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https://www.readbyqxmd.com/read/29332072/medical-management-of-movement-disorders
#1
Marina Picillo, Renato P Munhoz
Pharmacological treatment is the cornerstone in the management of movement disorders. Although most available treatment options have no impact on the underlying process of each movement disorder, symptomatic therapies can significantly improve patient's quality of life and level of disability. Here, we review the current knowledge on clinical symptomatic management of Parkinson's disease (both early and advanced stages), essential tremor, dystonia, and chorea. Ideally, treatment should be carried out by specialists with reasonable experience in movement disorders, as it needs to be tailored for each patient depending on several appraisals, including but not limited to patients' needs, compliance issues, potential side effects, caregiver support, and presence of comorbidities...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29322243/humanistic-burden-of-disease-for-patients-with-advanced-melanoma-in-canada
#2
Winson Y Cheung, Martha S Bayliss, Michelle K White, Angela Stroupe, Andrew Lovley, Bellinda L King-Kallimanis, Kathryn Lasch
BACKGROUND: Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). METHODS: Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach...
January 10, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29321132/intersection-of-pulmonary-hypertension-and-right-ventricular-dysfunction-in-patients-on-left-ventricular-assist-device-support-is-there-a-role-for-pulmonary-vasodilators
#3
Christopher T Sparrow, Shane J LaRue, Joel D Schilling
Left ventricular assist devices (LVADs) improve survival and quality of life in patients with advanced heart failure. Despite these benefits, combined post- and precapillary pulmonary hypertension can be particularly problematic in patients on LVAD support, often exacerbating right ventricular (RV) dysfunction. Both persistently elevated pulmonary vascular resistance and RV dysfunction are associated with adverse outcomes, including death after LVAD. These observations have led to significant interest in the use of pulmonary vasodilators to treat pulmonary hypertension and preserve RV function among LVAD-supported patients...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29320386/examining-the-feasibility-and-acceptability-of-an-online-yoga-class-for-mood-disorders-a-moodnetwork-study
#4
Lisa Uebelacker, Steven C Dufour, Jacob G Dinerman, Samantha L Walsh, Casey Hearing, Lee T Gillette, Thilo Deckersbach, Andrew A Nierenberg, Lauren Weinstock, Louisa G Sylvia
BACKGROUND: Despite ongoing advances in the treatment of mood disorders, a substantial proportion of people diagnosed with major depression or bipolar disorder remain symptomatic over time. Yoga, which has been shown to reduce stress and depressive symptoms, as well as to improve overall quality of life, shows promise as an adjunctive treatment. However, dissemination of yoga for clinical populations remains challenging. The purpose of this pilot study was to test the feasibility and acceptability of an online yoga intervention for individuals with mood disorders...
January 2018: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29319026/sequelae-of-pulmonary-multidrug-resistant-tuberculosis-at-the-completion-of-treatment
#5
Rupak Singla, Manashree Mallick, Parul Mrigpuri, Neeta Singla, Amitesh Gupta
BACKGROUND: Treatment of multidrug-resistant (MDR-TB) mainly focuses on bacteriological cure. However, only limited studies have evaluated the sequelae left after the completion of treatment among MDR-TB patients. OBJECTIVE: To assess the persistent symptoms, radiological sequelae, pulmonary function impairment and quality of life at the completion of treatment among MDR-TB patients. METHODS: Forty six MDR-TB patients were enrolled, who completed two years of treatment under programmatic management of Drug Resistant tuberculosis at a tertiary referral institute in Delhi, India...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29317770/corticosteroid-sparing-in-inflammatory-bowel-disease-is-more-often-achieved-in-the-immunomodulator-and-biological-era-results-from-the-dutch-population-based-ibdsl-cohort
#6
Steven F G Jeuring, Vince B C Biemans, Tim R A van den Heuvel, Maurice P Zeegers, Wim H Hameeteman, Mariëlle J L Romberg-Camps, Liekele E Oostenbrug, Ad A M Masclee, Daisy M A E Jonkers, Marieke J Pierik
OBJECTIVES: Corticosteroid-free remission is an emerging treatment goal in the management of inflammatory bowel disease (IBD). In the population-based Inflammatory Bowel Disease South Limburg cohort, we studied temporal changes in corticosteroid use and assessed the corticosteroid-sparing effects of immunomodulators and biologicals in real life. METHODS: In total, 2,823 newly diagnosed patients with Crohn's disease (CD) or ulcerative colitis (UC) were included. Corticosteroid exposure and cumulative days of use were compared between patients diagnosed in 1991-1998 (CD: n=316, UC: n=539), 1999-2005 (CD: n=387, UC: n=527), and 2006-2011 (CD: n=459, UC: n=595)...
January 9, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29317381/using-social-media-for-the-promotion-of-education-and-consultation-in-adolescents-who-have-undergone-kidney-transplant-protocol-for-a-randomized-control-trial
#7
Claudiana Pase, Andréia Dias Mathias, Clotilde Druck Garcia, Clarissa Garcia Rodrigues
BACKGROUND: Falling ill represents a traumatic experience especially in adolescence, since in addition to the moments of ambiguity and contradictions that this period brings, there is coping with the disease. Renal transplantation provides a better quality of life but the dependence on dialysis is replaced by the greater responsibility of self-care. With advances in technology, contemporary communication methods are a strategic mechanism for the approximation of the adolescent and the multiprofessional team...
January 9, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#8
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29312843/update-on-mesenchymal-stem-cell-therapies-for-cartilage-disorders
#9
EDITORIAL
Nikolaos K Paschos, Mackenzie L Sennett
Cartilage disorders, including focal cartilage lesions, are among the most common clinical problems in orthopedic practice. Left untreated, large focal lesions may result in progression to osteoarthritis, with tremendous impact on the quality of life of affected individuals. Current management strategies have shown only a modest degree of success, while several upcoming interventions signify better outcomes in the future. Among these, stem cell therapies have been suggested as a promising new era for cartilage disorders...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29310603/characteristics-of-positive-interaction-parenting-style-among-primiparous-teenage-optimal-age-and-advanced-age-mothers-in-canada
#10
Theresa H M Kim, Jennifer A Connolly, Michael Rotondi, Hala Tamim
BACKGROUND: Positive-interaction parenting early in childhood is encouraged due to its association with behavioural development later in life. The objective of this study was to examine if the level of positive-interaction parenting style differs among teen, optimal age, and advanced age mothers in Canada, and to identify the characteristics associated with positive-interaction parenting style separately for each age group. METHODS: This was a cross-sectional secondary analysis of the National Longitudinal Survey of Children and Youth...
January 8, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29310322/effect-of-training-in-advanced-trauma-life-support-on-the-kinematics-of-the-spine-a-simulation-study
#11
Raquel Gordillo Martin, Pedro E Alcaráz, Laura Juguera Rodriguez, Antonio Nieto Fernandez-Pacheco, Elena Marín-Cascales, Tomás T Freitas, Manuel Pardo Rios
More than 7.5 million people in the world are affected by spinal cord injury (SCI). In this study, we aimed to analyze the effect of training in advanced trauma life support (ATLS) on the kinematics of the spine when performing different mobilization and immobilization techniques on patients with suspected SCI. A quasi-experimental study, clinical simulation, was carried out to determine the effect of training in ATLS on 32 students enrolled in the Master's program of Emergency and Special Care Nursing. The evaluation was performed through 2 maneuvers: placing of the scoop stretcher (SS) and spinal board (SB), with an actor who simulated a clinical situation of suspected spinal injury...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29308799/an-enzymatic-advance-in-nicotine-cessation-therapy
#12
Song Xue, Marsida Kallupi, Bin Zhou, Lauren C Smith, Pedro O Miranda, Olivier George, Kim D Janda
A nicotine-degrading enzyme termed NicA2 was altered (NicA2-J1) through fusion of an albumin binding domain to increase its half-life. Examination of NicA2-J1 in vivo demonstrated a complete blockade of brain nicotine access, which in turn blunted nicotine's psychoactive effects. These data further support development of pharmacokinetic nicotine cessation therapeutics.
January 8, 2018: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/29305926/lower-dose-epinephrine-administration-and-out-of-hospital-cardiac-arrest-outcomes
#13
Cameron A Fisk, Michele Olsufka, Lihua Yin, Andrew M McCoy, Andrew J Latimer, Charles Maynard, Graham Nichol, Jonathan Larsen, Leonard A Cobb, Michael R Sayre
BACKGROUND: International guidelines recommend administration of 1 mg of intravenous epinephrine every 3 to 5 minutes during cardiac arrest. The optimal dose of epinephrine is not known. We evaluated the association of reduced frequency and dose of epinephrine with survival after out-of-hospital cardiac arrest (OHCA). METHODS: Included were patients with non-traumatic OHCA treated by advanced life support (ALS) providers from January 1, 2008 to June 30, 2016...
January 3, 2018: Resuscitation
https://www.readbyqxmd.com/read/29305251/cardiac-arrest-during-pregnancy-ongoing-clinical-conundrum-an-expert-review
#14
REVIEW
Carolyn M Zelop, Sharon Einav, Jill M Mhyre, Stephanie Martin
While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305227/current-trends-in-neonatal-ecmo
#15
REVIEW
Burhan Mahmood, Debra Newton, Eugenia K Pallotto
Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for patients with respiratory and cardiac failure refractory to maximal medical management. The extracorporeal life support organization registry is the largest available resource for describing the population and outcomes of patients treated with this therapy. The use of ECMO for neonatal patients is decreasing in proportion to the total annual ECMO runs most likely due to advancements in medical management. Although the overall survival for neonatal ECMO has decreased, this is likely a reflection of the increasingly complex neonatal patients treated with this therapy...
January 2, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29304160/a-retrospective-review-of-vital-signs-and-clinical-outcomes-of-febrile-infants-younger-than-3-months-old-presenting-to-the-emergency-department
#16
Shu-Ling Chong, Gene Yong-Kwang Ong, Wendy Yi Wen Chin, John Mingzhou Chua, Praseetha Nair, Alicia Shu Zhen Ong, Kee Chong Ng, Ian Maconochie
OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED...
2018: PloS One
https://www.readbyqxmd.com/read/29302797/proactive-care-of-older-people-undergoing-surgery
#17
Judith Partridge, Magda Sbai, Jugdeep Dhesi
The number of older patients undergoing surgery is increasing due to changing demographics, surgical and anaesthetic advances and shifts in patient expectations of healthcare. The benefits of surgery in older people are well documented and include symptom control and increased life expectancy. However, older surgical patients present not only with the index pathology requiring surgery but with concurrent age related physiological decline, multimorbidity and geriatric syndromes. These additional issues increase the risk of adverse postoperative outcome, in particular of postoperative medical and functional complications...
January 4, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29302599/what-are-the-ethical-aspects-surrounding-the-collegial-decisional-process-in-limiting-and-withdrawing-treatment-in-intensive-care
#18
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
The decision to limit or withdraw life-support treatment is an integral part of the job of a physician working in the intensive care unit, and of the approach to care. However, this decision is influenced by a number of factors. It is widely accepted that a medical decision that will ultimate lead to end-of-life in the intensive care unit (ICU) must be shared between all those involved in the care process, and should give precedence to the patient's wishes (either directly expressed by the patient or in written form, such as advance directives), and taking into account the opinion of the patient's family, including the surrogate if the patient is no longer capable of expressing themselves...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29302598/what-are-the-ethical-aspects-surrounding-intensive-care-unit-admission-in-patients-with-cancer
#19
REVIEW
Jean-Philippe Rigaud, Audrey Large, Nicolas Meunier-Beillard, Stéphanie Gélinotte, Pierre-Louis Declercq, Fiona Ecarnot, Auguste Dargent, Jean-Pierre Quenot
Improvements in living conditions and increasing life expectancy have combined to result in ever older patients being admitted to hospital. In parallel, the increasing incidence of cancer, along with the improved efficacy of anti-cancer therapies has led to greater needs for intensive care among cancer patients. The objectives underpinning the management of cancer patients in the intensive care unit (ICU) are to achieve a return to a clinical status that would allow the patient to be either, transferred back to the original unit, or discharged from the hospital with an acceptable quality of life, and where warranted, pursuit of cancer therapy...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298714/paediatric-palliative-care-improves-patient-outcomes-and-reduces-healthcare-costs-evaluation-of-a-home-based-program
#20
P H Chong, J A De Castro Molina, K Teo, W S Tan
BACKGROUND: Around the world, different models of paediatric palliative care have responded to the unique needs of children with life shortening conditions. However, research confirming their utility and impact is still lacking. This study compared patient-related outcomes and healthcare expenditures between those who received home-based paediatric palliative care and standard care. The quality of life and caregiver burden for patients receiving home-based paediatric palliative care were also tracked over the first year of enrolment to evaluate the service's longitudinal impact...
January 3, 2018: BMC Palliative Care
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