-prescribed with other medications (opioid + benzodiazepines, opioid + antidepressants, opioid + anticonvulsants, opioid + antipsychotics and opioid + hypnotics) dispensed from January 2013 to December 2014 were identified...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28181924/sleep-problems-in-relation-to-smoking-and-alcohol-use-in-chinese-adolescents
#8
Hua Chen, Qi-Gui Bo, Cun-Xian Jia, Xianchen Liu
This study examined sleep patterns and sleep problems in relation to smoking and alcohol use in Chinese adolescents. A questionnaire survey of 2090 adolescent students was conducted in Lijin County, Shandong, China. A self-administered questionnaire was used to collect the data. After adjustment for demographics and internalizing and externalizing problems, poor sleep quality was associated with increased risk of smoking (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.24-5.40), alcohol use (OR, 2.65; 95% CI, 2...
February 9, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28181131/randomized-trial-of-aromatherapy-versus-conventional-care-for-breast-cancer-patients-during-perioperative-periods
#9
Kentaro Tamaki, Akiko Komatsu Fukuyama, Shigeharu Terukina, Yoshihiko Kamada, Kano Uehara, Miwa Arakaki, Kazuko Yamashiro, Minoru Miyashita, Takanori Ishida, Keely May McNamara, Noriaki Ohuchi, Nobumitsu Tamaki, Hironobu Sasano
PURPOSE: Several studies focused on the effect of aromatherapy on mood, quality of life (QOL), and physical symptoms in patients with cancer. We compared the effects on QOL, vital signs, and sleep quality between aromatherapy and conventional therapy during perioperative periods of the breast cancer patients in this study. METHODS: Patients were randomly assigned in a 2:1 ratio to receive aromatherapy or usual care. The primary endpoint was QOL, which was assessed using the quality of life questionnaire QLQ-C30, Version 3...
February 8, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28174078/hypnosis-and-top-down-regulation-of-consciousness
#10
REVIEW
Devin B Terhune, Axel Cleeremans, Amir Raz, Steven Jay Lynn
Hypnosis is a unique form of top-down regulation in which verbal suggestions are capable of eliciting pronounced changes in a multitude of psychological phenomena. Hypnotic suggestion has been widely used both as a technique for studying basic science questions regarding human consciousness but also as a method for targeting a range of symptoms within a therapeutic context. Here we provide a synthesis of current knowledge regarding the characteristics and neurocognitive mechanisms of hypnosis. We review evidence from cognitive neuroscience, experimental psychopathology, and clinical psychology regarding the utility of hypnosis as an experimental method for modulating consciousness, as a model for studying healthy and pathological cognition, and as a therapeutic vehicle...
February 4, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28168780/preterm-births-and-use-of-medication-in-early-adulthood-a-population-based-registry-study
#11
Anders Engeland, Tone Bjørge, Kari Klungsøyr, Svetlana Skurtveit, Kari Furu
PURPOSE: To explore associations between preterm birth and use of medications in young adulthood as a proxy for different diseases. METHODS: We linked data on birth characteristics from the Medical Birth Registry of Norway (1967-1999) and the Norwegian Prescription Database (2004-2015). Individuals born as singletons during 1974-1984 and alive at the age of 31 were included (main analyses) (n = 450 555). Relative risks (RRs) with 95% confidence intervals (CIs) of using different medications were estimated by log-binomial regression...
February 7, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#12
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28159096/the-cost-of-insomnia-and-the-benefit-of-increased-access-to-evidence-based-treatment-cognitive-behavioral-therapy-for-insomnia
#13
REVIEW
Sarah A Reynolds, Matthew R Ebben
Insomnia is a highly prevalent, often chronic condition, which is left untreated or not treated according to recommended guidelines in most cases. This results in high health and financial burdens to society. The cost of untreated insomnia and the prevailing reliance on sedative-hypnotic use as a first-line treatment are evaluated in this article. The cost-benefit potential of cognitive behavioral therapy for insomnia is also assessed.
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28158165/ketamine-an-update-on-cellular-and-subcellular-mechanisms-with-implications-for-clinical-practice
#14
Gary J Iacobucci, Ognjen Visnjevac, Leili Pourafkari, Nader Djalal Nader
BACKGROUND: Ketamine is one of the oldest hypnotic agents used to provide an anesthetic agent with analgesic properties and minimal suppressive effects on respiration. The ability of ketamine in modulating glutamatergic (N-methyl D-aspartate) pain receptors has made this anesthetic drug a new option for the management of patients with chronic pain syndromes. Further preclinical and clinical findings suggest ketamine may have wide ranging effects on both cognition and development. Recent advances have revealed an unprecedented role for ketamine in the acute management of depression...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28145912/possible-opioid-shopping-and-its-correlates
#15
Alexander M Walker, Lisa B Weatherby, M Soledad Cepeda, Daniel Bradford, Yingli Yuan
BACKGROUND: We created an operational definition of possible opioid shopping in US commercial health insurance data and examined its correlates. METHODS: The population consisted of 264,204 treatment courses in persons with a fill for an opioid or diuretic prescription in 2012 and a second within 18 months. We examined counts of prescribers and pharmacies and the numbers of fills and overlaps for ability to discriminate courses of opioids from diuretics, which were a negative control...
January 31, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28143413/use-of-the-empower-brochure-to-deprescribe-sedative-hypnotic-drugs-in-older-adults-with-mild-cognitive-impairment
#16
Philippe Martin, Cara Tannenbaum
BACKGROUND: Evidence-based mailed educational brochures about the harms of sedative-hypnotic use lead to discontinuation of chronic benzodiazepine use in older adults. It remains unknown whether patients with mild cognitive impairment (MCI) are able to understand the information in the EMPOWER brochures, and whether they achieve similar rates of benzodiazepine discontinuation. METHODS: Post-hoc analysis of the EMPOWER randomized, double-blind, wait-list controlled trial that assessed the effect of a direct-to-consumer educational intervention on benzodiazepine discontinuation...
January 31, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28135791/-safety-of-non-anesthesiologist-administration-of-propofol-for-gastrointestinal-endoscopy
#17
REVIEW
Jun Kyu Lee, Dong Kee Jang, Won Hee Kim, Jung Wook Kim, Byung Ik Jang
Propofol (2,6-diisopropylphenol) is a hypnotic drug with a very rapid onset and offset of action. It has increasingly been used in gastrointestinal endoscopy. Administration of propofol by nurses or endoscopists is commonly referred to as non-anesthesiologist-administered propofol (NAAP). There have been a lot of studies on the safety of NAAP compared with those by anesthesiologists. Safety results of those studies are summarized in this review.
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28129552/the-pharmacokinetics-and-tissue-distribution-of-coumaroylspinosin-in-rat-a-novel-flavone-c-glycoside-derived-from-zizyphi-spinosi-semen
#18
Xiaotong Zhao, Junjun Liu, Zhiyou Wen, Yanqing Zhang, Mingxin Yu, Bingcheng Pan, Jun Zeng, Junbo Xie
Zizyphi Spinosi Semen (ZSS) has a long history of sedative-hypnotic use in China. As a novel flavone C-glycoside, coumaroylspinosin is a main flavonoid only found in ZSS. Up to now, its pharmacokinetic information and tissue distribution in vivo are not available yet. With a simple, rapid and sensitive HPLC-MS/MS method, the pharmacokinetics and tissue distribution of coumaroylspinosin were investigated in Sprague-Dawley (SD) rats after its intravenous administration. Puerarin was used as the internal standard (IS)...
January 22, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28127845/bright-light-therapy-for-sleep-disturbance-in-dementia-is-most-effective-for-mild-to-moderate-alzheimer-s-type-dementia-a-case-series
#19
Hirotaka Sekiguchi, Shuji Iritani, Kiyoshi Fujita
BACKGROUND: Sleep problems in people with dementia are common and place a high burden on caregivers. Although hypnotic agents are often used to treat sleep disturbances, their use is associated with a considerable number of high-risk side-effects such as daytime sleepiness, amnesia, and an increased frequency of falling. The administration of bright light therapy (BLT) in the morning was a non-pharmacological remedy that was expected to treat sleep disorders in patients with dementia by entraining the circadian rhythm to ameliorate disturbances to the normal sleep-wake cycle...
January 27, 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/28122506/variation-in-use-of-antipsychotic-medications-in-nursing-homes-in-the-united-states-a-systematic-review
#20
Hannah Cioltan, Samah Alshehri, Carol Howe, Jeannie Lee, Mindy Fain, Howard Eng, Kenneth Schachter, Jane Mohler
BACKGROUND: The use of antipsychotic medications (APMs) in nursing home residents in the U.S. is an increasingly prominent issue and has been associated with increased risk of hospitalization, cardiovascular events, hip fractures, and mortality, among other adverse health events. The Food and Drug Administration has placed a black box warning on these drugs, specifying that they are not meant for residents with dementia, and has asked providers to review their treatment plans. The purpose of this systematic PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)-based review was to summarize original research studies on facility level characteristics contributing to the use of antipsychotics in nursing homes across the United States, in order to investigate the variation of use...
January 26, 2017: BMC Geriatrics
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