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psychiatric medical management

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https://www.readbyqxmd.com/read/28640591/managing-psychotropic-medications-in-complex-real-world-patients-using-comprehensive-therapeutic-drug-monitoring
#1
Jeffrey J Sutherland, Ryan D Morrison, J Scott Daniels, Stephen B Milne, Timothy P Ryan
There are multiple treatment options for depression, anxiety, psychosis, and other psychiatric disorders, and psychiatry patients are often comorbid with complex, polypharmacy treatment regimens. Unlike cardiovascular disease and diabetes, there are no readily available biomarkers to gauge treatment success with psychotropic medications, often resulting in subjective determination of medication therapy effectiveness. The physiochemical properties of psychiatric medications in general lend themselves to quantitative measurement in blood, offering an avenue to optimize treatment for each patient...
June 22, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28630647/patterns-of-psychiatric-admissions-and-predictors-of-patient-s-outcome-in-jimma-university-teaching-and-referral-hospital-a-retrospective-study
#2
Sinan Tadesse, Abraham Tamirat Gizaw, Getachew Kirose Abraha, Lakew Abebe Gebretsadik
BACKGROUND: Psychiatric morbidity burden accounts 12.45% of the disease admission burden in Ethiopia; only two referral hospitals are found to manage all cases. The aim of this study is to assess the predictors of patient outcomes. METHOD: A 3 years retrospective patients' cards, charts and medical notes review in psychiatry case admission department of Jimma university teaching and training specialised hospital was conducted. All the admitted cases included in this study...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28629675/misdiagnosis-is-an-important-factor-for-diagnostic-delay-in-mcardle-disease
#3
Renata Siciliani Scalco, Jasper M Morrow, Suzanne Booth, Sherryl Chatfield, Richard Godfrey, Ros Quinlivan
Diagnosis of McArdle disease is frequently delayed by many years following the first presentation of symptoms to a health professional. The aim of this study was to investigate the importance of misdiagnosis in delaying diagnosis of McArdle disease. The frequency of misdiagnosis, duration of diagnostic delay, categories of misdiagnoses and inappropriate medical interventions were assessed in 50 genetically confirmed patients. The results demonstrated a high frequency of misdiagnosis (90%, n = 45/50) most commonly during childhood years (67%; n = 30/45) compared with teenage years and adulthood (teenage: n = 7/45; adult n = 5/45; not known n = 3/45)...
May 3, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28620564/moyamoya-syndrome-in-a-child-with-neurofibromatosis-type-1-magnetic-resonance-imaging-as-a-tool-for-clinical-decision-making
#4
Jonathan Mayl, Hanisha Patel, Tushar Chandra
Moyamoya syndrome is a rare cerebrovasculopathy of unknown etiology which is associated with multiple risk factors. Moyamoya was first discovered in Japan and is reported to have an increased prevalence in the Japanese population. The term "Moyamoya" translates into "puff of smoke" and is named after the finding of the collateral cerebral vasculature that develops secondary to occlusion of an internal carotid artery at the entrance into the circle of Willis. This collateral vasculature characterizes the disease...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28617151/lithium-exposure-during-pregnancy-outcomes-for-women-who-attended-a-specialist-antenatal-clinic
#5
Jacqueline Frayne, Thinh Nguyen, Tabitha Mok, Yvonne Hauck, Helena Liira
INTRODUCTION: Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. METHODS: A cohort study of 33 women with severe mental illness, who were prescribed lithium at any time during the pregnancy, and gave birth between December 2007 and January 2015 at a specialist antenatal clinic in Western Australia. A descriptive comparison for women who continued lithium throughout pregnancy, and those who ceased on discovery of pregnancy was undertaken examining demographic, obstetric, neonatal and psychiatric variables...
June 15, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28615765/adverse-drug-reaction-monitoring-in-a-tertiary-care-psychiatry-setting-a-comparative-study-between-inpatients-and-outpatients
#6
Tejaswi Gummadi, Virupaksha Shanmugam Harave, Lakshmi Narayan Aiyar, Saraswathy Ganesan RajaLekshmi, Radhika Kunnavil
BACKGROUND: Psychotropic medications are the mainstay of treatment in psychiatric disorders and are associated with ADRs which affect the compliance and treatment course. Previous studies have looked at the frequency, profile of ADRs and their management aspects. However, the systematic comparison between IP and OP was lacking even though there is a prescription pattern difference. Hence this study was aimed to compare the proportion, pattern, severity and resolution of ADRs once detected...
May 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28603433/evaluation-of-effectiveness-and-safety-of-a-herbal-compound-in-primary-insomnia-symptoms-and-sleep-disturbances-not-related-to-medical-or-psychiatric-causes
#7
Giancarlo Palmieri, Paola Contaldi, Giuseppe Fogliame
BACKGROUND AND PURPOSE: Sleep disturbances and related daytime activities impairment are common diseases nowadays. General practitioners are often the first health care professional asked to alleviate sleep disturbances and primary insomnia symptoms. Beyond a wide class of hypnotic drugs, botanicals can represent an alternative treatment for those kinds of symptoms. The scope of the present study is to evaluate safety and effectiveness of a herbal compound composed of valerian, hop, and jujube (Vagonotte(®)) on primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28601143/psychiatric-and-palliative-care-in-the-intensive-care-unit
#8
REVIEW
Stephanie M Harman
Palliative care is specialized medical care focused on patients with serious illness and their families. In the intensive care unit (ICU), palliative care encompasses core skills to support patients and their families throughout their ICU course and post-ICU stays. Psychiatric symptoms are common among patients approaching the end of life and require particular attention in the setting of sedating medications, typically used when patients require ventilators and other life-sustaining treatments. For patients with preexisting severe mental illness who have a concurrent serious medical illness, a palliative psychiatric approach can address complex symptom management and support ethical and value-based shared decision making...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28601142/medical-complications-of-psychiatric-treatment-an-update
#9
REVIEW
Sheila C Lahijani, Kirk A Harris
Psychiatric medications are used commonly in hospitalized patients and are particularly indicated in patients who are critically ill to manage many conditions. Due to their many indications in the intensive care unit (ICU), psychiatric medications should be closely monitored in these medically compromised patients for adverse reactions and medical complications because they may affect essentially all organ systems. These range from life-threatening reactions to other less significant effects, such as sedation, to other detrimental complications, such as pancreatitis...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28601138/psychiatric-disorders-and-suicidality-in-the-intensive-care-unit
#10
REVIEW
Renee M Garcia
Suicidality is a general term that describes the continuum of suicidal ideation, intent, self-injurious behavior, attempts, and completed suicide. Suicidality across the entire spectrum is a public health concern with significant impact, including billions in work loss and medical costs. There are many challenges to managing suicidality in an intensive care unit setting, which will be reviewed here. Additionally, this article will review the prevalence of suicide attempts in different psychiatric diagnoses, conducting a suicide assessment, role of involuntary psychiatric holds, and most common challenges encountered in the ICU setting...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28601137/psychiatric-aspects-of-heart-disease-and-cardiac-aspects-of-psychiatric-disease-in-critical-care
#11
REVIEW
Peter A Shapiro
Strong emotional reactions are common in patients admitted to cardiac critical care; only some are pathological. Cardiac critical care and associated technologies are associated with predictable psychiatric problems. Many occur as secondary complications of the medical status of the patient, which must be carefully assessed. Depression is common in patients with coronary disease and also for patients with heart failure; treatment is helpful, but persistent depression is associated with elevated morbidity and mortality...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28594303/self-inflicted-enucleations-clinical-features-of-seven-cases
#12
Mamta Shah, Lucy Sun, Solly Elmann, Ivan Vrcek, Ronald Mancini, Hee Joon Kim, Jacqueline Carrasco, Roman Shinder
We report the clinical presentation, radiography, and management outcomes of autoenucleations (AE). Charts of 7 patients evaluated at 4 institutions with AE were reviewed. Four males and three females had a mean age of 50 years (range 26-72 years). The etiologies were psychosis secondary to underlying mental illness (6, 88%) and substance use (1, 12%), and the mechanism was largely blunt digital injury (6, 88%). Three (43%) AE patients suffered bilateral enucleations. Common concomitant injuries included eyelid lacerations (5, 71%) and optic nerve avulsion (3, 43%)...
June 2017: Orbit
https://www.readbyqxmd.com/read/28590144/pharmacological-treatment-of-depression-in-geriatric-chronic-pain-patients-a-biopsychosocial-approach-integrating-functional-restoration
#13
Peter Polatin, Kelley Bevers, Robert J Gatchel
A recent literature review concluded that the comorbidity of chronic pain and depression in adults is approximately 50%-65%. Physical and cognitive declines, concurrent multiple health conditions, and complex medication regimens add to the unique and complex challenges of effectively treating pain in particularly geriatric populations. Interdisciplinary medical intervention and monitoring for psychiatric sequelae, such as depression, cognitive change, and synergistic physical side effects are necessary. Areas covered: This review covers an extensive multi-database wide search of the pharmacotherapy of pain and depression in older adults, including biopsychosocial approaches...
June 14, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28587701/brain-atrophy-is-a-frequent-finding-in-elderly-patients-with-first-episode-psychosis
#14
Ulla-Marja Louhija, Tuula Saarela, Kati Juva, Björn Appelberg
BACKGROUND: To characterize the yearly incidence, diagnostic distribution, and neuro-radiologic findings in patients aged over 60 years, referred to psychiatric treatment with first episode psychosis (FEP). METHODS: A computerized search, including all patients referred to psychiatric treatment during 12 consecutive months with a de novo diagnosis of psychosis was performed in the Helsinki region catchment area with 1.2 million inhabitants. Diagnoses based on hospital records were made by a group of one neurologist and three psychiatrists...
June 7, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28585880/service-needs-and-barriers-to-care-five-or-more-years-after-moderate-to-severe-tbi-among-veterans
#15
R Jay Schulz-Heik, John H Poole, Marie N Dahdah, Campbell Sullivan, Maheen M Adamson, Elaine S Date, Rose Salerno, Karen Schwab, Odette Harris
PRIMARY OBJECTIVE: The objective of this paper is to identify the most frequent service needs, factors associated with needs, and barriers to care among Veterans and service members five or more years after moderate to severe traumatic brain injury (TBI). RESEARCH DESIGN: Survey administered via telephone 5-16 years after injury (median eight years) and subsequent acute inpatient rehabilitation at a regional Veterans Affairs (VA) medical centre. METHODS AND PROCEDURES: Participants were 119 Veterans and military personnel, aged 23-70 (median 35), 90% male...
June 6, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28585222/potential-therapeutic-effects-of-psilocybin
#16
REVIEW
Matthew W Johnson, Roland R Griffiths
Psilocybin and other 5-hydroxytryptamine2A agonist classic psychedelics have been used for centuries as sacraments within indigenous cultures. In the mid-twentieth century they were a focus within psychiatry as both probes of brain function and experimental therapeutics. By the late 1960s and early 1970s these scientific inquires fell out of favor because classic psychedelics were being used outside of medical research and in association with the emerging counter culture. However, in the twenty-first century, scientific interest in classic psychedelics has returned and grown as a result of several promising studies, validating earlier research...
June 5, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28580656/prepartum-psychosis-and-neonaticide-rare-case-study-and-forensic-psychiatric-synthesis-of-literature
#17
Maria-Valeria Karakasi, Maria Markopoulou, Ioannis K Tentes, Panagiotis N Tsikouras, Epameinondas Vasilikos, Pavlos Pavlidis
Peripartum psychosis is a rare but serious psychiatric disorder characterized by the presence of a mood episode with psychotic features. Although controversy surrounds the nosological status of peripartum mental disorders, these conditions continue to be of exceptional interest to the medical and forensic mental health communities. The aim of this study was to report a rare case of prepartum psychosis which escalated to the endpoint of neonaticide and summarize literature on peripartum mental disorders and infanticide...
June 5, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28576305/cystic-fibrosis-transmembrane-regulator-modulators-implications-for-the-management-of-depression-and-anxiety-in-cystic-fibrosis
#18
REVIEW
Jaideep S Talwalkar, Jonathan L Koff, Hochang B Lee, Clemente J Britto, Arielle M Mulenos, Anna M Georgiopoulos
BACKGROUND: Individuals with cystic fibrosis (CF) are at high risk for depression and anxiety, which are associated with worse medical outcomes. Novel therapies for CF hold great promise for improving physical health, but the effects of these therapies on mental health remain poorly understood. OBJECTIVE: This review aims to familiarize psychiatrists with the potential effect of novel CF therapies on depression and anxiety. METHODS: We discuss novel therapies that directly target the mutant CF protein, the CF transmembrane regulator (CFTR), which are called CFTR modulators...
April 5, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28573362/resource-utilization-in-emergency-department-patients-with-known-or-suspected-poisoning
#19
Stephen J Traub, Soroush Saghafian, Matthew R Buras, M'Hamed Temkit
INTRODUCTION: Previous work has shown poisoning-related emergency department (ED) visits are increasing, and these visits are resource-intensive. Little is known, however, about how resource utilization for patients with known or suspected poisoning differs from that of general ED patients. METHODS: We reviewed 4 years of operational data at a single ED. We identified visits due to known or suspected poisoning (index cases), and paired them with time-matched controls...
June 1, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28567500/treatment-of-sleep-dysfunction-in-parkinson-s-disease
#20
REVIEW
Amy W Amara, Lana M Chahine, Aleksandar Videnovic
Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sleep and neuropsychiatric disorders. The primary neurodegenerative process of PD involves brain regions that regulate the sleep-wake cycle, such as brainstem and hypothalamic nuclei. Sleep disorders in PD include insomnia, REM sleep behavior disorder (RBD), sleep disordered breathing (SDB), restless legs syndrome (RLS), and circadian disruption...
July 2017: Current Treatment Options in Neurology
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