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https://www.readbyqxmd.com/read/28717823/-interdisciplinary-pain-assessment-in-the-hospital-setting-merely-a%C3%A2-door-opener-to-multimodal-pain-therapy
#1
E Sens, M Mothes-Lasch, J F Lutz
BACKGROUND: Chronic pain is characterized by a complex interaction of somatic, mental and social factors. Assessing these factors in patients with chronic pain is vital during the diagnostic work-up and when making a structured treatment plan. Interdisciplinary pain assessment (ISA) is the most promising method to deal with these challenges. This article presents our experience in performing pain assessments in the hospital setting and also illustrates the characteristic features of chronic pain patients undergoing such assessments...
July 17, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28716996/long-term-benzodiazepine-and-z-drugs-use-in-the-uk-a-survey-of-general-practice
#2
James Davies, Todd C Rae, Luke Montagu
BACKGROUND: Current British National Formulary (BNF) guidelines state that benzodiazepines and zolpidem, zopiclone, and zaleplon, commonly known as Z-drugs (BZD), be prescribed for no more than 4 weeks, although anecdotal data suggest that many patients are prescribed BZDs for much longer. As there are no recent, evidence-based estimates of long-term (>12 months) BZD use in the UK, the scale of this potential problem is unknown. AIM: To produce the first reliable, evidence-based estimate of long-term BZD use in the UK...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28716269/dopamine-agonist-withdrawal-syndrome-daws-in-a-tertiary-parkinson-disease-treatment-center
#3
Shnehal Patel, Xiomara Garcia, Mohammad Edrees Mohammad, Xin Xin Yu, Katelyn Vlastaris, Kaley O'Donnell, Kathryn Sutton, Hubert H Fernandez
INTRODUCTION: Dopamine agonists are a mainstay of treatment for patients with Parkinson disease (PD). However, side effects limit their use, often necessitating dose change. Upon withdrawal, patients may experience dopamine agonist withdrawal syndrome (DAWS). To date, there is no established protocol for the prevention or treatment of DAWS. METHODS: We performed a retrospective chart review of PD patients who were taking a dopamine agonist. RESULTS: In our large cohort of 313 PD patients who were on a dopamine agonist, we found that 39...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28716221/parkin-mutation-may-be-associated-with-serious-akinesia-in-a-patient-with-parkinson-s-disease
#4
Yuto Uchihara, Hiroshi Kataoka, Hiroyo Yoshino, Ryogo Syobatake, Nobutaka Hattori, Satoshi Ueno
Acute akinesia (AA) is an unusual motor complication in Parkinson's disease (PD). Reported risk factors for AA include infection, trauma, surgical intervention, and the withdrawal of antiparkinsonian medication. Recently, patients with genetic PD were reported to have a three-fold risk of AA than patients with non-genetic PD. We describe a patient with PD associated with a Parkin mutation in whom serious akinesia developed. A 42-year-old man with exon 2 heterozygous deletion and exon 4 heterozygous deletion in the PARK2 gene showed five unexpected AA for several 12h...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28714604/antidepressants-antipsychotics-and-mood-stabilizers-in-pregnancy-what-do-we-know-and-how-should-we-treat-pregnant-women-with-depression
#5
REVIEW
Asher Ornoy, Liza Weinstein-Fudim, Zivanit Ergaz
Depression is generally treated with antidepressants, but may often need antipsychotics and mood stabilizers. We discuss the updated data regarding the safety in pregnancy of antidepressants and antipsychotics, except selective serotonin reuptake inhibitors, and their possible impact on the long-term development of the offspring. Several earlier studies demonstrated a slight increase in the rate of major anomalies following maternal tricyclic antidepressant treatment, but most current literature shows their relative safety in pregnancy...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28714199/the-effect-of-dopaminergic-medication-on-conflict-adaptation-in-parkinson-s-disease
#6
Marit F L Ruitenberg, Elger L Abrahamse, Patrick Santens, Wim Notebaert
Parkinson's disease (PD) is a neurological disorder associated primarily with motor symptoms such as tremor, slowness of movement, and difficulties with gait and balance. Most patients take dopaminergic medication to improve their motor functions. Previous studies reported indications that such medication can impair higher cognitive functions (cf. dopamine overdose hypothesis). In the present study, we examined the effect of medication status on conflict adaptation. PD patients performed a Stroop task in which we manipulated the proportion of congruent and incongruent items, thereby allowing us to explore conflict adaptation...
July 16, 2017: Journal of Neuropsychology
https://www.readbyqxmd.com/read/28712356/discontinuing-psychiatric-medications-a-survey-of-long-term-users
#7
Laysha Ostrow, Lauren Jessell, Manton Hurd, Sabrina M Darrow, David Cohen
OBJECTIVE: Individuals undergoing long-term psychiatric treatment frequently choose to stop taking psychiatric medications. To enhance service user choice and prevent undesirable outcomes, this first U.S. survey of a large sample of longer-term users sought to increase knowledge about users' experience of medication discontinuation. METHODS: A sample of 250 U.S. adults with a diagnosis of serious mental illness and a recent goal to stop up to two prescribed psychiatric medications, which they had taken for at least nine months, completed a web-based survey about experiences, strategies, and supports during discontinuation...
July 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28710873/mecamylamine-treatment-for-alcohol-dependence-a-randomized-controlled-trial
#8
Ismene L Petrakis, Elizabeth Ralevski, Ralitza Gueorguieva, Stephanie S O'Malley, Albert Arias, Kevin A Sevarino, Jane S Jane, Erin O'Brien, John H Krystal
BACKGROUND AND AIMS: The nicotinic acetylcholine receptor antagonist, mecamylamine, is a potential novel pharmacotherapy for alcohol use disorder. The aims were to compare alcohol consumption between mecamylamine and placebo and test if smoking status modified treatment effects. DESIGN: Outpatient, randomized, double-blind clinical trial for 12 weeks of treatment with mecamylamine (10mg) (n=65) vs. placebo (n=63). SETTING: Connecticut, USA...
July 15, 2017: Addiction
https://www.readbyqxmd.com/read/28710724/best-candidates-for-dopamine-agonist-withdrawal-in-patients-with-prolactinomas
#9
Myoung Jin Ji, Jung Hee Kim, Ji Hyun Lee, Jung Hyun Lee, Yong Hwy Kim, Sun Ha Paek, Chan Soo Shin, Seong Yeon Kim
PURPOSE: Dopamine agonist (DA) therapy is recommended as the first-line treatment for prolactinomas. However, it requires long treatment duration, and a high recurrence rate after DA withdrawal has been reported. We aimed to elucidate the predictors for long-term remission following DA withdrawal and propose the best candidates who can achieve complete remission after DA withdrawal. METHODS: In a retrospective cohort study, we included 89 patients with prolactinoma who have withdrawn DAs with normal prolactin (PRL) levels at Seoul National University Hospital, from 2000 to 2016...
July 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28707583/cannabis-an-overview-of-its-adverse-acute-and-chronic-effects-and-their-implications
#10
Talitha C Ford, Amie C Hayley, Luke A Downey, Andrew C Parrott
In many communities, cannabis is perceived as a low-risk drug, leading to political lobbying to decriminalise its use. However, acute and chronic cannabis use has been shown to be harmful to several aspects of psychological and physical health, such as mood states, psychiatric outcomes, neurocognition, driving and general health. Furthermore, cannabis is highly addictive, and the adverse effects of withdrawal can lead to regular use. These in turn have adverse implications for public safety and health expenditure...
July 12, 2017: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/28702504/response-inhibition-in-parkinson-s-disease-a-meta-analysis-of-dopaminergic-medication-and-disease-duration-effects
#11
REVIEW
Peter Manza, Matthew Amandola, Vivekanand Tatineni, Chiang-Shan R Li, Hoi-Chung Leung
Parkinson's disease is a neurodegenerative disorder involving the basal ganglia that results in a host of motor and cognitive deficits. Dopamine-replacement therapy ameliorates some of the hallmark motor symptoms of Parkinson's disease, but whether these medications improve deficits in response inhibition, a critical executive function for behavioral control, has been questioned. Several studies of Parkinson's disease patients "on" and "off" (12-h withdrawal) dopaminergic medications suggested that dopamine-replacement therapy did not provide significant response inhibition benefits...
2017: NPJ Parkinson's Disease
https://www.readbyqxmd.com/read/28701842/quality-of-dying-in-the-medical-intensive-care-unit-comparison-between-thai-buddhists-and-thai-muslims
#12
Veerapong Vattanavanit, Supattra Uppanisakorn, Rungsun Bhurayanontachai, Bodin Khwannimit
BACKGROUND AND AIMS: Religious belief is an important aspect that influences the life of a patient, especially in Asia. We aim to compare the quality of death in an Intensive Care Unit (ICU) between Buddhists and Muslims from the perspectives of the relatives of the patients and the nurses and physicians. SUBJECTS AND METHODS: This was a cohort study of critically ill patients who died after admission to a medical ICU in Songklanagarind Hospital in Thailand between 2015 and 2016...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28701200/assessing-colonoscopic-inspection-skill-using-a-virtual-withdrawal-simulation-a-preliminary-validation-of-performance-metrics
#13
Christine M Zupanc, Guy M Wallis, Andrew Hill, Robin Burgess-Limerick, Stephan Riek, Annaliese M Plooy, Mark S Horswill, Marcus O Watson, Hans de Visser, David Conlan, David G Hewett
BACKGROUND: The effectiveness of colonoscopy for diagnosing and preventing colon cancer is largely dependent on the ability of endoscopists to fully inspect the colonic mucosa, which they achieve primarily through skilled manipulation of the colonoscope during withdrawal. Performance assessment during live procedures is problematic. However, a virtual withdrawal simulation can help identify and parameterise actions linked to successful inspection, and offer standardised assessments for trainees...
July 12, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28700791/efficacy-of-tramadol-extended-release-for-opioid-withdrawal-a-randomized-clinical-trial
#14
Kelly E Dunn, D Andrew Tompkins, George E Bigelow, Eric C Strain
Importance: Opioid use disorder (OUD) is a significant public health problem. Supervised withdrawal (ie, detoxification) from opioids using clonidine or buprenorphine hydrochloride is a widely used treatment. Objective: To evaluate whether tramadol hydrochloride extended-release (ER), an approved analgesic with opioid and nonopioid mechanisms of action and low abuse potential, is effective for use in supervised withdrawal settings. Design, Setting, and Participants: A randomized clinical trial was conducted in a residential research setting with 103 participants with OUD...
July 12, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28700092/oral-paracetamol-acetaminophen-for-cancer-pain
#15
REVIEW
Philip J Wiffen, Sheena Derry, R Andrew Moore, Ewan D McNicol, Rae F Bell, Daniel B Carr, Mairead McIntyre, Bee Wee
BACKGROUND: Pain is a common symptom with cancer, and 30% to 50% of all people with cancer will experience moderate to severe pain that can have a major negative impact on their quality of life. Non-opioid drugs are commonly used to treat mild to moderate cancer pain, and are recommended for this purpose in the WHO cancer pain treatment ladder, either alone or in combination with opioids.A previous Cochrane review that examined the evidence for nonsteroidal anti-inflammatory drugs (NSAIDs) or paracetamol, alone or combined with opioids, for cancer pain was withdrawn in 2015 because it was out of date; the date of the last search was 2005...
July 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28699845/development-and-implementation-of-an-alcohol-withdrawal-protocol-using-a-5-item-brief-alcohol-withdrawal-scale-baws
#16
Darius A Rastegar, Dinah Applewhite, Anika A H Alvanzo, Christopher Welsh, Timothy Niessen, Edward S Chen
BACKGROUND: The standard of care for management of alcohol withdrawal is symptom-triggered treatment using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. Many items of this 10-question scale rely on subjective assessments of withdrawal symptoms, making it time-consuming and cumbersome to use. Therefore, there is interest in shorter and more objective methods to assess alcohol withdrawal symptoms. METHODS: We initially piloted a 6-item withdrawal scale developed at another institution...
July 12, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28693445/older-persons-existential-loneliness-as-interpreted-by-their-significant-others-an-interview-study
#17
Helena Larsson, Margareta Rämgård, Ingrid Bolmsjö
BACKGROUND: In order to better understand people in demanding medical situations, an awareness of existential concerns is important. Studies performed over the last twenty years conclude that when dying and death come closer, as in the case with older people who are stricken by infirmity and diseases, existential concerns will come to the fore. However, studies concerning experiences of existential loneliness (EL) are sparse and, in addition, there is no clear definition of EL. EL is described as a complex phenomenon and referred to as a condition of life, an experience, and a process of inner growth...
July 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28692145/efficacy-and-safety-of-tiotropium-in-school-age-children-with-moderate-to-severe-symptomatic-asthma-a-systematic-review
#18
Gustavo J Rodrigo, Hugo Neffen
BACKGROUND: Recently published data support the benefits and safety of the once-daily (OD) long-acting anticholinergic tiotropium bromide bronchodilator for the treatment of uncontrolled moderate to severe asthma in adults and adolescents. However, its role for the treatment of school-age asthmatics has not yet been clearly defined. The aim of this systematic review was to assess the efficacy and safety of tiotropium Respimat(®) in children aged 6-11 years with moderate to severe symptomatic asthma...
July 10, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28688059/a-case-of-severe-refractory-hypotension-after-amlodipine-overdose
#19
Melissa Chudow, Kevin Ferguson
Calcium channel blockers (CCBs) are responsible for a substantial portion of the mortality associated with cardiovascular medication overdose cases. Amlodipine, a dihydropyridine CCB, can cause prolonged hypotension in overdose. This report describes a severe amlodipine overdose case that was refractory to multiple therapeutic approaches. A 53-year-old male presented after ingesting eighty 10 mg amlodipine tablets in a suicide attempt. The patient was initially managed with calcium boluses, glucagon, multiple vasoactive agents, lipid emulsion infusions and hyperinsulinemic euglycemic therapy...
July 7, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28683783/polydrug-abuse-among-opioid-maintenance-treatment-patients-is-related-to-inadequate-dose-of-maintenance-treatment-medicine
#20
Pertti Kalevi Heikman, Leea Hellevi Muhonen, Ilkka Antero Ojanperä
BACKGROUND: Polydrug abuse is a known problem among opioid-dependent patients receiving opioid maintenance treatment (OMT). However, improved laboratory diagnostics is required to reveal polydrug abuse in its current scope. Furthermore, there are few studies focusing on the relationship between polydrug abuse and adequacy of the dose of OMT medicine. This study aimed to evaluate the polydrug abuse among opioid-dependent patients receiving OMT with inadequate (Group IA) and adequate (Group A) doses of OMT medicine as experienced by the patients...
July 6, 2017: BMC Psychiatry
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