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141. 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

142. Tourette Syndrome and Other Tic Disorders (Follow-up)

studies, other treatments for tics, treatment for obsessive-compulsive symptoms in patients with tics, treatment for attention deficithyperactivity disorder (ADHD) in patients with tics, and treatment for other symptoms in patients with tics. Next: Treatments for Tics Treatments for tics that have demonstrated efficacy in replicated controlled trials (RCTs) include the following: Dopamine D2 receptor antagonist therapy Dopamine agonist therapy Habit reversal therapy Dopamine D2 receptor antagonist (...) : evidence from transcranial magnetic stimulation. Am J Psychiatry . 1997 Sep. 154(9):1277-84. . Moll GH, Heinrich H, Trott GE, et al. Children with comorbid attention-deficit-hyperactivity disorder and tic disorder: evidence for additive inhibitory deficits within the motor system. Ann Neurol . 2001 Mar. 49(3):393-6. . Gilbert DL, Bansal AS, Sethuraman G, et al. Association of cortical disinhibition with tic, ADHD, and OCD severity in Tourette syndrome. Mov Disord . 2004 Apr. 19(4):416-25. . Gilbert DL

2014 eMedicine.com

143. Teratology and Drug Use During Pregnancy (Diagnosis)

are death, malformation, growth retardation, and functional disorder. 5. The access of adverse environmental influences to developing tissues depends on the nature of the agent. 6. Manifestations of deviant development increase in degree as dosage increases from the no-effect to the totally lethal effect. [ ] Previous Next: Drug Exposures in the Male Partner Research is increasingly addressing the role of paternal exposure to medications before conception or during his partner’s pregnancy. Certain (...) outcomes bases on all relevant human data, animal data, and the drugs pharmacology. Adverse developmental outcomes include the four groups of developmental toxicities: - "Structural abnormalities" describes dysmorphology, which includes malformations, variations, deformations, and disruptions. - "Embryo-fetal and/or infant mortality" describes development mortality, which includes miscarriage, stillbirth, and infant death (including neonatal death). - "Functional impairment" describes functional

2014 eMedicine.com

144. Tourette Syndrome and Other Tic Disorders (Diagnosis)

, such as blinking, sniffing, facial movements, or tensing of the abdominal musculature. Other neurobehavioral manifestations include attention-deficit-hyperactivity disorder, obsessive-compulsive disorder, poor impulse control, and other behavioral problems. Symptoms wax and wane and vary significantly from one patient to another. Although diagnosis requires the presence of chronic multiple independent motor tics and at least one phonic tic, these are not always the patient's most disabling symptom. Historical (...) -compulsive disorder (OCD) and attention deficithyperactivity disorder (ADHD). Neuropathological studies, however, have failed to reveal any consistent structural abnormalities in these areas. Volumetric MRI studies have suggested that the normal asymmetry of the basal ganglia is lost in affected individuals. Healthy right-handed males normally demonstrate a predominance of the left putamen but this appears to be absent in TS, supporting the possibility of a developmental abnormality. Little is known

2014 eMedicine.com

145. Bipolar Affective Disorder (Follow-up)

at . Accessed: August 26, 2009. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet . 2013 Apr 20. 381(9875):1371-9. . . Post RM, Speer AM, Hough CJ, Xing G. Neurobiology of bipolar illness: implications for future study and therapeutics. Ann Clin Psychiatry . 2003 Jun. 15(2):85-94. . Roybal K, Theobold D, Graham A, DiNieri JA, Russo SJ, Krishnan V, et al. Mania-like behavior induced by disruption of CLOCK. Proc Natl Acad Sci U S A . 2007 Apr (...) an antipsychotic agent in patients with bipolar depression with psychotic features, and consider psychosocial interventions (eg, psychoeducation; psychotherapy strategies such as cognitive behavioral therapy [CBT], interpersonal and social rhythm therapy [IPSRT], family focused therapy; chronic care model-based interventions). The patient’s response to treatment may depend on the number of previous episodes of bipolar disorder. In a report that analyzed pooled data, the importance of early intervention

2014 eMedicine.com

146. Pulmonary Rehabilitation (Diagnosis)

See the list below: Peripheral muscle dysfunction Respiratory muscle dysfunction Nutritional abnormalities Cardiac impairment Skeletal disease Sensory deficits Psychosocial dysfunction Mechanisms for these morbidities See the list below: Deconditioning Malnutrition Effects of hypoxemia Steroid myopathy or intensive care unit (ICU) neuropathy Hyperinflation Diaphragmatic fatigue Frequent hospitalizations Effects of various medications Psychosocial dysfunction resulting from anxiety, depression (...) ) for patients with chronic respiratory disease. These goals are achieved through patient and family education, exercise training, psychosocial and behavioral intervention, and outcome assessment. The rehabilitation intervention is geared toward the unique problems and needs of each patient and is implemented by a multidisciplinary team of health care professionals. For patient education resources, see the , as well as . Next: Benefits of Pulmonary Rehabilitation The benefits of pulmonary rehabilitation

2014 eMedicine.com

147. Psychosocial and Environmental Pregnancy Risks (Diagnosis)

maternal BPA levels and pregnancy and pediatric outcomes such as miscarriage rates, infant reactive airway disease, low birth weight, liver dysfunction, and neurologic complaints (eg, hyperactivity). [ , , , ] A recent study found increased rates of depression and behavioral problems in young boys who were exposed to BPA in utero; this included an increase in rates of oppositional defiance disorder (ODD). [ ] Plant estrogens from soy and legumes can adversely affect reproduction in rats and sheep (...) dose because the fetus is in direct line with the x-ray beam, but the average exposure is still only 100 mrad. Trauma series radiographs of the extremities, skull, and ribs deliver low doses because of fetal distance to the target area, except for the hip or pelvic radiograph, which delivers about 200 mrad Computed tomography (CT) scanning This important imaging modality is used commonly to evaluate for multiple disorders. Newer generation tomography equipment is more sensitive and there is less

2014 eMedicine.com

148. Parasomnias (Diagnosis)

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 and adults, morbidity may be more (...) and zolpidem. Ann Pharmacother . 2003 Oct. 37(10):1429-33. . Oulis P, Kokras N, Papadimitriou GN, Masdrakis VG. Bupropion-induced sleepwalking. J Clin Psychopharmacol . 2010 Feb. 30(1):83-4. . Mathew T, Sarma GR, Nadig R, Varghese R. Topiramate-induced somnambulism in a migraineur: a probable idiosyncratic adverse effect. J Clin Sleep Med . 2012 Apr 15. 8(2):197-8. . . Owens J, Opipari L, Nobile C, Spirito A. Sleep and daytime behavior in children with obstructive sleep apnea and behavioral sleep disorders

2014 eMedicine.com

149. Pulmonary Rehabilitation (Overview)

See the list below: Peripheral muscle dysfunction Respiratory muscle dysfunction Nutritional abnormalities Cardiac impairment Skeletal disease Sensory deficits Psychosocial dysfunction Mechanisms for these morbidities See the list below: Deconditioning Malnutrition Effects of hypoxemia Steroid myopathy or intensive care unit (ICU) neuropathy Hyperinflation Diaphragmatic fatigue Frequent hospitalizations Effects of various medications Psychosocial dysfunction resulting from anxiety, depression (...) ) for patients with chronic respiratory disease. These goals are achieved through patient and family education, exercise training, psychosocial and behavioral intervention, and outcome assessment. The rehabilitation intervention is geared toward the unique problems and needs of each patient and is implemented by a multidisciplinary team of health care professionals. For patient education resources, see the , as well as . Next: Benefits of Pulmonary Rehabilitation The benefits of pulmonary rehabilitation

2014 eMedicine.com

150. Psychosocial and Environmental Pregnancy Risks (Overview)

maternal BPA levels and pregnancy and pediatric outcomes such as miscarriage rates, infant reactive airway disease, low birth weight, liver dysfunction, and neurologic complaints (eg, hyperactivity). [ , , , ] A recent study found increased rates of depression and behavioral problems in young boys who were exposed to BPA in utero; this included an increase in rates of oppositional defiance disorder (ODD). [ ] Plant estrogens from soy and legumes can adversely affect reproduction in rats and sheep (...) dose because the fetus is in direct line with the x-ray beam, but the average exposure is still only 100 mrad. Trauma series radiographs of the extremities, skull, and ribs deliver low doses because of fetal distance to the target area, except for the hip or pelvic radiograph, which delivers about 200 mrad Computed tomography (CT) scanning This important imaging modality is used commonly to evaluate for multiple disorders. Newer generation tomography equipment is more sensitive and there is less

2014 eMedicine.com

151. Depression (Treatment)

to other medications. TCAs may also be useful for those with comorbid attention deficit hyperactivity disorder (ADHD), enuresis, and narcolepsy, as well as for augmentation strategies. The TCAs require a baseline electrocardiogram (...) depressive disorder. While more structured than dynamic treatments, IPT has less structure than cognitive and behavioral approaches. IPT draws from attachment theory and emphasizes the role of interpersonal relationships, [ ] focusing on current interpersonal difficulties. Specific areas of emphasis include grief, interpersonal disputes, role transitions, and interpersonal deficits. [ ] The initial phase of treatment (sessions 1-4) focuses on building a working alliance as well as identifying an area

2014 eMedicine.com

152. Somnambulism (Sleep Walking) (Overview)

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

153. Teratology and Drug Use During Pregnancy (Overview)

are death, malformation, growth retardation, and functional disorder. 5. The access of adverse environmental influences to developing tissues depends on the nature of the agent. 6. Manifestations of deviant development increase in degree as dosage increases from the no-effect to the totally lethal effect. [ ] Previous Next: Drug Exposures in the Male Partner Research is increasingly addressing the role of paternal exposure to medications before conception or during his partner’s pregnancy. Certain (...) outcomes bases on all relevant human data, animal data, and the drugs pharmacology. Adverse developmental outcomes include the four groups of developmental toxicities: - "Structural abnormalities" describes dysmorphology, which includes malformations, variations, deformations, and disruptions. - "Embryo-fetal and/or infant mortality" describes development mortality, which includes miscarriage, stillbirth, and infant death (including neonatal death). - "Functional impairment" describes functional

2014 eMedicine.com

154. Bulimia (Treatment)

disorders in eating disorders: clinical and therapeutic implications. Compr Psychiatry . 2006 Nov-Dec. 47(6):482-8. . Surman CB, Randall ET, Biederman J. Association between attention-deficit/hyperactivity disorder and bulimia nervosa: analysis of 4 case-control studies. J Clin Psychiatry . 2006 Mar. 67(3):351-4. . . Yates, WR, Lund, BC, Johnson, C, et al. Attention deficit hyperactivity symptoms and disorder in eating disorder inpatients. Int J Eat Disord . 2009. 42:375-378. Wonderlich SA, Rosenfeldt S (...) European study of affected women and their unaffected sisters. Psychother Psychosom . 2007. 76(4):234-41. . Fernandez-Aranda F, Krug I, Granero R, et al. Individual and family eating patterns during childhood and early adolescence: an analysis of associated eating disorder factors. Appetite . 2007 Sep. 49(2):476-85. . Mikami AY, Hinshaw SP, Patterson KA, Lee JC. Eating pathology among adolescent girls with attention-deficit/hyperactivity disorder. J Abnorm Psychol . 2008 Feb. 117(1):225-35. . Eddy KT

2014 eMedicine.com

155. Chronic Obstructive Pulmonary Disease (Treatment)

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

156. Amphetamine-Related Psychiatric Disorders (Treatment)

. 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 correlate with craving in female (...) Amphetamine-Related Psychiatric Disorders (Treatment) Amphetamine-Related Psychiatric Disorders Treatment & Management: Medical Care, Consultations, Activity Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

157. Fibromyalgia (Treatment)

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

158. Geriatric Rehabilitation (Treatment)

] < 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

159. Assistive Devices to Improve Independence (Treatment)

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

160. Bipolar Affective Disorder (Treatment)

at . Accessed: August 26, 2009. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet . 2013 Apr 20. 381(9875):1371-9. . . Post RM, Speer AM, Hough CJ, Xing G. Neurobiology of bipolar illness: implications for future study and therapeutics. Ann Clin Psychiatry . 2003 Jun. 15(2):85-94. . Roybal K, Theobold D, Graham A, DiNieri JA, Russo SJ, Krishnan V, et al. Mania-like behavior induced by disruption of CLOCK. Proc Natl Acad Sci U S A . 2007 Apr (...) an antipsychotic agent in patients with bipolar depression with psychotic features, and consider psychosocial interventions (eg, psychoeducation; psychotherapy strategies such as cognitive behavioral therapy [CBT], interpersonal and social rhythm therapy [IPSRT], family focused therapy; chronic care model-based interventions). The patient’s response to treatment may depend on the number of previous episodes of bipolar disorder. In a report that analyzed pooled data, the importance of early intervention

2014 eMedicine.com

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