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https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#1
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension because of depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension of when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoid fluid overload...
May 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28505499/clinical-predictors-of-acute-response-to-transcranial-direct-current-stimulation-tdcs-in-major-depression
#2
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/28492457/the-role-of-amantadine-withdrawal-in-3-cases-of-treatment-refractory-altered-mental-status
#3
Leah D Fryml, Kristen R Williams, Christopher G Pelic, James Fox, Gregory Sahlem, Sophie Robert, Gonzalo J Revuelta, Edward Baron Short
Amantadine, which was originally developed as an antiviral medication, functions as a dopamine agonist in the central nervous system and consequently is utilized in the treatment of Parkinson disease, drug-induced extrapyramidal reactions, and neuroleptic malignant syndrome. For reasons that are not entirely understood, abrupt changes in amantadine dosage can produce a severe withdrawal syndrome. Existing medical literature describes case reports of amantadine withdrawal leading to delirium, which at times has progressed to neuroleptic malignant syndrome...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28492363/vagus-nerve-stimulation-improves-working-memory-performance
#4
Lihua Sun, Jari Peräkylä, Katri Holm, Joonas Haapasalo, Kai Lehtimäki, Keith H Ogawa, Jukka Peltola, Kaisa M Hartikainen
Vagus nerve stimulation (VNS) is used for treating refractory epilepsy and major depression. While the impact of this treatment on seizures has been established, its impact on human cognition remains equivocal. The goal of this study is to elucidate the immediate effects of vagus nerve stimulation on attention, cognition, and emotional reactivity in patients with epilepsy. Twenty patients (12 male and 8 female; 45 ± 13 years old) treated with VNS due to refractory epilepsy participated in the study. Subjects performed a computer-based test of executive functions embedded with emotional distractors while their brain activity was recorded with electroencephalography...
February 19, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28483102/use-of-buprenorphine-in-treatment-of-refractory-depression-a-review-of-current-literature
#5
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/28480502/enriched-environment-attenuates-behavioral-seizures%C3%A2-and-depression-in-chronic%C3%A2-temporal-lobe-epilepsy
#6
Marigowda Vrinda, Arun Sasidharan, Sahajan Aparna, Bettadapura N Srikumar, Bindu M Kutty, Byrathnahalli S Shankaranarayana Rao
OBJECTIVE: Temporal lobe epilepsy (TLE) is commonly associated with depression, anxiety, and cognitive impairment. Despite significant progress in our understanding of the pathophysiology of TLE, it remains the most common form of refractory epilepsy. Enriched environment (EE) has a beneficial effect in many neuropsychiatric disorders. However, the effect of EE on cognitive changes in chronic TLE has not been evaluated. Accordingly, the present study evaluated the effects of EE on chronic epilepsy-induced alterations in cognitive functions, electrophysiology, and cellular changes in the hippocampus...
May 8, 2017: Epilepsia
https://www.readbyqxmd.com/read/28469875/deep-brain-stimulation-in-the-bed-nucleus-of-the-stria-terminalis-and-medial-forebrain-bundle-in-a-patient-with-major-depressive-disorder-and-anorexia-nervosa
#7
Patric Blomstedt, Matilda Naesström, Owe Bodlund
Deep brain stimulation (DBS) may be considered in severe cases of therapy-refractory major depressive disorder (MDD). However, DBS for MDD is still an experimental therapy. Therefore, it should only be administered in clinical studies driven by multidisciplinary teams, including surgeons with substantial experience of DBS in the treatment of other conditions.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28448702/ketamine-for-depression-1-clinical-summary-of-issues-related-to-efficacy-adverse-effects-and-mechanism-of-action
#8
Chittaranjan Andrade
Ketamine is an anesthetic drug that is also used for off-label indications such as the mediation of analgesia and sedation in various settings. It is additionally recognized as an agent with antidepressant potential. For depression, it is most commonly administered as a slow intravenous infusion in subanesthetic doses (usually 0.5 mg/kg). As an antidepressant, is strikingly different from conventional antidepressant drugs in that it brings about rapid and marked attenuation of depressive symptoms even in patients with refractory depression...
April 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28441895/ketamine-s-dose-related-effects-on-anxiety-symptoms-in-patients-with-treatment-refractory-anxiety-disorders
#9
Paul Glue, Natalie J Medlicott, Sarah Harland, Shona Neehoff, Bridie Anderson-Fahey, Martin Le Nedelec, Andrew Gray, Neil McNaughton
The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorders. We evaluated the efficacy and safety of ketamine in 12 patients with refractory generalized anxiety disorder and/or social anxiety disorder who were not currently depressed, using an ascending single dose study design (0...
April 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28428905/deep-brain-stimulation-target-selection-in-an-advanced-parkinson-s-disease-patient-with-significant-tremor-and-comorbid-depression
#10
Amar S Patel
CLINICAL VIGNETTE: A 67-year-old female with advanced Parkinson's disease (PD), medically refractory tremor, and a history of significant depression presented for evaluation of deep brain stimulation (DBS) candidacy. CLINICAL DILEMMA: Traditionally, the subthalamic nucleus (STN) has been preferred over the globus pallidus interna (GPi) as a DBS target for PD patients with levodopa-responsive fluctuations in rigidity and akinesia, for whom tremor is also a significant source of impairment...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/28428507/-opioid-therapy-and-management-of-side-effects-associated-with-opioids
#11
Toshihiko Nakatani
Opioids are very useful medications to reduce suffering of cancer patients such as refractory pain and dyspnea. We physicians have to use opioids to have good management of pain and suffering associated with cancer including management of side effects caused by opioids. Opioids couple opioid receptors and affect several pharmacological effects. Other than analgesic effect, opioids have some side effects of constipation, nausea and vomiting, respiratory depression. In this chapter, I take important side effects of constipation, nausea and vomiting and respiratory depression...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28427306/prefrontal-tdcs-and-sertraline-in-obsessive-compulsive-disorder-a-case-report-and-review-of-the-literature
#12
Ulrich Palm, Bianka Leitner, Beatrice Kirsch, Nora Behler, Ulrike Kumpf, Linda Wulf, Frank Padberg, Alkomiet Hasan
Obsessive-compulsive (OC) disorder is a disabling disorder resulting in tremendous individual and social burden. It has a large overlap with depression and anxiety disorders and shows treatment resistance in a relevant proportion of patients. Since a couple of years, different noninvasive brain stimulation methods have been investigated to improve OC symptoms. The application of transcranial direct current stimulation (tDCS) has shown inconsistent results which can probably be attributed to a lack in randomized controlled trials with adequate sample size...
April 21, 2017: Neurocase
https://www.readbyqxmd.com/read/28427025/psychiatric-symptoms-after-temporal-epilepsy-surgery-a-one-year-follow-up-study
#13
Carmen Iranzo-Tatay, Teresa Rubio-Granero, Antonio Gutierrez, Mercedes Garcés, Rebeca Conde, Asier Gómez-Ibáñez, Sergio Arques-Egea, Lucia Sancho-Miñana, David Hervas-Marín, Vicente Villanueva
Psychiatric symptoms must be considered in patients with refractory temporal lobe epilepsy after epilepsy surgery. The main objectives of our study were to describe clinical and socio-demographical characteristics of a cohort of patients with pharmacoresistant temporal lobe epilepsy who underwent temporal lobe epilepsy surgery, and moreover, to evaluate possible risk factors for developing psychiatric symptoms. In order to achieve those goals, we conducted a prospective evaluation of psychopathology throughout the first year after surgery in a clinical sample of 72 patients, by means of three clinical rated measures; the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Brief Psychiatric Rating Scale (BPRS)...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28400547/anemia-in-thyroid-diseases
#14
Ewelina Szczepanek-Parulska, Aleksandra Hernik, Marek Ruchała
Anemia is a frequent, although often underestimated, clinical condition accompanying thyroid diseases. In spite of the fact that anemia and thyroid dysfunction often occur simultaneously, the causative relationship between these two disorders remains ambiguous. Thyroid hormones stimulate erythrocytes precursors proliferation directly, as well as via erythropoietin production enhancement, whereas iron-deficient anemia negatively influences thyroid hormonal status. Thus, different forms of anemia might emerge in the course of thyroid dysfunction...
March 28, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28396172/role-of-suppression-of-the-inward-rectifier-current-in-terminal-action-potential-repolarization-in-the-failing-heart
#15
Michael G Klein, Matie Shou, Jayna Stohlman, Soroosh Sohljoo, Myles Haigney, Richard R Tidwell, Robert E Goldstein, Thomas P Flagg, Mark C Haigney
BACKGROUND: The failing heart exhibits an increased arrhythmia susceptibility that is often attributed to action potential (AP) prolongation due to significant ion channel remodeling. The inwardly rectifying K(+) current (IK1) has been reported to be reduced, but its contribution to shaping the AP waveform and cell excitability in the failing heart remains unclear. OBJECTIVE: The purpose of this study was to define the effect of IK1 suppression on the cardiac AP and excitability in the normal and failing hearts...
April 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#16
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28386221/deep-brain-stimulation-of-the-nucleus-accumbens-core-affects-trait-impulsivity-in-a-baseline-dependent-manner
#17
Maria C Schippers, Bastiaan Bruinsma, Mathijs Gaastra, Tanja I Mesman, Damiaan Denys, Taco J De Vries, Tommy Pattij
Deep brain stimulation (DBS) of the nucleus accumbens (NA) is explored as a treatment for refractory psychiatric disorders, such as obsessive-compulsive disorder (OCD), depressive disorder (MDD), and substance use disorder (SUD). A common feature of some of these disorders is pathological impulsivity. Here, the effects of NAcore DBS on impulsive choice and impulsive action, two distinct forms of impulsive behavior, were investigated in translational animal tasks, the delayed reward task (DRT) and five-choice serial reaction time task (5-CSRTT), respectively...
2017: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/28384319/correction-antidepressant-and-neurocognitive-effects-of-isoflurane-anesthesia-versus-electroconvulsive-therapy-in-refractory-depression
#18
Howard R Weeks, Scott C Tadler, Kelly W Smith, Eli Iacob, Mikala Saccoman, Andrea T White, Joshua D Landvatter, Gordon J Chelune, Yana Suchy, Elaine Clark, Michael K Cahalan, Lowry Bushnell, Derek Sakata, Alan R Light, Kathleen C Light
[This corrects the article DOI: 10.1371/journal.pone.0069809.].
2017: PloS One
https://www.readbyqxmd.com/read/28373849/deep-brain-stimulation-in-anorexia-nervosa-hope-for-the-hopeless-or-exploitation-of-the-vulnerable-the-oxford-neuroethics-gold-standard-framework
#19
Rebecca J Park, Ilina Singh, Alexandra C Pike, Jacinta O A Tan
Neurosurgical interventions for psychiatric disorders have a long and troubled history (1, 2) but have become much more refined in the last few decades due to the rapid development of neuroimaging and robotic technologies (2). These advances have enabled the design of less invasive techniques, which are more focused, such as deep brain stimulation (DBS) (3). DBS involves electrode insertion into specific neural targets implicated in pathological behavior, which are then repeatedly stimulated at adjustable frequencies...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28367707/pharmacological-treatment-of-unipolar-depressive-disorders-summary-of-wfsbp-guidelines
#20
Michael Bauer, Emanuel Severus, Hans-Jürgen Möller, Allan H Young
OBJECTIVE: Major depressive disorder (MDD) is a severe mood disorder affecting individuals of all ages and is characterised by single or recurrent major depressive episodes. Key elements of acute and maintenance treatment of MDD include pharmacotherapy, and psychological approaches such as psychoeducation and adherence monitoring. METHODS: This summary of the 'Practice guidelines for the biological treatment of unipolar depressive disorders' comprises acute, continuation and maintenance treatment developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP), and focuses on pharmacological treatment options...
April 3, 2017: International Journal of Psychiatry in Clinical Practice
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