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https://www.readbyqxmd.com/read/28813123/pharmacotherapy-for-hypertension-in-adults-aged-18-to-59-years
#1
REVIEW
Vijaya M Musini, Francois Gueyffier, Lorri Puil, Douglas M Salzwedel, James M Wright
BACKGROUND: Hypertension is an important risk factor for adverse cardiovascular events including stroke, myocardial infarction, heart failure and renal failure. The main goal of treatment is to reduce these events. Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older. We wanted to know what the effects of therapy are in people 18 to 59 years of age...
August 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28812541/systematic-review-of-interventions-for-treating-or-preventing-antipsychotic-induced-tardive-dyskinesia
#2
Hanna Bergman, Dawn-Marie Walker, Adriani Nikolakopoulou, Karla Soares-Weiser, Clive E Adams
BACKGROUND: Antipsychotic medication can cause tardive dyskinesia (TD) - late-onset, involuntary, repetitive movements, often involving the face and tongue. TD occurs in > 20% of adults taking antipsychotic medication (first-generation antipsychotics for > 3 months), with this proportion increasing by 5% per year among those who continue to use these drugs. The incidence of TD among those taking newer antipsychotics is not different from the rate in people who have used older-generation drugs in moderate doses...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28811950/autoscopic-hallucination-in-alcohol-dependence-syndrome-a-rare-or-missed-phenomenon
#3
Sulochana Joshi, Binita Thapa, Rabi Shakya
Autoscopic phenomenon, a psychic illusionary duplication of one's own self, has been the subject of interest in the literature and science for years. It has been reported in various diseases of the central nervous system but with an unknown mechanism. Hallucinations are a common presentation in alcohol dependence syndrome during delirium tremens and as induced disorder. However, autoscopic hallucination has been rarely reported in the cases of alcohol dependence. We present a case of a 40-year-old man who experienced autoscopic hallucination during the withdrawal state of alcohol...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#4
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28808924/a-critical-evaluation-on-moh-current-treatments
#5
REVIEW
Andrea Negro, Martina Curto, Luana Lionetto, Simona Guerzoni, Luigi Alberto Pini, Paolo Martelletti
Migraine is the most frequent neurological disorder observed in clinical practice characterized by moderate to severe pain attacks associated with neurological, gastrointestinal, and dysautonomic symptoms. Each year, 2.5% of patients with episodic migraine develop chronic migraine (CM). CM is characterized by high frequency of the attacks that may result into chronic intake of abortive medications. Nearly, the 70% of CM patients referring to tertiary head centers show acute pain medications overuse that may lead to the development of medication overuse headache (MOH)...
August 15, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28805585/understanding-and-treating-pain-syndromes-in-parkinson-s-disease
#6
Marialuisa Gandolfi, Christian Geroin, Angelo Antonini, Nicola Smania, Michele Tinazzi
Pain affects many people with Parkinson's disease (PD) and diminishes their quality of life. Different types of pain have been described, but their related pathophysiological mechanisms remain unclear. The aim of this chapter is to provide movement disorders specialists an update about the pathophysiology of pain and a practical guide for the management of pain syndromes in clinical practice. This chapter reviews current knowledge on the pathophysiological mechanisms of sensory changes and pain in PD, as well as assessment and treatment procedures to manage these symptoms...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805115/hindrances-to-achieve-professional-confidence-the-nurse-s-participation-in-ethical-decision-making
#7
Anne Storaker, Dagfinn Nåden, Berit Sæteren
BACKGROUND: Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient's dignity in their clinical work. OBJECTIVES: The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28802938/impulse-control-and-related-disorders-in-parkinson-s-disease
#8
Daniel Weintraub, Daniel O Claassen
Impulse control disorders (ICDs), such as compulsive gambling, buying, sexual, and eating behaviors, are a serious and increasingly recognized complication in Parkinson's disease (PD), occurring in up to 20% of PD patients over the course of their illness. Related behaviors include punding (stereotyped, repetitive, purposeless behaviors), dopamine dysregulation syndrome (DDS) (compulsive medication overuse), and hobbyism (e.g., compulsive internet use, artistic endeavors, and writing). These disorders have a significant impact on quality of life and function, strain interpersonal relationships, and worsen caregiver burden, and are associated with significant psychiatric comorbidity...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28797271/successful-long-term-extracorporeal-membrane-oxygenation-for-invasive-pulmonary-aspergillosis-a-case-report
#9
Hiroyuki Tanaka, Kei Nishiyama, Nobuaki Shime
BACKGROUND: Extracorporeal membrane oxygenation is an established life-saving procedure for severe acute respiratory failure due to various causes. In general, the duration of extracorporeal membrane oxygenation ranges from 1 to 2 weeks, with withdrawal recommended if no improvement is noted. We report a successful case of long-term extracorporeal membrane oxygenation management for respiratory failure due to invasive pulmonary Aspergillus infection. CASE PRESENTATION: A 64-year-old Asian man with no previous underlying medical conditions was transferred to our hospital for fever and dyspnea...
August 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28795846/a-novel-non-opioid-protocol-for-medically-supervised-opioid-withdrawal-and-transition-to-antagonist-treatment
#10
Gregory Rudolf, Jim Walsh, Abigail Plawman, Paul Gianutsos, William Alto, Lloyd Mancl, Vania Rudolf
BACKGROUND: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies. METHODS: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin...
August 10, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28780696/evidence-and-decision-algorithm-for-the-withdrawal-of-antipsychotic-treatment-in-the-elderly-with-dementia-and-neuropsychiatric-symptoms
#11
REVIEW
Marta Miarons, Christopher Cabib, Francisco Javier Barón, Laia Rofes
PURPOSE: Antipsychotics (APs) are commonly used to manage neuropsychiatric symptoms (NPS) in elderly patients with dementia, even though several large studies have demonstrated an association between AP treatment and increased morbidity and mortality in people with dementia. The aim of this study is to review the scientific literature of the use of AP in the elderly with dementia and to propose an algorithm to assist in decision-making regarding the withdrawal of APs. METHODS: A computerized literature search (MEDLINE: 1966 to December 2016, EMBASE: 1982 to December 2016) was used to locate relevant literature...
August 5, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28777674/dsm-5-tobacco-use-disorder-and-sleep-disturbance-findings-from-the-national-epidemiologic-survey-on-alcohol-and-related-conditions-iii-nesarc-iii
#12
Amie C Hayley, Con Stough, Luke A Downey
INTRODUCTION: The DSM-5 Tobacco use disorder diagnosis incorporates tobacco misuse, addictive behaviors and withdrawal symptomology. Tobacco use is bidirectionally associated with sleep pathology; however, no epidemiological studies have yet evaluated the associations between DSM-5 Tobacco use disorder and self-reported sleep disturbance. The current study aimed to evaluate health, medical and sleep-related factors among individuals within this diagnostic stratum. METHOD: A total of N = 36,177 adults who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) were included for analyses...
August 4, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28774339/measurement-education-and-tracking-in-integrated-care-metric-use-of-a-culturally-adapted-education-tool-versus-standard-education-to-increase-engagement-in-depression-treatment-among-hispanic-patients-study-protocol-for-a-randomized-control-trial
#13
Katherine Sanchez, Brittany H Eghaneyan, Michael O Killian, Leopoldo Cabassa, Madhukar H Trivedi
BACKGROUND: Significant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Stigma and poor communication between patients and their providers result in low use of antidepressant medications and early treatment withdrawal. Cultural factors which influence treatment decisions among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications...
August 3, 2017: Trials
https://www.readbyqxmd.com/read/28771932/acute-liver-failure-induced-by-idiosyncratic-reaction-to-drugs-challenges-in-diagnosis-and-therapy
#14
Shannan R Tujios, William M Lee
Acute liver failure (ALF) requires urgent attention to identify etiology and determine prognosis, in order to assess likelihood of survival or need for transplantation. Identifying idiosyncratic drug-induced liver injury (iDILI) may be particularly difficult, but the illness generally follows a subacute course, allowing time to assess outcome and find a liver graft if needed. Not all drugs that cause iDILI lead to ALF; the most common are antibiotics including anti-tuberculous medications, non-steroidal anti-inflammatory agents and herbal and dietary supplements (HDS)...
August 3, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28769860/efficacy-and-tolerability-of-gabapentin-in-adults-with-sleep-disturbance-in-medical-illness-a-systematic-review-and-meta-analysis
#15
Guang Jian Liu, Md Rezaul Karim, Li Li Xu, Song Lin Wang, Chao Yang, Li Ding, Yun-Fu Wang
BACKGROUND AND PURPOSE: The aim of this study was to systematically review the efficacy and tolerability of gabapentin in the treatment of sleep disturbance in patients with medical illness. METHODS: PubMed was searched for randomized, double-blinded, placebo-controlled trials that reported sleep changes during gabapentin treatment up to November 2015. FINDINGS: This review included 26 studies involving 4,684 participants. Except for Composite Endpoint 3 [standardized mean difference (SMD) = 0...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28769859/adverse-effects-of-antidepressants-for-chronic-pain-a-systematic-review-and-meta-analysis
#16
Carina Riediger, Tibor Schuster, Kristian Barlinn, Sarah Maier, Jürgen Weitz, Timo Siepmann
BACKGROUND: Antidepressants are widely used in the treatment of chronic pain. Applied doses are lower than those needed to unfold an antidepressive effect. While efficacy of antidepressants for chronic pain has been reported in large randomized-controlled trials (RCT), there is inconsistent data on adverse effects and tolerability. We aimed at synthesizing data from RCT to explore adverse effect profiles and tolerability of antidepressants for treatment of chronic pain. METHODS: Systematic literature research and meta-analyses were performed regarding side effects and safety of different antidepressants in the treatment of chronic pain according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28768628/risk-of-neonatal-drug-withdrawal-after-intrauterine-co-exposure-to-opioids-and-psychotropic-medications-cohort-study
#17
Krista F Huybrechts, Brian T Bateman, Rishi J Desai, Sonia Hernandez-Diaz, Kathryn Rough, Helen Mogun, Leslie S Kerzner, Jonathan M Davis, Megan Stover, Devan Bartels, Jennifer Cottral, Elisabetta Patorno
Objectives To assess the impact of in utero co-exposure to psychotropic medications and opioids on the incidence and severity of neonatal drug withdrawal.Design Observational cohort study.Setting Nationwide sample of pregnancies in publicly insured women in the US, nested in the Medicaid Analytic eXtract (2000-10).Participants 201 275 pregnant women with public insurance who were exposed to opioids around the time of delivery and their liveborn infants.Interventions In utero exposure to psychotropic medications, in particular antidepressants, atypical antipsychotics, benzodiazepines, gabapentin, and non-benzodiazepine hypnotics (Z drugs), with prescriptions filled within the same time window as prescriptions for opioids...
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28766237/the-toxicology-investigators-consortium-case-registry-the-2016-experience
#18
Lynn A Farrugia, Sean H Rhyee, Diane P Calello, Sharan L Campleman, Anne M Riederer, Hannah R Malashock, Anthony Pizon, Timothy Wiegand, Paul M Wax, Jeffrey Brent
The Toxicology Investigators Consortium (ToxIC) Case Registry was established by the American College of Medical Toxicology in 2010. The Registry contains data from participating sites with the agreement that all bedside medical toxicology consultations will be entered. Currently, 83% of accredited medical toxicology fellowship programs in the USA participate. The Registry continues to grow each year, and as of 31 December 2016, a new milestone was reached, with more than 50,000 cases reported since its inception...
August 1, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28763808/endocuff-assisted-colonoscopy-is-associated-with-a-lower-adenoma-miss-rate-a-multicenter-randomized-tandem-study
#19
Konstantinos Triantafyllou, Dimitrios Polymeros, Periklis Apostolopoulos, Catarina Lopes Brandao, Paraskevas Gkolfakis, Alessandro Repici, Ioannis S Papanikolaou, Mario Dinis-Ribeiro, George Alexandrakis, Cesare Hassan
Background and study aims The Endocuff (ARC Medical Design, Leeds, UK) is a device that, when mounted on the tip of an endoscope, may assist with inspection of a greater surface of the colonic mucosa by pulling backwards, flattening, and stretching the colonic folds as the endoscope is gradually withdrawn. We aimed to compare the adenoma miss rates of Endocuff-assisted colonoscopy with those of conventional colonoscopy. Patients and methods The included patients underwent same-day, back-to-back, (Endocuff-assisted colonoscopy as the index procedure followed by conventional colonoscopy or vice versa, randomly assigned 1:1) colonoscopies, performed by six endoscopists with documented adenoma detection rates > 35 %, in four tertiary endoscopy facilities...
August 1, 2017: Endoscopy
https://www.readbyqxmd.com/read/28754353/-futile-care-an-emergency-medicine-approach-ethical-and-legal-considerations
#20
Jeremy R Simon, Chadd Kraus, Mark Rosenberg, David H Wang, Elizabeth P Clayborne, Arthur R Derse
Futility often serves as a proposed reason for withholding or withdrawing medical treatment, even in the face of patient and family requests. Although there is substantial literature describing the meaning and use of futility, little of it is specific to emergency medicine. Furthermore, the literature does not provide a widely accepted definition of futility, and thus is difficult if not impossible to apply. Some argue that even a clear concept of futility would be inappropriate to use. This article will review the origins of and meanings suggested for futility, specific challenges such cases create in the emergency department (ED), and the relevant legal background...
July 26, 2017: Annals of Emergency Medicine
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