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JAMA Otolaryngol Head Neck Surg 2019 Feb 14. Epub 2019 Feb 14.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Masschusetts.

Importance: Health care organizations are complex and evolving systems. To date, longitudinal evaluation to ensure the sustainability of quality improvement (QI) initiatives has been missing from the otolaryngology literature. We sought to reassess perioperative management of laryngotracheal reconstruction, which requires adequate sedation. Read More

J Clin Endocrinol Metab 2019 Feb 8. Epub 2019 Feb 8.

Professor and Vice Chair of Medicine, Department of Medicine, University of Washington, Seattle, WA.

Context: The lifetime prevalence of anabolic androgenic steroid (AAS) use is estimated at 1-5% worldwide. AAS use occurs primarily male elite athletes and men who want a muscular appearance. The evidence for effective, safe management of AAS cessation and withdrawal is weak. Read More

Indian J Psychiatry 2019 Jan-Feb;61(1):60-64

Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India.

Background: Benzodiazepines (BDZs) have been the treatment of choice for alcohol withdrawal syndrome (AWS); however, they are associated with several side effects and also have abuse potential. In some studies, the use of baclofen has been effective in reducing symptoms of alcohol withdrawal symptoms.

Aim: The objective of this study was to compare the efficacy of baclofen and benzodiazepine (lorazepam) in reducing symptoms of AWS. Read More

Semin Fetal Neonatal Med 2019 Feb 5. Epub 2019 Feb 5.

Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA.

Neonatal abstinence syndrome is defined by signs and symptoms of withdrawal that infants develop after intrauterine maternal drug exposure. All infants with documented in utero opioid exposure, or a high pre-test probability of exposure should have monitoring with a standard assessment instrument such as a Finnegan Score. A Finnegan score of >8 is suggestive of opioid exposure, even in the absence of declared use during pregnancy. Read More

Am J Emerg Med 2019 Jan 30. Epub 2019 Jan 30.

Community Regional Medical Center, P.O. Box 1232, Fresno, CA 93715, United States of America. Electronic address:

Objective: The purpose of this study was to evaluate the safety and efficacy of a single parenteral dose of phenobarbital in addition to symptom-triggered lorazepam for the acute management of alcohol withdrawal syndrome (AWS).

Methods: This was a retrospective chart review of adult patients who presented to the Emergency Department with moderate or severe symptoms of alcohol withdrawal. Patients were included if they received at least 4 mg of lorazepam through the hospital's Alcohol Withdrawal Order Set on hospital day one. Read More

Semin Fetal Neonatal Med 2019 Jan 28. Epub 2019 Jan 28.

Yale School of Medicine, Department of Pediatrics, 333 Cedar St., PO Box 208064, New Haven, CT, 06520-8064, USA. Electronic address:

Infants with in-utero opioid exposure are most commonly assessed using the Finnegan Neonatal Abstinence Scoring System (FNASS) or a modified version of that tool. Traditionally, the purpose of these tools has been to characterize the extent of withdrawal signs to guide the pharmacologic treatment for infants with neonatal opioid withdrawal syndrome (NOWS). In the past decade however, in response to some of the limitations of the FNASS tool, there has been an increasing emphasis on developing novel assessment tools not based on the FNASS in addition to the promotion of non-pharmacologic treatment options as the first line treatment for infants with opioid exposure. Read More

Eur Psychiatry 2019 Feb 7;58:1-9. Epub 2019 Feb 7.

Medical Division, Gedeon Richter Plc, Budapest, Hungary.

Background: Negative symptoms in schizophrenia are heterogeneous and multidimensional; effective treatments are lacking. Cariprazine, a dopamine D-preferring D/D receptor partial agonist and serotonin 5-HT receptor partial agonist, was significantly more effective than risperidone in treating negative symptoms in a prospectively designed trial in patients with schizophrenia and persistent, predominant negative symptoms.

Methods: Using post hoc analyses, we evaluated change from baseline at week 26 in individual items of the Positive and Negative Syndrome Scale (PANSS) and PANSS-derived factor models using a mixed-effects model for repeated measures (MMRM) in the intent-to-treat (ITT) population (cariprazine = 227; risperidone = 227). Read More

Acta Derm Venereol 2019 02 8. Epub 2019 Feb 8.

Royal Randwick Medical Centre, 70/73-115 Belmore Road, Randwick NSW 203, Australia.

Concerns about topical steroid withdrawal are causing some patients to cease long-term topical corticosteroid therapy, however, little is known about the ensuing clinical outcomes. This qualitative case series studied 10 children whose parents stopped their chronic topical corticosteroid use and subsequently developed features typically reported in adults experiencing topical steroid withdrawal. Patients were seen in an Australian general practice between April 2014 and October 2018, with follow-up periods ranging from 18 months to 4 years. Read More

Emerg Infect Dis 2019 Apr 17;25(4). Epub 2019 Apr 17.

In July 2017, fever and sepsis developed in 3 recipients of solid organs (1 heart and 2 kidneys) from a common donor in the United States; 1 of the kidney recipients died. Tularemia was suspected only after blood cultures from the surviving kidney recipient grew Francisella species. The organ donor, a middle-aged man from the southwestern United States, had been hospitalized for acute alcohol withdrawal syndrome, pneumonia, and multiorgan failure. Read More

Clin Toxicol (Phila) 2019 Feb 7:1-4. Epub 2019 Feb 7.

b Department of Surgery , University of California, Davis Medical Center , Sacramento , CA, USA.

Objective: Current evidence supports symptom-triggered therapy for alcohol withdrawal syndrome (AWS). Early, escalating therapy with benzodiazepines (BZD) appears to decrease ICU length of stay (LOS); however, the effect on hospital LOS remains unknown. The hypothesis of this study is that focused BZD treatment in the first 24 h will decrease hospital LOS. Read More

Front Psychiatry 2018 22;9:773. Epub 2019 Jan 22.

Kershaw Unit, Gartnavel Royal Hospital, Glasgow, United Kingdom.

The Alcohol Withdrawal Syndrome (AWS), which may occur with or without delirium, is a frequent consequence of sudden alcohol cessation in patients with moderate to severe Alcohol Dependence Syndrome (ADS). Withdrawal as a result of habituation to alcohol is part of the definition of the Alcohol Dependence Syndrome (ICD10). Since the recognition of Delirium Tremens, in the early nineteenth century, the management of the syndrome, an acute medical emergency, has proven controversial. Read More

Alcohol Alcohol 2019 Feb 5. Epub 2019 Feb 5.

Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, India.

Aim: To define the prevalence and clinical presentation of pellagra, a multi-systemic disease caused by the deficiency of niacin, in patients admitted to a tertiary addiction treatment centre in southern India, with alcohol dependence syndrome (ADS)-(ICD10).

Methods: Review of the health records of 2947 patients who received inpatient care for ADS between 2015 and 2017.

Results: Out of 2947, 31 (1%) were diagnosed with pellagra. Read More

J Matern Fetal Neonatal Med 2019 Feb 5:1-11. Epub 2019 Feb 5.

e Neurology , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , USA.

Objective: Though central nervous system irritability is a well-established consequence of neonatal drug withdrawal, brain function in infants with neonatal abstinence syndrome (NAS) is not well understood. Amplitude-integrated electroencephalography (aEEG) is a bedside tool used for monitoring brain activity and seizures. We describe the prevalence of abnormal aEEG background patterns in infants with NAS. Read More

Asian J Psychiatr 2019 Jan 24;40:30-38. Epub 2019 Jan 24.

Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:

Objective: Penetration of mobile technology is rapidly rising. Excessive use leads to Technology addiction, which often start early in adolescence. The purpose of the present study was to assess Technology addiction and its correlates among school students in rural India. Read More

Semin Fetal Neonatal Med 2019 Jan 25. Epub 2019 Jan 25.

Departments of Medicine (Biomedical Genetics), Neurology, Ophthalmology, Epidemiology, and Biostatistics, Boston University Schools of Medicine and Public Health, Boston, MA, USA. Electronic address:

Neonatal abstinence syndrome (NAS) due to in-utero opioid exposure is a growing epidemic with significant variability in clinical presentation and severity. Currently, NAS severity cannot be predicted based on clinical factors alone. To date, small studies have identified genetic variants in opioid receptor and stress response genes that are associated with differences in NAS pharmacologic treatment rates and length of hospitalization. Read More

Zhonghua Nei Ke Za Zhi 2019 Feb;58(2):108-118

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

To establish the experts consensus on the management of delirium in critically ill patients. A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group. Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Read More

Adv Emerg Nurs J 2019 Jan/Mar;41(1):65-75

Trauma/Surgical ICU, Harborview Medical Center, Seattle, Washington (Dr Glann); Georgetown University School of Nursing & Health Studies, Washington, District of Columbia (Dr Carman); Duke University School of Nursing, Durham, North Carolina (Dr Thompson); and Raymond G. Murphy VA Medical Center, New Mexico, Albuquerque (Drs Olson, Nuttall, and Fleming and Ms Reese).

Alcoholism continues to be a persistent health problem in the United States, accounting for up to 62% of emergency department (ED) visits. This quality improvement (QI) project examined whether identifying the benefit for early use of Alcohol Use Disorders Identification Test (AUDIT C) and Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIW-ar) in the ED would avoid escalation of care and offset poor outcomes of alcohol withdrawal syndrome (AWS). A preimplementation chart review (N = 99) showed an average of 12%-15% of patients requiring escalation of care at the project site. Read More

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):473-478

Objectives: Neonatal abstinence syndrome (NAS) is characterized by withdrawal symptoms in neonates exposed to legal or illegal substances , and it is often managed with medications such as opiates, phenobarbital, and clonidine. Clonidine use is increasing, but further safety data regarding its use in neonates are warranted. This study evaluated the effects of clonidine on heart rate and blood pressure in neonates treated for NAS at doses up to 24 mcg/kg/day. Read More

JAMA 2019 01;321(4):385-393

RAND Corporation, Pittsburgh, Pennsylvania.

Importance: Neonatal abstinence syndrome (NAS) has increased over the last 2 decades, but limited data exist on its association with economic conditions or clinician supply.

Objective: To determine the association among long-term unemployment, clinician supply (as assessed by primary care and mental health clinician shortage areas), and rates of NAS and evaluate how associations differ based on rurality.

Design, Setting, And Participants: Ecological time-series analysis of a retrospective, repeated cross-sectional study using outcome data from all 580 counties in Florida, Kentucky, Massachusetts, Michigan, New York, North Carolina, Tennessee, and Washington from 2009 to 2015 and economic data from 2000 to 2015. Read More

J Am Med Dir Assoc 2019 Jan 25. Epub 2019 Jan 25.

Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA.

Objectives: Among kidney disease patients ≥80 years progressing to end-stage renal disease, there is growing interest in conservative nondialytic management approaches. However, among those who have initiated hemodialysis, little is known about the impact of withdrawal from dialysis on mortality, nor the patient characteristics associated with withdrawal from dialysis.

Study Design: Historical cohort study. Read More

Ann Dermatol Venereol 2019 Jan 25. Epub 2019 Jan 25.

Service de dermatologie-infectiologie, CHI Fréjus Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France.

Background: Toxic shock syndrome (TSS) was first described by Todd in 1978. The relevant Lancet publication reported 7 cases of children with fever, exanthema, hypotension and diarrhoea associated with multiple organ failure. An association between TSS and use of hyper-absorbent tampons in menstruating women was discovered in the 1980s. Read More

Biochem Pharmacol 2019 Mar 25;161:163-172. Epub 2019 Jan 25.

Research Center for Biopharmaceutics and Pharmacokinetics, College of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou, China. Electronic address:

In this study, we aimed to investigate a potential role of small heterodimer partner (Shp, a nuclear receptor) in regulation of morphine withdrawal syndrome and to determine the mechanisms thereof. Somatic opiate withdrawal and pharmacokinetic experiments were performed with wild-type (WT) and Shp knockout (Shp-KO) mice. Regulatory effects of Shp on Ugt2b expression were assessed in vitro (using mouse hepatoma Hepa1-6 cells) and in vivo (using Shp-KO mice). Read More

Neurol Int 2018 Dec 20;10(4):7877. Epub 2018 Dec 20.

Course of Neurology, Department of Health Sciences, Tsukuba University of Technology.

Drug-induced Parkinsonism is often reversible after withdrawal of the causative drug. Its clinical course, however, is not well understood, as the majority of cases are caused by drugs prescribed by departments outside of neurology. We reviewed 21 cases of drug-induced parkinsonism for several factors, including age, sex, causative drug and reason for prescription, department by which it was prescribed, and outcome. Read More

AEM Educ Train 2019 Jan 20;3(1):50-57. Epub 2018 Nov 20.

Schwartz/Reisman Emergency Medicine Institute University of Toronto Toronto Ontario Canada.

Background: Ideal management of alcohol withdrawal syndrome (AWS) incorporates a symptom-driven approach, where patients are regularly assessed using a standardized scoring system (Clinical Institute Withdrawal Assessment for Alcohol-Revised [CIWA-Ar]) and treated according to severity. Accurate administration of the CIWA-Ar requires experience, yet there is no training program to teach this competency. The objective of this study was to develop and evaluate a curriculum to teach clinicians how to accurately assess and treat AWS. Read More

Paediatr Anaesth 2019 Jan 21. Epub 2019 Jan 21.

Division of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, Canada.

Objectives: This study aims to assess the impact of a quality improvement initiative to increase assessments of pain, agitation, and iatrogenic withdrawal syndrome, on the use of sedative and analgesic medication in a pediatric intensive care unit.

Design And Setting: This is a retrospective pre- and post, observational, quality improvement study conducted in an eighteen-bed medical-surgical-cardiac, tertiary intensive care unit.

Patients: We included patients consecutively admitted from October 1- March 31 (pre period 2015-2016, post period 2016-2017) who were mechanically ventilated beyond 48 hours. Read More

J Dig Dis 2019 Jan 20. Epub 2019 Jan 20.

Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.

Aim: As a stress-related disorder, irritable bowel syndrome (IBS) has aberrant brain-gut communication and low-grade inflammation in the intestine. This study determined the effect of corticotropin-releasing factor (CRF) on regulating the NOD-like receptor pyrin domain-containing protein 6 (NLRP6)- inflammatory cytokine axis in a murine model of IBS.

Methods: C57BL/6 mice were subjected to water avoidance stress (WAS) for 1 h/day over the course of 10 days. Read More

Alcohol 2019 Jan 17. Epub 2019 Jan 17.

Social and Administrative Pharmacy Department, Faculty of Pharmaceutical Sciences, Chulalongkorn University. Bangkok, Thailand. Electronic address:

Aims: To identify the extent to which patients admitted to a general hospital in Vietnam meet the criteria for risky alcohol drinking, alcohol use disorder (AUD), and alcohol withdrawal syndrome (AWS), describe problems and behavior of alcohol use such as types and quantity of alcohol drinking in a hospitalized population in Vietnam and investigate the association among age, disease-related factors and alcohol consumption with AWS.

Methods: This study was conducted prospectively in 1340 patients admitted to a general hospital. All patients were screened for risky alcohol drinking. Read More

Psychiatr Pol 2018 Dec 29;52(6):983-996. Epub 2018 Dec 29.

Zakład Zaburzeń Afektywnych, Katedra Psychiatrii UJ CM, Kraków.

Objectives: Assessment of adverse drug interactions with herbal preparations (HP), i.e., plant medicines and nutritional supplements which contain plant extracts. Read More

J Pharmacopuncture 2018 Dec 31;21(4):277-283. Epub 2018 Dec 31.

Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Objectives: Ethanol withdrawal following its chronic use is a serious outcome and challenging to treatment. The chronic use of ethanol induces a progressive neuroplasticity in different reigns of brain. In this study we evaluated the effects of aqueous extract of L. Read More

Cureus 2018 Nov 3;10(11):e3540. Epub 2018 Nov 3.

Epidemiology and Public Health, King Fahad Medical City, Riyadh, SAU.

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state manifested with a unique computed tomography (CT) or magnetic resonance imaging (MRI) appearance. PRES is associated with different conditions, such as eclampsia, sepsis, organ transplantation, and drugs, especially immunosuppressive medications. Besides pharmacologic side effects, antibiotics can cause PRES as well. Read More

G Ital Cardiol (Rome) 2019 Jan;20(1):46-61

Presidente SIC, Struttura Cardiologica, Policlinico Universitario, Cagliari.

Palliative care is recognized as an approach that improves quality of life of patients and families facing life-threatening illnesses. This is achieved through prevention, early identification, assessment and treatment of symptoms and other psycho-social, spiritual and economic issues. Palliative care is not dependent on prognosis and can be delivered as "simultaneous care", together with disease-modifying treatments and adequate symptom relief. Read More

BMJ Support Palliat Care 2019 Jan 12. Epub 2019 Jan 12.

Hôpital de la Cité-de-la-Santé, Laval, QC H7M 3L9, Canada

Sudden cessation of baclofen can produce a withdrawal syndrome even if it was previously orally administered. We present the case of a man who exhibited signs of baclofen withdrawal syndrome during palliative sedation. Attempts were made to induce muscle relaxation with ever-increasing doses of benzodiazepine. Read More

Medicine (Baltimore) 2019 Jan;98(2):e13649

Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.

Rationale: Posterior reversible encephalopathy syndrome (PRES) was termed by Hinchey in 1996. Patients have a reversible vasogenic brain edema in imaging and acute neurological symptoms such as headache, seizures, encephalopathy, and visual disturbances when suffering from hypertension, pre-eclampsia/eclampsia, renal failure, immunosuppressive medications, autoimmune disorders, sepsis, thrombocytopaenia, hypocalcaemia, alcohol withdrawal, and many other potential causes. de Havenon A et al have proposed a new syndrome named PRES with spinal cord involvement (PRES-SCI). Read More

Neurochem Res 2019 Jan 10. Epub 2019 Jan 10.

Department of Molecular Medicine, School of Medicine, Ewha Womans University, Seoul, 07985, Republic of Korea.

The effect of 3, 4, 5-trimethoxy cinnamic acid (TMCA) against morphine-induced dependence in mice and rats was investigated. Mice were pretreated with TMCA and then morphine was injected intraperitoneally; whereas rats were treated with TMCA (i.p. Read More

J Pharm Pract 2019 Jan 10:897190018822561. Epub 2019 Jan 10.

2 SWGA Clinical Campus, University of Georgia College of Pharmacy, Albany, GA, USA.

Objectives:: To describe the potential role of phenobarbital as appropriate therapy in the treatment and prevention of alcohol withdrawal syndrome (AWS) among medically cleared psychiatric inpatients.

Methods:: This was a single-center, retrospective, observational study of adult patients admitted to the psychiatric unit and administered phenobarbital for the treatment or prevention of AWS. Changes in vital signs and signs and symptoms of AWS were observed to assess the safety and efficacy of phenobarbital. Read More

MMWR Morb Mortal Wkly Rep 2019 Jan 11;68(1):6-10. Epub 2019 Jan 11.

From 2004 to 2014, the incidence of neonatal abstinence syndrome (NAS) in the United States increased 433%, from 1.5 to 8.0 per 1,000 hospital births. Read More

J Opioid Manag 2018 Nov/Dec;14(6):445-452

Department of Graduate Health Sciences, West Liberty University, West Liberty, West Virginia; Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, West Virginia.

Neonatal abstinence syndrome (NAS) is a group of problems associated with withdrawal symptoms of a newborn who was exposed to maternal opiate use while in the womb. West Virginia (WV) is of utmost concern as this state exhibits among the highest rates of opioid abuse and consequently, NAS. In this manuscript, we review factors associated with the prevalence of NAS in WV. Read More

J Intellect Disabil Res 2019 Jan 9. Epub 2019 Jan 9.

Centro Medicina dell'Invecchiamento, Department of Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy.

Background: Down syndrome (DS) is characterised by premature ageing that affects selected organ systems, and persons with this condition can present patterns of co-morbidities and deficits often observed in the older population without DS. However, information on the characteristics of adult persons with DS is limited. The objective of the study is to describe characteristics of adults with DS collected with a standardised, comprehensive assessment instrument. Read More

Neuropsychopharmacology 2019 Jan 9. Epub 2019 Jan 9.

Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Preclinical and human studies suggest that hippocampal dysfunction is a key factor in the onset of psychosis. People at Clinical High Risk for psychosis (CHR-P) present with a clinical syndrome that can include social withdrawal and have a 20-35% risk of developing psychosis in the next 2 years. Recent research shows that resting hippocampal blood flow is altered in CHR-P individuals and predicts adverse clinical outcomes, such as non-remission/transition to frank psychosis. Read More

J Trauma Nurs 2019 Jan/Feb;26(1):41-49

Departments of Surgery (Messrs Higgins and Church and Drs Oyler, Parli, Fryman, and Bernard) and Nursing Professional Practice and Support (Mr Higgins and Dr Halcomb), University of Kentucky, Lexington; and College of Nursing, University of South Florida, Tampa (Dr Bugajski).

Alcohol withdrawal syndrome (AWS) manifests after alcohol-dependent individuals suddenly cease alcohol consumption. Clinical Institute Withdrawal Assessment-Alcohol, revised (CIWA-Ar) is a widely used tool to assess and guide treatment of AWS. CIWA-Ar was developed in voluntarily detoxification centers, and the reliability and validity of CIWA-Ar have been minimally evaluated in hospitalized patients. Read More

Evid Based Complement Alternat Med 2018 2;2018:1980491. Epub 2018 Dec 2.

Evidence-Based Medicine Research Center, School of Basic Medical Sciences, Jiangxi University of Traditional Chinese Medicine, Jiangxi, China.

Background: There is a worldwide epidemic of nonorganic gastrointestinal disorders (NOGDs), which are a class of disorders that cause various discomforts and ultimately progress into organic gastrointestinal diseases. Because of the unsatisfactory efficacy of Western medical treatments, traditional Chinese medicine (TCM) is becoming a promising complementary and alternative treatment to manage NOGDs.

Objectives: To investigate the efficacy and safety of Hou Gu Mi Xi (HGMX), a newly developed dietary TCM formula, on the syndrome of spleen qi deficiency (SQD) in patients with NOGDs. Read More

Mol Psychiatry 2019 Jan 7. Epub 2019 Jan 7.

Center for Neurobiology and Behavior, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

With the urgency to treat patients more effectively for opioid use disorder in the midst of the opioid epidemic, a key area for precision medicine is to improve individualized medication-assisted treatment for opioid use disorder. The expansion of medication-assisted treatment is a key to reducing illicit opioid use, preventing opioid overdose deaths, and reducing the comorbidities and societal impacts of opioid use disorder. The most common medication for opioid use disorder will soon be buprenorphine. Read More

J Clin Neurosci 2019 Jan 2. Epub 2019 Jan 2.

Hospital Universitario de La Princesa, Department of Neurology, Madrid, Spain.

The incidence of brain abscess is higher among immunosuppressed patients. We report a case of a brain abscess in the temporal lobe in a patient under treatment with adalimumab and methotrexate, who developed radiological worsening. Clinical remission was essential to suspect Immune Reconstitution Inflammatory Syndrome and to continue empirical antimicrobial therapy due to the low suspicion of worsening of the abscess itself. Read More

Cerebellum 2019 Jan 4. Epub 2019 Jan 4.

Pharmacy El Toro, La Fuente 11, 12429, El Toro, Castellon, Spain.

Cannabis is the third most used psychoactive drug worldwide. Despite being legally scheduled as a drug with high harm potential and no therapeutic utility in countries like the USA, evidence shows otherwise and legislative changes and reinterpretations of existing ambiguous laws make this drug increasingly available by legal means. Nevertheless, this substance is able to generate clear addiction syndromes in some individuals who use it, which are accompanied by brain alterations resembling those caused by other addictive drugs. Read More

Prim Care Companion CNS Disord 2018 Dec 20;20(6). Epub 2018 Dec 20.

Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA.

Objective: To describe the characteristics of the electrical phenomena of antidepressant discontinuation syndrome known as brain zaps and their effect on quality of life.

Methods: We examined 595 unsolicited posts made by individuals frequenting a popular lay mental health website. The site was accessed between December 13, 2014, and December 12, 2016, and its content was saved in a text document. Read More

Vopr Pitan 2018 18;87(1):51-62. Epub 2017 Dec 18.

Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow.

Consumption of diets that are inadequate in energy value to the actual energy expenditure can lead to the development of metabolic syndrome (MS), which has consequences such as type 2 diabetes mellitus, non-alcoholic steatohepatosis, atherosclerosis, gout, allergic diseases. Experimental models of MS are needed to develop new approaches to its dietary and drug correction. The aim of the work was a comparative analysis of functional, biochemical and vitamin markers characterizing the effect of a diet with a high content of fructose (F) on males and females of various rat lines and the selection on this basis of an optimal in vivo MS model. Read More

Adv Ther 2019 Feb 27;36(2):278-297. Epub 2018 Dec 27.

Chair and Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy.

Blood pressure lowering by all classes of antihypertensive drugs is accompanied by significant reductions of stroke and major cardiovascular (CV) events. Drugs acting on the renin-angiotensin-aldosterone system, such as angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), showed similar benefit on major CV events to other antihypertensive medications. In real-world practice, ARBs reduced by 10% the incidence of CV mortality, non-fatal myocardial infarction, non-fatal stroke and provided superior protection against CV events than ACEIs in high-risk patients. Read More

Indian J Psychiatry 2018 Oct-Dec;60(4):499-503

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Parkinsonism-hyperpyrexia syndrome (PHS) is a rare but potentially life-threatening complication of the management of Parkinson's disease (PD). Central hypodopaminergic state which results due to abrupt withdrawal of dopaminergic medications in patients with PD is the postulated cause. Clinical manifestations of PHS are very akin to neuroleptic malignant syndrome (NMS). Read More

J Clin Pharm Ther 2018 Dec 21. Epub 2018 Dec 21.

Department of Pediatric, The First Hospital of Jilin University, Changchun, China.

What Is Known And Objective: An imbalance in the genetically controlled pro- and anti-inflammatory cytokine production could potentially promote ongoing low-grade inflammation following an episode of acute gastroenteritis and, subsequently, could result in irritable bowel syndrome (IBS; post-infectious IBS, PI-IBS). Since there is very little known on the impact of pro-inflammatory cytokines such as tumour necrosis factor-α (TNF-α) on IBS, we conducted the present study with aims of determining the correlation between TNF-α gene polymorphisms (-308 G > A and -238 G > A) and susceptibility to IBS and drug efficacy in children.

Methods: Diarrhoea-predominant IBS patients and healthy subjects were recruited for DNA extraction. Read More

Chin Med 2018 18;13:63. Epub 2018 Dec 18.

3Yueyang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China.

Background: The pathogenesis of irritable bowel syndrome (IBS) is closely related to intestinal dysbacteriosis and can be controlled by moxibustion treatment. However, the mechanism underlying the therapeutic value of moxibustion in IBS treatment remains unknown.

Methods: An IBS rat model was established by colorectal distention (CRD) stimulus and mustard oil clyster. Read More