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https://www.readbyqxmd.com/read/28805985/willingness-to-pay-for-antiretroviral-drugs-among-hiv-and-aids-clients-in-south-east-nigeria
#1
Chinyere Mbachu, Chijioke Okoli, Obinna Onwujekwe, Fabian Enabulele
BACKGROUND: The current trend of withdrawal of donor support for HIV/AIDS treatment in Nigeria may require that the cost of antiretroviral drugs be borne in part by infected people and their families. OBJECTIVE: This study was conducted to determine the economic value for free antiretroviral drugs (ARVs) expressed by clients receiving treatment for HIV/AIDS in a tertiary hospital. STUDY METHOD: The contingent valuation method was used to elicit the values attached to free ARVs from people living with HIV/AIDS that were receiving care in a public tertiary hospital in south-east Nigeria...
August 14, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28805585/understanding-and-treating-pain-syndromes-in-parkinson-s-disease
#2
Marialuisa Gandolfi, Christian Geroin, Angelo Antonini, Nicola Smania, Michele Tinazzi
Pain affects many people with Parkinson's disease (PD) and diminishes their quality of life. Different types of pain have been described, but their related pathophysiological mechanisms remain unclear. The aim of this chapter is to provide movement disorders specialists an update about the pathophysiology of pain and a practical guide for the management of pain syndromes in clinical practice. This chapter reviews current knowledge on the pathophysiological mechanisms of sensory changes and pain in PD, as well as assessment and treatment procedures to manage these symptoms...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28802695/scarce-resource-allocation-during-disasters-a-mixed-method-community-engagement-study
#3
Elizabeth Lee Daugherty Biddison, Howard S Gwon, Monica Schoch-Spana, Alan C Regenberg, Chrissie Juliano, Ruth R Faden, Eric S Toner
BACKGROUND: During a catastrophe, health care providers may face difficult questions regarding who will receive limited life-saving resources. The ethical principles that should guide decision-making have been considered by expert panels but have not been well explored with the public or front line clinicians. The objective of this study was to characterize the public's values regarding how scarce mechanical ventilators should be allocated during an influenza pandemic, with the ultimate goal of informing a statewide scare resource allocation framework...
August 9, 2017: Chest
https://www.readbyqxmd.com/read/28800807/the-changing-health-policy-environment-and-behavioral-health-services-delivery
#4
REVIEW
Laura N Medford-Davis, Rakel C Beall
Deinstitutionalization has left an inadequate supply of inpatient psychiatric beds. Simultaneous cuts to public funding and insurance coverage for outpatient mental health treatment have increased the frequency of acute psychiatric crises. The resulting lack of available options has shifted the burden of treatment to emergency departments and the criminal justice system. Recent legislation has improved insurance access, but rules are not always enforced and there are still few options for care. Discussion of mental health care delivery must acknowledge that many emergent behavioral health crises arise in the context of acute substance intoxication, withdrawal, or dependence...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28799513/ketogenic-diets-in-the-treatment-of-epilepsy
#5
Maurizio Elia, Joerg Klepper, Baerbel Leiendecker, Hans Hartmann
BACKGROUND: Although a larger number of antiepileptic drugs became available in the last decades, epilepsy remains drug-resistant in approximately a third of patients. Ketogenic diet (KD), first proposed at the beginning of the last century, is complex and has anticonvulsant effects, yet not completely understood. Over the last decades, different types of ketogenic diets (KDs) have been developed, namely classical KD and modified Atkins diet (MAD). They offer an effective alternative for children and adults with drug-resistant epilepsies...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28799510/safety-profile-of-the-newest-antiepileptic-drugs-a-curated-literature-review
#6
Caterina Palleria, Giuseppe Cozza, Rajeshree Khengar, Vincenzo Libri, Giovambattista De Sarro
BACKGROUND: Despite the introduction of new antiepileptic drugs (AEDs), the quality of life and therapeutic response for patients with epilepsy remain unsatisfactory. In addition, whilst several antiepileptic drugs (AEDs) have been approved and consequently marketed in recent years, little is known about their long-term safety and tolerability. Availability of the newest AEDs, characterized by improved pharmacokinetic profiles, has positively impacted the treatment approach for patients with partial seizures in clinical practice...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28797258/work-stress-associated-cool-down-reactions-among-nurses-and-hospital-physicians-and-their-relation-to-burnout-symptoms
#7
Arndt Büssing, Zarah Falkenberg, Carina Schoppe, Daniela Rodrigues Recchia, Désirée Poier
BACKGROUND: Hospital staff experience high level of work stress and they have to find strategies to adapt and react to it. When they perceive emotional exhaustion and job dissatisfaction in response to constant work stress, one reaction might be emotional withdrawal. This emotional distancing can be seen as an adaptive strategy to keep 'functionality' in the job. Both, perception of emotional exhaustion and emotional distancing as a strategy, can be operationalized as 'Cool Down'. We assume that work stress associated variables are positively associated with Cool Down reactions, while internal and external resources are negatively associated and might function as a buffer against emotional distancing...
August 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28793780/iatrogenic-opioid-withdrawal-in-critically-ill-patients-a-review-of-assessment-tools-and-management
#8
Ada W Chiu, Sofia Contreras, Sangeeta Mehta, Jennifer Korman, Marc M Perreault, David R Williamson, Lisa D Burry
OBJECTIVE: To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. DATA SOURCES: We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28777203/a-review-of-alprazolam-use-misuse-and-withdrawal
#9
Nassima Ait-Daoud, Allan Scott Hamby, Sana Sharma, Derek Blevins
: Alprazolam is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder. Its clinical use has been a point of contention as most addiction specialists consider it to be highly addictive, given its unique psychodynamic properties which limit its clinical usefulness, whereas many primary care physicians continue to prescribe it for longer periods than recommended. Clinical research data has not fully shed light on its "abuse liability," yet it is one of the most frequently prescribed benzodiazepines...
August 2, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28774339/measurement-education-and-tracking-in-integrated-care-metric-use-of-a-culturally-adapted-education-tool-versus-standard-education-to-increase-engagement-in-depression-treatment-among-hispanic-patients-study-protocol-for-a-randomized-control-trial
#10
Katherine Sanchez, Brittany H Eghaneyan, Michael O Killian, Leopoldo Cabassa, Madhukar H Trivedi
BACKGROUND: Significant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Stigma and poor communication between patients and their providers result in low use of antidepressant medications and early treatment withdrawal. Cultural factors which influence treatment decisions among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications...
August 3, 2017: Trials
https://www.readbyqxmd.com/read/28771932/acute-liver-failure-induced-by-idiosyncratic-reaction-to-drugs-challenges-in-diagnosis-and-therapy
#11
Shannan R Tujios, William M Lee
Acute liver failure (ALF) requires urgent attention to identify etiology and determine prognosis, in order to assess likelihood of survival or need for transplantation. Identifying idiosyncratic drug-induced liver injury (iDILI) may be particularly difficult, but the illness generally follows a subacute course, allowing time to assess outcome and find a liver graft if needed. Not all drugs that cause iDILI lead to ALF; the most common are antibiotics including anti-tuberculous medications, non-steroidal anti-inflammatory agents and herbal and dietary supplements (HDS)...
August 3, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28754353/-futile-care-an-emergency-medicine-approach-ethical-and-legal-considerations
#12
Jeremy R Simon, Chadd Kraus, Mark Rosenberg, David H Wang, Elizabeth P Clayborne, Arthur R Derse
Futility often serves as a proposed reason for withholding or withdrawing medical treatment, even in the face of patient and family requests. Although there is substantial literature describing the meaning and use of futility, little of it is specific to emergency medicine. Furthermore, the literature does not provide a widely accepted definition of futility, and thus is difficult if not impossible to apply. Some argue that even a clear concept of futility would be inappropriate to use. This article will review the origins of and meanings suggested for futility, specific challenges such cases create in the emergency department (ED), and the relevant legal background...
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28752347/-prolonged-neuroleptic-malignant-syndrome-after-haloperidol-injection
#13
N Wystub, S Heymel, M Fritzenwanger, P C Schulze, R Pfeifer
Neuroleptic malignant syndrome (NMS) is a rare disorder caused by drug-induced dopamine-receptor-blockage or low dopamine concentration in the brain. It is a severe reaction to neuroleptic drugs in antipsychotic therapy. Symptoms in NMS typically consist of fever, muscle rigidity and cognitive changes; laboratory findings include elevated infectious disease markers and creatine kinase as well as signs of rhabdomyolysis. To differentiate NMS from other malignant hyperthermia syndromes identifying the offending drug and clinical history are essential...
July 27, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28750885/regional-cerebral-saturation-monitoring-during-withdrawal-of-life-support-until-death
#14
Cornelia Genbrugge, Ward Eertmans, Frank Jans, Willem Boer, Jo Dens, Cathy De Deyne
AIMS: The aim of this pilot study was to explore the regional cerebral oxygen saturation (rSO2) during the process of dying in Intensive Care Unit (ICU) patients in whom it was decided to withdraw life support. METHODS: Regional cerebral saturation was measured from the moment active treatment was stopped until the moment of death, defined as the onset of asystole. Simultaneously, heart rate and arterial blood pressure were recorded using a radial arterial catheter...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28750598/hemodynamic-instability-secondary-to-vasopressin-withdrawal-in-septic-shock
#15
Brittany D Bissell, Carolyn Magee, Peter Moran, Melissa L Thompson Bastin, Alexander H Flannery
RATIONALE: Vasopressors such as norepinephrine are first line for support of mean arterial pressure (MAP) in the management of septic shock. Their use, however, is commonly associated with many adverse events. These detriments frequently trigger the use of alternative, noncatecholamine therapies, including vasopressin. Vasopressin deficiency is a known physiologic consequence of septic shock, and while guidelines recommend vasopressin in addition to norepinephrine, no consensus exists on the duration of deficiency or ideal time of cessation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28745154/using-telehealth-in-the-management-of-hypertension
#16
Charlotte Elizabeth Harrison, Karen Wild
Telehealth is a recent concept in hypertension management, and involves using electronic technology to monitor patients' vital signs, such as blood pressure, in their homes. This article presents the findings of a literature review that explored the issues associated with implementing telehealth in the primary care setting. It outlines the challenges associated with telehealth, as well as the potential benefits in terms of improving hypertension management. Aim To explore the usefulness of, and evidence for, telehealth in the management of hypertension in the primary care setting...
July 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#17
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28733295/the-impact-of-healthcare-professionals-personality-and-religious-beliefs-on-the-decisions-to-forego-life-sustaining-treatments-an-observational-multicentre-cross-sectional-study-in-greek-intensive-care-units
#18
Asimenia Ntantana, Dimitrios Matamis, Savvoula Savvidou, Kyriaki Marmanidou, Maria Giannakou, Μary Gouva, George Nakos, Vasilios Koulouras
OBJECTIVES: To assess the opinion of intensive care unit (ICU) personnel and the impact of their personality and religious beliefs on decisions to forego life-sustaining treatments (DFLSTs). SETTING: Cross-sectional, observational, national study in 18 multidisciplinary Greek ICUs, with >6 beds, between June and December 2015. PARTICIPANTS: 149 doctors and 320 nurses who voluntarily and anonymously answered the End-of-Life (EoL) attitudes, Personality (EPQ) and Religion (SpREUK) questionnaires...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28730421/-documentation-of-decisions-to-withhold-or-withdraw-life-sustaining-therapies-recommendation-of-the-ethics-section-of-the-german-interdisciplinary-association-of-critical-care-and-emergency-medicine-divi-in-collaboration-with-the-ethics-section-of-the-german
#19
REVIEW
G Neitzke, B Böll, H Burchardi, K Dannenberg, G Duttge, R Erchinger, P Gretenkort, C Hartog, K Knochel, M Liebig, A Michalsen, G Michels, M Mohr, F Nauck, P Radke, F Salomon, H Stopfkuchen, U Janssens
No abstract text is available yet for this article.
July 20, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28730065/exploring-structural-violence-in-the-context-of-disability-and-poverty-in-zimbabwe
#20
Jennifer T Muderedzi, Arne H Eide, Stine H Braathen, Babill Stray-Pedersen
BACKGROUND: While it is widely assumed that disability, poverty and health are closely linked, research falls short of fully understanding the link. One approach to analysing the links between disability and poverty is through the concept of structural violence, referring to social structures that contribute to the impoverishment of individuals or communities. These structures can be political, ecological, legal and economic, among others. OBJECTIVE: To explore structural violence and how it affects families of children with cerebral palsy among the Tonga ethnic group living in poor rural communities of Binga in Zimbabwe...
2017: Afr J Disabil
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