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https://www.readbyqxmd.com/read/28632523/frontotemporal-dementia-presenting-as-gambling-disorder-when-a-psychiatric-condition-is-the-clue-to-a-neurodegenerative-disease
#1
Giacomo Tondo, Fabiola De Marchi, Emanuela Terazzi, Marta Sacchetti, Roberto Cantello
Behavioral variant frontotemporal dementia, the most common form of frontotemporal dementia, is characterized by executive dysfunction and changes in personality and behavior, sometimes with associated psychiatric disorders. We report a man who suddenly developed a gambling disorder when he was 55 years old. A year later he developed personality changes of agitation, euphoria, and disinhibition, along with binge eating and dysthymia. He did not improve on paroxetine 40 mg/day. Two years after the onset of his symptoms, he came to our clinic for evaluation...
June 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/28631765/-noninvasive-ventilation-and-sedation-evidence-and-practical-tools-for-its-utilization
#2
Ilaria Battistoni, Marco Marini, Giorgio Caretta, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Massimo Iacoviello, Renata De Maria, Serafina Valente, Michele Massimo Gulizia
Noninvasive ventilation (NIV) has gained increased acceptance inside the critical area, since it has been shown to be effective in reducing or avoiding the need for oro-tracheal intubation. NIV efficacy is dependent on the selection of the appropriate patients and on their compliance to therapy. Actually, full collaboration is not easily reached especially in agitated patients.Sedation during NIV is useful to reduce the rate of treatment failure, but robust data to guide the development of best practice are limited and sometimes local customs appear to exert a strong influence on patterns of care...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28623497/-psychiatric-emergencies
#3
F Schneider, S Weber-Papen
Psychiatric emergencies present a frequent and interdisciplinary challenge. Clinical diagnosis and management are complicated by the acuity, and the patient's compliance is often limited by the illness. Psychiatric emergencies include states of acute agitation, suicidality, delirium, stupor, and drug-induced emergencies. Sometimes interventions such as conversational contact, responding empathically to patients, or "talking down" are sufficient. If pharmacotherapy is necessary, benzodiazepines and antipsychotic drugs are the primary agents of choice...
June 16, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28623009/s%C3%A3-ntomas-neuropsiqui%C3%A3-tricos-como-factor-de-confusi%C3%A3-n-en-la-detecci%C3%A3-n-de-la-demencia
#4
David Córcoles, Angeles Malagón, Magdalena Bellsolà, Ana Gonzalez, Romina Cortizo, Jordi Leon, Antoni Bulbena, Victor Pérez, Luis M Martín
OBJECTIVE: The aim of the study was to evaluate whether the neuropsychiatric symptoms interfere with cognitive impairment detection in primary care and to describe which of them generate more confusion. DESIGN: Descriptive and observational study. LOCATION: Mobile psychiatric unit in collaboration with primary healthcare centers in Barcelona. PARTICIPANTS: A total of 104 patients over 65years referred to mobile psychiatric unit from primary healthcare clinicians suspecting mental disease...
June 13, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28620429/novel-approaches-to-ultrasonography-of-the-lung-and-pleural-space-where-are-we-now
#5
REVIEW
Daniel Lichtenstein
This review article is an update of what should be known for practicing basic lung ultrasound in the critically ill (LUCI) and is also of interest for less critical disciplines (e.g. pulmonology). It pinpoints on the necessity of a professional machine (not necessarily a sophisticated one) and probe. It lists the 10 main signs of LUCI and some of the main protocols made possible using LUCI: the BLUE protocol for a respiratory failure, the FALLS protocol for a circulatory failure, the SESAME protocol for a cardiac arrest and the investigation of a ventilated acute respiratory distress syndrome patient, etc...
June 2017: Breathe
https://www.readbyqxmd.com/read/28616094/arbaclofen-in-fragile-x-syndrome-results-of-phase-3-trials
#6
Elizabeth Berry-Kravis, Randi Hagerman, Jeannie Visootsak, Dejan Budimirovic, Walter E Kaufmann, Maryann Cherubini, Peter Zarevics, Karen Walton-Bowen, Paul Wang, Mark F Bear, Randall L Carpenter
BACKGROUND: Arbaclofen improved multiple abnormal phenotypes in animal models of fragile X syndrome (FXS) and showed promising results in a phase 2 clinical study. The objective of the study is to determine safety and efficacy of arbaclofen for social avoidance in FXS. METHODS: Two phase 3 placebo-controlled trials were conducted, a flexible dose trial in subjects age 12-50 (209FX301, adolescent/adult study) and a fixed dose trial in subjects age 5-11 (209FX302, child study)...
2017: Journal of Neurodevelopmental Disorders
https://www.readbyqxmd.com/read/28614434/post-stroke-psychosis-how-long-should-we-treat
#7
Maria do Céu Ferreira, Célia Machado, Beatriz Santos, Álvaro Machado
Objective: To describe a rare case of a patient who developed psychotic symptoms after a right stroke that disappeared with antipsychotic treatment, but appears to need low-dose maintenance antipsychotic therapy. Case description: A 65-year-old man presented at the psychiatric emergency service with a history of persistent delusional jealousy, visual illusions and agitation with onset about 1 month after a right posterior cerebral artery ischemic stroke. These symptoms only disappeared with therapeutic dosages of an antipsychotic drug (3 mg/day of risperidone)...
June 12, 2017: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28614197/sedation-management-in-children-supported-on-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure
#8
James B Schneider, Todd Sweberg, Lisa A Asaro, Aileen Kirby, David Wypij, Ravi R Thiagarajan, Martha A Q Curley
OBJECTIVES: To describe sedation management in children supported on extracorporeal membrane oxygenation for acute respiratory failure. DESIGN: Secondary analysis of prospectively collected data from a multicenter randomized trial of sedation (Randomized Evaluation of Sedation Titration for Respiratory Failure). SETTING: Twenty-one U.S. PICUs. PATIENTS: One thousand two hundred fifty-five children, 2 weeks to 17 years old, with moderate/severe pediatric acute respiratory distress syndrome...
June 13, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28614125/development-and-validation-of-a-risk-scale-for-emergence-agitation-after-general-anesthesia-in-children-a-prospective-observational-study
#9
Maai Hino, Takahiro Mihara, Saeko Miyazaki, Toshiyuki Hijikata, Takaaki Miwa, Takahisa Goto, Koui Ka
BACKGROUND: Emergence agitation (EA) is a common complication in children after general anesthesia. The goal of this 2-phase study was (1) to develop a predictive model (EA risk scale) for the incidence of EA in children receiving sevoflurane anesthesia by performing a retrospective analysis of data from our previous study (phase 1) and (2) to determine the validity of the EA risk scale in a prospective observational cohort study (phase 2). METHODS: Using data collected from 120 patients in our previous study, logistic regression analysis was used to predict the incidence of EA in phase 1...
June 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28613368/-rapid-tranquillisation-for-agitated-patients-with-psychostimulant-intoxication
#10
P Geerts, K Titeca, G M D Lemmens, J De Fruyt
Because psychostimulant intoxication can lead to serious health risks for the patient, it is often necessary to ensure that the patient receives both adequate medical surveillance and rapid tranquillisation.<br/> AIM: To find out whether there is scientific evidence that psychopharmacological intervention helps patients with psychostimulant intoxication to manage aggression and agitation.<br/> METHOD: We searched the literature systematically.<br/> RESULTS: Our study showed that intravenous droperidol worked faster and was more effective than intravenous lorazepam in inducing sedation in patients intoxicated with psychostimulants...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28612365/knowledge-attitude-and-practice-of-intensive-care-unit-nurses-about-physical-restraint
#11
Mohammad Suliman, Sami Aloush, Khitam Al-Awamreh
BACKGROUND: Physical restraint is mainly used in intensive care units (ICUs) to prevent delirious or agitated patients from removing tubes and lines connected to them. However, inappropriate use of physical restraint could have many detrimental physical effects on the patient, such as nerve damage, asphyxiation or even death. AIM: The aim of the study is to investigate nurses' knowledge, attitude and practice of physical restraint in ICUs in Jordanian hospitals, about which little is known...
June 13, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28609340/effect-of-interscalene-brachial-plexus-block-on-the-pulmonary-function-of-obese-patients-a-prospective-observational-cohort-study
#12
M Stephen Melton, Hanni E Monroe, Wenjing Qi, Stephanie L Lewis, Karen C Nielsen, Stephen M Klein
BACKGROUND: The effect of interscalene block (ISB) on pulmonary function of obese participants has not been investigated. The goal of this study is to assess the association of obesity (body mass index [BMI] >29 kg/m vs BMI <25 kg/m) and change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) after ISB in participants undergoing outpatient shoulder surgery. METHODS: This prospective, observational cohort study compared obese (BMI >29 kg/m) and normal-weight (BMI <25 kg/m) groups undergoing ISB for ambulatory shoulder surgery, on preblock and postblock FVC and FEV1, at 30 minutes postblock and in the postanesthesia care unit (PACU)...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28608540/sevoflurane-vs-propofol-in-post-operative-catheter-related-bladder-discomfort-a-prospective-randomized-study
#13
H-C Kim, H-P Park, J Lee, M-H Jeong, K-H Lee
BACKGROUND: Post-operative catheter-related bladder discomfort (CRBD) causes increased emergence agitation. Muscarinic receptor activation is a major mechanism in CRBD development. Experimental studies showed that sevoflurane has anti-muscarinic effects whereas propofol does not. Our hypothesis was that sevoflurane anaesthesia would reduce the incidence of CRBD following bladder surgery. METHODS: In total, 82 patients undergoing transurethral bladder tumour excision (TURBT) were assigned randomly to two groups according to the maintenance anaesthetic agent received: sevoflurane (n = 41) or propofol (n = 41)...
June 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28606595/a-multisite-retrospective-study-evaluating-the-implementation-of-the-pasero-opioid-induced-sedation-scale-poss-and-its-effect-on-patient-safety-outcomes
#14
Christie Davis, Christopher Geik, Karen Arthur, James Fuller, Elizabeth Johnston, Francesca Levitt, Edward Leung, Gregory McCart, Derek McMichael, Julie Painter, Therese Staublin, Todd Walroth
The Joint Commission recommended the Pasero Opioid-induced Sedation Scale (POSS) to minimize opioid-induced respiratory depression. However, there is a paucity of data describing its impact on patient safety. This study assessed the impact of POSS implementation or reeducation on naloxone use in patients receiving hydromorphone. This retrospective, Institutional Review Board-approved study performed with the Indianapolis Coalition for Patient Safety was conducted in two phases, 3 months before and after intervention...
June 9, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28602751/time-of-elevation-of-head-of-bed-for-patients-receiving-mechanical-ventilation-and-its-related-factors
#15
L Martí-Hereu, A Arreciado Marañón
INTRODUCTION: The semirecumbent position is a widespread recommendation for the prevention of pneumonia associated with mechanical ventilation. AIMS: To identify the time of elevation of head of bed for patients under mechanical ventilation and the factors related to such elevation in an intensive care unit. MATERIALS AND METHODS: An observational, descriptive cross-sectional study. Conducted in an intensive care unit of a tertiary hospital from April to June 2015...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28601627/effects-of-small-dose-dexmedetomidine-on-hyperdynamic-responses-to-electroconvulsive-therapy
#16
Xiang Li, Fang Tan, Chao-Jun Jian, Na Guo, Zhi-Yong Zhong, Zi-Qing Hei, Shao-Li Zhou
BACKGROUND: Acute hemodynamic responses to electroconvulsive therapy (ECT) may increase the risk of cardiovascular complications in vulnerable patients. The aim of the current study was to assess the effect of small-dose dexmedetomidine on hyperdynamic responses to ECT. METHODS: Seventy-eight patients were enrolled and randomly allocated to receive either 0.2 μg/kg dexmedetomidine (Dex group, n = 39) or saline (Control group, n = 39) prior to ECT. Heart rate (HR) and mean arterial pressure (MAP) were recorded immediately after the administration of dexmedetomidine (T1), and 0, 1, 3, 5 and 10 min after the electrical stimuli ended (T2, T3, T4, T5 and T6)...
June 7, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28598043/clinical-profile-of-hypertensive-emergencies-in-an-intensive-care-unit
#17
Shubhangi V Dhadke, Vithal N Dhadke, Dhruv S Batra
AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28597920/a-case-of-nonfatal-intoxication-associated-with-the-recreational-use-of-diphenidine
#18
Enrico Gerace, Elena Bovetto, Daniele Di Corcia, Marco Vincenti, Alberto Salomone
Diphenidine is a dissociative drug that shows several psychotropic effects including euphoria, shifts in perception of reality, hallucinations, and transient anterograde amnesia. In this study, a case of acute intoxication occurring after diphenidine intake is reported. A 30-year-old Caucasian male was hospitalized after he was found in a confused and agitated state and unable to communicate. The physical examination displayed tachycardia, miotic pupils, and increased both body temperature and respiratory rate...
June 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28595522/implementation-of-dynamic-lighting-in-a-nursing-home-impact-on-agitation-but-not-on-rest-activity-patterns
#19
Amely Wahnschaffe, Claudia Nowozin, Sven Haedel, Andreas Rath, Stefan Appelhof, Mirjam Münch, Dieter Kunz
Disturbances of circadian rest-activity rhythms in demented patients often culminate in the clinical problem of evening and nighttime agitation. The aim of the current study was to test the impact of a dynamic lighting system on agitation and rest-activity cycles. From midwinter on, a ceiling mounted dynamic lighting system was installed in the common room of a nursing home and programmed to produce high illuminance with higher blue light proportions during the day and lower illuminance without blue light in the evening...
June 7, 2017: Current Alzheimer Research
https://www.readbyqxmd.com/read/28594246/a-review-of-vilazodone-exposures-with-focus-on-serotonin-syndrome-effects
#20
C William Heise, Hannah Malashock, Daniel E Brooks
BACKGROUND: Vilazodone is an antidepressant with selective serotonin reuptake inhibition and partial 5HT1A agonism. Serotonin syndrome is believed to be due to excessive stimulation of 5-HT2A and 5-HT1A receptors, resulting in the clinical triad of altered mentation, autonomic instability and neuromuscular abnormalities. The goal of this study is to define serotonergic effects after vilazodone exposure. METHODS: A retrospective review of two databases: the American Association of Poison Controls Centers' National Poison Data System (NPDS) and the American College of Medical Toxicology's Toxicology Investigators Consortium (ToxIC Registry)...
June 8, 2017: Clinical Toxicology
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