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https://www.readbyqxmd.com/read/28812302/management-of-sleep-wake-disturbances-comorbid-with-cancer
#1
Ann M Berger Aprn, Ellyn E Matthews Cbsm, Ashley M Kenkel
It is critical that clinicians and healthcare systems adopt routine screening and affordable interventions to reduce chronic insomnia and improve the quality of life in cancer patients and survivors. We provide expert clinical advice on how to manage sleep-wake disturbances that occur comorbidly with cancer. Our discussion focuses on the etiology, screening, and assessment of sleep-wake disturbances, and on both nonpharmacologic and pharmacologic interventions to manage sleep disturbances, insomnia, and sleep-related breathing disorders...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28807522/orthostatic-hypotension-a-practical-approach-to-investigation-and-management
#2
Amy C Arnold, Satish R Raj
The maintenance of blood pressure upon the assumption of upright posture depends on rapid cardiovascular adaptations driven primarily by the autonomic nervous system. Failure of these compensatory mechanisms can result in orthostatic hypotension (OH), defined as sustained reduction in systolic blood pressure > 20 mm Hg or diastolic blood pressure > 10 mm Hg within 3 minutes of standing or > 60° head-up tilt. OH is a common finding, particularly in elderly populations, associated with cardiovascular and cerebrovascular morbidity and mortality...
May 17, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28806160/delirium-in-hospitalized-patients-risks-and-benefits-of-antipsychotics
#3
REVIEW
Robyn Pauline Thom, Clare Kelleher Mock, Polina Teslyar
Consensus panel guidelines advocate for the judicious use of antipsychotic drugs to manage delirium in hospitalized patients when nonpharmacologic measures fail and the patient is in significant distress from symptoms, poses a safety risk to self or others, or is impeding essential aspects of his or her medical care. Here, we review the use of haloperidol, olanzapine, quetiapine, risperidone, and aripiprazole for this purpose.
August 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28802935/depression-and-anxiety-in-parkinson-s-disease
#4
Anette Schrag, Raquel N Taddei
Depression and anxiety are some of the most common comorbidities arising in patients with Parkinson's disease. However, their timely recognition and diagnosis are often hindered by overlap with other somatic features and a low rate of self-report. There is a need for greater awareness and for better assessment and treatment options are highly required. Currently available scales can serve as tools to monitor change over time and the effect of interventional strategies. Development of new therapeutic strategies, including nonpharmacological approaches such as transcranial magnetic stimulation and deep brain stimulation, may provide alternatives to currently available treatment approaches...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28802933/cognition-in-parkinson-s-disease
#5
Claire O'Callaghan, Simon J G Lewis
Cognitive decline is now recognized as a common nonmotor symptom of Parkinson's disease, and it has been the subject of increasing research in recent decades. Cognitive deficits in Parkinson's disease can be distinguished as dopaminergically mediated executive dysfunction seen in the milder stages vs a global dementia syndrome that can occur with disease progression. The neural basis of these deficits has been explored from the perspective of multimodal imaging techniques to measure the structural, functional, and metabolic correlates of cognitive decline in Parkinson's disease...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28802926/nonmotor-symptoms-and-natural-history-of-parkinson-s-disease-evidence-from-cognitive-dysfunction-and-role-of-noninvasive-interventions
#6
Roberta Biundo, Eleonora Fiorenzato, Angelo Antonini
Parkinson's disease (PD) is a common neurodegenerative disorder, characterized by motor and nonmotor symptoms (NMS). Several subsequent studies substantiate the great functional burden related to NMS, their progression, and negative effect on quality of life in PD. Additional evidence indicates interesting relationships between striatal dopaminergic function and NMS. The basal ganglia are implicated in the modulation and integration of sensory information and pain, bladder function is under control of both inhibitory (D1) and facilitatory (D2) dopaminergic inputs, finally reduced dopaminergic activity in the mesocortical and mesolimbic pathways is involved in the development of several NMS including mood, motivational, and cognitive alterations...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28800920/does-platelet-rich-plasma-lead-to-earlier-return-to-sport-when-compared-with-conservative-treatment-in-acute-muscle-injuries-a-systematic-review-and-meta-analysis
#7
Ujash Sheth, Tim Dwyer, Ira Smith, David Wasserstein, John Theodoropoulos, Sachdeep Takhar, Jaskarndip Chahal
PURPOSE: To compare the time to return to sport and reinjury rate after platelet-rich plasma (PRP) injection versus control therapy (i.e., physiotherapy or placebo injection) in patients with acute grade I or II muscle strains. METHODS: All eligible studies comparing PRP against a control in the treatment of acute (≤7 days) grade I or II muscle strains were identified. The primary outcome was time to return to play. The secondary outcome was the rate of reinjury at a minimum of 6 months of follow-up...
August 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28797377/pain-in-the-elderly-identification-evaluation-and-management-of-older-adults-with-pain-complaints-and-pain-related-symptoms
#8
REVIEW
Andrew Dentino, Roberto Medina, Eugene Steinberg
Pain is a common and often underappreciated and undermanaged problem in older adults. This article addresses the scope of the issue of pain prevalence in older adults, types of pain and their characteristics, approach to and clinical workup of older adults with pain complaints and pain-related symptoms, nonpharmacologic and pharmacologic management strategies, and caveats with attention to medication side effects in the elderly.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28796676/sleep-disorder-diagnosis-during-pregnancy-and-risk-of-preterm-birth
#9
Jennifer N Felder, Rebecca J Baer, Larry Rand, Laura L Jelliffe-Pawlowski, Aric A Prather
OBJECTIVE: To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). METHODS: In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28795688/interventional-and-surgical-occlusion-of-the-left-atrial-appendage
#10
REVIEW
Etem Caliskan, James L Cox, David R Holmes, Bernhard Meier, Dhanunjaya R Lakkireddy, Volkmar Falk, Sacha P Salzberg, Maximilian Y Emmert
With a steadily increasing prevalence, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide and an independent risk factor for stroke caused by thromboembolic events. The left atrial appendage (LAA) is the primary source of thromboemboli in patients with nonvalvular AF who have a stroke. Novel strategies (such as mechanical and nonpharmacological intervention) targeting the LAA in patients with AF for stroke prevention have become a major focus during the past decade. Some devices for percutaneous LAA occlusion are supported by robust clinical data obtained from randomized trials or large registries, and are a valid alternative to pharmacological stroke prevention...
August 10, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28794840/virtual-reality-distraction-decreases-routine-intravenous-sedation-and-procedure-related-pain-during-preoperative-adductor-canal-catheter-insertion-a-retrospective-study
#11
Pooja G Pandya, T Edward Kim, Steven K Howard, Erica Stary, Jody C Leng, Oluwatobi O Hunter, Edward R Mariano
BACKGROUND: Virtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion. METHODS: This 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28790808/copd-patients-self-reported-adherence-psychosocial-factors-and-mild-cognitive-impairment-in-pulmonary-rehabilitation
#12
Antonia Pierobon, Elisa Sini Bottelli, Laura Ranzini, Claudio Bruschi, Roberto Maestri, Giorgio Bertolotti, Marinella Sommaruga, Valeria Torlaschi, Simona Callegari, Anna Giardini
In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28782838/critical-appraisal-of-clinical-trials-in-multiple-system-atrophy-toward-better-quality
#13
REVIEW
Ana Castro Caldas, Johannes Levin, Ruth Djaldetti, Olivier Rascol, Gregor Wenning, Joaquim J Ferreira
Multiple system atrophy (MSA) is a rare neurodegenerative disease of undetermined cause. Although many clinical trials have been conducted, there is still no treatment that cures the disease or slows its progression. We sought to assess the clinical trials, methodology, and quality of reporting of clinical trails conducted in MSA patients. We conducted a systematic review of all trials with at least 1 MSA patient subject to any pharmacological/nonpharmacological interventions. Two independent reviewers evaluated the methodological characteristics and quality of reporting of trials...
August 7, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28779961/the-effect-of-swaddling-on-pain-vital-signs-and-crying-duration-during-heel-lance-in-newborns
#14
Zeynep Erkut, Suzan Yildiz
To determine the effect of swaddling on pain, vital signs, and crying duration during heel lance in the newborn. This was a randomized controlled study of 74 (control: 37, experiment: 37) newborns born between December 2013 and February 2014 at the Ministry of Health Bagcılar Training and Research Hospital. An information form, observation form, and Neonatal Infant Pain Scale were used as data collection tools. Data from the pain scores, peak heart rates, oxygen saturation, total crying time, and duration of the procedure were collected using a video camera...
August 2, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28779826/polypharmacy-and-medication-management-in-older-adults
#15
REVIEW
Jennifer Kim, Abby Luck Parish
Polypharmacy in older adults is a global problem that has recently worsened. Approximately 30% of adults aged 65 years and older in developed countries take 5 or more medications. Although prescribed and over-the-counter medications may improve a wide range of health problems, they also may cause or contribute to harm, especially in older adults. Polypharmacy in older adults is associated with worsening of geriatric syndromes and adverse drug events. Given the risks and burdens of polypharmacy and potentially inappropriate medications, nurses must use patient-centered approaches and nonpharmacologic strategies to treat common symptoms and to optimize patient function and quality of life...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779821/impaired-sleep-a-multifaceted-geriatric-syndrome
#16
REVIEW
Grace E Dean, Carleara Weiss, Jonna L Morris, Eileen R Chasens
Impaired sleep increases in prevalence in older adults, with multiple possible causes that can interact with each other and can lead to poor health outcomes. This article describes normal changes in sleep with aging, sleep disorders that increase in prevalence in older adults, medications and sleep, and medical conditions and psychosocial conditions associated with impaired sleep. In addition, a brief assessment that nurses could use to assess for impaired sleep and nonpharmacologic interventions to improve sleep are discussed...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28777006/cancer-pain-management-recommendations-from-a-latin-american-experts-panel
#17
Yolanda Escobar Alvarez, Claudia Agamez Insignares, Monica Ahumada Olea, Olga Barajas, German Calderillo R, Jenny Cecilia Calvache Guamán, Ricardo Caponero, Benjamín A Cavenago Salazar, Auro Del Giglio, Ana Rocío Pupo Araya, Ricardo Villalobos-Valencia, Andrés Yepes Pérez, Nilda Zumelzu Delgado
Generating a consensus in the Latin-American region on cancer pain management is a current need. Thus a panel of Latin-American experts met in Madrid in March 2017 in order to review the published literature, discuss the best approach for cancer pain classification and evaluation and also make recommendations of pharmacological and nonpharmacological therapies for cancer pain management improvement in Latin-American countries. The result of that meeting is presented in this document. The experts participating were from Costa Rica, Mexico, Chile, Colombia, Peru, Brazil and Ecuador, and the project coordinator was from Spain...
August 4, 2017: Future Oncology
https://www.readbyqxmd.com/read/28771285/assessment-diagnosis-and-treatment-of-binge-eating-disorder
#18
Janet A Ambrogne
Binge eating disorder (BED) is the most prevalent eating disorder in the United States, believed to affect an estimated 2.8 million adults. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, BED was recognized as a separate diagnosis. The purpose of the current article is to provide an overview of BED including assessment, diagnosis, and current pharmacological and nonpharmacological treatment options. Implications for nursing are also addressed. [Journal of Psychosocial Nursing and Mental Health Services, 55(8), 32-38...
August 1, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28770653/simple-lighting-manipulations-facilitate-behavioral-entrainment-of-mice-to-18-h-days
#19
Thijs J Walbeek, Michael R Gorman
In an invariantly rhythmic world, a robust and stable mammalian circadian clock is presumed to confer fitness advantages. In shift-work or after rapid transmeridian travel, however, a stable clock might be maladaptive and a more flexibly resettable clock may have advantages. The rate at which rodents can adjust to simulated time zone travel and the range of entrainment can be markedly increased through simple light manipulations, namely, by exposing animals to extremely dim light (<0.01 lux) at night or by bifurcating rhythms under 24-h light-dark-light-dark (LDLD) cycles...
July 1, 2017: Journal of Biological Rhythms
https://www.readbyqxmd.com/read/28767205/prevalence-and-pharmacotherapy-of-behavioral-and-psychological-symptoms-of-dementia-in-a-geriatric-psychiatry-unit-a-retrospective-analysis
#20
Arnim Quante, Atdhe Sulejmani
Objective: To observe (1) the proportion and nature of behavioral and psychological symptoms of dementia (BPSD) in patients treated at a geriatric psychiatry ward in Germany over a time span of 1 year and (2) the use and effect of various pharmacologic interventions in managing BPSD in a real-world scenario. Methods: This study was a naturalistic, retrospective analysis. Between May 2015 and May 2016, 437 patients aged 65 to 100 years with various psychiatric diseases (including dementia, schizophrenia, and depression) were admitted to a geriatric psychiatry unit in Germany...
July 27, 2017: Primary Care Companion to CNS Disorders
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