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121. Interventions to Improve Minority Health Care and Racial and Ethnic Disparities

A study suggests a telemedicine/care coordination intervention may reduce disparities in black Veterans with diabetes; this finding warrants further research. 3 Interventions to Improve Minority Health Care and Reduce Racial and Ethnic Disparities Evidence-based Synthesis Program Arthritis and Pain Management Interventions Our search identified one fair quality systematic review examining the ef fects of behavioral interventions for arthritis in minority and white populations. We also identified one (...) primary study of V A patients evaluating the effects of a decision aid on expected postoperative total knee replacement pain and function levels. The systematic review of behavioral interventions for arthritis found limited evidence from two randomized controlled trials that exercise interventions may be effective in improving differences in pain and disability between white and black patients. In addition, one primary V A study investigating an educational intervention provides evidence of improving

2011 Veterans Affairs Evidence-based Synthesis Program Reports

122. Evidence based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity

have covered pharmacotherapy for younger and older people, for those with personality disorder, as well as for ‘club drugs’ and cannabis and polydrug users. We review pharmacothera- pies in common clinical use as well as those with limited but prom- ising evidence and highlight important areas of ‘key uncertainty’. We have reviewed the evidence in as brief a format as possible and refer readers to the other guidelines such as NICE, where more detail is provided. Whilst some avenues have developed (...) A, Sell L, Sinclair J, Tyrer P, West R, Williams T, Winstock A Abstract The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts

2012 British Association for Psychopharmacology

123. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease Full Text available with Trip Pro

. . . . . . . . . . . . . . . . . . . . . . . .e425 5.12.5. Chronic Kidney Disease. . . . . . . . . . .e425 5.12.6. HIV Infection and SIHD. . . . . . . . . .e426 5.12.7. Autoimmune Disorders. . . . . . . . . . . .e426 5.12.8. Socioeconomic Factors. . . . . . . . . . . .e426 5.12.9. Special Occupations. . . . . . . . . . . . . .e426 6. Patient Follow-Up: Monitoring of Symptoms and Antianginal Therapy. . . . . . . . . . . . . . . . . . . . . . . . .e426 6.1. Clinical Evaluation, Echocardiography During Routine, Periodic Follow-Up: Recommendations (...) symptoms were stable can develop new or recurrent chest pain or other symptoms suggesting ACS. Just as in the case of patients with new-onset chest pain, the clinician must determine whether such recurrent or worsening pain is consistent with ACS or simply represents symptoms more consistent with chronic stable angina that do not require emergent attention. As indicated previously, patients with AMI or moderate- to high-risk UA fall outside of the scope of this guideline, whereas those with chronic

2011 American Heart Association

124. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

of modifi- able risk factors; 2) proper handling of all medications given preoperatively (Sections 4.1, 4.3, and 4.5); 3) establishment of central venous access and careful cardiovascular monitor- ing; 4) induction of a state of unconsciousness, analgesia, and immobility; and 5) a smooth transition to the early postoper- ative period, with a goal of early extubation, patient mobili- zation, and hospital discharge. Attention should be directed at preventing or minimizing adverse hemodynamic and hor (...) subspecialty certification. 18 2.1.2. Use of CPB Several adverse outcomes have been attributed to CPB, including 1) neurological deficits (eg, stroke, coma, postop- erative neurocognitive dysfunction); 2) renal dysfunction; and 3) the Systemic inflammatory Response Syndrome (SIRS). The SIRS is manifested as generalized systemic inflammation occurring after a major morbid event, such as trauma, infection, or major surgery. It is often particularly apparent after on-pump cardiac surgery, during which surgi

2011 American Heart Association

125. Coronary Artery Bypass Graft Surgery: Guideline For

of central venous access and careful cardiovascular monitoring; 4) induction of a state of unconsciousness, analgesia, and immobility; and 5) a smooth transition to the e128 Hillis et al. JACC Vol. 58, No. 24, 2011 2011 ACCF/AHA CABG Guideline December 6, 2011:e123–210early postoperative period, with a goal of early extubation, patient mobilization, and hospital discharge. Attention should be directed at preventing or minimizing adverse hemodynamic and hormonal alterations that may induce myocardial

2011 American College of Cardiology

126. Stimulants for the Control of Hedonic Appetite Full Text available with Trip Pro

) for obesity, although dexamphetamine and methylpenidate are approved and widely used for treating attention deficit hyperactivity disorder (ADHD) in adults and children. Experience gained over many years in the treatment of ADHD demonstrates that with careful dose titration, stimulants can be used safely. In obesity, improvement in mood and executive functioning could assist with the lifestyle changes necessary for weight control, acting synergistically with appetite suppression. The obesity crisis has (...) Stimulants for the Control of Hedonic Appetite The focus of this paper is treatment of obesity in relation to the management of hedonic appetite. Obesity is a complex condition which may be potentiated by excessive reward seeking in combination with executive functioning deficits that impair cognitive control of behavior. Stimulant medications address both reward deficiency and enhance motivation, as well as suppressing appetite. They have long been recognized to be effective for treating

2016 Frontiers in pharmacology

127. "Manual Dexterity and Oculomotor Control in Schizophrenia"

vulnerability markers for schizophrenia. Control of manual dexterity will be assessed by a force sensor (Power Grip Manipulandum, PGM) Oculomotor movements during behavioral task will be recorded using a video-oculography device The involvement of cortical inhibition in this volitional inhibition task will be studied by neuronavigation guided TMS coupled to EMG recording 2 - Description of the project methodology There is strong evidence for schizophrenia being a neuro-developmental disorder (Rapoport et al (...) objective is to study the interactions and related substratum of oculomotor movements during force control task. The secondary objectives: (i) To show that increased motor noise is indeed present in schizophrenia. (ii) To show by TMS that cortical excitability in the primary motor cortex (M1) is task-modulated and decreased in schizophrenia. (iii) Assess the role of deficient cortical inhibition in these behavioral deficits To this end, three different groups of subjects will be studied: schizophrenic

2016 Clinical Trials

128. Deep Brain Stimulation to Relieve Depression

, Treatment-Resistant Behavioral Symptoms Mood Disorders Mental Disorders (...) ] A measure of safety is that the stimulation does not worsen or cause suicidal ideation or behavior. The Columbia Suicide Severity Rating Scale will assess suicidality. Clinically significant suicidality is defined as greater than 3 on suicidal ideation subscale of the Columbia Suicide Severity Scale AND worsening of the score compared to baseline, OR any suicidal behavior noted on the suicidal behavior subscale. Neurocognitive status [ Time Frame: 6 months ] A measure of safety is that the stimulation

2016 Clinical Trials

129. Combination Nicotine Patch / Lorcaserin for Smoking Cessation

Other major medical condition; Current psychiatric disease (with the exception of anxiety disorders, obsessive compulsive disorder (OCD) and ADHD); Suicidal ideating (thinking about ways to commit suicide) (within the past 10 years) or lifetime occurrence of attempted suicide; Current depression - The Patient Health Questionnaire (PHQ-9) for Depression will be used to screen for current (within 2 weeks) depression. Potential subjects who score >9 (or who score >0 on item #9 ("Thoughts that you would (...) by (Responsible Party): Duke University Study Details Study Description Go to Brief Summary: This study plans to compare the efficacy of the nicotine patch / lorcaserin combination treatment vs. the nicotine patch alone in terms of leading to a reduction in smoking behavior and withdrawal symptoms. Condition or disease Intervention/treatment Phase Nicotine Dependence Drug: lorcaserin Drug: nicotine patch Drug: placebo lorcaserin Phase 2 Detailed Description: This study proposes to investigate the potential

2016 Clinical Trials

130. Varenicline supports smoking reduction and smoking cessation, according to RCT Full Text available with Trip Pro

billion per year (with sick leave and lost productivity estimated to cost the wider economy £2.5 billion). Finding effective smoking cessation treatments is still a challenge for pharmaceutical companies. Last year Dr Andrew Jones and I wrote a Mental Elf blog on a which found some impressive outcomes. The most effective agent analysed in that review was varenicline (superior to both nicotine replacement therapy and bupropion). Many of the studies of cessation aids involve investigating their efficacy (...) than three months in the past year, and be not willing to quit in a month but willing to reduce smoking with a view to quitting within three months. There were also stringent exclusion criteria: suicide attempts/behaviours, major depression or anxiety (classed as severe or unstable), any lifetime diagnoses of psychosis, panic disorder, schizophrenia, alcohol or substance misuse (previous 12 months), pulmonary disease, or use of non-cigarette tobacco products. The primary outcome measure

2015 The Mental Elf

131. Repetitive Transcranial Magnetic Stimulation for Adolescent Depression: Efficacy, Predictive Biomarkers, and Mechanisms

in dose of antidepressant medication (within 6 weeks prior to initial evaluation). This includes all antidepressants and any adjunctive psychotropic medications that are being used to address problems related to mood or anxiety (e.g. antipsychotic medications, mood stabilizers.) This does not include stimulant medications that are being used to treat Attention Deficit Hyperactivity Disorder (ADHD).** Current treatment with Bupropion at a dose greater than 150mg per day. Current treatment (...) -Resistant Behavioral Symptoms Mood Disorders Mental Disorders

2015 Clinical Trials

132. Depersonalization Disorder: Therapeutic Effect of Neuronavigated Repetitive Transcranial Stimulation

Device: Placebo rTMS Not Applicable Detailed Description: Depersonalization disorder is characterised by a profound disruption of self-awareness. Depersonalization symptoms may occasionally arise (30 to 70% of the population) or may become chronic in depersonalization disorder. Its prevalence is around 2.4% in the general population. This disorder is particularly resistant to pharmacological treatments. This study is a randomized, double-blind, placebo-controlled study, and the investigators (...) Depersonalization Disorder: Therapeutic Effect of Neuronavigated Repetitive Transcranial Stimulation Depersonalization Disorder: Therapeutic Effect of Neuronavigated Repetitive Transcranial Stimulation - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please

2015 Clinical Trials

133. Fatigue

environment contains the properties for restoring directed attention and relieving attention fatigue. Sleep Disorders and Inactivity Causative or contributing factors in CRF may be: Disrupted sleep. Poor sleep hygiene. Decreased nighttime sleep or excessive daytime sleep. Inactivity. Patients with less daytime activity and more nighttime awakenings were noted to consistently report higher levels of CRF. Those with lower peak-activity scores, as measured by wristwatch activity monitors, experienced higher (...) , stress, life demands, sleep, neurophysiologic changes, disruption of circadian rhythms, cardiac issues, and neuroimmunologic changes are generally incorporated in these models, based on the rationale that these factors are associated with fatigue in contexts other than cancer.[ ] The cancer literature supports some of these variables. There is a burgeoning amount of evidence, particularly in women with breast cancer and men with prostate cancer, that fatigue is associated with markers of increased

2012 PDQ - NCI's Comprehensive Cancer Database

134. Grief, Bereavement, and Coping With Loss

complicated grief. Most clinicians will be focused on understanding the differences between normal and complicated grief reactions: What is the difference? Under what circumstances should I refer a patient/family member for grief therapy? Prolonged or Complicated Grief as a Mental Disorder The Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) includes bereavement as a diagnosable code to be used when bereavement is a focus of clinical attention following (...) .[ ] Throughout the middle phase, attention alternated between the themes of loss/grief and future/restoration. A unique characteristic of CGT was the concept of revisiting loss via retelling the story of the death. This concept was particularly important for persons inclined to avoid thinking about the trauma of the loss. Specific procedures that were modeled after the "imaginal exposure" component of interventions for post-traumatic stress disorder were utilized for retelling.[ ] The termination phase

2012 PDQ - NCI's Comprehensive Cancer Database

135. Depression

and emotional upset. Depression in patients with cancer not only affects the patients themselves but also has a major negative impact on their families. Definitions: Depression is suspected when a number of specific symptoms are observed (affect, sleep disturbance, thought patterns). These are specified in the categorization of psychiatric/behavioral disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th editions.[ , ] However, there are a number of pathways that may result (...) . Medications:[ ][ ][ - ];[ ][ ] Steroids. Endogenous and exogenous cytokines, i.e., interferon-alfa and aldesleukin (interleukin-2 [IL-2]).[ ] Methyldopa. Reserpine. Barbiturates. Propranolol. Some antibiotics (e.g., amphotericin B). Some chemotherapeutic agents (e.g., procarbazine, L-asparaginase). A survey in England of women with breast cancer showed that among several factors, depression was the strongest predictor of emotional and behavioral problems in their children.[ ] Fear of death, disruption

2012 PDQ - NCI's Comprehensive Cancer Database

136. Fampridine Sustained Release (4-aminopyridine)

-Aminopyridine, is a pesticide for birds that is registered as Avitrol with the EPA (http://extoxnet.orst.edu/pips/4-aminop.htm). Avitrol repels birds by poisoning a few members of a flock, causing them to become hyperactive. Avitrol is available as grain baits or as a powder concentrate. 2.4 Important Safety Issues with Consideration to Related Drugs Fampridine is closely related to 3,4-diaminopyridine (3,4-DAP) that has undergone clinical evaluation in a number of neurological investigations. 3,4-DAP has (...) SAEs were Nervous system disorders (5.4%) and Infections and Infestations (4.3%). No other SOC grouping included > 1% of subjects. Dr. Boehm has provided a list of SAEs reported by at least 3 fampridine subjects in the pooled MS and SCI trials. The most frequent were MS relapse (n= 38, 2.5%), convulsion (n=19, 1.3%), urinary tract infection (n=18, 1.2%), and cellulitis (n=16, 1.1%). There was 1 SAE of pancytopenia and 1 SAE of pancreatitis, both described below. No subjects experienced SAEs

2009 FDA - Drug Approval Package

137. Psychosis and schizophrenia in adults: updated NICE guidance for 2014 Full Text available with Trip Pro

professionals, health economists, service user and carer representatives. Other individuals and groups may register as stakeholders; allowing them to raise questions for the development group. The process has recently been reviewed and critiqued, particularly in relation to the manner in which dissent is handled at development group meetings ( ). In this paper the authors argue that through the process of guideline development, using the examples of depression and ADHD, the authority of medical models (...) Consider Bupropion (care in those showing mood symptoms) or Varenicline Offer nicotine replacement during inpatient stays for those not wishing to quit smoking in order to reduce consumption Routinely monitor weight as well as cardiovascular and metabolic risk indicators The importance of physical wellbeing is frequently noted in the guidance Comprehensive service provision Support for carers Mental health services should offer carers of people with psychosis and schizophrenia an assessment

2014 The Mental Elf

138. Animal model of methylphenidate's long-term memory-enhancing effects Full Text available with Trip Pro

Animal model of methylphenidate's long-term memory-enhancing effects Methylphenidate (MPH), introduced more than 60 years ago, accounts for two-thirds of current prescriptions for attention deficit hyperactivity disorder (ADHD). Although many studies have modeled MPH's effect on executive function, almost none have directly modeled its effect on long-term memory (LTM), even though improvement in LTM is a critical target of therapeutic intervention in ADHD. We examined the effects of a wide (...) range of doses of MPH (0.01-10 mg/kg, i.p.) on Pavlovian fear learning, a leading model of memory. MPH's effects were then compared to those of atomoxetine (0.1-10 mg/kg, i.p.), bupropion (0.5-20 mg/kg, i.p.), and citalopram (0.01-10 mg/kg, i.p.). At low, clinically relevant doses, MPH enhanced fear memory; at high doses it impaired memory. MPH's memory-enhancing effects were not confounded by its effects on locomotion or anxiety. Further, MPH-induced memory enhancement seemed to require both

2014 Learning & Memory

139. Connectivity Affecting the Antidepressant REsponse Study

emotional oddball task that includes attentional and affective components. Participants will be stratified by cerebral lesion severity and randomized in a 2:1 ratio to a double-blinded 8-week trial of escitalopram or matching placebo. Those who do not remit will transition to an 8-week trial of open-label bupropion, an antidepressant with a different mechanism of action. This will allow us to determine if different and distinct circuit deficits affect response to antidepressants with different (...) : 141137 First Posted: January 6, 2015 Last Update Posted: August 10, 2018 Last Verified: August 2018 Keywords provided by Warren Taylor, Vanderbilt University: Depression Geriatrics Elderly MRI Antidepressants Additional relevant MeSH terms: Layout table for MeSH terms Depressive Disorder Depression Depressive Disorder, Major Mood Disorders Mental Disorders Behavioral Symptoms Antidepressive Agents Citalopram Bupropion Dexetimide Psychotropic Drugs Serotonin Uptake Inhibitors Neurotransmitter Uptake

2014 Clinical Trials

140. A 6-week, Study of MG01CI Low Dose and High Dose Compared With Placebo in Adults and Adolescents With Fragile X Syndrome

by Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale (ADHD RS-IV) [ Time Frame: 6 weeks ] To evaluate the efficacy of MG01CI (Metadoxine Extended-release) once daily compared with placebo in the treatment of symptoms of FXS in adults and adolescents as measured by the inattentive subscale of the Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale (ADHD RS-IV) (as rated by the investigator in a clinical interview of the parent/legal authorized guardian/consistent caregiver). Secondary (...) Outcome Measures : Evaluation of efficacy of MG01C as measured by total score on the ADHD RS-IV. [ Time Frame: 6 weeks ] To evaluate the efficacy of MG01CI (Metadoxine Extended-release) once daily compared with placebo in the treatment of symptoms of FXS in adults and adolescents as measured by the total score on the ADHD RS-IV. Other Outcome Measures: Evaluation of safety by AE's count [ Time Frame: 6 weeks ] To evaluate the safety, and tolerability of treatment with MG01CI once daily on the adverse

2014 Clinical Trials

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