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Refractory Bipolar

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https://www.readbyqxmd.com/read/29776917/treatment-refractory-mania-with-psychosis-in-a-post-transplant-patient-on-tacrolimus-a-case-report
#1
Muaid Ithman, Kunal Malhotra, Meelie Bordoloi, Garima Singh
Bipolar affective disorder type I imparts significant morbidity and disease burden in the Population. It is characterized by occurrence of one or more manic episodes which may be preceded or followed by a depressive or hypomanic phase. About half of these manic episodes are characterized by the presence of psychotic features [1]. The condition is further complicated when patient has multiple comorbid conditions. We report here a case of a 66 year old Caucasian female, previously diagnosed with Bipolar disorder who developed treatment refractory mania with psychotic feature after being on Tacrolimus (an immunosuppressive agent) after kidney transplantation...
May 18, 2018: Clinical Medicine & Research
https://www.readbyqxmd.com/read/29759492/radiofrequency-ablation-using-an-open-irrigated-electrode-cooled-with-half-normal-saline
#2
Duy T Nguyen, Edward P Gerstenfeld, Wendy S Tzou, Paul T Jurgens, Lijun Zheng, Joseph Schuller, Matthew Zipse, William H Sauer
OBJECTIVES: This study evaluated the use of half-normal saline (HNS) as the radiofrequency ablation (RFA) cooling irrigant. BACKGROUND: Some instances of ventricular arrhythmia may originate deep within myocardium and can be refractory to standard ablation using open irrigated RFA. Recent data suggest that deeper ablation lesions can be created by decreasing the irrigant ionic concentration delivered through open irrigated RFA than by using normal saline (NS). METHODS: Bovine myocardium was placed in a circulating saline bath...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29756288/mixed-states-in-bipolar-and-major-depressive-disorders-systematic-review-and-quality-appraisal-of-guidelines
#3
REVIEW
N Verdolini, D Hidalgo-Mazzei, A Murru, I Pacchiarotti, L Samalin, A H Young, E Vieta, A F Carvalho
OBJECTIVE: This systematic review provided a critical synthesis and a comprehensive overview of guidelines on the treatment of mixed states. METHOD: The MEDLINE/PubMed and EMBASE databases were systematically searched from inception to March 21st, 2018. International guidelines covering the treatment of mixed episodes, manic/hypomanic, or depressive episodes with mixed features were considered for inclusion. A methodological quality assessment was conducted with the Appraisal of Guidelines for Research and Evaluation-AGREE II...
May 13, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29753180/a-work-flow-to-build-and-validate-patient-specific-left-atrium-electrophysiology-models-from-catheter-measurements
#4
Cesare Corrado, Steven Williams, Rashed Karim, Gernot Plank, Mark O'Neill, Steven Niederer
Biophysical models of the atrium provide a physically constrained framework for describing the current state of an atrium and allow predictions of how that atrium will respond to therapy. We propose a work flow to simulate patient specific electrophysiological heterogeneity from clinical data and validate the resulting biophysical models. In 7 patients, we recorded the atrial anatomy with an electroanatomical mapping system (St Jude Velocity); we then applied an S1-S2 electrical stimulation protocol from the coronary sinus (CS) and the high right atrium (HRA) whilst recording the activation patterns using a PentaRay catheter with 10 bipolar electrodes at 12 ± 2 sites across the atrium...
April 27, 2018: Medical Image Analysis
https://www.readbyqxmd.com/read/29737638/preventing-morphine-reinforcement-with-high-frequency-deep-brain-stimulation-of-the-lateral-hypothalamic-area
#5
Mojdeh Fattahi, Ghorbangol Ashabi, Seyed Morteza Karimian, Esmail Riahi
Deep brain stimulation (DBS) has been proposed as a promising intervention for patients with treatment-refractory substance use disorder. Here, we investigated if high-frequency DBS in the lateral hypothalamic area (LHA) could affect drug-induced reinforcement. Rats were bilaterally implanted with bipolar stimulation electrodes in the LHA and trained to the morphine conditioned place preference. DBS (monophasic square pulses, 130 Hz, 100-microsecond pulse duration and 150 μA) was applied during the morphine-pairing trials (30 minutes daily for 4 days) or drug-free postconditioning test (15 minutes) to determine its effect on the acquisition or expression of morphine reward, respectively...
May 8, 2018: Addiction Biology
https://www.readbyqxmd.com/read/29727818/efficacy-and-safety-of-ketogenic-diet-for-treatment-of-pediatric-convulsive-refractory-status-epilepticus
#6
Ravindra Arya, Katrina Peariso, Marina Gaínza-Lein, Jessica Harvey, Ann Bergin, J Nicholas Brenton, Brian T Burrows, Tracy Glauser, Howard P Goodkin, Yi-Chen Lai, Mohamad A Mikati, Iván Sánchez Fernández, Dmitry Tchapyjnikov, Angus A Wilfong, Korwyn Williams, Tobias Loddenkemper
PURPOSE: To describe the efficacy and safety of ketogenic diet (KD) for convulsive refractory status epilepticus (RSE). METHODS: RSE patients treated with KD at the 6/11 participating institutions of the pediatric Status Epilepticus Research Group from January-2011 to December-2016 were included. Patients receiving KD prior to the index RSE episode were excluded. RSE was defined as failure of ≥2 anti-seizure medications, including at least one non-benzodiazepine drug...
April 27, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29703415/electroconvulsive-therapy-for-depression-in-a-patient-with-an-inspire-hypoglossal-nerve-stimulator-device-for-obstructive-sleep-apnea-a-case-report
#7
Katie Mingo, Alan Kominsky
OUTCOME OBJECTIVES: METHODS: This is a case report of a patient who underwent placement and initiation of a hypoglossal nerve stimulator device in the context of receiving electroconvulsive therapy for bipolar depression between February and September 2016. To our knowledge, this has not yet been reported in the literature. Outcome measurements included successful device activation and successful device use throughout electroconvulsive therapy. RESULTS: The patient underwent successful device implantation, activation, and use without disruption throughout electroconvulsive therapy sessions...
April 19, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29659202/lamotrigine-rechallenge-in-treatment-resistant-bipolar-disorder
#8
Takayoshi Inaba, Rintaro Sogawa, Yoshito Mizoguchi, Hiroshi Tateishi, Yutaka Kunitake, Takahiro A Kato, Akira Monji
Background: Although lamotrigine may be useful for treating patients with treatment-resistant bipolar disorder, some lamotrigine-associated adverse effects, including mild to moderate skin rash, may prevent the continuation of treatment. Methods: We investigated lamotrigine rechallenge for the treatment of bipolar disorder. The present study was based on retrospective chart review of outpatients with bipolar disorder (DSM-5 criteria) who visited the hospital's psychiatric department between July 2011 and August 2017...
March 29, 2018: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29600219/femoral-osteomyelitis-presenting-as-a-pathologic-fracture-in-a-53-year-old-male-a-rare-case-report
#9
Nathan M Krebs, Ryan C Krebs, Amjad M Yaish
Introduction: Hematogenous osteomyelitis of long bones in immunocompetent adults is extremely rare and uncommonly presents as a pathological fracture. Case Report: A 53-year-old Caucasian male presented with an atraumatic mid-shaft femur fracture secondary to hematogenous osteomyelitis. The organism was found to be Streptococcus anginosus. The patient required multiple surgical debridements and was treated with an antibiotic-impregnated cement rod and external fixator along with IV Rocephin...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29565952/the-effect-of-bipolar-pulsed-radiofrequency-treatment-on-chronic-lumbosacral-radicular-pain-refractory-to-monopolar-pulsed-radiofrequency-treatment
#10
Dong Gyu Lee, Yun Woo Cho, Sang Ho Ahn, Min Cheol Chang
BACKGROUND: Patients with lumbosacral radicular pain may complain of persisting pain after monopolar pulsed radiofrequency (PRF) treatment. OBJECTIVE: We evaluated the effect of bipolar PRF stimulation of the dorsal root ganglion (DRG) in patients with chronic lumbosacral radicular pain who were unresponsive to both monopolar PRF stimulation of the DRG and transforaminal epidural steroid injection (TFESI). STUDY DESIGN: This is a prospective observational study...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29490377/lithium-treatment-in-children-and-adolescents
#11
Anne Duffy, Paul Grof
INTRODUCTION: There is a resurgence of interest in lithium treatment of bipolar disorders in part related to its unique anti-suicidal and neuroprotective effects. METHODS: This is a narrative review of key studies pertaining to the effectiveness and tolerability of lithium treatment in pediatric populations. RESULTS: Evidence supports that lithium is an effective and generally well-tolerated acute treatment for pediatric mania compared to placebo...
February 28, 2018: Pharmacopsychiatry
https://www.readbyqxmd.com/read/29428124/bipolar-disorder-and-heart-transplantation-a-case-report
#12
Ana María Ramírez-Giraldo, Diana Restrepo
INTRODUCTION: Bipolar disorder is a chronic and recurrent mood disease that includes symptoms that fluctuate from euphoria to depression. As a mood disorder, itis one of the main contraindications for transplantation procedures. The case is presented of a patient with bipolar disorder who had a heart transplant after a cardiac arrest. Heart transplantation is the treatment of choice in patients with heart failure and arrhythmias that do not respond to conventional treatment. METHODS: Case report and narrative review of literature...
January 2018: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/29331701/the-use-of-triiodothyronine-t3-in-the-treatment-of-bipolar-depression-a-review-of-the-literature
#13
REVIEW
T Parmentier, P Sienaert
BACKGROUND: There is a paucity of treatment options for bipolar depression. The use of triiodothyronine (T3) has been suggested as adjunctive treatment. METHODS: A search on Medline, Limo and ScienceDirect was performed using the search terms bipolar disorder, bipolar depression, treatment resistant, treatment refractory, thyroid hormones, triiodothyronine, T3, acceleration and augmentation. RESULTS: We retrieved three open studies, one comparative study, two double blind and one retrospective chart review...
March 15, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29275886/the-extent-of-left-atrial-low-voltage-areas-included-in-pulmonary-vein-isolation-is-associated-with-freedom-from-recurrent-atrial-arrhythmia
#14
Dong Huang, Jing-Bo Li, Tarek Zghaib, Esra Gucuk Ipek, Muhammad Balouch, David D Spragg, Hiroshi Ashikaga, Harikrishna Tandri, Sunil K Sinha, Joseph E Marine, Ronald D Berger, Hugh Calkins, Saman Nazarian
BACKGROUND: The extent of left atrial (LA) baseline low-voltage areas (LVA-B), which may be a surrogate for fibrosis, is associated with recurrent atrial fibrillation (AF) after ablation. This study aimed to assess the relationship between the extent of LVA-B isolated by ablation (LVA-I) and AF recurrence. METHODS: The study cohort included 159 consecutive patients with drug-refractory AF who underwent an initial AF ablation with LA voltage mapping during sinus rhythm...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29239239/depressive-disorders-in-patients-with-pharmaco-resistant-mesial-temporal-lobe-epilepsy
#15
Eleonora Borges Gonçalves, Tania Aparecida Marchiori de Oliveira Cardoso, Clarissa Lin Yasuda, Fernando Cendes
Objectives To assess depressive disorders in patients with mesial temporal lobe epilepsy (MTLE) refractory to medical treatment. Methods Adult patients with refractory MTLE completed two questionnaires (Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory (BDI) had a semi-structured psychiatric interview and a high resolution MRI scan. For complete neuropsychiatric diagnosis, as per International Classification of Diseases (ICD-10), the results were combined with clinical history and additional information from the patients' family...
February 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29173781/psychopharmacology-of-bipolar-disorders-in-children-and-adolescents
#16
REVIEW
Ekaterina Stepanova, Robert L Findling
Bipolar disorder is a debilitating illness that often leads to functional impairment when untreated. Monotherapy with mood stabilizers is preferable, although combination therapy may be necessary in refractory cases. Most studies focus on the use of lithium, anticonvulsants, and second-generation antipsychotics in the treatment of acute manic or depressive phases, as well as maintaining adequate response after the episode. More research is needed in the area of psychopharmacology of pediatric bipolar disorder to bridge the gap between clinical needs and the available data...
December 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29060281/an-intracardiac-electrogram-model-to-bridge-virtual-hearts-and-implantable-cardiac-devices
#17
Weiwei Ai, Nitish Patel, Partha Roop, Avinash Malik, Nathan Allen, Mark L Trew
Virtual heart models have been proposed to enhance the safety of implantable cardiac devices through closed loop validation. To communicate with a virtual heart, devices have been driven by cardiac signals at specific sites. As a result, only the action potentials of these sites are sensed. However, the real device implanted in the heart will sense a complex combination of near and far-field extracellular potential signals. Therefore many device functions, such as blanking periods and refractory periods, are designed to handle these unexpected signals...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29016803/the-bipolar-ablation-of-refractory-typical-atrial-flutter-with-carto-3-confidense-system
#18
Artur Baszko, Mateusz Klaczynski, Piotr Kalmucki, Wojciech Telec, Andrzej Szyszka
No abstract text is available yet for this article.
August 4, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28964126/modeling-bipolar-stimulation-of-cardiac-tissue
#19
Suran K Galappaththige, Richard A Gray, Bradley J Roth
Unipolar stimulation of cardiac tissue is often used in the design of cardiac pacemakers because of the low current required to depolarize the surrounding tissue at rest. However, the advantages of unipolar over bipolar stimulation are not obvious at shorter coupling intervals when the tissue near the pacing electrode is relatively refractory. Therefore, this paper analyzes bipolar stimulation of cardiac tissue. The strength-interval relationship for bipolar stimulation is calculated using the bidomain model and a recently developed parsimonious ionic current model...
September 2017: Chaos
https://www.readbyqxmd.com/read/28892425/laparoscopic-resection-of-a-pancreatic-%C3%AE-cell-tumor-in-a-dog
#20
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
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