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Refractory Bipolar

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https://www.readbyqxmd.com/read/28892425/laparoscopic-resection-of-a-pancreatic-%C3%AE-cell-tumor-in-a-dog
#1
Janet Kovak Mcclaran, Philippa Pavia, Anthony J Fischetti, Taryn A Donovan
Laparoscopic partial pancreatectomy has been performed in experimental canine studies and has been evaluated in human medicine but has not been reported in a clinical veterinary case. The authors present a 9 yr old field spaniel with weakness and hypoglycemia with insulin levels and Amended Insulin: Glucose Ratio results equivocal for a pancreatic insulinoma. Multiple abdominal ultrasounds did not detect the tumor, yet dual-phase computed tomographic angiography revealed the presence of a focal hypoattenuating nodule in the left lobe of the pancreas...
September 11, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28876373/minimally-invasive-epicardial-pacemaker-implantation-in-neonates-with-congenital-heart-block
#2
Roberto Costa, Katia Regina da Silva, Martino Martinelli Filho, Roger Carrillo
BACKGROUND: Few studies have characterized the surgical outcomes following epicardial pacemaker implantation in neonates with congenital complete atrioventricular block (CCAVB). OBJECTIVE: This study sought to assess the long-term outcomes of a minimally invasive epicardial approach using a subxiphoid access for pacemaker implantation in neonates. METHODS: Between July 2002 and February 2015, 16 consecutive neonates underwent epicardial pacemaker implantation due to CCAVB...
September 4, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28866299/clinical-experience-using-intranasal-ketamine-in-the-longitudinal-treatment-of-juvenile-bipolar-disorder-with-fear-of-harm-phenotype
#3
Demitri Papolos, Mark Frei, Daniel Rossignol, Steven Mattis, Laura C Hernandez-Garcia, Martin H Teicher
OBJECTIVES: Fear of Harm (FOH) is a pediatric onset phenotype of bipolar disorder (BD) characterized by BD plus treatment resistance, separation anxiety, aggressive obsessions, parasomnias, and thermal dysregulation. Intranasal ketamine (InK) in 12 youths with BD-FOH produced marked improvement during a two-week trial. Here we report on the open effectiveness and safety of InK in maintenance treatment of BD-FOH from the private practice of one author. METHODS: As part of a chart review, patients 18 years or older and parents of younger children responded to a clinical effectiveness and safety survey...
August 30, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28852259/chlorpromazine-as-prophylaxis-for-bipolar-disorder-with-treatment-and-electroconvulsive-therapy-refractory-mania-old-horse-new-trick
#4
Tamonud Modak, Saurabh Kumar, Arghya Pal, Rishab Gupta, Raman Deep Pattanayak, Sudhir Kumar Khandelwal
A 22-year-old male diagnosed with bipolar affective disorder presented to us with a 3(rd) episode mania resistant to both olanzapine and haloperidol as well as electroconvulsive therapy. He, however, responded to chlorpromazine (CPZ) which was also effective as a mood stabilizer. The patient had a relapse of his illness when CPZ was stopped and responded again when it was started. The case demonstrates that CPZ may have a role in as both an anti-manic agent and for the maintenance for bipolar disorders. The possible underlying mechanism for this role is also discussed...
July 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28843212/the-influence-of-endophenotypic-disease-specific-and-environmental-variables-on-the-expression-of-anxiety-in-pediatric-epilepsy
#5
William A Schraegle, Jeffrey B Titus
Children and adolescents with epilepsy often show higher rates of anxiety, which carries an increased risk for reduced health-related quality of life (HRQOL). The current study assessed the role of parental psychiatric history (i.e., anxiety, depression, and/or bipolar disorder) on the rate of anxiety features in youth seen in a tertiary epilepsy clinic. Data included parental ratings on the Behavior Assessment System for Children (BASC-2) and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 180 children and adolescents (mean age=11...
August 23, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28744855/seizure-outcome-after-hippocampal-deep-brain-stimulation-in-patients-with-refractory-temporal-lobe-epilepsy-a-prospective-controlled-randomized-double-blind-study
#6
Arthur Cukiert, Cristine Mella Cukiert, Jose Augusto Burattini, Pedro Paulo Mariani, Daniela Fontes Bezerra
OBJECTIVE: We designed a prospective, randomized, controlled, double-blind study to evaluate the efficacy of hippocampal deep brain stimulation (Hip-DBS) in patients with refractory temporary lobe epilepsy (TLE). METHODS: Sixteen adult patients with refractory TLE were studied. Patient's workup included medical history, interictal and ictal electroencephalography (EEG), and high-resolution 1.5T magnetic resonance imaging (MRI). Patients were randomized on a 1:1 proportion to an active (stimulation on) or to a control (no stimulation) arm...
July 26, 2017: Epilepsia
https://www.readbyqxmd.com/read/28738324/the-link-between-refractoriness-and-neuroprogression-in-treatment-resistant-bipolar-disorder
#7
Isabelle E Bauer, Jair C Soares, Salih Selek, Thomas D Meyer
Treatment refractoriness remains one of the biggest challenges in the field of bipolar disorder (BD) as treatments are often suboptimal or unsatisfactory. Recent evidence points towards a potential link between the progressively evolving nature of BD, increased inflammation, and reduced treatment response. There are several medications and other somatic treatments available, but remission rates are low, and medication compliance is still problematic. Psychotherapeutic techniques appear to be promising in several disease states and in relapse prevention, but additional research is needed to determine who will benefit from what strategy the most...
2017: Modern Trends in Pharmacopsychiatry
https://www.readbyqxmd.com/read/28686543/a-physician-s-attempt-to-self-medicate-bipolar-depression-with-n-n-dimethyltryptamine-dmt
#8
Tanida Brown, Wanda Shao, Shehzad Ayub, David Chong, Christian Cornelius
N,N-dimethyltryptamine (DMT) is a psychoactive substance that has been gaining popularity in therapeutic and recreational use. This is a case of a physician who chronically took DMT augmented with phenelzine in an attempt to self-medicate refractory bipolar depression. His presentation of altered mental status, mania, and psychosis is examined in regards to his DMT use. This case discusses DMT, the possible uses of DMT, and the theorized mechanism of DMT in psychosis and treatment of depression, particularly involving its agonist activity at 5-HT1A, 5-HT2A, and 5-HT2C...
July 7, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28659991/bupropion-maintenance-treatment-in-refractory-bipolar-depression-a-case-report
#9
Julia Dehning, Heinz Grunze, Armand Hausmann
BACKGROUND: The optimal duration of antidepressant treatment in bipolar depression appears to be controversial due to a lack of quality evidence, and guideline recommendations are either vague or contradictive. This is especially true for second line treatments such as bupropion that had not been subject to rigourous long term studies in Bipolar Disorder. CASE PRESENTATION: We report the case of a 75 year old woman who presented with treatment refractory bipolar depression...
2017: Clinical Practice and Epidemiology in Mental Health: CP & EMH
https://www.readbyqxmd.com/read/28659508/resolution-of-refractory-bipolar-disorder-with-psychotic-features-and-suicidality-through-lifestyle-interventions-a-case-report
#10
Kelly Brogan
Background • This case illustrates the relationship between gut, hormonal, and brain function in that dietary change, mindfulness interventions, and detoxification led to resolution of disabling luteally exacerbated psychiatric symptoms. Summary • A 45-y-old, married, Caucasian female with a history of diagnosed bipolar disorder with psychotic features, premenstrual dysphoric disorder, panic disorder, and repeated occurrence of suicide attempts and self-mutilating behavior presented for outpatient management...
April 2017: Advances in Mind-body Medicine
https://www.readbyqxmd.com/read/28578510/trans-falcine-and-contralateral-sub-frontal-electrode-placement-in-pediatric-epilepsy-surgery-technical-note
#11
Jonathan Pindrik, Nguyen Hoang, R Shane Tubbs, Brandon J Rocque, Curtis J Rozzelle
INTRODUCTION: Phase II monitoring with intracranial electroencephalography (ICEEG) occasionally requires bilateral placement of subdural (SD) strips, grids, and/or depth electrodes. While phase I monitoring often demonstrates a preponderance of unilateral findings, individual studies (video EEG, single photon emission computed tomography [SPECT], and positron emission tomography [PET]) can suggest or fail to exclude a contralateral epileptogenic onset zone. This study describes previously unreported techniques of trans-falcine and sub-frontal insertion of contralateral SD grids and depth electrodes for phase II monitoring in pediatric epilepsy surgery patients when concern about bilateral abnormalities has been elicited during phase I monitoring...
August 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28573688/autoantibodies-against-voltage-gated-potassium-channel-vgkc-and-glutamic-acid-decarboxylase-gad-in-psychosis-a-systematic-review-meta-analysis-and-case-series
#12
REVIEW
Rosemary Grain, John Lally, Brendon Stubbs, Steffi Malik, Anne Lemince, Timothy R Nicholson, Robin M Murray, Fiona Gaughran
Antibodies to the voltage-gated potassium channel (VGKC) complex and glutamic acid decarboxylase (GAD) have been reported in some cases of psychosis. We conducted the first systematic review and meta-analysis to investigate their prevalence in people with psychosis and report a case series of VGKC-complex antibodies in refractory psychosis. Only five studies presenting prevalence rates of VGKC seropositivity in psychosis were identified, in addition to our case series, with an overall prevalence of 1.5% (25/1720) compared to 0...
June 2, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28570803/ketamine-for-depression-2-diagnostic-and-contextual-indications
#13
REVIEW
Chittaranjan Andrade
There is a substantial body of literature comprising anecdotal material and descriptions of uncontrolled and randomized controlled trials addressing the use of subanesthetic doses of ketamine for the off-label treatment of major depressive episodes. This article examines diagnostic indications for the off-label use of ketamine as an antidepressant and possible contexts in which ketamine may be trialled. Ketamine is indicated in patients who are in a major depressive episode. Most of the research data have been collected from patients with major depressive disorder, but patients with bipolar depression have also been studied...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28540033/use-of-repeated-intravenous-ketamine-therapy-in-treatment-resistant-bipolar-depression-with-suicidal-behaviour-a-case-report-from-spain
#14
REVIEW
Álvaro López-Díaz, José Luis Fernández-González, José Evaristo Luján-Jiménez, Sara Galiano-Rus, Luis Gutiérrez-Rojas
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of a female patient admitted for several months due to a treatment-resistant depressive bipolar episode with chronic suicidal behaviour...
April 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28505499/clinical-predictors-of-acute-response-to-transcranial-direct-current-stimulation-tdcs-in-major-depression
#15
Giordano D'Urso, Bernardo Dell'Osso, Rodolfo Rossi, Andre Russowsky Brunoni, Marco Bortolomasi, Roberta Ferrucci, Alberto Priori, Andrea de Bartolomeis, Alfredo Carlo Altamura
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. METHODS: Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response...
May 8, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28483102/use-of-buprenorphine-in-treatment-of-refractory-depression-a-review-of-current-literature
#16
REVIEW
Cornel N Stanciu, Oliver M Glass, Thomas M Penders
OBJECTIVE: Current treatment strategies for depressive disorders have limited efficacy, leaving many patients unimproved or with significant residual symptoms. The development of additional treatments represent a significant unmet need for providers. Several lines of evidence suggest that the opioid system may be involved in regulation of mood and incentives salience. Intervention based on modifying central opioid receptors may represent a novel approach to treatment of depressive disorders among those unresponsive to accepted treatments...
April 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28403104/effect-of-bipolar-pulsed-radiofrequency-on-refractory-chronic-cervical-radicular-pain-a-report-of-two-cases
#17
Min Cheol Chang
RATIONALE: Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28248888/comparison-between-bipolar-pulsed-radiofrequency-and-monopolar-pulsed-radiofrequency-in-chronic-lumbosacral-radicular-pain-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Min Cheol Chang, Yun Woo Cho, Sang Ho Ahn
BACKGROUND: Chronic lumbosacral radicular pain is a challenging medical problem with respect to therapeutic management. Many patients with lumbosacral radicular pain complain of persistent leg pain after transforaminal epidural steroid injection. Nowadays, pulsed radiofrequency (PRF) stimulation on the dorsal root ganglion (DRG) is widely used for controlling lumbosacral radicular pain. METHODS: We evaluated the effect of bipolar PRF on the DRG for the management of lumbosacral radicular pain...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28219848/bioelectronic-neuromodulation-of-the-paravertebral-cardiac-efferent-sympathetic-outflow-and-its-effect-on-ventricular-electrical-indices
#19
Una Buckley, Ray W Chui, Pradeep S Rajendran, Tina Vrabec, Kalyanam Shivkumar, Jeffrey L Ardell
BACKGROUND: Neuromodulation of the paravertebral ganglia by using symmetric voltage controlled kilohertz frequency alternating current (KHFAC) has the potential to be a reversible alternative to surgical intervention in patients with refractory ventricular arrhythmias. KHFAC creates scalable focal inhibition of action potential conduction. OBJECTIVE: The purpose of this article was to evaluate the efficacy of KHFAC when applied to the T1-T2 paravertebral chain to mitigate sympathetic outflow to the heart...
July 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28211248/anesthetic-considerations-for-pediatric-electroconvulsive-therapy
#20
REVIEW
Andrew D Franklin, Jenna H Sobey, Eric T Stickles
Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population...
May 2017: Paediatric Anaesthesia
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