Purpose. To evaluate the efficacy and safety profile of a new crosslinked sodium hyaluronate drainage implant in nonpenetrating glaucoma surgery. Methods. From July 2008 until January 2010, 55 eyes from 55 patients with glaucoma were operated upon. After a standard deep sclerectomy was performed, a crosslinked sodium hyaluronate (HEALAflow®) was ...

We evaluated the validity of questions designed to identify lifetime and active epilepsy, medication use, and seizure occurrence on population-based surveys. Subjects were interviewed by telephone, and responses were compared with information in their medical records. Prevalence, sensitivity, specificity, and positive predictive value (PPV) were calculated. The prevalence of ever ...

With the high prevalence of obesity and associated comorbidities, the costs of health services produce a great economic impact. The objective of this work was to evaluate the economic benefits of bariatric surgery and to relate the costs to the impact on the health of the individual. A historic cohort ...

With many new medications on the market and new data about the various side-effects of antiepilepsy drugs (AEDs), the medical management of epilepsy can seem unnecessarily complicated for the non-specialist. The process can be thought of taking place in 7 steps: 1) assessing the need for medications; 2) defining the ...

BACKGROUND: When epilepsy does not respond to the initial anti-epileptic drug (AED) the subsequent search for an effective AED is predominantly a matter of trial and error, as only limited criteria exist for rational AED selection. Since epilepsy in siblings is likely to be relatively homogeneous, we hypothesized that an ...

Early treatment of prolonged seizures with benzodiazepines given intravenously by paramedics in the prehospital setting has been shown to be associated with improved outcomes. However, an increasing number of Emergency Medical System (EMS) protocols use an intramuscular (IM) route because it is faster and consistently achievable. RAMPART (Rapid Anticonvulsant Medication ...

Modern epilepsy started in India in 1995 at Sri Chitra Tirunal Institute of Medical Science and Technology, Trivandrum and at All India Institute of Medical Sciences, New Delhi. At both centres the attempt was to get the program going with patients having surgically remediable epilepsy syndromes -who could be evaluated ...

OBJECTIVE: The goal of this study was to determine whether racial disparities exist with respect to adherence to antiepileptic drugs (AEDs) in patients with epilepsy. METHOD: We reviewed the pharmacy and clinical records of 108 patients with epilepsy who were part of the indigent care program at Shands-Jacksonville. We determined ...

"If I wished to show a student the difficulties of getting at truth from medical experience, I would give him the history of epilepsy to read." Oliver Wendell Holmes (1)If the medical experience of epilepsy is obscured by uncertainties, then its classification is mired in the mud of expert opinion. ...

Patients with medically intractable epilepsy who are not candidates for epilepsy surgery could benefit from neurostimulation. At this time, vagus nerve stimulation (VNS) therapy is the only Food and Drug Administation-approved neurostimulation modality; it has been shown to be efficacious and just as well tolerated in children and adolescents as ...

WebEase (Epilepsy Awareness, Support, and Education) is an online epilepsy self-management program to assist people with taking medication, managing stress, and improving sleep quality. The primary study aims were to determine if those who participated in WebEase demonstrated improvements in medication adherence, perceived stress, and sleep quality. Participants were randomized ...

Objectives  The aim of this article is to highlight the roles that pharmacists currently have in the management of patients with epilepsy and the opportunities and challenges associated with these roles. Key findings  There are many opportunities for pharmacists in the management of patients with epilepsy owing to the accessibility ...

BACKGROUND: To report 3-year results investigating the safety and efficacy of canaloplasty, a procedure involving circumferential viscodilation of Schlemm's canal and tensioning of the inner canal wall to treat open-angle glaucoma. METHODS: This was a prospective, multi-center, interventional study of 109 eyes of 109 adult, open-angle glaucoma patients undergoing canaloplasty ...

The surgical treatment of head and neck cancer can be limited by the risk of postoperative complications, both local and medical. When it occurs, it usually leads to prolonged length of stay after the surgery and sometimes can be life-threatening. Early identification of risk factors based on clinical data is ...

Antidepressants are the most commonly prescribed class of medications in the United States. The clinician should be mindful of the many antidepressants that can produce seizures following an accidental exposure or an overdose. A broader understanding of the seizure potential of antidepressants, combined with the ability to recognize individuals at ...

The medication administration stage of the medication-use process is especially vulnerable to error because errors are least likely to be caught before reaching the patient. Medication administration, however, remains poorly understood. In this article we describe medication administration as observed in an ethnographic study conducted on one medical unit and ...

OBJECTIVE:: To identify exposures possibly contributing to anemia cases among hexavalent chromium medical surveillance program enrollees. METHODS:: An investigation encompassed metals surveillance programs, extensive workplace sampling and remediation, consultation, evaluation of laboratory accuracy, and follow-up of anemic individuals. RESULTS:: Workers had underlying medical conditions that affected surveillance results. There was ...

Two case examples and a review of the sleep literature illustrate the potential of antipsychotic medication to trigger sleepwalking episodes in the context of schizophrenia. Causative hypotheses are briefly reviewed, as well as risk factors, differential diagnosis, and management. Sleepwalking may contribute to delusions, aggression, and accidental suicide. It is ...

Medical Priority Dispatch System (MPDS) is a type of Emergency Medical Dispatch (EMD) system used to prioritize 9-1-1 calls and optimize resource allocation. Dispatchers use a series of scripted questions to assign determinants to calls based on chief complaint and acuity. We analyzed the prehospital interventions performed on patients with ...

As expected, since we recently celebrated the 250th anniversary of birth of Wolfgang Amadeus Mozart, there has been again a renewal of interest in his short but intensive life, as well as in the true reason of his untimely dead. Mozart lived and died in time when the medical knowledge ...

Epilepsy is a common disease with significant morbidity and mortality. Approximately one-third of patients with epilepsy are refractory to available seizure medications, emphasizing the need to develop better drugs with novel mechanisms of action. Ezogabine, also known as retigabine, is a new potential adjunctive treatment for adults with intractable partial ...

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder occurring in approximately 3-5% of school-aged children. The core symptoms of ADHD are effectively treated with stimulant medications such as methylphenidate; however, there are also negative side effects, including insomnia. It has been suggested that administration of stimulant medication may alter the ...

The wide interindividual variability in clinical response and tolerability of antipsychotic medications has led investigators to postulate that these variabilities may be under genetic control. Although not always consistent, there are promising indications from emergent pharmacogenetic studies that efficacy of antipsychotic medications for the various symptom domains of psychopathology in ...

Smith-Magenis syndrome (SMS) is a complex genetic syndrome caused by an interstitial deletion of chromosome 17p11.2. Children and adults with SMS appear to have unique neurobehavioral problems that include: sleep disturbance, self-injurious and maladaptive behaviors, stereotypies, and sensory integration disorders. We gathered retrospective psychotropic use information from parents or other ...

We have previously documented inequalities in the quality of medical care provided to those with mental ill health but the implications for mortality are unclear. We aimed to test whether disparities in medical treatment of cardiovascular conditions, specifically receipt of medical procedures and receipt of prescribed medication, are linked with ...

OPINION STATEMENT: Tics come in a variety of types and frequencies; have a waxing and waning course; are exacerbated by stress, anxiety, and fatigue; and often resolve or improve in the teenage or early adult years. Tourette syndrome requires the presence of chronic, fluctuating motor and phonic tics. In addition ...

Extensive research has been conducted on post-mortem brain tissue in schizophrenia (SCZ), particularly the dorsolateral prefrontal cortex (DLPFC). However, to what extent the reported changes are due to the disorder itself, and which are the cumulative effects of lifetime medication remains to be determined. In this study, we employed label-free ...

Sudden cardiac death has become a significant clinical concern when prescribing antipsychotic drugs, especially to older people with dementia. Sudden death syndrome has been known for decades to occur in association with taking first-generation antipsychotic medications, but it has become more prominent recently due to safety reviews about the use ...

To identify reasons for discontinuation and continuation of antipsychotic medications in the treatment of schizophrenia from the patients' and their clinicians' perspectives. Two measures were previously developed to assess the Reasons for Antipsychotic Discontinuation/Continuation (RAD), one from the patient's perspective and another from the clinician's perspective. These measures were administered ...

To examine the incidence of cardiometabolic conditions and change in care costs for patients with schizophrenia treated with antipsychotic medications, medical and pharmacy claims from the South Carolina Medicaid program were used to compare the incidence rates for five cardiometabolic conditions in 2,231 patients with schizophrenia who were newly prescribed ...

Of the 24 million people with schizophrenia worldwide, fewer than 50% receive appropriate care.¹ Even patients with access to the best available treatments suffer from significant functional and social deficits.² This article is based on a teleconference that discussed issues related to the development of new treatments for schizophrenia.

Quality of life (QOL) describes an individual's subjective perception of their position in life as evidenced by their physical, psychological and social functioning. Although an established outcome measure in physical health, QOL has more recently become an increasingly important measure in mental health clinical work and research. This article reviews ...

A patient with a 28-year history of schizophrenia was treated with a wide range of antipsychotic medications since diagnosis. She had experienced no clinically significant symptomatic relief until she commenced treatment on clozapine. Her psychotic symptoms, self care, and general sense of well-being improved significantly. After 6 years of successful treatment, ...

There is relatively little research examining motives for nonmedical use (NMU) of attention-deficit/hyperactivity disorder (ADHD) medications and predictors of motivation. We present results of a secondary analysis of an Internet-based epidemiological survey to explore the relationship between stimulant formulation and motivation for NMU of ADHD stimulant medications in a college-aged ...

Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. To evaluate the effectiveness of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia. Randomized controlled trial. ...

To describe the design and rationale of an investigator-initiated observational study to examine the cardiovascular safety of the following commonly-used medications to treat attention deficit hyperactivity disorder (ADHD): amphetamines, methylphenidate, and atomoxetine. We are conducting an observational cohort study using data from five large Medicaid programs and the HealthCore Integrated ...

Many antipsychotic medications carry a substantial liability for weight gain, and one mechanism common to all antipsychotics is binding to the dopamine D2 receptor. We therefore examined the relationship between -141C Ins/Del (rs1799732), a functional promoter region polymorphism in DRD2, and antipsychotic-induced weight gain in 58 first episode schizophrenia patients ...

PURPOSE: The influence of medications and diagnoses on fall risk in psychiatric inpatients was evaluated. METHODS: In this retrospective case-control study, psychiatric inpatients age 18 years or older with a documented fall that was reported served as study cases. These patients were matched to control patients from the same hospital ...

In this article, we investigated the current practice for treatment of schizophrenia. According to our data, physicians consider one-product regimens 53 percent of the time. Two-product regimens are considered 29 percent of the time, and regimens of three or more products are considered 18 percent of the time. At the ...

Irritability is a common neuropsychiatric feature of Huntington's disease (HD), with prevalences varying from 38% to 73%. Similar prevalences of irritability are reported in other neurodegenerative disorders and traumatic brain injury, especially when the frontal lobe is involved. Before therapeutic interventions are initiated, the clinician should analyze the severity and ...

BACKGROUND: Hyponatraemia due to antipsychotic use is a potentially serious problem; however, it is not known whether it is an adverse drug reaction (ADR) to antipsychotic use or is due to the underlying psychiatric disease. OBJECTIVE: To estimate the strength of the association between antipsychotics and hyponatraemia or syndrome of ...

Until now, studies on the reproductive safety of psychotropics have typically assessed the risk of congenital malformations and perinatal complications associated with in utero exposure to such medications. However, little is known of their inherent potential neurobehavioral teratogenicity. The objective is to analyze available data from studies investigating developmental outcome ...

In this article, we provide information on patient-reported side effects from a cross-section of real-world patients. Specifically, data on side effects were tabulated for patients taking at least one of the following atypical antipsychotic medications: aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, or ziprasidone. Approximately 54 percent of the 353 respondents reported ...

The authors present a case series involving four patients who were referred to a specialized somatoform disorders clinic because of chronic medically unexplained physical complaints. The patients were eventually diagnosed with cenesthopathic schizophrenia, a term that has been proposed for a type of schizophrenia in which tactile hallucinations and delusional ...

BACKGROUND: Although antipsychotic polytherapy is considered appropriate in limited circumstances (e.g., during a brief "cross-titration" period when switching medications), its increasing prevalence indicates use beyond this limited scope. Despite absence of support in the medical literature and higher costs, antipsychotic polytherapy is common in the treatment of schizophrenia and related ...

Second-generation antipsychotics (SGAs) are thought to have a lower likelihood of inducing extrapyramidal symptoms (EPS) than are first-generation antipsychotics (FGAs). Clinical observations suggest that younger patients may be more sensitive to SGA-associated EPS than are adults and require therapy with anticholinergic agents. To determine the proportion of patients 5-18 years ...

INTRODUCTION: Different classes of psychotropics can cause hyperprolactinemia to varying degrees. Among antipsychotics, typical agents and risperidone are the most frequent and significant offenders. In this review we discuss the pathophysiology, offending medications, assessment and management of hyperprolactinemia. METHODS: We did a literature review between 1976 and 2008 using PubMed, ...

AIM: To examine psychotropic medication review practices in residential aged care facilities. METHODS: Psychotropic medicine use data were collected from residents from 40 residential aged care facilities throughout Tasmania. As an indication of review practices, the measure was repeated at 33 of the original facilities a year later. RESULTS: A ...

The effective medications currently marketed for attention-deficit hyperactivity disorder (ADHD) have central and peripheral catecholaminergic effects that have been shown to result in statistically significant increases in heart rate and blood pressure. The impact of these medications on serious cardiovascular events in healthy children is unknown, but serious cardiovascular events ...

OBJECTIVE: The aim of this paper is to highlight the association between antipsychotic medication, in this instance paliperidone, and hyperprolactinaemia, and discuss the impact of this adverse effect on patient management. METHOD: Four patients with paliperidone-induced hyperprolactinaemia are described with a brief review of the literature. RESULTS: Four female patients ...