Current Issue : January - March Volume : 2015 Issue Number : 1 Articles : 7 Articles
Objective: To systematically review studies of cognitive remediation therapy (CRT) for anorexia nervosa (AN), and\nto discuss findings with references to clinical practice and future research.\nMethod: The literature was reviewed using the PubMed, Web of Science and PsycINFO search terms ââ?¬Å?cognitive\nremediation therapyââ?¬Â AND ââ?¬Å?anorexia nervosaââ?¬Â. Papers published online between 2005 and 2013 were selected on\nthe basis of three inclusion criteria: 1) studies of any design focusing on CRT for AN, 2) papers that were written in\nEnglish or had an available published English translation, and 3) papers published in peer reviewed journals.\nResults: A total of 45 papers were identified of which 21 were recognized as being relevant for the review.\nRelevant papers were divided into three different categories 1) single case reports, 2) case series and 3) randomised\ncontrolled trials (RCTs). Single case studies and case series yielded strong evidence of feasibility and acceptability of\nCRT for AN despite great variety in sample compositions. Four RCTs demonstrate that CRT has the potential of\nenhancing the effectiveness of current treatments, reduce attrition, increase cognitive set-shifting abilities and\nquality of life, as well as reduce eating disorder psychopathology.\nDiscussion: The number of CRT studies published is growing rapidly, in particular RCTs. Further research is needed\nto define the primary aim of delivering CRT to patients with eating disorders, and to establish how to best measure\nthe effect of the intervention. Moreover, researchers and clinicians should focus on identifying and assessing\nspecific versus non-specific CRT contributions, and explore long-term effects of the intervention. It is imperative that\nadolescent RCTs are conducted to evaluate how CRT may be effective as a treatment for this young patient group....
Atrial fibrillation is the most common arrhythmia and accounts for one-third of hospitalizations for rhythm disorders in theUnited\nStates. The prevalence of atrial fibrillation averages 1% and increases with age. With the aging of the population, the number of\npatients with atrial fibrillation is expected to increase 150% by 2050, withmore than 50% of atrial fibrillation patients being over the\nage of 80. This increasing burden of atrial fibrillation will lead to a higher incidence of stroke, as patients with atrial fibrillation have\na five- to sevenfold greater risk of stroke than the general population. Strokes secondary to atrial fibrillation have a worse prognosis\nthan in patients without atrial fibrillation.Vitamin Kantagonists (e.g., warfarin), direct thrombin inhibitors (dabigatran), and factor\nXa inhibitors (rivaroxaban and apixaban) are all oral anticoagulants that have been FDA approved for the prevention of stroke in\natrial fibrillation. This review will summarize the experience of anticoagulants in patients with atrial fibrillation with a focus on the\nexperience at the Duke Clinic Research Institute....
The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms\nsuch as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by\nboxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s\nand has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American\nfootball players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma,\nincluding concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations\nof CTE from 202 published cases. The clinical features include impairments in mood (for example, depression\nand hopelessness), behavior (for example, explosivity and violence), cognition (for example, impaired memory,\nexecutive functioning, attention, and dementia), and, less commonly, motor functioning (for example, parkinsonism,\nataxia, and dysarthria). We present proposed research criteria for traumatic encephalopathy syndrome (TES) which\nconsist of four variants or subtypes (TES behavioral/mood variant, TES cognitive variant, TES mixed variant, and TES\ndementia) as well as classifications of ââ?¬Ë?probable CTEââ?¬â?¢ and ââ?¬Ë?possible CTEââ?¬â?¢. These proposed criteria are expected to be\nmodified and updated as new research findings become available. They are not meant to be used for a clinical\ndiagnosis. Rather, they should be viewed as research criteria that can be employed in studies of the underlying\ncauses, risk factors, differential diagnosis, prevention, and treatment of CTE and related disorders....
Aim of this work was to evaluate efficacy of blood verses iron sucrose for the correction of iron deficiency anemia in pregnancy in the treatment of iron deficiency anemia during pregnancy. A retrospective observational study was done by checking records of the 50 patients attending the antenatal clinic with iron deficiency anemia at PCMS and RC. Comparative efficacy of blood transfusion with iron sucrose was measured. First group recived blood transfusion. Second group received 200 mg of IS in 100 ml NS for five alternate days. Type and severity of anemia was determined on the basis of WHO guidelines and blood investigations. Hemoglobin estimations were done pre and post therapy. Blood transfusion produced significant rise in hemoglobin levels (2.787±0.568) compared to Iron sucrose treatment (2.158±0.404). Adverse reactions were reported in two patients attending the antenatal clinic with blood transfusion and in four patients with iron sucrose therapy. Our results suggest blood transfusion was more effective and tolerable in the treatment of iron deficiency anemia tolerability when compared with iron sucrose therapy. Larger trials required to prove a possible advantage of blood transfusion in the management of iron deficiency anemia in pregnancy....
This single-blind, placebo-controlled study assesses the efficacy of synergic administration of intravenous laser blood irradiation\n(ILBI) and etanercept in selected subtypes of juvenile idiopathic arthritis (JIA). Etanercept is a tumor necrosis factor alpha blocking\nagent with recognized importance in JIA. Laser radiation has immunomodulatory effects in animal and human studies. Fourteen\npatients (Group I) received ILBI and 9 patients (Group II) received placebo laser. ILBI was performed in addition to ongoing JIA\nmedication, including etanercept. ILBI was administrated in 3 sets of 5 consecutive daily sessions, with a 7-week interval between\nevery set of sessions. Evaluation was performed using ACR (American College of Rheumatology) Pediatric Criteria (ACR Pedi)\nat study enrollment and at 10 and 20 weeks, respectively. After 10 weeks, 85.7% of the patients in Group I fulfilled Pedi 30 criteria,\ncompared to only 55.6% of the patients in Group II. After 20 weeks, all patients in both groups had a Pedi 30 response. In Group I,\n92.8% of the subjects met the Pedi 50 response, compared to only 55.6% in the placebo group. One patient in Group I responded\nbest, fulfilling Pedi 70 criteria. If applied synergistically, ILBI and etanercept would have an increased efficacy in promoting JIA\nremission....
Quetiapine belongs to novel antipsychotic and can used as a first line antipsychotic in the treatment of psychosis. It improves cognitive function and overall global functioning by improving psychopathologies. The aim was to find out the effect of quetiapine as a cognitive restorer in acute schizophrenia. 46 patients of acute schizophrenia attended to OPD at Patna Medical College, Patna were treated with optimal dose of quetiapine 300 mg/day. The initial cognitive function scored on MMSE and VIQ on WAISR (Indian adaptation) was recorded and repeated at two occasions at an interval of 4 weeks. The analysis of obtained data showed improvement from baseline at the end of fourth week but during 4th to 8th week interval was not significant. The overall improvement in cognition was noted at end of 8th week. VIQ showed significant improvement throughout the study at every time of measurement except a digit span which showed significant improvement only at the end of 8th week. The quetiapine has the ability to improve cognitive function. The major changes noted in global functioning during initial 4 weeks of treatment. So that quetiapine act as a cognitive restorer....
Background: The patient perspective is increasingly considered in healthcare policy decisions. The use of research\non patient preferences seems however limited. Using the available research on patient preferences would make\nhealthcare policy decisions more evidence-based regarding the patient perspective. Objective of this study is to\ninvestigate whether and how results of research on patient preferences are incorporated in current procedures for\npharmaceutical coverage decisions and clinical practice guideline (CPG) development.\nMethods: A document analysis on procedure descriptions was combined with case studies. Analyses were\nperformed for five European countries. In the document analysis we systematically checked whether the procedure\nprovides guidance on the systematic use of research on patient preferences, and whether the search and use of\nresearch on patient preferences is mentioned in the decision making procedure. In the case studies, which were for\nexploratory purposes, we scored whether or not research question on patient preferences were formulated,\nwhether or not a search strategy including terms relating to patient preferences was mentioned, whether results of\nthis search strategy were shown and finally, how many references with preference-related terms were included in\nthe reference list of the case.\nResults: None of the procedures for pharmaceutical coverage decisions mentions the systematic consideration of\nresearch on patient preferences. For CPG development, the Scottish procedure refers to a mandatory literature\nsearch. In the Netherlands this step is optional. In the case studies for pharmaceutical coverage decisions only one\nreference related to patient preferences was found. Some of the case studies for CPG included research questions,\nsearch strategies and references relating to patient preferences.\nConclusions: This study illustrates that systematic consideration of research on patient preferences in\npharmaceutical coverage decisions and guideline development is limited, or if taken into account, this is not visible.\nThis contrasts the strong movement towards patient involvement in health care. Several potential barriers may\nexplain the limited use of research on patient preferences....
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