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Medication withdrawal

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https://www.readbyqxmd.com/read/28433926/discredited-legacy-stigma-and-familial-amyloid-polyneuropathy-in-northwestern-portugal
#1
Álvaro Mendes, Liliana Sousa, Jorge Sequeiros, Angus Clarke
RATIONALE: Genetic inherited conditions may result in feelings of stigmatisation, mainly because of visible physical appearance and its transmissibility to offspring. OBJECTIVE: This article reports accounts of stigmatisation from Portuguese patients affected by the inherited neurodegenerative disease, familial amyloid polyneuropathy (FAP), living in the largest cluster of patients worldwide. METHOD: We draw on semi-structured interviews conducted with individuals at-risk or affected by FAP, recruited through the national patients' association, about their experiences of stigmatisation related to the illness...
April 15, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28430755/differentiating-delirium-from-sedative-hypnotic-related-iatrogenic-withdrawal-syndrome-lack-of-specificity-in-pediatric-critical-care-assessment-tools
#2
Kate Madden, Michele M Burns, Robert C Tasker
OBJECTIVES: To identify available assessment tools for sedative/hypnotic iatrogenic withdrawal syndrome and delirium in PICU patients, the evidence supporting their use, and describe areas of overlap between the components of these tools and the symptoms of anticholinergic burden in children. DATA SOURCES: Studies were identified using PubMed and EMBASE from the earliest available date until July 3, 2016, using a combination of MeSH terms "delirium," "substance withdrawal syndrome," and key words "opioids," "benzodiazepines," "critical illness," "ICU," and "intensive care...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28424803/use-of-a-flumazenil-infusion-to-treat-chlordiazepoxide-toxicity
#3
I R Wallace, E C Campbell, M Trimble
"Alcohol detox" is a common presentation to acute medical services and is usually managed via standardised guidelines and protocols. We present a case of chlordiazepoxide toxicity, requiring repeated bolus doses and subsequently 24 hours of an intravenous infusion of flumazenil in response to guideline directed management of an alcohol withdrawal state. The use of prolonged flumazenil infusions to treat benzodiazepine toxicity is infrequently described. Chlordiazepoxide is metabolised in the hepatic microsomal pathway and hepatic impairment can lead to accumulation of toxic metabolites, which may have been the explanation for toxicity in this case...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28421999/use-and-withdrawal-of-immunosuppressors-in-primary-sj%C3%A3-gren-s-syndrome
#4
Jiram Torres-Ruiz, David Faz-Muñoz, Nora Hernández-Díaz, Gabriela Hernandez-Molina
OBJECTIVES: To assess the use and causes of withdrawal of glucocorticoids and immunosuppressors among patients with primary Sjögren's syndrome (pSS) in the clinical setting. METHODS: We retrospectively reviewed the medical records of 155 pSS patients and registered demographics, glandular/extraglandular features, serological data, cumulative ESSDAI and SSDDI. A single rheumatologist attributed the indication and cause of withdrawal of glucocorticoids and immunosuppressors...
April 18, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28414849/-the-rights-of-the-dying-the-refusal-of-medical-treatments-in-argentine-courts
#5
Juan Pedro Alonso
This paper addresses the judicialization of end of life medical decision-making, as part of the advance of the justice system in the regulation of medical practice and the rise of recognition of patient autonomy. The article analyzes, from a sociological standpoint, legal decisions regarding treatment refusal at the end of life produced by the Argentine courts between 1975 and 2015. Based on a qualitative design, 38 sentences collected from jurisprudential databases using key terms were analyzed. First, judicialized cases during the period are described; these are characterized by a high proportion of claims presented by health institutions, a pro-treatment bias in the legal actions requested, and a high percentage of unnecessary litigation in the absence of conflicts or in situations that do not require court intervention...
July 2016: Salud Colectiva
https://www.readbyqxmd.com/read/28412926/acute-symptomatic-seizures-in-geriatric-patients-with-multiple-risk-factors-a-diagnostic-challenge
#6
Ralf Landwehr, Robert Liszka
Acute symptomatic seizures and epileptic disorders are frequent health problems of elderly patients. An early and reliable distinction of the seizure etiology is important to ensure adequate treatment, and to prevent unwarranted diagnostic and therapeutic procedures. The most common causes of acute symptomatic seizures - acute cerebrovascular disorders, metabolic disorders, traumatic brain injury, meningo-encephalitis, cerebral tumors, and withdrawal of alcohol and other central agents - are well-defined and seem to permit straightforward diagnostic and therapeutic strategies...
April 13, 2017: Current Aging Science
https://www.readbyqxmd.com/read/28406856/treating-women-who-are-pregnant-and-parenting-for-opioid-use-disorder-and-the-concurrent-care-of-their-infants-and-children-literature-review-to-support-national-guidance
#7
Stacey L Klaman, Krystyna Isaacs, Anne Leopold, Joseph Perpich, Susan Hayashi, Jeff Vender, Melinda Campopiano, Hendrée E Jones
OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28404154/active-observation-versus-interval-appendicectomy-after-successful-non-operative-treatment-of-an-appendix-mass-in-children-china-study-an-open-label-randomised-controlled-trial
#8
Nigel J Hall, Simon Eaton, Michael P Stanton, Agostino Pierro, David M Burge
BACKGROUND: Despite a scarcity of supporting evidence, most surgeons recommend routine interval appendicectomy after successful non-operative treatment of an appendix mass in children. We aimed to compare routine interval appendicectomy with active observation. METHODS: We enrolled participants in the CHildren's INterval Appendicectomy (CHINA) study, a multicentre, open-label, randomised controlled study at 19 specialist paediatric surgery centres, 17 of which were in the UK, one in Sweden, and one in New Zealand...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396815/catatonia-secondary-to-sudden-clozapine-withdrawal-a-case-with-three-repeated-episodes-and-a-literature-review
#9
John Bilbily, Betsy McCollum, Jose de Leon
A literature search identified 9 previously published cases that were considered as possible cases of catatonia secondary to sudden clozapine withdrawal. Two of these 9 cases did not provide enough information to make a diagnosis of catatonia according to the Diagnostic and Statistical Manual, 5th Edition (DSM-5). The Liverpool Adverse Drug Reaction (ADR) Causality Scale was modified to assess ADRs secondary to drug withdrawal. From the 7 published cases which met DSM-5 catatonia criteria, using the modified scale, we established that 3 were definitive and 4 were probable cases of catatonia secondary to clozapine withdrawal...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28395845/complementary-feeding-at-4-versus-6-months-of-age-for-preterm-infants-born-at-less-than-34-weeks-of-gestation-a-randomised-open-label-multicentre-trial
#10
Shuchita Gupta, Ramesh Agarwal, Kailash Chandra Aggarwal, Harish Chellani, Anil Duggal, Sugandha Arya, Sunita Bhatia, Mari Jeeva Sankar, Vishnubhatla Sreenivas, Vandana Jain, Arun Kumar Gupta, Ashok K Deorari, Vinod K Paul
BACKGROUND: Evidence on the optimal time to initiation of complementary feeding in preterm infants is scarce. We examined the effect of initiation of complementary feeding at 4 months versus 6 months of corrected age on weight for age at 12 months corrected age in preterm infants less than 34 weeks of gestation. METHODS: In this open-label, randomised trial, we enrolled infants born at less than 34 weeks of gestation with no major malformation from three public health facilities in India...
May 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28393968/-encapsulating-peritoneal-sclerosis
#11
Rubén Torres, Paula Ebner, María Eugenia Sanhueza, Miriam Alvo, Erico Segovia, Paula Segura
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is a complication of peritoneal dialysis (PD) with a low prevalence but high mortality. It is characterized by peritoneal inflammation and fibrosis with subsequent development of intestinal encapsulation. It is associated with a long lapse on PD, frequent episodes of peritonitis, high glucose solution use, and high peritoneal transport status. AIM: To report the clinical features of patients on PD, who developed EPS...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28392910/drug-shortages-in-israel-regulatory-perspectives-challenges-and-solutions
#12
Eyal Schwartzberg, Denize Ainbinder, Alla Vishkauzan, Ronni Gamzu
BACKGROUND: Pharmaceutical drug shortages (DSs) are a global problem which presents challenges to countries around the world. Shortages of pharmaceutical products may have a direct detrimental impact on public health and patients' wellbeing by causing delayed, or even lack of, treatment. Moreover, DSs may force both patients and caregivers to use unfamiliar drugs, which could lead to medication errors. The objective of our study was to analyze DSs in Israel during the years 2013-2015, assessing their etiology and exploring the steps taken for their mitigation and prevention...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28389482/what-are-the-risks-and-benefits-of-temporarily-discontinuing-medications-to-prevent-acute-kidney-injury-a-systematic-review-and-meta-analysis
#13
Penny Whiting, Andrew Morden, Laurie A Tomlinson, Fergus Caskey, Thomas Blakeman, Charles Tomson, Tracey Stone, Alison Richards, Jelena Savović, Jeremy Horwood
OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28388864/clinical-and-histologic-features-of-azathioprine-induced-hepatotoxicity
#14
Sith Siramolpiwat, Dussadee Sakonlaya
BACKGROUND: Hepatoxicity is a relative uncommon complication related with Azathioprine, however most studies were performed in inflammatory bowel diseases patients. The aim of this study is to report the clinical profile of patients with Azathioprine-induced hepatotoxicity. METHODS: All medical records of patients received Azathioprine from 2010 to 2015 were retrospectively reviewed. Hepatotoxicity was defined as serum alanine aminotransferase (ALT) or aspatate aminotransferase (AST) or total bilirubin >2 times upper limit normal...
April 7, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28385310/prevalence-and-clinical-manifestations-of-primary-aldosteronism-encountered-in-primary%C3%A2-care%C3%A2-practice
#15
Silvia Monticone, Jacopo Burrello, Davide Tizzani, Chiara Bertello, Andrea Viola, Fabrizio Buffolo, Luisa Gabetti, Giulio Mengozzi, Tracy A Williams, Franco Rabbia, Franco Veglio, Paolo Mulatero
BACKGROUND: Despite being widely recognized as the most common form of secondary hypertension, among the general hypertensive population the true prevalence of primary aldosteronism (PA) and its main subtypes, aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH), remains a matter of debate. OBJECTIVES: This study sought to determine the prevalence and clinical phenotype of PA in a large cohort of unselected patients with hypertension, consecutively referred to our hypertension unit, by 19 general practitioners from Torino, Italy...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28382713/ultra-small-superparamagnetic-iron-oxides-for-metastatic-lymph-node-detection-back-on-the-block
#16
REVIEW
Ansje S Fortuin, Roger Brüggemann, Janine van der Linden, Ilia Panfilov, Bas Israël, Tom W J Scheenen, Jelle O Barentsz
In the past 15 years, encouraging clinical results for the detection of small lymph node metastases was obtained by the use of Combidex-enhanced MRI (CEM, also known as magnetic resonance lymphography). Withdrawal of the European Medicines Agency approval application by the manufacturer made it impossible for patients to benefit from this agent; a loss, especially for men with prostate cancer. Current conventional imaging techniques are not as accurate as CEM is, thus a surgical diagnostic exploration (extended lymph node dissection) is still the preferred technique to evaluate the lymph nodes, resulting in peri- and postoperative complications...
April 6, 2017: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/28379321/use-of-psychoactive-medication-in-short-and-long-term-abstainers-from-alcohol
#17
Bertrand Nalpas, Pascal Perney
Aim: To document the use of prescribed psychoactive medicines in France in patients recovering from alcohol use disorders (AUDs). Method: Survey among short- and long-term abstainers attending groups of French self-help associations for AUDs, recording socio-demographic profile, duration of abstinence, prescription of psychoactive medication and attitudes towards that, and whether or not in medical or psychological follow-up for AUD. Result: Five hundred seventy-five abstainers participated...
April 4, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28378050/adrenal-vein-sampling-for-primary-aldosteronism-a-2-week-protocol-for-withdrawal-of-renin-stimulating-antihypertensives
#18
Kevin C Ching, Debbie L Cohen, Douglas L Fraker, Scott O Trerotola
OBJECTIVE: For evaluation of primary aldosteronism, international guidelines recommend a 4-6 week withdrawal of spironolactone, eplerenone, and amiloride prior to adrenal vein sampling (AVS). It is not always feasible to withdraw these drugs in patients with severe hypertension and hypokalemia. We present our experience evaluating the efficacy and clinical outcomes of a 2-week protocol for withdrawal of renin-stimulating antihypertensives prior to AVS. DESIGN: A single-center retrospective review of all patients who underwent AVS for primary aldosteronism between January 2014 and December 2015...
April 4, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28376406/availability-of-dopamine-transporters-in-heroin-dependent-subjects-a-18-f-fecnt-pet-imaging-study
#19
Shasha Xu, Ying Liu, Yu Li, Yangping Deng, Jie Yuan, Rongbin Lv, Yuankai Wang, Guangming Zhang, Zhirui Guo, Daxu Fu, Hui Zeng, Mei Han, Xingdang Liu
This study was to reconfirm the reduced dopamine transporter (DAT) availability in heroin-dependent subjects and validate the use of 2β-carbomethoxy-3β-(4-chlorophenyl)-8-(2-fluoroethyl)-nortropane ((18)F-FECNT) as a PET radiotracer to assess the changes of striatal DAT in drug addicted subjects. Herein, we assessed DAT standardized uptake values (SUV) of (18)F-FECNT in the striatum and cerebellum of 20 heroin-dependent subjects and 10 healthy controls and analyzed the correlation between DAT availability and heroin withdrawal symptom scores and anxiety/depression rating scales in heroin-dependent subjects, as well as the relationship between the withdrawal symptoms scores and age...
March 25, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28376379/the-effect-of-subthalamic-stimulation-on-viscoelastic-stiffness-of-skeletal-muscles-in-patients-with-parkinson-s-disease
#20
Tõnu Rätsep, Toomas Asser
BACKGROUND: Myotonometric evaluation of viscoelastic stiffness of skeletal muscles has been proposed to document the effect of surgical or pharmacological treatment on rigidity in patients with Parkinson's disease. The aim of the study was to analyze the changes of viscoelastic stiffness induced by deep brain stimulation. METHODS: Fifteen patients in an advanced stage of Parkinson's disease participated in the study. The study took place in the off-medication conditions after one night of drug withdrawal...
March 29, 2017: Clinical Biomechanics
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