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Assisted outpatient treatment

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https://www.readbyqxmd.com/read/28635345/avatar-assisted-therapy-a-proof-of-concept-pilot-study-of-a-novel-technology-based-intervention-to-treat-substance-use-disorders
#1
Michael S Gordon, Steven B Carswell, Mary Schadegg, Kayla Mangen, Kelly Merkel, Susan Tangires, Frank J Vocci
BACKGROUND: Avatar-assisted therapy (AAT) is a novel and emerging technology that uses the Internet to enable clinicians and clients in substance abuse treatment to participate in group counseling sessions from separate and remote locations in real time through the use of avatars and virtual environments. OBJECTIVES: The current study is a pilot proof-of-concept feasibility study involving individuals in outpatient substance abuse treatment. This report addresses two questions: (1) are individuals who present for substance abuse treatment interested in receiving AAT and (2) what factors are associated with better treatment success...
February 17, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28631527/buprenorphine-naloxone-versus-methadone-and-lofexidine-in-community-stabilisation-and-detoxification-a-randomised-controlled-trial-of-low-dose-short-term-opiate-dependent-individuals
#2
Fergus D Law, Alison M Diaper, Jan K Melichar, Simon Coulton, David J Nutt, Judy S Myles
Buprenorphine/naloxone, methadone and lofexidine are medications with utility in the treatment of opiate withdrawal. We report the first randomised controlled trial to compare the effects of these two medications on withdrawal symptoms and outcome during opiate induction/stabilisation and detoxification. A double-blind randomised controlled trial was conducted in an outpatient satellite clinic of a specialist drug service. Eighty opiate dependent individuals meeting DSM-IV criteria for opiate dependence, using ⩽ ½ g heroin smoked/chased or ¼ g heroin injected or ⩽ 30mg methadone, with ⩽ 3 years of opioid dependency, underwent a short-term opiate treatment programme involving induction/stabilisation on methadone 30mg or buprenorphine/naloxone 4mg/1mg, followed by detoxification (where the methadone group was assisted by lofexidine)...
June 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28626861/diphenylcyclopropenone-for-the-treatment-of-cutaneous-in-transit-melanoma-metastases-results-of-a-prospective-non-randomised-single-centre-study
#3
T Read, S Webber, J Tan, M Wagels, H Schaider, H P Soyer, B M Smithers
BACKGROUND: Current treatments for in-transit melanoma (ITM) metastases are frequently invasive and do not improve overall survival. Recently there has been increasing investigation into the use of topical agents for ITM. Diphenylcyclopropenone or diphencyprone (DPCP) is a novel, topical agent that has been reported to have immune-sensitising properties useful in the treatment of ITM. OBJECTIVE: To assess the clinical outcomes of patients treated within a prospective, non-randomised, non-comparative study using DPCP for cutaneous in-transit melanoma metastases...
June 19, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28623639/anemia-after-continuous-flow-left-ventricular-assist-device-implantation-characteristics-and-implications
#4
Javier Amione-Guerra, Ana S Cruz-Solbes, Arvind Bhimaraj, Barry H Trachtenberg, Sai R Pingali, Jerry D Estep, Myung H Park, Ashrith Guha
BACKGROUND: Anemia is common in patients with heart failure and is associated with adverse outcomes. Management of anemia in CF-LVAD patients is not well studied. Our purpose is to characterize and identify the etiology of anemia in CF-LVAD patients. Secondary objectives are to describe the effect of CF-LVAD on pre-existing anemia and assess its impact after CF-LVAD support. METHODS: Cross-sectional study from January to July 2015 of ambulatory patients supported with a CF-LVAD for at least 6-months that presented with hemoglobin <12 g/dL and no recent gastrointestinal bleeding...
June 14, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28612397/understanding-and-treating-offenders-with-serious-mental-illness-in-public-sector-mental-health
#5
H Richard Lamb, Linda E Weinberger
This article begins with the history of the rise and fall of the state hospitals and subsequent criminalization of persons with serious mental illness (SMI). Currently, there is a belief among many that incarceration has not been as successful as hoped in reducing crime and drug use, both for those with and those without SMI. Moreover, overcrowding in correctional facilities has become a serious problem necessitating a solution. Consequently, persons with SMI in the criminal justice system are now being released in large numbers to the community and hopefully treated by public sector mental health...
June 14, 2017: Behavioral Sciences & the Law
https://www.readbyqxmd.com/read/28600107/remote-collection-of-patient-reported-outcomes-following-outpatient-hand-surgery-a-randomized-trial-of-telephone-mail-and-e-mail
#6
Justin Schwartzenberger, Angela Presson, Adam Lyle, Andrew O'Farrell, Andrew R Tyser
PURPOSE: Obtaining remote patient-reported outcomes (PRO) is limited by low patient response rates and resource-intensive collection methods. We hypothesized that an e-mail-delivered Web-based data collection tool would outperform the traditional methods of telephone and standard mail for collecting long-term Boston Carpal Tunnel Questionnaire (BCTQ) scores at a minimum of 1 year following carpal tunnel release (CTR). METHODS: We conducted a randomized trial of 969 patients who underwent CTR at a tertiary medical center within the past 5 years...
June 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28594601/a-parenting-education-program-for-women-in-treatment-for-opioid-use-disorder-at-an-outpatient-medical-practice
#7
Linda S Kahn, Whitney E Mendel, Kyla L Fallin, Elizabeth A Borngraber, Thomas H Nochajski, William E Rea, Richard D Blondell
Opioid use during pregnancy poses serious risks for the mother and the unborn child. Opioid-use disorder may be managed with medication-assisted treatment (MAT) in an outpatient setting, but few MAT practices specifically address the challenges faced by pregnant women. This article describes a medical office-based educational support group for women in MAT for opioid-use disorder who were pregnant and/or parenting young children. Focus groups were conducted to elicit patient feedback. Women indicated that they found the educational support groups beneficial and offered suggestions...
June 8, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28554602/the-relationship-between-diversion-related-attitudes-and-sharing-and-selling-buprenorphine
#8
Shannon R Kenney, Bradley J Anderson, Genie L Bailey, Michael D Stein
OBJECTIVE: Buprenorphine medication-assisted treatment (B-MAT) is an efficacious and popular outpatient treatment for opioid use disorder. However, the likelihood of buprenorphine diversion is a public health concern. We examined the relationship between attitudes toward diversion as predictors of both sharing and selling buprenorphine. METHOD: Participants (n=476) were patients undergoing short-term inpatient opioid detoxification. Multinomial logistic regression was used to estimate the adjusted association of sharing and selling buprenorphine with demographics, substance use behaviors, and attitudes toward sharing and selling buprenorphine...
July 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28554223/outpatient-management-of-severe-ovarian-hyperstimulation-syndrome-a-systematic-review-and-a-review-of-existing-guidelines
#9
Amr Gebril, Haitham Hamoda, Raj Mathur
Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of assisted reproductive treatment. Management of women with severe OHSS has traditionally included hospitalisation for close monitoring and supportive treatment. The aim of this review is to assess the evidence for safety and efficacy of outpatient management of severe OHSS. A systematic review of studies describing outpatient management options was performed. Current guidance from advisory bodies was also reviewed. Outpatient management has been found in observational studies to be safe and cost-effective compared to inpatient management...
May 29, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28514458/effect-of-expedited-microneedle-assisted-photodynamic-therapy-for-field-treatment-of-actinic-keratoses-a-randomized-clinical-trial
#10
Tatyana A Petukhova, Lauren A Hassoun, Negar Foolad, Mayanka Barath, Raja K Sivamani
Importance: Photodynamic therapy (PDT) is an effective and cosmetically favorable treatment modality for actinic keratoses (AKs). However, prolonged incubation times and pain associated with treatment are burdensome to the patient and a hindrance to widespread use of PDT as standard field therapy for AK. Objective: To evaluate efficacy and pain associated with microneedle expedited PDT. Design, Setting, and Participants: The Microneedle Photodynamic Therapy II (MNPDT-II) study was a randomized, single-blinded, split-face controlled, 2-arm clinical trial...
May 17, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28505988/intensive-seated-robotic-training-of-the-ankle-in-patients-with-chronic-stroke-differentially-improves-gait
#11
Johanna L Chang, Regina Y Lin, Maira Saul, Philip J Koch, Hermano Igo Krebs, Bruce T Volpe
BACKGROUND: Robotic driven treatment plans targeting isolated joints of the upper limb have improved the sensorimotor condition of patients with stroke. Similar intensive efforts to allay lower limb gait impairment have not been so successful. In patients with stroke, targeted robot assisted training of the ankle joint, in a seated position, has demonstrated significant alterations in ankle stiffness and foot-ankle orientation at foot strike which may provide a new treatment option for gait impairment...
May 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28503100/age-and-gender-considerations-for-technology-assisted-delivery-of-therapy-for-substance-use-disorder-treatment-a-patient-survey-of-access-to-electronic-devices
#12
Denis Antoine, Sean Heffernan, Amina Chaudhry, Van King, Eric C Strain
BACKGROUND: Technology-assisted treatment (TAT) can be an effective supplement to established face-to-face therapy modalities with a growing literature in substance use disorder (SUD) treatment. TAT access, interest, and familiarity are potential limitations to the use and efficacy of these approaches to treatment. METHODS: 174 participants in outpatient SUD treatment were administered a survey regarding technology device and Internet access, and interest in engaging in TAT SUD counseling (SUDC)...
December 2016: Addictive Disorders & Their Treatment
https://www.readbyqxmd.com/read/28494750/direct-and-indirect-risk-associated-with-the-use-of-dietary-supplements-among-persons-with-dementia-in-a-norwegian-memory-clinic
#13
Hilde Risvoll, Trude Giverhaug, Kjell H Halvorsen, Marit Waaseth, Frauke Musial
BACKGROUND: The use of dietary supplements (DS) is common among persons with dementia. Direct risks associated with DS use include adverse events and DS-drug interactions. A direct risk is a risk caused by the treatment itself. Indirect risks are related to the treatment setting, such as the conditions of use, and not to the treatment itself. Because dementia symptoms may reduce a person's ability to cope with the administration of DS, the use of DS may pose a threat to safety as an indirect risk...
May 12, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28492461/overcoming-barriers-to-initiating-medication-assisted-treatment-for-heroin-use-disorder-in-a-general-medical-hospital-a-case-report-and-narrative-literature-review
#14
Sameer Hassamal, Matthew Goldenberg, Waguih Ishak, Margaret Haglund, Karen Miotto, Itai Danovitch
Deaths due to heroin overdoses are increasing and are the leading cause of death among intravenous heroin users. Although medication-assisted treatment (MAT) improves morbidity and mortality in patients with opioid use disorders, it is underutilized. Most efforts to expand access to MAT have focused on outpatient settings. Although the inpatient medical setting presents a critical opportunity to initiate treatment, general hospitals are often unfamiliar with MAT, creating a number of barriers to its use. In this report, we describe the case of a woman with heroin use disorder who was initiated on buprenorphine maintenance treatment while hospitalized for cardiac disease related to her intravenous heroin use...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28485202/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#15
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28482273/neighborhood-disorder-and-glycemic-control-in-late-adolescents-with-type-1-diabetes
#16
Tara L Queen, Katherine J W Baucom, Ashley C Baker, Daniel Mello, Cynthia A Berg, Deborah J Wiebe
OBJECTIVE: To evaluate the contribution of neighborhood characteristics to treatment adherence and glycemic control in late adolescents with Type 1 diabetes. RESEARCH DESIGN AND METHODS: As part of a larger study, 220 late adolescents with Type 1 diabetes (aged 17.8 ± 0.4 years, 59.6% female, diabetes duration 7.3 ± 3.9 years) were recruited from outpatient pediatric clinics during their senior year of high school. Adolescents completed self-report measures of adherence behaviors and subjective social status, and their HbA1c values were collected during a lab assessment...
June 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28473233/relapse-to-opioid-use-disorder-after-inpatient-treatment-protective-effect-of-injection-naltrexone
#17
Edward V Nunes, Michael Gordon, Peter D Friedmann, Marc J Fishman, Joshua D Lee, Donna T Chen, Mei Chen Hu, Tamara Y Boney, Donna Wilson, Charles P O'Brien
BACKGROUND: Opioid use disorder is often treated with short term hospitalization and medically supervised withdrawal from opioids followed by counseling alone without medication assisted treatment (MAT). More evidence is needed to confirm the expectation that the rate of relapse would be high after short term inpatient treatment and withdrawal from opioids without follow-up MAT. OBJECTIVE/METHODS: To examine relapse to opioid use disorder in a randomized, multi-site effectiveness trial of extended-release injection naltrexone (XR-NTX) vs community-based treatment as usual (TAU) without medication, as a function of the type of clinical service where treatment was initiated-short-term inpatient (N=59), long-term inpatient (N=48), or outpatient (N=201)...
April 23, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28460284/improved-facial-affect-recognition-in-schizophrenia-following-an-emotion-intervention-but-not-training-attention-to-facial-features-or-treatment-as-usual
#18
Stella Tsotsi, Mary H Kosmidis, Vasilis P Bozikas
In schizophrenia, impaired facial affect recognition (FAR) has been associated with patients' overall social functioning. Interventions targeting attention or FAR per se have invariably yielded improved FAR performance in these patients. Here, we compared the effects of two interventions, one targeting FAR and one targeting attention-to-facial-features, with treatment-as-usual on patients' FAR performance. Thirty-nine outpatients with schizophrenia were randomly assigned to one of three groups: FAR intervention (training to recognize emotional information, conveyed by changes in facial features), attention-to-facial-features intervention (training to detect changes in facial features), and treatment-as-usual...
April 23, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28458604/effectiveness-of-ambulatory-tru-close-thoracic-vent-for-the-outpatient-management-of-pneumothorax-a-prospective-pilot-study
#19
Yong Pyo Kim, Seok Jin Haam, Sungsoo Lee, Geun Dong Lee, Seung-Moon Joo, Tae Jun Yum, Kwang-Hun Lee
OBJECTIVE: This study aimed to assess the technical feasibility, procedural safety, and long-term therapeutic efficacy of a small-sized ambulatory thoracic vent (TV) device for the treatment of pneumothorax. MATERIALS AND METHODS: From November 2012 to July 2013, 18 consecutive patients (3 females, 15 males) aged 16-64 years (mean: 34.7 ± 14.9 years, median: 29 years) were enrolled prospectively. Of these, 15 patients had spontaneous pneumothorax and 3 had iatrogenic pneumothorax...
May 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28451797/-repetitive-peripheral-muscle-stimulation-vs-pelvic-floor-muscle-training-comparison-of-two-approaches-to-incontinence-treatment
#20
Sabine Schrank, Laura Adlbrecht, Hanna Mayer
BACKGROUND: Although there are various measures for the prevention, treatment, and management of urinary incontinence (UI), absorbing aids (and only scant continence-promoting measures) are primarily used in nursing homes in Austria. Repetitive peripheral muscle stimulation (RPMS) is already used as a common method for the treatment and prevention of incontinence in the outpatient setting and is an effective alternative compared to the usual incontinence treatments. However, there are no empirical data as yet on the effect of RPMS in nursing home residents...
April 27, 2017: Zeitschrift Für Gerontologie und Geriatrie
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