Abstract: Skilled clinical decision making in the diagnosis and treatment of chronic pain can create unique clinical and ethical challenges, particularly when opioid medications are involved. This report presents the case of a pregnant woman who sought treatment for an illicit opioid dependence, initiated by opioid analgesic treatment of chronic pain. While recognizing opioids’ high level of effectiveness for pain relief, the case demonstrates the potential harms of opioid medications for particular patients
One of the upsides of so many snowstorms this winter has been the chance to catch up on reading. I’ve been enjoying Erik Brynjolfsson and Andrew McAfee’s book the Second Machine Age about the social revolution instigated by the digital revolution.
Eighteen states and the District of Columbia have legalized possession and use of medical marijuana. Registries from these state-approved programs suggest that up to 94% of participating patients are registered for severe or chronic pain .
Abstract: Clozapine-induced fever has been reported frequently, but clozapine-induced elevated serum C-reactive protein (S-CRP) over 100 mg/L with early onset, without associated myocarditis, has not been reported in the literature. In this case report, we present a case of an 80-year-old Slovenian female with dementia and psychotic symptoms who developed elevated S-CRP (122 mg/L) and fever (38.2°C) on the seventh day with 25 mg of clozapine daily, which improved after clozapine discontinuation.
Abstract: Objective: The objective was to examine whether prophylactic treatment with antipsychotics can decrease the incidence and severity of postsurgical delirium.Method: A meta-analysis of existing trials comparing delirium incidence between patients given prophylactic antipsychotic and placebo was performed. Secondary outcomes were total hospital days, total days of delirium and severity. Pooled odds ratios (ORs) and mean differences were calculated using a random-effects model.Results: Five randomized placebo-controlled trials comprising a total of 1491 patients were included.
Importance Delayed-onset posttraumatic stress disorder (PTSD) accounts for approximately 25% of PTSD cases. Current models do not adequately explain the delayed increases in PTSD symptoms after trauma exposure. Objective To test the roles of initial psychiatric reactions, mild traumatic brain injury (MTBI), and ongoing stressors on delayed-onset PTSD
Abstract: Aims: Tuberculosis and mental illness share common risk factors including homelessness, HIV positive serology, alcohol/substance abuse and migrant status leading to frequent comorbidity. We sought to generate a comprehensive literature review that examines the complex relationship between tuberculosis and mental illness.Methods: A literature search was conducted in MedLine, Ovid and Psychinfo, with further examination of the references of these articles. In total 316 articles were identified
Considerable progress has been made in understanding how neural circuits contribute to mental processing and psychiatric disorders. This research has highlighted the importance of network dysfunction, particularly changes in the balance between excitatory and inhibitory transmission within and across brain regions that underlie cognition, emotion, and motivation.
Abstract: Objective: Traumatic life events are important risk factors for eating disorders (ED). War has been associated, in military populations, with an increased post-service incidence of ED and an increased mean body mass index. We hypothesize that a modification of eating behavior (EB) related to stress during wartime may increase the risk of developing an ED later on among civilians exposed to war stress during adulthood.Methods: This descriptive cross-sectional study was performed in a group of 303 undergraduate young adult students of both sexes from Lebanon, 6 months after the July 2006 war.
A new report highlights the potential benefits and pitfalls of online communication and social media relationships. Medscape Medical News