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Claudia Bausewein, Philipp Schumacher, Anna Bolzani
PURPOSE OF REVIEW: Optimal management of breathlessness requires generally more than one component. Breathlessness services aim to provide specific interventions and support for patients suffering from breathlessness due to any advanced disease and their carers. This review aims to describe recent studies evaluating the effects of breathlessness services for patients with advanced chronic conditions. RECENT FINDINGS: Various breathlessness services have been tested and vary regarding structure, duration, frequency and professionals involved...
June 20, 2018: Current Opinion in Supportive and Palliative Care
Maria Aparecida Dos Santos Traverzim, Sergio Makabe, Daniela Fátima Teixeira Silva, Christiane Pavani, Sandra Kalil Bussadori, Kristianne Santos Porta Fernandes, Lara Jansiski Motta
BACKGROUND: Labor pain is one of the most intense pains experienced by women, which leads to an increase in the number of women opting to undergo a cesarean delivery. Pharmacological and nonpharmacological analgesia methods are used to control labor pain. Epidural analgesia is the most commonly used pharmacological analgesia method. However, it may have side effects on the fetus and the mother. Light-emitting diode (LED) photobiomodulation is an effective and noninvasive alternative to pharmacological methods...
June 2018: Medicine (Baltimore)
Nasim Baradaran-Akbarzadeh, Mahin Tafazoli, Morteza Mojahedi, Seyed Reza Mazlom
INTRODUCTION: Sexual health is one of the key factors to sustain marital life and having a good sexual function. On the other hand, temperament affects sexual function. Training is also one of the basic foundations for promoting sexual health. Therefore, the researcher has designed and implemented a study (2017) aimed "determining the study of educational package on sexual function in cold temperament women of reproductive age." METHODS: This randomized clinical trial study was performed on 80 women in two groups (40 in each group)...
2018: Journal of Education and Health Promotion
Lisa Burry, Sangeeta Mehta, Marc M Perreault, Jay S Luxenberg, Najma Siddiqi, Brian Hutton, Dean A Fergusson, Chaim Bell, Louise Rose
BACKGROUND: Guidelines suggest limited and cautious use of antipsychotics for treatment of delirium where nonpharmacological interventions have failed and symptoms remain distressing or dangerous, or both. It is unclear how well these recommendations are supported by current evidence. OBJECTIVES: Our primary objective was to assess the efficacy of antipsychotics versus nonantipsychotics or placebo on the duration of delirium in hospitalised adults. Our secondary objectives were to compare the efficacy of: 1) antipsychotics versus nonantipsychotics or placebo on delirium severity and resolution, mortality, hospital length of stay, discharge disposition, health-related quality of life, and adverse effects; and 2) atypical vs...
June 18, 2018: Cochrane Database of Systematic Reviews
Michele Vitacca, Dina Visca, Antonio Spanevello
OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation. Cardiovascular diseases, osteoporosis, depression/anxiety, musculoskeletal impairment and obstructive sleep apnea are frequent and important comorbidities in COPD, often under-diagnosed, and associated with poor health status and prognosis. METHODS: Pulmonary rehabilitation improves symptoms, quality of life, pulmonary function, and health care in patients with chronic respiratory disease...
February 2018: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Sandra L Staveski, Karen Boulanger, Lee Erman, Li Lin, Christina Almgren, Chloe Journel, Stephen J Roth, Brenda Golianu
OBJECTIVES: The purpose of this pilot study was three-fold: 1) to evaluate the safety and feasibility of instituting massage therapy in the immediate postoperative period after congenital heart surgery, 2) to examine the preliminary results on effects of massage therapy versus standard of care plus three reading visits on postoperative pain and anxiety, and 3) to evaluate preliminary effects of opioid and benzodiazepine exposure in patients receiving massage therapy compared with reading controls...
June 14, 2018: Pediatric Critical Care Medicine
L Astudillo, A Laure, V Fabry, G Pugnet, P Maury, M Labrunée, L Sailler, A Pavy-Le Traon
Postural tachycardia syndrome (PoTS) is a multifactorial syndrome defined by an increase in heart rate ≥30bpm, within 10minutes of standing (or during a head up tilt test to at least 60°), in absence of orthostatic hypotension. It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve in supine position. Patients have an intense fatigue with a high incidence on quality of life. This syndrome can be explained by many pathophysiological mechanisms. It can be associated with Ehlers-Danlos disease and some autoimmune disorders...
June 13, 2018: La Revue de Médecine Interne
Sabrina Gmuca, Rui Xiao, Pamela F Weiss, David D Sherry, Andrea M Knight, Jeffrey S Gerber
Objective: Thirty percent of adults with fibromyalgia receive an opioid, but the prevalence of opioid prescribing in pediatric chronic musculoskeletal pain is unknown. The aims of this study were to determine the prevalence of and factors associated with opioid exposure and polypharmacy among children with chronic musculoskeletal pain. Methods: In this retrospective cohort study using health care claims data from 2000 to 2013, the index date was the first ICD-9 code 729...
June 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Jessica E Carter, Srinivas Pyati, Frances A Kanach, Ann Miller W Maxwell, Charles M Belden, Christopher M Shea, Thomas Van de Ven, Jillian Thompson, Helen Hoenig, Karthik Raghunathan
BACKGROUND: Complementary integrative health therapies have a perioperative role in the reduction of pain, analgesic use, and anxiety, and increasing patient satisfaction. However, long implementation lags have been quantified. The Consolidated Framework for Implementation Research (CFIR) can help mitigate this translational problem. METHODS: We reviewed evidence for several nonpharmacological treatments (CFIR domain: characteristics of interventions) and studied external context and organizational readiness for change by surveying providers at 11 Veterans Affairs (VA) hospitals (domains: outer and inner settings)...
June 12, 2018: Anesthesia and Analgesia
Sharmila Dissanaike
This commentary discusses ethical implications of the common practice of treating children's and adults' burn pain differently. Physicians have obligations to ensure that (1) their own discomfort with children's pain doesn't lead them to make pain management decisions that could place a patient at greater risk and (2) to engage in thoughtful, individualized pain management strategies. Long-term consequences of overzealous pain medication administration, for example, could include delayed recovery and integration or opioid dependence...
June 1, 2018: AMA Journal of Ethics
Hatice Bodur, Fatma Gül Yurdakul, Şebnem Ataman, Yeşim Garip, Kemal Nas, Fikriye Figen Ayhan Fikriye Figen Ayhan, Özgür Akgül, Ayşen Akinci, Zuhal Altay, Murat Birtane, Derya Soy Buğdayci, Erhan Çapkin, Remzi Çevik, Tuncay Duruöz, Gülcan Gürer, Cahit Kaçar, Ayhan Kamanli, Ece Kaptanoğlu, Taciser Kaya, Hilal Kocabaş, Ömer Kuru, Meltem Alkan Melikoğlu, Erhan Özdemirel, Sumru Özel, Aylin Rezvani, İlhan Sezer, İsmihan Sunar, Gürkan Yilmaz
Objectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloArthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice. Patients and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed...
March 2018: Archives of Rheumatology
Béla Faludi, Renáta Rozgonyi
Insomnia - one of the most prevalent sleep complain - has a great impact on the everyday life. Basically two different form of insomnia can be defined: the insomnia disorder and the co-morbid insomnias. To treat adequately determination of background pathology is essential, which is based on the help of Sleep Medicine Centers. According to the newest guidelines, the treatment of insomnia disorder is based on cognitive behavioural therapies followed by pharmaceutical intervention. In this review we provide the short description of cognitive behavioural therapies and basic principles of hypnotic drugs...
May 30, 2018: Ideggyógyászati Szemle
Brian S Appleby, Deborah R Yobs
Prion diseases (e.g., Creutzfeldt-Jakob disease) are rapidly progressive neurodegenerative diseases that are invariably fatal. Diagnosing prion disease can be difficult and can lead to frustration. There is no currently available disease-altering treatment for prion diseases and the care and management of affected patients are directed towards symptomatic relief and quality of life. In this chapter, we highlight the many unique challenges of prion disease and how they affect care and management strategies. Symptomatic treatment follows many of the same principles observed in geriatric and/or hospice care, with some important differences due to disease-specific characteristics...
2018: Handbook of Clinical Neurology
Hsin-Hsi Tsai, Jong S Kim, Eric Jouvent, M Edip Gurol
Intracerebral hemorrhage (ICH) and lacunar infarction (LI) are the major acute clinical manifestations of cerebral small vessel diseases (cSVDs). Hypertensive small vessel disease, cerebral amyloid angiopathy, and hereditary causes, such as Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), constitute the three common cSVD categories. Diagnosing the underlying vascular pathology in these patients is important because the risk and types of recurrent strokes show significant differences...
May 2018: Journal of Stroke
Mehmet Akif Topcuoglu, Liping Liu, Dong-Eog Kim, M Edip Gurol
Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism...
May 2018: Journal of Stroke
Laxmi V Ghimire, Fu-Sheng Chou
BACKGROUND: Junctional ectopic tachycardia is a serious tachyarrhythmic complication following pediatric cardiac surgery. It is difficult to manage and is associated with significant morbidity and mortality. Conventional nonpharmacological and pharmacological measures have shown limited effects. Dexmedetomidine is an α2 agonist which has recently been shown in multiple studies to be effective. AIMS: The aim of this systematic review with meta-analysis was to evaluate the efficacy of prophylactic dexmedetomidine administration in the prevention of junctional ectopic tachycardia in pediatric patients following cardiac surgeries...
June 7, 2018: Paediatric Anaesthesia
Eric H Kossoff, Beth A Zupec-Kania, Stéphane Auvin, Karen R Ballaban-Gil, A G Christina Bergqvist, Robyn Blackford, Jeffrey R Buchhalter, Roberto H Caraballo, J Helen Cross, Maria G Dahlin, Elizabeth J Donner, Orkide Guzel, Rana S Jehle, Joerg Klepper, Hoon-Chul Kang, Danielle A Lambrechts, Y M Christiana Liu, Janak K Nathan, Douglas R Nordli, Heidi H Pfeifer, Jong M Rho, Ingrid E Scheffer, Suvasini Sharma, Carl E Stafstrom, Elizabeth A Thiele, Zahava Turner, Maria M Vaccarezza, Elles J T M van der Louw, Pierangelo Veggiotti, James W Wheless, Elaine C Wirrell
Ketogenic dietary therapies (KDTs) are established, effective nonpharmacologic treatments for intractable childhood epilepsy. For many years KDTs were implemented differently throughout the world due to lack of consistent protocols. In 2009, an expert consensus guideline for the management of children on KDT was published, focusing on topics of patient selection, pre-KDT counseling and evaluation, diet choice and attributes, implementation, supplementation, follow-up, side events, and KDT discontinuation. It has been helpful in outlining a state-of-the-art protocol, standardizing KDT for multicenter clinical trials, and identifying areas of controversy and uncertainty for future research...
June 2018: Epilepsia Open
Salia Farrokh, Pouya Tahsili-Fahadan, Eva K Ritzl, John J Lewin, Marek A Mirski
BACKGROUND: The incidence of seizures in intensive care units ranges from 3.3% to 34%. It is therefore often necessary to initiate or continue anticonvulsant drugs in this setting. When a new anticonvulsant is initiated, drug factors, such as onset of action and side effects, and patient factors, such as age, renal, and hepatic function, should be taken into account. It is important to note that the altered physiology of critically ill patients as well as pharmacological and nonpharmacological interventions such as renal replacement therapy, extracorporeal membrane oxygenation, and target temperature management may lead to therapeutic failure or toxicity...
June 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
Larry Charleston, Jeffrey Royce, Teshamae S Monteith, Susan W Broner, Hope L O'Brien, Salvador L Manrriquez, Matthew S Robbins
OBJECTIVE: To review the challenges and potential solutions in treatment options for quality migraine care in adult patients who are under or uninsured. BACKGROUND: The Affordable Care Act has improved access to health care for many; however, those who are underserved continue to face treatment disparities and have inadequate access to appropriate migraine management. METHODS: This manuscript is the second of a 2-part narrative review which was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society...
May 2018: Headache
Carla Ida Ripamonti, Andrea Antonuzzo, Paolo Bossi, Stefano Cavalieri, Fausto Roila, Sonia Fatigoni
PURPOSE OF REVIEW: Cancer-related fatigue (CRF) is a frequent and distressing symptom present at any stage of the disease. However, it is still underreported, rarely properly assessed and undertreated. RECENT FINDINGS: There are international guidelines available, but also several barriers to their implementation into clinical practice. SUMMARY: According to guidelines, all patients should be clinically screened for CRF on regular basis, at the initial cancer visit and at intervals during every clinic visit, also at posttreatment follow-up visits...
July 2018: Current Opinion in Oncology
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