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https://www.readbyqxmd.com/read/28079675/recent-advances-in-the-management-of-neuropsychiatric-symptoms-in-dementia
#1
Orestes V Forlenza, Júlia Cunha Loureiro, Marcos Vasconcelos Pais, Florindo Stella
PURPOSE OF REVIEW: The present article addresses intriguing questions related to the clinical intervention in distinct neuropsychiatric syndromes of patients with dementia. RECENT FINDINGS: We reviewed 154 articles published between 2015 and 2016 targeting psychopharmacological and nonpharmacological interventions, and safety-tolerability concerns. We selected 115 articles addressing the purpose of this study. Of these, 33 were chosen because they were dedicated to subtopics: agitation (42), depression (33), apathy (18), sleep disorders/anxiety (8), and psychosis (4)...
January 12, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28078203/catatonia-our-current-understanding-of-its-diagnosis-treatment-and-pathophysiology
#2
REVIEW
Sean A Rasmussen, Michael F Mazurek, Patricia I Rosebush
Catatonia is a psychomotor syndrome that has been reported to occur in more than 10% of patients with acute psychiatric illnesses. Two subtypes of the syndrome have been identified. Catatonia of the retarded type is characterized by immobility, mutism, staring, rigidity, and a host of other clinical signs. Excited catatonia is a less common presentation in which patients develop prolonged periods of psychomotor agitation. Once thought to be a subtype of schizophrenia, catatonia is now recognized to occur with a broad spectrum of medical and psychiatric illnesses, particularly affective disorders...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#3
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28076483/sedation-in-colonoscopy-by-using-three-different-propofol-infusion-methods-and-analysis-of-plasma-concentration-levels-a-prospective-comparative-study
#4
Paulo Henrique Boaventura de Carvalho, José Pinhata Otoch, Mohamad Ali Khan, Paulo Sakai, Hugo Gonçalo Guedes, Everson Luiz de Almeida Artifon
Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28075189/11-analytically-confirmed-cases-of-mexedrone-use-among-polydrug-users
#5
Liam Roberts, Loretta Ford, Neel Patel, J Allister Vale, Sally M Bradberry
INTRODUCTION: Mexedrone, 3-methoxy-2-(methylamino)-1-(4-methylphenyl)propan-1-one, is the alpha-methoxy-derivative of mephedrone (4-methyl-N-methyl cathinone). Mexedrone inhibits the re-uptake of serotonin and dopamine in a dose-dependent manner and has affinity for serotonin and dopamine membrane transporters and receptors (5-HT2 and D2 receptors), producing sympathomimetic effects similar to amfetamines. To date there are no published clinical reports on mexedrone use that are analytically confirmed...
January 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28074804/outcome-of-four-pretreatment-regimes-on-hemodynamics-during-electroconvulsive-therapy-a-double-blind-randomized-controlled-crossover-trial
#6
Devangi Ashutosh Parikh, Sanchita Nitin Garg, Naina Parag Dalvi, Priyanka Pradip Surana, Deepa Sannakki, Bharati Anil Tendolkar
CONTEXT: Electroconvulsive therapy (ECT) is associated with tachycardia and hypertension. AIMS: The aim of this study was to compare two doses of dexmedetomidine, esmolol, and lignocaine with respect to hemodynamics, seizure duration, emergence agitation (EA), and recovery profile. METHODOLOGY: Thirty patients undergoing ECT were assigned to each of the following pretreatment regimes over the course of five ECT sessions in a randomized crossover design: Group D1 (dexmedetomidine 1 μg/kg), Group D0...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074297/-delirium-analgesia-and-sedation-in-intensive-care-medicine-development-of-a-protocol-based-management-approach
#7
A Wolf, R Mörgeli, A Müller, B Weiss, C Spies
Intensive care treatment has long-term consequences that are often not immediately apparent to the health care providers. The combination of muscle weakness, cognitive damage, and psychological disorders is comprised under the term post-intensive care syndrome (PICS). Analgesia and sedation protocols, as well as nonpharmacological preventive and therapeutic approaches, are effective tools for avoiding complications and improving long-term survival. The principle of "early goal-directed therapy" is fundamental...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28067961/quality-of-life-in-relation-to-neuropsychiatric-symptoms-in-alzheimer-s-disease-5-year-prospective-alsova-cohort-study
#8
Kristiina Hongisto, Ilona Hallikainen, Tuomas Selander, Soili Törmälehto, Saku Väätäinen, Janne Martikainen, Tarja Välimäki, Sirpa Hartikainen, Jaana Suhonen, Anne M Koivisto
OBJECTIVE: To examine the association between neuropsychiatric symptoms (NPS) with self- and caregiver-rated Quality of Life (QoL) for patients with Alzheimer's disease (AD) during a 5-year follow-up. METHODS: The ALSOVA 5-year follow-up study included, at baseline, 236 patients with either very mild (Clinical Dementia Rating Scale (CDR) 0.5), or mild (CDR 1) AD, together with their caregivers from three Finnish hospital districts. QoL was evaluated using patient self-reported, and caregiver-rated, QoL in AD (QoL-AD) scores...
January 9, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28064156/high-prevalence-of-baffle-leaks-in-adults-after-atrial-switch-operations-for-transposition-of-the-great-arteries
#9
Gabriella De Pasquale, Francesca Bonassin Tempesta, Bruno Santos Lopes, Daniela Babic, Angela Oxenius, Theresa Seeliger, Christiane Gruner, Felix C Tanner, Patric Biaggi, Christine Attenhofer Jost, Matthias Greutmann
AIMS: To determine the prevalence of baffle leaks in adults after atrial switch operations for transposition of the great arteries, as these may predispose to paradoxical embolic events, particularly in patients with transvenous pacemaker or defibrillator leads. METHODS AND RESULTS: We routinely perform contrast echocardiography with agitated saline in all patients after atrial switch operations. For this study, we analysed patients who had saline contrast echocardiography between 2010 and 2012...
January 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28063863/correlation-between-observational-scales-of-sedation-and-comfort-and-bispectral-index-scores-bis
#10
Michael Barbato, Greg Barclay, Jan Potter, Wilf Yeo, Joseph Chung
CONTEXT: When palliative care patients enter the phase of unconsciousness preceding death it is standard practice to initiate or continue a subcutaneous infusion of an opioid plus or minus a sedative. The doses are determined somewhat empirically and adjustments are based on clinical assessment and observational measures of sedation and comfort. Following reports that these observational measures could be misleading, this study assesses their validity by comparing them with an objective measure of sedation, the Bispectral Index score (BIS)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28051993/serotonergic-synergy-in-the-pharmacotherapy-of-acute-posttraumatic-stress-disorder-exacerbation-a-case-report
#11
J Gibson Pennington, Jeffrey Guina
OBJECTIVE: Posttraumatic stress disorder (PTSD) is often associated with acute panic, dissociation, suicidality, and aggression. However, pharmacologic interventions for such acute exacerbations are understudied. In this article, we report a case of combat-related PTSD with severe panic, suicidality, and agitation which responded favorably to a combination of ziprasidone, propranolol, and hydroxyzine. METHODS: An extensive literature search did not reveal any use of this combination, and there were few studies about each medication individually, with regard to PTSD...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28044944/a-pragmatic-approach-to-the-diagnosis-and-treatment-of-mixed-features-in-adults-with-mood-disorders
#12
Roger S McIntyre, Yena Lee, Rodrigo B Mansur
Mixed features specifier (MFS) is a new nosological entity defined and operationalized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th Edition. The impetus to introduce the MFS and supplant mixed states was protean, including the lack of ecological validity, high rates of misdiagnosis, and guideline discordant treatment for mixed states. Mixed features specifier identifies a phenotype in psychiatry with greater illness burden, as evidenced by earlier age at onset, higher episode frequency and chronicity, psychiatric and medical comorbidity, suicidality, and suboptimal response to conventional antidepressants...
December 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28038782/-functional-decline-and-presence-of-symptoms-in-palliative-care-cause-or-consequence
#13
Alfredo Zamora-Mur, María Nabal-Vicuña, Aranzazu Zamora-Catevilla, Rafael García-Foncillas, Verónica Calderero-Aragón, Óscar Aubí-Catevilla, Fernando Lostalé-Latorre
INTRODUCTION: Several publications have related functional decline to the appearance of symptoms, especially psychiatric or psychological ones, such as anxiety and depression. Moreover, an initial depressive disorder or prior to functional decline usually worsens it. It was decided to investigate the relationship between the presence of functional decline, measured by a decrease in the Barthel index (BI), and the presence of symptoms. MATERIAL AND METHODS: A prospective analytical study conducted on patients referred to a Home Care Support Team (HCST)...
December 27, 2016: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28038388/evaluation-of-perampanel-in-patients-with-intellectual-disability-and-epilepsy
#14
Francesca M Snoeijen-Schouwenaars, Jans S van Ool, In Y Tan, Helenius J Schelhaas, Marian H J M Majoie
INTRODUCTION: Initial registration studies of perampanel (PMP), an AMPA receptor antagonist, have now been followed up by 'clinical' studies that confirmed its efficacy and safety in patients with refractory epilepsy. Publications on the use of PMP among patients with intellectual disability (ID) are still limited. This study extends our knowledge with respect to the relevance of PMP for patients with both ID and epilepsy, and furthermore specifies the behavioral side effects of PMP in this specific population...
December 27, 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28035924/the-effect-of-the-association-between-donepezil-and-choline-alphoscerate-on-behavioral-disturbances-in-alzheimer-s-disease-interim-results-of-the-ascomalva-trial
#15
Anna Carotenuto, Raffaele Rea, Enea Traini, Angiola Maria Fasanaro, Giovanna Ricci, Valentino Manzo, Francesco Amenta
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a group of psychological reactions, psychiatric symptoms, and behaviors commonly found in Alzheimer's disease (AD). Four clusters of BPSD have been described: mood disorders (depression, anxiety, and apathy), psychotic symptoms (delusions and hallucinations), aberrant motor behaviors (pacing, wandering, and other purposeless behaviors), and inappropriate behaviors (agitation, disinhibition, and euphoria). Most of them are attributed to acetylcholine deficiency...
December 30, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28031390/methylphenidate-cognition-and-epilepsy-a-double-blind-placebo-controlled-single-dose-study
#16
Jesse Adams, Valerie Alipio-Jocson, Katherine Inoyama, Victoria Bartlett, Saira Sandhu, Jemima Oso, John J Barry, David W Loring, Kimford Meador
OBJECTIVE: To evaluate the potential efficacy of immediate-release methylphenidate (MPH) for treating cognitive deficits in epilepsy. METHODS: This was a double-blind, randomized, single-dose, 3-period crossover study in patients with epilepsy and chronic cognitive complaints comparing the effects of placebo and MPH 10 and 20 mg given 1 week apart. Cognitive outcome was evaluated on the basis of an omnibus z score calculated from performance on the Conners Continuous Performance Test 3 (ability to discriminate between target and nontarget stimuli [d'] and hit reaction time standard deviation), Symbol-Digit Modalities Test, and Medical College of Georgia Paragraph Memory Test...
December 28, 2016: Neurology
https://www.readbyqxmd.com/read/28031070/mixed-features-in-bipolar-disorder
#17
Eva Solé, Marina Garriga, Marc Valentí, Eduard Vieta
Mixed affective states, defined as the coexistence of depressive and manic symptoms, are complex presentations of manic-depressive illness that represent a challenge for clinicians at the levels of diagnosis, classification, and pharmacological treatment. The evidence shows that patients with bipolar disorder who have manic/hypomanic or depressive episodes with mixed features tend to have a more severe form of bipolar disorder along with a worse course of illness and higher rates of comorbid conditions than those with non-mixed presentations...
December 29, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28027085/bispectral-index-can-reliably-detect-deep-sedation-in-mechanically-ventilated-patients-a-prospective-multicenter-validation-study
#18
Zhu-Heng Wang, Han Chen, Yan-Lin Yang, Zhong-Hua Shi, Qing-Hua Guo, Yu-Wei Li, Li-Ping Sun, Wei Qiao, Guan-Hua Zhou, Rong-Guo Yu, Kai Yin, Xuan He, Ming Xu, Laurent J Brochard, Jian-Xin Zhou
BACKGROUND: Excessively deep sedation is prevalent in mechanically ventilated patients and often considered suboptimal. We hypothesized that the bispectral index (BIS), a quantified electroencephalogram instrument, would accurately detect deep levels of sedation. METHODS: We prospectively enrolled 90 critically ill mechanically ventilated patients who were receiving sedation. The BIS was monitored for 24 hours and compared with the Richmond Agitation Sedation Scale (RASS) evaluated every 4 hours...
December 22, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28024853/inferior-vena-cava-compression-as-a-novel-maneuver-to-detect-patent-foramen-ovale-a%C3%A2-transesophageal-echocardiographic-study
#19
Eiji Yamashita, Tomoyuki Murata, Eri Goto, Takeshi Fujiwara, Takehito Sasaki, Kentaro Minami, Kohki Nakamura, Koji Kumagai, Shigeto Naito, Kazuomi Kario, Shigeru Oshima
BACKGROUND: The Valsalva maneuver, the most sensitive test for patent foramen ovale (PFO) detection, is difficult during transesophageal echocardiography (TEE), especially after sedation. The aim of this study was to compare PFO detection effectiveness between inferior vena cava (IVC) compression and the Valsalva maneuver. METHODS: A total of 293 patients with paroxysmal atrial fibrillation undergoing TEE before initial atrial fibrillation ablation were prospectively enrolled...
December 23, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28009620/the-treatment-of-disruptive-vocalization-in-dementia-behavioral-and-psychological-symptoms-of-dementia-with-electroconvulsive-therapy-a-case-series
#20
Timothy Edwin Lau, Prakash Kishor Babani, Lisa Anne McMurray
OBJECTIVE: There is emerging evidence that electroconvulsive therapy (ECT) can help with the behavioral and psychological symptoms of dementia. One of the most distressing behavioral symptoms of dementia is disruptive vocalization. Previous small case series have suggested that antidepressants and ECT can be beneficial for this distressing condition. The aim of this study was to describe the successful use of ECT in treating 5 patients with disruptive vocalization. METHODS: A retrospective chart review of 5 patients with dementia of mixed etiologies was conducted comparing pretreatment and posttreatment scores on the Cohen-Mansfield Agitation Inventory...
December 21, 2016: Journal of ECT
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