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Letícia Pereira de Brito Sampaio
The ketogenic diet (KD), a high-fat, low-carbohydrate, and adequate-protein diet is an established, effective nonpharmacologic treatment option for intractable childhood epilepsy. The KD was developed in 1921 and even though it has been increasingly used worldwide in the past decade, many neurologists are not familiar with this therapeutic approach. In the past few years, alternative and more flexible KD variants have been developed to make the treatment easier and more palatable while reducing side effects and making it available to larger group of refractory epilepsy patients...
October 2016: Arquivos de Neuro-psiquiatria
Hyun Min Kim, Jong-Mi Seong, Jaetaek Kim
The objective of this study was to carry out a large population-based study to understand the factors associated with hypoglycemia-related hospitalizations among older Korean adults with diabetes mellitus.This study analyzed data from a subset of the 2013 Health Insurance and Review and Assessment service-Adult Patient Sample. A total of 307,170 subjects, comprising 41.7% men and 58.3% women, had diabetes mellitus. Hypertension (80.8%) was the most common comorbidity, and dyslipidemia (59.0%) and ischemic heart disease (21...
October 2016: Medicine (Baltimore)
Sahan P Semasinghe Bandaralage, Selvanayagam Nirthanan, Selvanayagam Niranjan
Despite proven effectiveness in treating tachyarrhythmias, sotalol is proarrhythmic and can cause torsades de pointes. Given the emergence of studies that show no benefit from rhythm control strategies in managing atrial fibrillation, as well as the introduction of nonpharmacological approaches to treating arrhythmias, we felt it necessary to ascertain if there was any role for sotalol given its side effects. Review of the literature regarding sotalol use in the prevention and treatment of supraventricular and ventricular tachyarrhythmias seems to show that more effective and safer agents and nonpharmacological alternatives are currently available...
October 3, 2016: American Journal of Therapeutics
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Elena Antonelli, Laura Vagnoli, Enrica Ciucci, Chiara Vernucci, Federica Lachi, Andrea Messeri
OBJECTIVES: The majority of children and adolescents presenting to the emergency department are in pain and require painful procedures. This randomized study was to investigate the efficacy of 3 different nonpharmacologic interventions (clowns, dogs, and musicians) to reduce pain and analyze the perception of positive and negative affects after the presence of these activities in a short-stay observation unit (SSOU). METHODS: Participants were composed of 105 children (54 boys and 51 girls; aged 3-16 years) assigned randomly to an experimental group (N = 57) that was composed of patients who were present in the SSOU...
October 4, 2016: Pediatric Emergency Care
Nadia Justel, Mariana Psyrdellis, Ricardo M Pautassi
During extinction, the organism learns that a conditioned stimulus or a conditioned response is no longer associated with an unconditioned stimulus, and as a consequence, a decrement in the response is presented. The exposure to novel situations (e.g. exploration of a novel open field) has been used widely to modulate (i.e. either enhance or deteriorate) learning and memory. The aim of the present study was to test whether open-field exposure could modulate consummatory extinction. The results indicated that open-field exposure accelerated the extinction response (i...
October 4, 2016: Neuroreport
Dafna Willner, Valeria Spennati, Shelly Stohl, Giulia Tosti, Simone Aloisio, Federico Bilotta
Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraoperative and postoperative blood loss. The aim of this systematic review is to report clinical evidence on the relationship between intraoperative blood loss (primary outcome) and on transfusion requirements and postoperative complications (secondary outcomes) in patients undergoing spine surgery...
October 3, 2016: Anesthesia and Analgesia
Andrea Marchi, Vlasta Bari, Beatrice De Maria, Murray Esler, Elisabeth Lambert, Mathias Baumert, Alberto Porta
We propose a sympathetic baroreflex (sBR) sequence method for characterizing sBR from spontaneous beat-to-beat fluctuations of muscle sympathetic nerve activity (MSNA) and diastolic arterial pressure (DAP). The method exploits a previously defined MSNA variability quantifying the fluctuations of MSNA burst rate. The method is based on the detection of MSNA and DAP sequences characterized by the contemporaneous DAP increase and MSNA decrease or vice versa. The percentage of sBR sequences (SEQ%sBR) was taken as an indication of the degree of sBR solicitation and the average slope of the regression lines in the (DAP, MSNA) plane was taken as sBR sensitivity (sBRSSEQ) and expressed in bursts(...
2016: Frontiers in Physiology
Safiya Imtiaz Shaikh, D Nagarekha, Ganapati Hegade, M Marutheesh
Postoperative nausea and vomiting (PONV) is one of the complex and significant problems in anesthesia practice, with growing trend toward ambulatory and day care surgeries. This review focuses on pathophysiology, pharmacological prophylaxis, and rescue therapy for PONV. We searched the Medline and PubMed database for articles published in English from 1991 to 2014 while writing this review using "postoperative nausea and vomiting, PONV, nausea-vomiting, PONV prophylaxis, and rescue" as keywords. PONV is influenced by multiple factors which are related to the patient, surgery, and pre-, intra-, and post-operative anesthesia factors...
September 2016: Anesthesia, Essays and Researches
Gülbanu Zencir, Ismet Eser
The most painful activities during the days following cardiac surgery are coughing and deep breathing exercises. Cold therapy is an effective nonpharmacological method that decreases the pain during coughing and mobilization. In this study, the effects of cold therapy on pain and breathing exercises among patients with median sternotomy following cardiac surgery were investigated in a randomized crossover clinical trial. Data were collected from patients with median sternotomy (N = 34) in the first two postoperative days...
October 13, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Ipsit V Vahia, Rujvi Kamat, Cheng Vang, Carolina Posada, Lisa Ross, Sarah Oreck, Alok Bhatt, Colin Depp, Dilip V Jeste, Daniel D Sewell
OBJECTIVE: To investigate the feasibility, safety, and utility of tablet devices as novel nonpharmacologic tools in managing older psychiatric inpatients with agitation and dementia. METHODS: Thirty-six patients at a geriatric psychiatry inpatient unit were provided with tablets when agitated and used various apps on the tablet related to communication, games, music, web browser, and photography during their stay. Study staff documented the frequency, duration, and app usage history and rated the extent to which agitation improved after tablet use...
August 4, 2016: American Journal of Geriatric Psychiatry
Giuseppe Lanza, Cornelius G Bachmann, Imad Ghorayeb, Yuping Wang, Raffale Ferri, Walter Paulus
Neurophysiological techniques have been applied in restless legs syndrome (RLS) to obtain direct and indirect measures of central and peripheral nervous system excitability, as well as to probe different neurotransmission pathways. Data converge on the hypothesis that, from a pure electrophysiological perspective, RLS should be regarded as a complex sensorimotor disorder in which cortical, subcortical, spinal cord, and peripheral nerve generators are all involved in a network disorder, resulting in an enhanced excitability and/or decreased inhibition...
August 27, 2016: Sleep Medicine
Jennifer Greene Naples, Walid F Gellad, Joseph T Hanlon
When possible, chronic noncancer pain (CNCP) in older adults should be managed by nonpharmacologic modalities in conjunction with nonopioid analgesics. If moderate-to-severe pain persists despite these approaches, however, nonparenteral opioids may be considered as adjunctive therapy. This article reviews the epidemiology of opioid use and their effectiveness for CNCP in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly...
November 2016: Clinics in Geriatric Medicine
Anika Thielmann, Biljana Gerasimovska-Kitanovska, Krzysztof Buczkowski, Tuomas H Koskela, Vildan Mevsim, Slawomir Czachowski, Ferdinando Petrazzuoli, Marija Petek-Šter, Heidrun Lingner, Robert D Hoffman, Selda Tekiner, Juliette Chambe, Tamer Edirne, Kathryn Hoffmann, Enzo Pirrotta, Ayşegül Uludağ, Hülya Yikilkan, Sanda Kreitmayer Pestic, Andrzej Zielinski, Clara Guede Fernández, Birgitta Weltermann
Background. Patients use self-care to relieve symptoms of common colds, yet little is known about the prevalence and patterns across Europe. Methods/Design. In a cross-sectional study 27 primary care practices from 14 countries distributed 120 questionnaires to consecutive patients (≥18 years, any reason for consultation). A 27-item questionnaire asked for patients' self-care for their last common cold. Results. 3,074 patients from 27 European sites participated. Their mean age was 46.7 years, and 62.5% were females...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Hongyong Deng, Clive E Adams
OBJECTIVE: To survey the reports of randomized trials of traditional Chinese medicine (TCM) interventions for schizophrenia and produce a broad overview of this type of research activity in this area. METHOD: We searched the Cochrane Schizophrenia Group's comprehensive Trials Register (January 2016), selected all relevant randomized trials, and extracted the data within each study. Finally, we sought relevant reviews on the Cochrane Library. RESULTS: We initially screened 423 articles from which we identified 378 relevant studies randomizing 35 341 participants (average study size 94, SD 60)...
October 13, 2016: Asia-Pacific Psychiatry: Official Journal of the Pacific Rim College of Psychiatrists
Fleur Harrison, Liesbeth Aerts, Henry Brodaty
Increasing recognition that apathy is one of the most prevalent behavioral and psychological symptoms of dementia and causes substantial caregiver distress has led to trials evaluating psychosocial and pharmacological treatments of apathy in dementia. We evaluated evidence of the efficacy of pharmacotherapies for apathy in dementia from studies since 2013. Previously reported benefits of acetylcholinesterase inhibitors and memantine were not replicated in recent studies. Antidepressants had mixed results with positive effects for apathy shown only for agomelatine, while stimulants, analgesics, and oxytocin study results were inconclusive...
November 2016: Current Psychiatry Reports
Aileen Wk Chan, Doris Sf Yu, K C Choi, Diana Tf Lee, Janet Wh Sit, Helen Yl Chan
PURPOSE: Age-related cognitivee decline is a growing public health concern worldwide. More than a quarter of adults with cognitive impairment experience sleep disturbance. The objective of this pilot study was to evaluate the preliminary effects of tai chi qigong (TCQ) on improving the night-time sleep quality of older adults with cognitive impairment. PARTICIPANTS: Older adults with cognitive impairment who complain of sleep disturbance. METHODS: A randomized controlled trial with two groups...
2016: Clinical Interventions in Aging
Ahmad Sabbahi, Ross Arena, Ahmed Elokda, Shane A Phillips
Hypertension (HTN) has recently been determined to be the number one overall risk factor of disease. With direct and indirect costs amounting to $46.4 billion in 2011 and projections of six-fold increases by 2030, the importance of low-cost nonpharmacological interventions can be appreciated. Vascular structural changes, endothelial dysfunction, and sympathetic overstimulation are major contributing factors to the pathophysiology of HTN. Exercise training (ET) for blood pressure (BP) control has been shown to be an effective and integral component of nonpharmacological interventions for BP control...
September 30, 2016: Progress in Cardiovascular Diseases
Rehab Aburas, Debajyoti Pati, Robert Casanova, Nicole Gilinsky Adams
The physical environment is one of the factors that affect women's experience of labor. The basics of the childbirth process have not changed since the beginning of human existence; however, the environment in which women today give birth has changed significantly. Incorporating design elements and strategies that calm and reduce negative emotions may create positive experiences for women in labor. The purpose of this study was to examine the impact of one such strategy, namely, the presentation of images of nature, on the labor and delivery experience...
September 30, 2016: HERD
C Kibaly, H H Loh, P-Y Law
Treatment of chronic pain has created a "silent epidemic," a term that describes the serious public health problem of the abuse of opioid painkillers and other prescription drugs. Conventional pharmacotherapy is limited by the loss of effectiveness in the long-term and by potentially lethal side effects. Efforts need to be focused on the development of nonpharmacological approaches. As significant progress is made in the viral vector technology, gene therapy involving recombinant viruses as vehicles may become a viable alternative for treatment of severe pain...
2016: International Review of Cell and Molecular Biology
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