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181. Geriatric Rehabilitation (Follow-up)

] < 20 mm Hg), balance disorders, and vasovagal syncope. Depression, confusion, dementia, and other cognitive deficits also contribute to falls. Cognitive impairment, depressive symptoms, and orthostatic hypotension most contribute to gait dysfunction. Slower performance on the Timed Up-and-Go Test (TUG), a mobility task, is independently associated with poorer performance on measures of global cognition, executive function, memory, and processing speed, suggesting that a thorough cognitive (...) they are discharged from a hospital after an established fracture. Attention to the male, as well as the female, geriatric population is warranted in regard to the prevention and treatment of osteoporosis. Compared with women, men generally develop osteoporosis at an older age. Types of osteoporosis Different types of osteoporosis are described. Localized osteoporosis is seen in primary disorders, such as complex regional pain syndrome (CRPS) (type I formerly known as reflex sympathetic dystrophy and type II

2014 eMedicine.com

182. Amphetamine-Related Psychiatric Disorders (Follow-up)

users. Curr Opin Psychiatry . 2006 May. 19(3):239-45. . Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. 2014. Available at . Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R. Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. Pediatrics . 2009 Feb. 123(2):611-6. . Alem A, Kebede D, Kullgren G (...) and is the primary treatment. Relapse prevention occurs though patient education, individual psychotherapy, appropriate medical treatment of continuing psychiatric illness (eg, major depression, panic disorder), and attendance at substance abuse meetings. Mandatory weekly urine drug screens help prevent relapse or expose relapse early so that aggressive treatment intervention can be pursued. If psychiatric conditions arise during prescription amphetamine use for ADHD, lower doses may be tried

2014 eMedicine.com

183. Assistive Devices to Improve Independence (Follow-up)

mobility, orthostatic hypotension (systolic blood pressure [SBP] < 20 mm Hg), balance disorders, and vasovagal syncope. Depression, confusion, dementia, and other cognitive deficits also contribute to falls. Cognitive impairment, depressive symptoms, and orthostatic hypotension most contribute to gait dysfunction. Slower performance on the Timed Up-and-Go Test (TUG), a mobility task, is independently associated with poorer performance on measures of global cognition, executive function, memory (...) they are discharged from a hospital after an established fracture. Attention to the male, as well as the female, geriatric population is warranted in regard to the prevention and treatment of osteoporosis. Compared with women, men generally develop osteoporosis at an older age. Types of osteoporosis Different types of osteoporosis are described. Localized osteoporosis is seen in primary disorders, such as complex regional pain syndrome (CRPS) (type I formerly known as reflex sympathetic dystrophy and type II

2014 eMedicine.com

184. Somnambulism (Sleep Walking) (Diagnosis)

objects during sleepwalking and occasionally become injured). The prognosis for resolution with maturation is excellent. Sleep-disordered breathing and, to a lesser extent, RLS have been associated with sleepwalking in children, though less often than in adults. The incidence of associated sleep disorders has been reported to be as high as 61%. Prolonged disturbed sleep may be associated with school and behavioral issues. A relationship with hyperactivity is suggested but not clear. In adolescents (...) ; difficulty in awakening Little or no recall of dream imagery Amnesia for the episode The episodes cause significant distress or impairment in social, occupational or other areas of functioning The symptoms cannot be explained by another mental disorder, medical condition, or the effects of a drug of abuse or medication In addition, if warranted, the sleepwalking type can be further differentiated into 1 of 2 subtypes: With sleep-related eating (SRE) With sleep-related sexual behavior (sexsomnia

2014 eMedicine.com

185. Chronic Obstructive Pulmonary Disease (Follow-up)

and follow-up with respect to maintenance. Successful cessation programs usually use the following resources and tools: Patient education A target date to quit Follow-up support Relapse prevention Advice for healthy lifestyle changes Social support systems Adjuncts to treatment (ie, pharmacologic agents) Mottillo et al reported meta-analysis results indicating that intensive behavioral interventions, including (but not limited to) individual counseling and telephone counseling, offer considerable benefit (...) for increasing smoking abstinence. [ ] Supervised use of pharmacologic agents is an important adjunct to self-help and group smoking cessation programs. Nicotine is the ingredient in cigarettes primarily responsible for tobacco addiction. Withdrawal from nicotine may cause unpleasant adverse effects, including anxiety, irritability, difficulty concentrating, anger, fatigue, drowsiness, depression, and sleep disruption. These effects usually occur during the first several weeks. Nicotine replacement therapies

2014 eMedicine.com

186. Fibromyalgia (Follow-up)

with fibromyalgia fully understand the nature of the disease, they are more likely to comply with treatment and to take an active role in managing the disease. European League Against Rheumatism (EULAR) 2016 guidelines recommend that initial management of fibromyalgia involve patient education and focus on nonpharmacological therapies. Patients whose condition fails to respond should receive treatment tailored to their specific needs, such as psychological therapies for mood disorders and unhelpful coping (...) education and support to the patient's significant family members. Therapeutic recommendations for fibromyalgia can now be based almost entirely on evidence from well-designed randomized controlled trials. Models of pain behavior that interrelate biologic, cognitive, emotional, and behavioral variables form the basis for cognitive-behavioral and operant-behavioral approaches to pain management. Wood published a useful summary of therapeutic approaches to central sensitivity syndrome (CSS) comorbidities

2014 eMedicine.com

187. Amphetamine-Related Psychiatric Disorders (Diagnosis)

: Summary of National Findings. 2014. Available at . Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R. Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. Pediatrics . 2009 Feb. 123(2):611-6. . Alem A, Kebede D, Kullgren G. The prevalence and socio-demographic correlates of khat chewing in Butajira, Ethiopia. Acta Psychiatr Scand Suppl . 1999. 397:84-91. . Shen W, Liu Y, Li L, Zhang Y, Zhou W. Negative moods (...) antidepressant-resistant amphetamine-induced depression. Of interest, low-dose amphetamines can be used as an adjunct in the treatment of depression, especially in patients with medical compromise, lethargy, hypersomnia, low energy, or decreased attention. Sleep disturbances appear in a fashion similar to mood disorders. During intoxication, sleep can be decreased markedly. In withdrawal, sleep often increases. A disrupted circadian rhythm can result from late or high doses of prescription amphetamines

2014 eMedicine.com

188. Assistive Devices to Improve Independence (Diagnosis)

mobility, orthostatic hypotension (systolic blood pressure [SBP] < 20 mm Hg), balance disorders, and vasovagal syncope. Depression, confusion, dementia, and other cognitive deficits also contribute to falls. Cognitive impairment, depressive symptoms, and orthostatic hypotension most contribute to gait dysfunction. Slower performance on the Timed Up-and-Go Test (TUG), a mobility task, is independently associated with poorer performance on measures of global cognition, executive function, memory (...) they are discharged from a hospital after an established fracture. Attention to the male, as well as the female, geriatric population is warranted in regard to the prevention and treatment of osteoporosis. Compared with women, men generally develop osteoporosis at an older age. Types of osteoporosis Different types of osteoporosis are described. Localized osteoporosis is seen in primary disorders, such as complex regional pain syndrome (CRPS) (type I formerly known as reflex sympathetic dystrophy and type II

2014 eMedicine.com

189. Geriatric Rehabilitation (Diagnosis)

] < 20 mm Hg), balance disorders, and vasovagal syncope. Depression, confusion, dementia, and other cognitive deficits also contribute to falls. Cognitive impairment, depressive symptoms, and orthostatic hypotension most contribute to gait dysfunction. Slower performance on the Timed Up-and-Go Test (TUG), a mobility task, is independently associated with poorer performance on measures of global cognition, executive function, memory, and processing speed, suggesting that a thorough cognitive (...) they are discharged from a hospital after an established fracture. Attention to the male, as well as the female, geriatric population is warranted in regard to the prevention and treatment of osteoporosis. Compared with women, men generally develop osteoporosis at an older age. Types of osteoporosis Different types of osteoporosis are described. Localized osteoporosis is seen in primary disorders, such as complex regional pain syndrome (CRPS) (type I formerly known as reflex sympathetic dystrophy and type II

2014 eMedicine.com

190. Mood Disorder: Depression (Follow-up)

sizes, short-duration trials, and inclusion of patients with mild depression and comorbid disorders that may have had good responses to placebo. TCAs are no longer considered the first-line treatment for youths with depressive disorders; however, individual cases may respond better to TCAs than to other medications. [ , , ] TCAs may also be useful for youths with comorbid attention deficit hyperactivity disorder (ADHD), enuresis, and narcolepsy, as well as for augmentation strategies. TCAs should (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE0MTkyLXRyZWF0bWVudA== processing > Pediatric Depression Treatment & Management Updated: Nov 15, 2017 Author: Angelo P Giardino, MD, MPH, PhD; Chief Editor: Caroly Pataki, MD Share Email Print Feedback Close Sections Sections Pediatric Depression Treatment Approach Considerations Current evidence-supported interventions include cognitive-behavioral therapy (CBT), pharmacotherapy, or a combination of both should be offered as treatment for children and adolescents with major depressive disorder (MDD). Safety

2014 eMedicine Pediatrics

191. Mood Disorder: Depression (Treatment)

sizes, short-duration trials, and inclusion of patients with mild depression and comorbid disorders that may have had good responses to placebo. TCAs are no longer considered the first-line treatment for youths with depressive disorders; however, individual cases may respond better to TCAs than to other medications. [ , , ] TCAs may also be useful for youths with comorbid attention deficit hyperactivity disorder (ADHD), enuresis, and narcolepsy, as well as for augmentation strategies. TCAs should (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE0MTkyLXRyZWF0bWVudA== processing > Pediatric Depression Treatment & Management Updated: Nov 15, 2017 Author: Angelo P Giardino, MD, MPH, PhD; Chief Editor: Caroly Pataki, MD Share Email Print Feedback Close Sections Sections Pediatric Depression Treatment Approach Considerations Current evidence-supported interventions include cognitive-behavioral therapy (CBT), pharmacotherapy, or a combination of both should be offered as treatment for children and adolescents with major depressive disorder (MDD). Safety

2014 eMedicine Pediatrics

192. Mood Disorder: Bipolar Disorder (Treatment)

. . Faraone SV, Biederman J, Wozniak J, Mundy E, Mennin D, O'Donnell D. Is comorbidity with ADHD a marker for juvenile-onset mania?. J Am Acad Child Adolesc Psychiatry . 1997 Aug. 36(8):1046-55. . Strober M, DeAntonio M, Schmidt-Lackner S, Freeman R, Lampert C, Diamond J. Early childhood attention deficit hyperactivity disorder predicts poorer response to acute lithium therapy in adolescent mania. J Affect Disord . 1998 Nov. 51(2):145-51. . Birmaher B. Longitudinal course of pediatric bipolar disorder. Am (...) Reactionary Internally driven May engage in predatory or reactionary acts Social Often good Often poor Often poor Often poor Academic Often good Varies Often poor Often poor Psychomotor activity Agitated in mania or mixed states; retarded in depressed states Easily agitated Chronically agitated Easily agitated ADHDattention deficit/hyperactivity disorder Table 2. Medications for Pediatric Bipolar Disorder: Common Adverse Effects and Special Concerns Medication Common Adverse Effects Pediatric Doses

2014 eMedicine Pediatrics

193. Mood Disorder: Bipolar Disorder (Follow-up)

. . Faraone SV, Biederman J, Wozniak J, Mundy E, Mennin D, O'Donnell D. Is comorbidity with ADHD a marker for juvenile-onset mania?. J Am Acad Child Adolesc Psychiatry . 1997 Aug. 36(8):1046-55. . Strober M, DeAntonio M, Schmidt-Lackner S, Freeman R, Lampert C, Diamond J. Early childhood attention deficit hyperactivity disorder predicts poorer response to acute lithium therapy in adolescent mania. J Affect Disord . 1998 Nov. 51(2):145-51. . Birmaher B. Longitudinal course of pediatric bipolar disorder. Am (...) Reactionary Internally driven May engage in predatory or reactionary acts Social Often good Often poor Often poor Often poor Academic Often good Varies Often poor Often poor Psychomotor activity Agitated in mania or mixed states; retarded in depressed states Easily agitated Chronically agitated Easily agitated ADHDattention deficit/hyperactivity disorder Table 2. Medications for Pediatric Bipolar Disorder: Common Adverse Effects and Special Concerns Medication Common Adverse Effects Pediatric Doses

2014 eMedicine Pediatrics

194. Stroke, Ischemic (Follow-up)

of hyperglycemia in acute stroke remains an area of uncertainty. [ ] Extreme hyperglycemia is detrimental in the setting of acute stroke. Hyperglycemia is common after acute ischemic stroke, even in patients without diabetes. A Cochrane review found that the use of IV insulin to maintain serum glucose in the range of 4–7.5 mmol/L (72-135 mg/dL) in the first 24 hours of ischemic stroke did not improve functional outcome, death rates, or final neurologic deficit and significantly increased the risk (...) deficits. Unfortunately, fibrinolytics may also cause symptomatic intracranial hemorrhage. Other complications include potentially extracranial hemorrhage and angioedema or allergic reactions. [ ] Inclusion/exclusion criteria Therefore, if the patient is a candidate for fibrinolytic therapy, a thorough review of the inclusion and exclusion criteria must be performed. The exclusion criteria largely focus on identifying risk of hemorrhagic complications associated with fibrinolytic use. The American

2014 eMedicine Emergency Medicine

195. A Sleep Laboratory Study to Investigate the Safety and Efficacy of the Rotigotine Skin Patch in Subjects With Restless Legs Syndrome and End-Stage Renal Disease Requiring Hemodialysis

) (recorded during the second night) as assessed by the investigator at Baseline Exclusion Criteria: Clinically relevant Polyneuropathy or Varicosis which cannot be clearly differentiated from RLS symptoms in the opinion of the investigator Clinically relevant concomitant diseases, such as Attention Deficit Hyperactivity Disorder, Painful Legs, and Moving Toes Other central nervous system diseases Evidence of an impulse control disorder according to the modified Minnesota Impulsive Disorders Interview (...) relevant Venous or Arterial Peripheral Vascular Disease Malignant Neoplastic Disease requiring therapy within 12 months prior to Screening (Visit 1) Treatment with any of the following drug classes: neuroleptics, norepinephrine and dopamine reuptake inhibitors (bupropion), gabapentin, budipine, dopamine antagonist antiemetics (except domperidone), opioids, monoamine oxidase (MAO) inhibitors, catechol‑O‑methyltransferase (COMT) inhibitors, or psychostimulants (eg, amphetamines) Subject is pregnant

2012 Clinical Trials

196. Primary Care Internet Based Depression Prevention for Adolescents (CATCH-IT) Also Known as Promoting AdolescenT Health

diagnosis at each time point to ensure eligibility is consistent throughout the study (certain psychiatric diagnosis might render a subject ineligible for the study, therefore a KSADS interview is conducted at each major assessment point) Vulnerability Factors [ Time Frame: 0, 2, 6, 12, 18, 24 months ] Change in scales of SCARED, Disruptive Behavior Disorder Scale (DBD - teen and parent), CRAFFT, Sibling Relationship Questionnaire (SRQ - teen and parent), Sibling Inventory of Differential Experience (...) Education group. Condition or disease Intervention/treatment Phase Major Depression Depressive Episodes Behavioral: CATCH-IT Not Applicable Detailed Description: Additional aims and hypothesis are provided below: -Aim 1: To determine whether the CATCH-IT depression prevention intervention prevents or delays major depressive episodes, as well as non-affective disorder episodes, compared to HEALTH EDUCATION. Hypothesis 1: Compared to youth in the HEALTH EDUCATION condition, youth assigned to CATCH

2012 Clinical Trials

197. Adderall XR and Processing Speed in Multiple Sclerosis (MS)

relapses and physical disability but there are no medications that have been shown to treat cognitive impairment. Amphetamines have been beneficial for selective attention and processing speed in attention deficit hyperactivity disorder (ADHD) and traumatic brain injury. This is study will determine whether Adderall XR improves objective measures of processing speed and attention in MS patients impaired in this cognitive domain, by comparing two doses of Adderall XR (5 and 10mg) to placebo before (...) atherosclerosis or angina Have a diagnosis of bipolar disorder or a history of a psychotic episode The following medications are not permitted to be used within 14 days the study Monoamine Oxidase Inhibitors Sympathomimetics or methadone Antipsychotic agents Modafinil The following medications are permitted if the dose has been stable for ≥ 28 days Short acting benzodiazepines, qhs administration only Anticonvulsants, including gabapentin and pregabalin Bupropion Tricyclic Antidepressants Anti-spasmodics

2012 Clinical Trials

198. A Pilot Study of Deep Brain Stimulation of the Amygdala for Treatment-Refractory Combat Post-Traumatic Stress Disorder

Disorder, Content, Disruptive/Aggressive Behaviour, Appearance and Insight. Ratings are based on patient self-reporting, combined with clinician observation (accorded greater score). Young Mania Rating Scale (YMRS) change from week 0 [ Time Frame: 2 months ] The YMRS is an 11-item clinician-administered cross-sectional rating instrument used to assess the severity of mania in patients with a diagnosis of bipolar disorder. The 11 items are: Elevated Mood, Increased Motor Activity/Energy, Sexual Interest (...) , Sleep, Irritability, Speech (Rate and Amount), Language - Thought Disorder, Content, Disruptive/Aggressive Behaviour, Appearance and Insight. Ratings are based on patient self-reporting, combined with clinician observation (accorded greater score). Young Mania Rating Scale (YMRS) change from week 0 [ Time Frame: 3 months ] The YMRS is an 11-item clinician-administered cross-sectional rating instrument used to assess the severity of mania in patients with a diagnosis of bipolar disorder. The 11 items

2012 Clinical Trials

199. Tailored Smoking Cessation Treatment for LIVE FOR LIFE&#174; Participants

six months (except basal or squamous cell skin cancer); Other major medical condition; Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide; Pregnant or nursing mothers; Current psychiatric disease (with the exception of anxiety disorders, OCD and ADHD); Current depression; Bulimia or anorexia; Alcohol abuse; Significant adverse reaction to bupropion/Wellbutrin/Zyban, Chantix/Varenicline or nicotine patches in the past. Use (within the past 30 days (...) only nicotine patches. Drug: nicotine patches 21mg nicotine patch for first 11 weeks; 14mg nicotine patch for next 2 weeks; 7mg nicotine patch for final 2 weeks. Active Comparator: bupropion (Zyban) and nicotine patches This group will consist of smokers who, based on smoking behavior, DO NOT respond favorably to pre-cessation NRT (assessed the day before the scheduled quit day). They will receive bupropion with nicotine patches. Drug: bupropion (Zyban) After being switched from NRT (occurring

2012 Clinical Trials

200. Varenicline for Nicotine Dependence Among Those With HIV/AIDS

), irritability, speech content, disruptive, or aggressive behavior items score < 3 (past 4 weeks) No psychiatric hospitalization or Emergency Room visits for psychiatric issues in the past 6 months No aggressive or violent acts or behavior in the past 6 months Able to communicate fluently in English. Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the combined consent/HIPAA form. Exclusion Criteria: Smoking Behavior Current enrollment (...) and counseling group, and there will be no significant differences between treatment arms in terms of the frequency of severe varenicline-related side effects; and 3) improved affect and reduced cognitive impairment will mediate the effect of varenicline therapy on quit rates. Condition or disease Intervention/treatment Phase Nicotine Dependence Drug: Varenicline Drug: Placebo Behavioral: Smoking Cessation Counseling Phase 3 Detailed Description: Among people diagnosed with HIV/AIDS, the widespread use

2012 Clinical Trials

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