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withdrawal of care

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https://www.readbyqxmd.com/read/28439787/social-withdrawal-among-individuals-receiving-psychiatric-care-derivation-of-a-scale-using-routine-clinical-assessment-data-to-support-screening-and-outcome-measurement
#1
Sebastian Rios, Christopher M Perlman
Social withdrawal is a symptom experienced by individuals with an array of mental health conditions, particularly those with schizophrenia and mood disorders. Assessments of social withdrawal are often lengthy and may not be routinely integrated within the comprehensive clinical assessment of the individual. This study utilized item response and classical test theory methods to derive a Social Withdrawal Scale (SWS) using items embedded within a routine clinical assessment, the RAI-Mental Health (RAI-MH). Using data from 60,571 inpatients in Ontario, Canada, a common factor analysis identified seven items from the RAI-MH that measure social withdrawal...
April 24, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/28439050/-calcium-and-bone-metabolism-across-women-s-life-stages-changes-of-biochemical-markers-of-bone-turnover-in-life-cycle-of-women
#2
Osamu Chaki
Development of bone metabolism markers began about 35 years ago. Current by the osteoporosis and bone metabolism diseases diagnosis and treatment efficacy. In childhood and adolescence, bone formation and resorption were increased, but formation rate was exceeded resorption rate. To keep strength of bone, bone formation and resorption are balanced(remodeling)in the period of maturity, Bone mineral density greatly decreases and biochemical markers of bone turnover markedly increase in postmenopausal women, indicating accelerated bone remodeling because of estrogen withdrawal...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#3
Aziz S Alali, Victroia McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
February 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28437212/the-impact-of-communication-skills-training-on-cardiology-fellows-and-attending-physicians-perceived-comfort-with-difficult-conversations
#4
Kathryn Berlacher, Robert M Arnold, Eva Reitschuler-Cross, Jeffrey Teuteberg, Winifred Teuteberg
BACKGROUND: Cardiologists need to decide which treatments are appropriate for seriously ill patients and whether they align with patient goals. Reconciling medical options with patients' wishes requires skilled communication. Although there is evidence that communication is teachable, few cardiologists receive formal training. OBJECTIVE: To demonstrate that providing communication skills training to cardiologists is feasible and improves their perceived preparedness (PP) for leading difficult conversations...
March 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28435152/systemic-lupus-erythematosus-withdrawing-standard-of-care-therapies-in-sle-trials
#5
Chi Chiu Mok
No abstract text is available yet for this article.
April 24, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28430755/differentiating-delirium-from-sedative-hypnotic-related-iatrogenic-withdrawal-syndrome-lack-of-specificity-in-pediatric-critical-care-assessment-tools
#6
Kate Madden, Michele M Burns, Robert C Tasker
OBJECTIVES: To identify available assessment tools for sedative/hypnotic iatrogenic withdrawal syndrome and delirium in PICU patients, the evidence supporting their use, and describe areas of overlap between the components of these tools and the symptoms of anticholinergic burden in children. DATA SOURCES: Studies were identified using PubMed and EMBASE from the earliest available date until July 3, 2016, using a combination of MeSH terms "delirium," "substance withdrawal syndrome," and key words "opioids," "benzodiazepines," "critical illness," "ICU," and "intensive care...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28429385/risk-factors-proximate-to-suicide-and-suicide-risk-assessment-in-the-context-of-denied-suicide-ideation
#7
Alan L Berman
Health care providers have significant opportunities to identify individuals at near-term risk for suicide, but lack empirical data on near-term risk factors. This study aimed to identify dynamic, state-related risk factors observed by clinical practitioners within the last 30 days of life of 157 patients who died by suicide and to compare these near-term risk factors among patients who denied versus responded positively to having suicide ideation (SI) when last asked by a clinical practitioner prior to their death...
April 21, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28426467/neuron-specific-enolase-predicts-poor-outcome-after-cardiac-arrest-and-targeted-temperature-management-a-multicenter-study-on-1-053-patients
#8
Kaspar Josche Streitberger, Christoph Leithner, Michael Wattenberg, Peter H Tonner, Julia Hasslacher, Michael Joannidis, Tommaso Pellis, Elena Di Luca, Markus Födisch, Alexander Krannich, Christoph J Ploner, Christian Storm
OBJECTIVE: Outcome prediction after cardiac arrest is important to decide on continuation or withdrawal of intensive care. Neuron-specific enolase is an easily available, observer-independent prognostic biomarker. Recent studies have yielded conflicting results on its prognostic value after targeted temperature management. DESIGN, SETTING, AND PATIENTS: We analyzed neuron-specific enolase serum concentrations 3 days after nontraumatic in-hospital cardiac arrest and out-of-hospital cardiac arrest and outcome of patients from five hospitals in Germany, Austria, and Italy...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28416497/prognostication-in-critically-ill-patients-with-severe-traumatic-brain-injury-the-tbi-prognosis-multicentre-feasibility-study
#9
Alexis F Turgeon, François Lauzier, Ryan Zarychanski, Dean A Fergusson, Caroline Léger, Lauralyn A McIntyre, Francis Bernard, Andrea Rigamonti, Karen Burns, Donald E Griesdale, Robert Green, Damon C Scales, Maureen O Meade, Martin Savard, Michèle Shemilt, Jérôme Paquet, Jean-Luc Gariépy, André Lavoie, Kesh Reddy, Draga Jichici, Giuseppe Pagliarello, David Zygun, Lynne Moore
OBJECTIVE: Severe traumatic brain injury is a significant cause of morbidity and mortality in young adults. Assessing long-term neurological outcome after such injury is difficult and often characterised by uncertainty. The objective of this feasibility study was to establish the feasibility of conducting a large, multicentre prospective study to develop a prognostic model of long-term neurological outcome in critically ill patients with severe traumatic brain injury. DESIGN: A prospective cohort study...
April 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28413967/uncontrolled-hypertension-and-oncology-clinical-%C3%AE-ips
#10
Rigas G Kalaitzidis, Moses S Elisaf
Angiogenesis is fundamental for tumour development and progression. Thus, anti-angiogenic agents have been developed and are mainly vascular endothelial growth factor (VEGF) pathway inhibitors. However, these agents commonly exhibit cardiac and renal toxicity, proteinuria and hypertension (HT). In fact, with the use of anti-angiogenic agents a rapiddose-dependent increaseof blood pressure (BP) is observed. Thepossible mechanisms of VEGF inhibitors-induced HTinclude systemic endothelial dysfunction, renal impairment as well as vascular micro- and macroangiopathy...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413788/a-tertiary-care-experience-with-paclitaxel-and-cetuximab-as-palliative-chemotherapy-in-platinum-sensitive-and-nonsensitive-in-head-and-neck-cancers
#11
Vanita Noronha, Vijay M Patil, Amit Joshi, Atanu Bhattacharjee, Davinder Paul, Sachin Dhumal, Shashikant Juvekar, Supreeta Arya, Kumar Prabhash
BACKGROUND: The combination of paclitaxel and cetuximab (PaCe) has led to an encouraging response rate in Phase 2 setting with limited toxicity. The aim of our study was to assess the efficacy of this regimen in our setting in platinum sensitive and nonsensitive patients. METHODS: This was a retrospective analysis of head and neck cancer patients treated with weekly PaCe as palliative chemotherapy between May 2010 and August 2014. The standard schedule of cetuximab along with 80 mg/m(2) of weekly paclitaxel was administered till either disease progression or withdrawal of patient's consent...
January 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28413713/catastrophic-outcome-of-patients-with-a-rebound-after-natalizumab-treatment-discontinuation
#12
Inés González-Suarez, Luis Rodríguez de Antonio, Aida Orviz, Sara Moreno-García, María D Valle-Arcos, Jordi A Matias-Guiu, Cristina Valencia, Manuela Jorquera Moya, Celia Oreja-Guevara
INTRODUCTION: Natalizumab (NTZ) is an effective drug for the treatment of relapsing-remitting multiple sclerosis. In some patients discontinuation is mandatory due to the risk of progressive multifocal leukoencephalopathy. However, severe clinical and radiological worsening has been described after drug cessation. Our aim was to describe the clinical and radiological features of the rebound phenomenon. MATERIAL AND METHODS: Patients switched from NTZ to Fingolimod (FTY) who had presented a rebound after discontinuation were selected...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28410920/potential-drug-interaction-with-opioid-agonist-in-the-setting-of-chronic-low-dose-opioid-antagonist-use
#13
James B Leonard, Vidya Nair, Christopher J Diaz, Jonathan B Penoyar, Penelope A Goode
Low dose naltrexone (LDN) has been evaluated in several small studies for the treatment of inflammatory conditions. It is thought to work through modulation of inflammatory mediators and upregulation of endogenous opioid receptors. This may hypersensitize patients to exogenous opioids. Drug-drug interaction screening tools built into electronic health records and other services identify the interaction as risk of opioid withdrawal rather than hypersensitivity. We present a case of a drug-drug interaction in a patient who was receiving LDN treatment of multiple sclerosis...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28409827/topiramate-for-essential-tremor
#14
REVIEW
Elisa Bruno, Alessandra Nicoletti, Graziella Quattrocchi, Roberta Allegra, Graziella Filippini, Carlo Colosimo, Mario Zappia
BACKGROUND: Essential tremor (ET) is one of the most common movement disorders. The management is primarily based on pharmacological agents and in clinical practice propranolol and primidone are considered the first-line therapy. However, these treatments can be ineffective in 25% to 55% of people and are frequently associated with serious adverse events (AEs). For these reasons, it is worthwhile evaluating other treatments for ET. Topiramate has been suggested as a potentially useful agent for the treatment of ET but there is uncertainty about its efficacy and safety...
April 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406856/treating-women-who-are-pregnant-and-parenting-for-opioid-use-disorder-and-the-concurrent-care-of-their-infants-and-children-literature-review-to-support-national-guidance
#15
Stacey L Klaman, Krystyna Isaacs, Anne Leopold, Joseph Perpich, Susan Hayashi, Jeff Vender, Melinda Campopiano, Hendrée E Jones
OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28404133/effect-on-hbs-antigen-clearance-of-addition-of-pegylated-interferon-alfa-2a-to-nucleos-t-ide-analogue-therapy-versus-nucleos-t-ide-analogue-therapy-alone-in-patients-with-hbe-antigen-negative-chronic-hepatitis-b-and-sustained-undetectable-plasma-hepatitis-b
#16
Marc Bourlière, Pascaline Rabiega, Nathalie Ganne-Carrie, Lawrence Serfaty, Patrick Marcellin, Yoann Barthe, Dominique Thabut, Dominique Guyader, Christophe Hezode, Magali Picon, Xavier Causse, Vincent Leroy, Jean Pierre Bronowicki, Patrizia Carrieri, Ghassan Riachi, Isabelle Rosa, Pierre Attali, Jean Michel Molina, Yannick Bacq, Albert Tran, Jean Didier Grangé, Fabien Zoulim, Hélène Fontaine, Laurent Alric, Inga Bertucci, Magali Bouvier-Alias, Fabrice Carrat
BACKGROUND: Findings from uncontrolled studies suggest that addition of pegylated interferon in patients with HBe antigen (HBeAg)-negative chronic hepatitis B receiving nucleos(t)ide analogues with undetectable plasma hepatitis B virus (HBV) DNA might increase HBs antigen (HBsAg) clearance. We aimed to assess this strategy. METHODS: In this randomised, controlled, open-label trial, we enrolled patients aged 18-75 years with HBeAg-negative chronic hepatitis B and documented negative HBV DNA while on stable nucleos(t)ide analogue regimens for at least 1 year from 30 hepatology tertiary care wards in France...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28392178/acupuncture-for-the-prevention-of-tension-type-headache-2016
#17
Arya Nielsen
Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache.Cochrane Database Syst Rev2016, Issue 48. Art No.: CD007587. DOI: 10.1002/14651858.CD007587.pub2. BACKGROUND: Acupuncture is often used for prevention of tension-type headache but its effectiveness is still controversial. This is an update of our Cochrane review originally published in Issue 1, 2009 of The Cochrane Library. OBJECTIVES: To investigate whether acupuncture is (a) more effective than no prophylactic treatment/routine care only; (b) more effective than "sham" (placebo) acupuncture; and (c) as effective as other interventions in reducing headache frequency in adults with episodic or chronic tension-type headache...
March 6, 2017: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/28389482/what-are-the-risks-and-benefits-of-temporarily-discontinuing-medications-to-prevent-acute-kidney-injury-a-systematic-review-and-meta-analysis
#18
Penny Whiting, Andrew Morden, Laurie A Tomlinson, Fergus Caskey, Thomas Blakeman, Charles Tomson, Tracey Stone, Alison Richards, Jelena Savović, Jeremy Horwood
OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28386787/prospective-evaluation-of-systematic-use-of-peripherally-inserted-central-catheters-picc-lines-for-the-home-care-after-allogeneic-hematopoietic-stem-cells-transplantation
#19
J Cornillon, J A Martignoles, E Tavernier-Tardy, M Gire, P Martinez, C Tranchan, A Vallard, K Augeul-Meunier, B Hacquard, D Guyotat
PURPOSE: Long-term catheters are often necessary for outpatient care after an allogeneic hematopoietic stem cell transplantation (HSCT), However, there is paucity of data on the use of peripherally inserted central catheter (PICC) in post-HSCT setting. METHODS: We prospectively evaluated the systematic use of PICC in 37 consecutive patients returning home after HSCT. RESULTS: In 6 out of 37 patients, the PICC was exclusively used for weekly blood controls...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28385705/sustainability-of-treatment-effect-of-a-3-year-early-intervention-programme-for-first-episode-psychosis
#20
Wing Chung Chang, Vivian Wing Yan Kwong, Emily Sin Kei Lau, Hon Cheong So, Corine Sau Man Wong, Gloria Hoi Kei Chan, Olivia Tsz Ting Jim, Christy Lai Ming Hui, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Eric Yu Hai Chen
BackgroundEvidence indicates that the positive effects of 2-year early intervention services for psychosis are not maintained after service withdrawal. Optimal duration of early intervention in sustaining initial improved outcomes remains to be determined.AimsTo examine the sustainability of the positive effects of an extended, 3-year, early intervention programme for patients with first-episode psychosis (FEP) after transition to standard care.MethodA total of 160 patients, who had received a 2-year early intervention programme for FEP, were enrolled to a 12-month randomised-controlled trial (ClinicalTrials...
April 6, 2017: British Journal of Psychiatry: the Journal of Mental Science
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