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Refractory Bipolar

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https://www.readbyqxmd.com/read/27914146/pregnancy-and-delivery-in-a-generalized-dystonia-patient-treated-with-internal-globus-pallidal-deep-brain-stimulation-a-case-report
#1
Hye Ran Park, Jae Meen Lee, Hyeyoung Park, Chae Won Shin, Han Joon Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27876122/a-hypothesis-on-the-mechanism-of-action-of-high-dose-thyroid-in-refractory-mood-disorders
#2
Tammas Kelly
Multiple lines of evidence suggest the hypothesis that high dose thyroid therapy corrects for cellular hypothyroidism found in bipolar disorders. Evidence indicates that bipolar disorders are associated with mitochondrial dysfunction which results in low cellular adenosine 5'-triphosphate (ATP) levels. Transport of thyroid hormones into cells is energy intensive and dependent on ATP except in the pituitary gland. Inadequate ATP levels makes it difficult to get thyroid hormone into cells leading to cellular hypothyroidism...
December 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27848034/vagus-nerve-stimulation-in-psychiatry-a-systematic-review-of-the-available-evidence
#3
REVIEW
Camelia-Lucia Cimpianu, Wolfgang Strube, Peter Falkai, Ulrich Palm, Alkomiet Hasan
Invasive and non-invasive vagus nerve stimulation (VNS) is a promising add-on treatment for treatment-refractory depression, but is also increasingly evaluated for its application in other psychiatric disorders, such as dementia, schizophrenia, somatoform disorder, and others. We performed a systematic review aiming to give a detailed overview of the available evidence of the efficacy of VNS for the treatment of psychiatric disorders. Data derived from animal models, experimental trials without health-related outcomes, case reports, single-session studies, and reviews were excluded...
November 16, 2016: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27812392/periesophageal-pseudoaneurysms-rare-cause-of-refractory-bleeding-treated-with-transarterial-embolization
#4
Divyanshoo R Kohli, Rachit D Shah, Daniel J Komorowski, George B Smallfield
A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27756468/the-electrophysiologic-effects-of-acute-mitral-regurgitation-in-a-canine-model
#5
Christopher P Lawrance, Matthew C Henn, Jacob R Miller, Michael A Kopek, Andrew J Zhang, Richard B Schuessler, Ralph J Damiano
BACKGROUND: Atrial fibrillation (AF) occurs in 30% of patients with mitral regurgitation referred for surgical intervention. However, the underlying mechanisms in this population are poorly understood. This study examined the effects of acute left atrial volume overload on atrial electrophysiology and the inducibility of AF. METHODS: Ten canines underwent insertion of an atrioventricular shunt between the left ventricle and left atrium. Shunt and aortic flows were calculated, and the shunt was titrated to a shunt fraction to 40% to 50% of cardiac output...
October 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27659841/neuroprogression-and-illness-trajectories-in-bipolar-disorder
#6
Natália S Kapczinski, Benson Mwangi, Ryan M Cassidy, Diego Librenza-Garcia, Mariane Bagatin Bermudez, Márcia Kauer-Sant'anna, Flávio Kapczinski, Ives Cavalcante Passos
The longitudinal course of bipolar disorder is highly variable, and a subset of patients seems to present a progressive course associated with brain changes and functional impairment. Areas covered: We discuss the theory of neuroprogression in bipolar disorder. This concept considers the systemic stress response that occurs within mood episodes and late-stage deficits in functioning and cognition as well as neuroanatomic changes. We also discuss treatment refractoriness that may take place in some cases of bipolar disorder...
October 3, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27500319/testing-the-efficacy-of-pharmacological-agents-in-a-pericardial-target-delivery-model-in-the-swine
#7
Tinen L Iles, Brian Howard, Stephen Howard, Stephen Quallich, Christopher Rolfes, Eric Richardson, Hanna R Iaizzo, Paul A Iaizzo
To date, many pharmacological agents used to treat or prevent arrhythmias in open-heart cases create undesired systemic side effects. For example, antiarrhythmic drugs administered intravenously can produce drops in systemic pressure in the already compromised cardiac patient. While performing open-heart procedures, surgeons will often either create a small port or form a pericardial cradle to create suitable fields for operation. This access yields opportunities for target pharmacological delivery (antiarrhythmic or ischemic preconditioning agents) directly to the myocardial tissue without undesired side effects...
2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27473672/growth-inhibition-by-testosterone-in-an-androgen-receptor-splice-variant-driven-prostate-cancer-model
#8
Daisuke Nakata, Kazuhide Nakayama, Tsuneo Masaki, Akira Tanaka, Masami Kusaka, Tatsuya Watanabe
BACKGROUND: Castration resistance creates a significant problem in the treatment of prostate cancer. Constitutively active splice variants of androgen receptor (AR) have emerged as drivers for resistance to androgen deprivation therapy, including the next-generation androgen-AR axis inhibitors abiraterone and enzalutamide. In this study, we describe the characteristics of a novel castration-resistant prostate cancer (CRPC) model, designated JDCaP-hr (hormone refractory). METHODS: JDCaP-hr was established from an androgen-dependent JDCaP xenograft model after surgical castration...
December 2016: Prostate
https://www.readbyqxmd.com/read/27448595/prospective-case-series-of-a-novel-minimally-invasive-bipolar-coagulation-system-in-the-treatment-of-grade-i-and-ii-internal-hemorrhoids
#9
Benjamin P Crawshaw, Andrew J Russ, Bridget O Ermlich, Conor P Delaney, Bradley J Champagne
Background Existing nonsurgical procedures for the treatment of grade I and II internal hemorrhoids are often painful, technically demanding, and often necessitate multiple applications. This study prospectively assessed the safety and efficacy of the HET Bipolar System, a novel minimally invasive device, in the treatment of symptomatic grade I and II internal hemorrhoids. Methods Patients with symptomatic grade I or II internal hemorrhoids despite medical management underwent hemorrhoidal ligation with the HET Bipolar System...
July 23, 2016: Surgical Innovation
https://www.readbyqxmd.com/read/27424078/clinical-and-biophysical-evaluation-of-variable-bipolar-configurations-during-radiofrequency-ablation-for-the-treatment-of-ventricular-arrhythmias
#10
Duy T Nguyen, Wendy S Tzou, Michael Brunnquell, Matthew Zipse, Joseph L Schuller, Lijun Zheng, Ryan A Aleong, William H Sauer
BACKGROUND: Bipolar radiofrequency ablation (bRFA) has been used to create larger ablation lesions and to treat refractory arrhythmias. However, little is known about optimal bRFA settings. OBJECTIVES: We sought to evaluate various bRFA settings, including active and ground catheter tip orientation and use of variable active and ground catheters during bRFA. METHODS: Two ablation catheters, one active and one ground, were oriented across from each other, with viable bovine myocardium in between...
July 13, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27394714/cardiac-contractility-modulation-a-novel-approach-for-the-treatment-of-heart-failure
#11
Freddy Abi-Samra, David Gutterman
Heart failure is a major health problem worldwide and, despite effective therapies, is expected to grow by almost 50 % over the next 15 years. Five-year mortality remains high at 50 % over 5 years. Because of the economic burden and large impact on quality of life, substantial effort has focused on treatments with multiple medical (beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ARB), aldosterone antagonists, and combination of ARB/neprilysin blockers, ivabradine) and device therapies (ICD, CRT) which have been implemented to reduce disease burden and mortality...
July 9, 2016: Heart Failure Reviews
https://www.readbyqxmd.com/read/27389115/bipolar-high-voltage-long-duration-pulsed-radiofrequency-improves-pain-relief-in-postherpetic-neuralgia
#12
Cheng-Fu Wan, Yan Liu, Dao-Song Dong, Lin Zhao, Qi Xi, Xue Yu, Wen-Yao Cui, Qiu-Shi Wang, Tao Song
BACKGROUND: Postherpetic neuralgia (PHN) is often refractory to existing treatments. Treatment of the dorsal root ganglion (DRG) using monopolar pulsed radiofrequency (PRF), which is a non- or minimally neurodestructive technique, is not efficacious in all patients. OBJECTIVES: This study aimed to determine the safety and clinical efficacy of bipolar high-voltage, long-duration PRF on the DRG in PHN patients. STUDY DESIGN: Self before-after controlled clinical trial...
July 2016: Pain Physician
https://www.readbyqxmd.com/read/27274384/pharmacotherapy-of-acute-bipolar-depression-in-adults-an-evidence-based-approach
#13
REVIEW
Ather Muneer
In the majority of cases of bipolar disorder, manic episodes are usually brief and typically responsive to currently available psychopharmacological agents. In contrast, depressive manifestations are more prevalent and persistent, and can present as major depressive/mixed episodes or residual interepisode symptoms. The depressive phase is often associated with other neuropsychiatric conditions, such as anxiety spectrum disorders, substance use disorders, stressor-related disorders, and eating disorders. It is viewed as a systemic disease with associated ailments such as metabolic syndrome, diabetes mellitus, and cardiovascular disease...
May 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27190727/the-treatment-of-adult-bipolar-disorder-with-aripiprazole-a-systematic-review
#14
REVIEW
Ather Muneer
Bipolar disorder is characterized by exacerbations of opposite mood polarity, ranging from manic to major depressive episodes. In the current nosological system of the Diagnostic and Statistical Manual - 5(th) edition (DSM-5), it is conceptualized as a spectrum disorder consisting of bipolar disorder type I, bipolar disorder type II, cyclothymic disorder, and bipolar disorder not otherwise specified. Treatment of all phases of this disorder is primarily with mood stabilizers, but many patients either show resistance to the conventional mood stabilizing medications or are intolerant to their side-effects...
2016: Curēus
https://www.readbyqxmd.com/read/27141292/bupropion-a-systematic-review-and-meta-analysis-of-effectiveness-as-an-antidepressant
#15
REVIEW
Krisna Patel, Sophie Allen, Mariam N Haque, Ilinca Angelescu, David Baumeister, Derek K Tracy
Bupropion has been used as an antidepressant for over 20 years, though its licence for such use varies and it is typically a third- or fourth-line agent. It has a unique pharmacology, inhibiting the reuptake of noradrenaline and dopamine, potentially providing pharmacological augmentation to more common antidepressants such as selective serotonergic reuptake inhibitors (SSRIs). This systematic review and meta-analysis identified 51 studies, dividing into four categories: bupropion as a sole antidepressant, bupropion coprescribed with another antidepressant, bupropion in 'other' populations (e...
April 2016: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/27071787/oxidative-stress-and-nitric-oxide-in-autism-spectrum-disorder-and-other-neuropsychiatric-disorders
#16
Kunio Yui, Yohei Kawasaki, Hiroshi Yamada, Shintaro Ogawa
The etiology of autism spectrum disorder (ASD) remains unclear; however, the toxic environmental exposure to oxidative stress has been suggested to play an important role in its pathogenesis. A loss of balance between oxidative stress and antioxidant capacity produces an excess of reactive nitrogen species (RNS) such as nitric oxide (NO). Polyunsaturated fatty acids (PUFAs), particularly arachidonic acid, docosahexaenoic acid and eicosapentaenoic acid, are closely related to NO and NO synthase. In the pathophysiology of ASD, NO is related to the activity of primary PUFAs...
2016: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/26999067/an-update-on-the-pharmacokinetics-and-pharmacodynamics-of-alisertib-a-selective-aurora-kinase-a-inhibitor
#17
REVIEW
Cameron T Durlacher, Zhi-Ling Li, Xiao-Wu Chen, Zhi-Xu He, Shu-Feng Zhou
Human Aurora kinases, including Aurora kinase A (AURKA), B (AURKB), and C (AURKC), play an essential role in mitotic events such as monitoring of the mitotic checkpoint, creation of bipolar mitotic spindle and alignment of centrosomes on it, also regulating centrosome separation, bio-orientation of chromosomes and cytokinesis. AURKA and AURKB are key regulators of mitosis and centrosome via polymerizing microfilaments and controlling chromatid segregation. In particular, AURKA plays critical roles in the regulation of mitotic entry, centrosome function, bipolar spindle assembly, and chromosome segregation...
June 2016: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/26995239/comparative-analysis-of-affective-temperament-in-patients-with-difficult-to-treat-and-easy-to-treat-major-depression-and-bipolar-disorder-possible-application-in-clinical-settings
#18
Minoru Takeshima, Takashi Oka
BACKGROUND: Difficult-to-treat major depressive disorder (MDD-DT), which involves antidepressant refractoriness or antidepressant-related adverse psychiatric effects, is bipolar in nature; therefore, it may share common temperamental features with bipolar disorder. To examine this hypothesis, affective temperament was compared between MDD-DT, easy-to-treat major depressive disorder (MDD-ET), and bipolar disorder. METHODS: Affective temperament was measured in 320 patients (69, 56, and 195 with MDD-ET, MDD-DT, and bipolar disorder, respectively) using the self-rated questionnaire version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A), with between-group differences examined using multiple logistic regression analysis controlling for confounders...
April 2016: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/26951440/adjunctive-vagus-nerve-stimulation-for-treatment-resistant-bipolar-disorder-managing-device-failure-or-the-end-of-battery-life
#19
José V Pardo
The vagus nerve stimulation (VNS) device is used not only to treat refractory seizure disorders but also mood disorders; the latter indication received CE Mark approval in 2001 and Food and Drug Administration approval in 2005. Original estimates for the end of battery life (EOBL) were approximately 6-10 years. Many neuropsychiatric patients have or will soon face EOBL. A patient with severe, life-threatening, treatment-resistant bipolar disorder underwent 9 years of stable remission following 20 months of adjunctive VNS...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26917855/maois-does-the-evidence-warrant-their-resurrection
#20
David Menkes, Peter Bosanac, David Castle
OBJECTIVE: The place of monoamine oxidase inhibitors (MAOIs) in psychiatry is reviewed, and the question posed as to whether they are now justifiably disregarded by prescribers. METHOD: Multiple databases (PubMed, Medline, Embase, Cochrane) were interrogated to provide an overview regarding the use, efficacy and toxicity of MAOIs. Data regarding funded use of these agents in New Zealand were obtained from PHARMAC. RESULTS: Evidence supports the use of MAOIs in major depressive disorder, certain anxiety disorders and, to lesser extent, bipolar depression...
August 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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