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https://www.readbyqxmd.com/read/28804788/pro-dopamine-regulator-kb220-to-balance-brain-reward-circuitry-in-reward-deficiency-syndrome-rds
#1
Kenneth Blum, Marcelo Febo, Lyle Fried, David Baron, Eric R Braverman, Kristina Dushaj, Mona Li, Zsolt Demetrovics, Rajendra D Badgaiyan
We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...
2017: Journal of Reward Deficiency Syndrome and Addiction Science
https://www.readbyqxmd.com/read/28801124/changing-our-approach-to-stage-d-heart-failure
#2
REVIEW
Miriam Becnel, Hector O Ventura, Selim R Krim
Despite the tremendous progress made in the management of heart failure (HF), many patients reach advanced stages. This paper aims to present a practical approach to the stage D HF patient who is no longer responding to optimal medical therapy. We discuss all available therapies for this patient population. We also offer some important caveats with regard to identification, risk stratification, evaluation and treatment including early patient referral to a center with an advanced HF program. Given the changing landscape of heart transplantation and an impending change in the allocation system, we also intend to engage a discussion on the need for a paradigm shift towards left ventricular assist device therapy in this population...
August 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#3
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28795284/dermatofibrosarcoma-protuberans
#4
REVIEW
Alvaro E Acosta, Catalina Santa Vélez
Dermatofibrosarcoma protuberans (DFSP) is a slow growing tumor with a very low metastatic potential but with significant subclinical extension and great capacity for local destruction. Thus, the first surgeon approached with such challenging tumor must attempt to cure the patient with a method that spares healthy tissue and ensures an optimal oncological, functional, and esthetic result. The treatment of DFSP often requires a multidisciplinary approach. Depending on location, dermatologic surgeons, surgical oncologists, head and neck surgeons, neurosurgeons, plastic surgeons, and occasionally medical oncologists may be involved with the management...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28795245/a-systematic-review-and-meta-analysis-of-the-treatment-of-anal-fissure
#5
REVIEW
R L Nelson, D Manuel, C Gumienny, B Spencer, K Patel, K Schmitt, D Castillo, A Bravo, A Yeboah-Sampong
BACKGROUND: Anal fissure has a very large number of treatment options. The choice is difficult. In an effort to assist in that, choice presented here is a systematic review and meta-analysis of all published treatments for anal fissure that have been studied in randomized controlled trials. METHODS: Randomized trials were sought in the Cochrane Controlled Trials Register, Medline, EMBASE and the trials registry sites clinicaltrials.gov and who/int/ictrp/search/en...
August 9, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28792572/-the-management-of-depression-in-older-adults-and-their-family-caregivers-findings-from-a-research-program-in-quebec
#6
Jane McCusker, Mark Yaffe, Tamara Sussman, Martin Cole, Maida Sewitch, Erin Strumpf, Ellen Freeman, Sylvie Lambert, Manon de Raad
Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Montreal, has conducted a research program over the past two decades that aims to inform improvements in the management of depression in primary care and general medical settings, among older adults. This paper reviews the findings from this research program, discusses the findings in the context of other research, and highlights the implications for practice and health policy.Methods Narrative review and synthesis of 25 published articles, that included: 4 systematic reviews, 10 observational studies, 9 intervention trials, and 2 consensus conference reports...
2017: Santé Mentale Au Québec
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#7
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#8
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28777182/driving-safety-and-fitness-to-drive-in-sleep-disorders
#9
Jon Tippin, Mark Eric Dyken
Driving an automobile while sleepy increases the risk of crash-related injury and death. Neurologists see patients with sleepiness due to obstructive sleep apnea, narcolepsy, and a wide variety of neurologic disorders. When addressing fitness to drive, the physician must weigh patient and societal health risks and regional legal mandates. The Driver Fitness Medical Guidelines published by the National Highway Traffic Safety Administration (NHTSA) and the American Association of Motor Vehicle Administrators (AAMVA) provide assistance to clinicians...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28776873/the-systematic-tool-to-reduce-inappropriate-prescribing-strip-combining-implicit-and-explicit-prescribing-tools-to-improve-appropriate-prescribing
#10
A Clara Drenth-van Maanen, Anne J Leendertse, Paul A F Jansen, Wilma Knol, Carolina J P W Keijsers, Michiel C Meulendijk, Rob J van Marum
Inappropriate prescribing is a major health care issue, especially regarding older patients on polypharmacy. Multiple implicit and explicit prescribing tools have been developed to improve prescribing, but these have hardly ever been used in combination. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) combines implicit prescribing tools with the explicit Screening Tool to Alert physicians to the Right Treatment and Screening Tool of Older People's potentially inappropriate Prescriptions criteria and has shared decision-making with the patient as a critical step...
August 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28776095/treatment-of-age-related-neovascular-macular-degeneration-the-patient-s-perspective
#11
S Müller, C Ehlken, U Bauer-Steinhusen, W Lechtenfeld, Z Hasanbasic, H Agostini, T Wilke
OBJECTIVES: The aim of this study was to assess patients' views and expectations with regard to neovascular age-related macular degeneration (nAMD) and intravitreal anti-VEGF therapy (IVT). METHODS: We conducted a multicenter, non-interventional, prospective cohort study including nAMD patients treated with IVT in Germany. Patients with at least one IVT before study enrollment and aged ≥50 years were included. Three telephone interviews were conducted during a 12-month observational period...
August 4, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28772036/implantation-of-a-left-ventricular-assist-device-to-provide-long-term-support-for-end-stage-duchenne-muscular-dystrophy-associated-cardiomyopathy
#12
Douglas Stoller, Faris Araj, Alpesh Amin, Catherine Fitzsimmons, Robert Morlend, Jennifer T Thibodeau, Claudio Ramaciotti, Mark H Drazner, Dan M Meyer, Pradeep P A Mammen
A young man with Duchenne muscular dystrophy presented to the UT Southwestern Neuromuscular Cardiomyopathy Clinic with advanced heart failure. Despite maximal medical therapy, his cardiac function continued to decline requiring initiation of inotrope therapy. Given the patient's clinical deterioration, a left ventricular assist device (LVAD) was implanted as destination therapy after undergoing a multidisciplinary assessment. The patient tolerated the surgical implantation of the LVAD without any significant complications, and he has had a relatively unremarkable course 38 months post-LVAD implantation...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28771478/patients-in-palliative-care-development-of-a-predictive-model-for-anxiety-using-routine-data
#13
Sonja Hofmann, Stephanie Hess, Carsten Klein, Gabriele Lindena, Lukas Radbruch, Christoph Ostgathe
INTRODUCTION: Anxiety is one of the most common psychological symptoms in patients in a palliative care situation. This study aims to develop a predictive model for anxiety using data from the standard documentation routine. METHODS: Data sets of palliative care patients collected by the German quality management benchmarking system called Hospice and Palliative Care Evaluation (HOPE) from 2007 to 2011 were randomly divided into a training set containing two-thirds of the data and a test set with the remaining one-third...
2017: PloS One
https://www.readbyqxmd.com/read/28767296/advance-care-planning-discussions-with-adolescent-and-young-adult-cancer-patients-admitted-to-a-community-palliative-care-service-a-retrospective-case-note-audit
#14
Sophie Fletcher, Rachel Hughes, Sarah Pickstock, Kirsten Auret
PURPOSE: Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. METHODS: Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015...
August 2, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28764713/non-iterative-geometric-approach-for-inverse-kinematics-of-redundant-lead-module-in-a-radiosurgical-snake-like-robot
#15
Olatunji Mumini Omisore, Shipeng Han, Lingxue Ren, Nannan Zhang, Kamen Ivanov, Ahmed Elazab, Lei Wang
BACKGROUND: Snake-like robot is an emerging form of serial-link manipulator with the morphologic design of biological snakes. The redundant robot can be used to assist medical experts in accessing internal organs with minimal or no invasion. Several snake-like robotic designs have been proposed for minimal invasive surgery, however, the few that were developed are yet to be fully explored for clinical procedures. This is due to lack of capability for full-fledged spatial navigation. In rare cases where such snake-like designs are spatially flexible, there exists no inverse kinematics (IK) solution with both precise control and fast response...
August 1, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28760474/impact-of-postoperative-liver-dysfunction-on-survival-after-left-ventricular-assist-device-implantation
#16
Kaustav Majumder, John R Spratt, Christopher T Holley, Samit S Roy, Rebecca J Cogswell, Kenneth Liao, Ranjit John
BACKGROUND: Liver dysfunction in left ventricular assist device (LVAD) recipients is common both before and after implantation. Postoperative liver dysfunction (PLD) develops in some LVAD recipients without preoperative liver dysfunction. The aim of this study was to assess clinical outcomes in such patients. METHODS: Records of all patients undergoing implantation of a HeartMate II (HM II, St. Jude Medical, Inc, Minneapolis, MN) LVAD at a single center at the University of Minnesota from January 2005 through June 2014 were analyzed...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28756504/the-relational-impact-of-multiple-sclerosis-an-integrative-review-of-the-literature-using-a-cognitive-analytic-framework
#17
Joanna Blundell Jones, Sue Walsh, Claire Isaac
This integrative literature review uses cognitive analytic therapy (CAT) theory to examine the impact of a chronic illness, multiple sclerosis (MS), on relationships and mental health. Electronic searches were conducted in six medical and social science databases. Thirty-eight articles met inclusion criteria, and also satisfied quality criteria. Articles revealed that MS-related demands change care needs and alter relationships. Using a CAT framework, the MS literature was analysed, and five key patterns of relating to oneself and to others were identified...
July 29, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28752193/readmissions-after-continuous-flow-left-ventricular-assist-device-implantation
#18
Mitsutoshi Kimura, Kan Nawata, Osamu Kinoshita, Haruo Yamauchi, Yasuhiro Hoshino, Masaru Hatano, Eisuke Amiya, Koichi Kashiwa, Miyoko Endo, Yukie Kagami, Mariko Nemoto, Minoru Ono
Continuous flow left ventricular assist device (CF-LVAD) therapy has improved the survival of patients with advanced heart failure. However, the readmission rate of CF-LVAD patients is still relatively high. A total of 90 patients who received CF-LVADs between April 2011 and March 2016 at our institute and were discharged home were analyzed retrospectively. They were followed up through March 2017. Clinical data, including frequency, length and etiology of readmission, were obtained from medical records. The mean observation period after initial discharge was 713 ± 322 days...
July 27, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28747138/perspectives-on-rehabilitation-of-children-with-cerebral-palsy-exploring-a-cross-cultural-view-of-parents-from-india-and-canada-using-the-international-classification-of-functioning-disability-and-health
#19
Pranay Jindal, Joy C MacDermid, Peter Rosenbaum, Briano DiRezze, Amitesh Narayan
PURPOSE: To explore parents' perspectives on rehabilitation of their child with cerebral palsy and their information needs. METHODS: Semistructured interviews were conducted with parents of children with CP from India (n = 11) and Canada (n = 7). Data were analyzed through an interpretive description approach using the International Classification of Functioning, Disability and Health framework. RESULTS: Body Structure and Function: Indian parents were more focused on fixing body structure and function challenges, and independent walking, than Canadian parents...
July 26, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28745986/ventilation-in-extremely-preterm-infants-and-respiratory-function-at-8-years
#20
COMPARATIVE STUDY
Lex W Doyle, Elizabeth Carse, Anne-Marie Adams, Sarath Ranganathan, Gillian Opie, Jeanie L Y Cheong
BACKGROUND: Assisted ventilation for extremely preterm infants (<28 weeks of gestation) has become less invasive, but it is unclear whether such developments in care are associated with improvements in short-term or long-term lung function. We compared changes over time in the use of assisted ventilation and oxygen therapy during the newborn period and in lung function at 8 years of age in children whose birth was extremely premature. METHODS: We conducted longitudinal follow-up of all survivors of extremely preterm birth who were born in Victoria, Australia, in three periods - the years 1991 and 1992 (225 infants), 1997 (151 infants), and 2005 (170 infants)...
July 27, 2017: New England Journal of Medicine
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