493,135 results match your criteria patients behavioral

Beyond rationality: Expanding the practice of shared decision making in modern medicine.

Soc Sci Med 2021 Apr 3;277:113900. Epub 2021 Apr 3.

Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1101 W. Montgomery Avenue, Philadelphia, PA, 19122, USA. Electronic address:

The contemporary healthcare field operates according to an autonomy model of medical decision-making. This model stipulates that patients have the right to make informed choices about their care. Shared decision making (SDM) has arisen as the dominant approach for clinicians and patients to collaborate in care planning and implementation. Read More

View Article and Full-Text PDF

Preparing for puberty in girls with special needs: a cohort study of caregiver concerns and patient outcomes.

J Pediatr Adolesc Gynecol 2021 Apr 7. Epub 2021 Apr 7.

Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.

Study Objective: To characterize the patient population with cognitive or physical impairments that presents for anticipatory guidance of puberty, evaluate caregiver concerns with respect to puberty, and describe chosen management strategies and outcomes following menarche.

Design: Retrospective cohort study SETTING: Academic tertiary care women and children's hospital PARTICIPANTS: Eligible female patients with special needs up to age 26 years presenting for anticipatory guidance from 2009-2018.

Main Outcome Measures: Primary outcomes included characterization of patients presenting for anticipatory guidance and their reasons for menstrual management. Read More

View Article and Full-Text PDF

Sexual behavior and contraceptive use among cisgender and gender minority college students who were assigned female at birth.

J Pediatr Adolesc Gynecol 2021 Apr 7. Epub 2021 Apr 7.

Department of Epidemiology, Harvard T.H. Chan School of Public Health; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital.

Study Objective: Our objective was to describe sexual behavior and contraceptive use among assigned female cisgender and gender minority college students (i.e., those whose gender identity does not match their sex assigned at birth). Read More

View Article and Full-Text PDF

Design and methods of a multi-site randomized controlled trial of an integrated care model of long-acting injectable buprenorphine with infectious disease treatment among persons hospitalized with infections and opioid use disorder.

Contemp Clin Trials 2021 Apr 7:106394. Epub 2021 Apr 7.

Yale School of Medicine, Department of Internal Medicine, Section of Infectious Disease, Yale AIDS Program, New Haven, CT, USA. Electronic address:

Background: Hospitalization with co-occurring opioid use disorder (OUD) and infections presents a critical time to intervene to improve outcomes for these intertwined epidemics that are typically managed separately. A surge in life-threatening infectious diseases associated with injection drug use, including bacterial and fungal infections, HIV, and HCV accounts for substantial healthcare utilization, morbidity, and mortality. Infectious Disease (ID) specialists manage severe infections that require hospitalization and are a logical resource to engage patients in medication treatment for OUD (MOUD). Read More

View Article and Full-Text PDF

Mini review: Promotion of substance abuse in HIV patients: Biological mediation by HIV-1 Tat protein.

Neurosci Lett 2021 Apr 7:135877. Epub 2021 Apr 7.

Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, 32610, USA. Electronic address:

Despite successful viral suppression by combinatorial anti-retroviral therapy, HIV infection continues to negatively impact the quality of life of patients by promoting neuropathy and HIV-Associated Neurocognitive Disorders (HAND), where substance use disorder (SUD) is highly comorbid and known to worsen health outcomes. While substance abuse exacerbates the progression of HIV, emerging evidence also suggests the virus may potentiate the rewarding effect of abused substances. As HIV does not infect neurons, these effects are theorized to be mediated by viral proteins. Read More

View Article and Full-Text PDF

Sex-related patterns of the gut-microbiota-brain axis in the neuropsychiatric conditions.

Brain Res Bull 2021 Apr 7. Epub 2021 Apr 7.

Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil. Electronic address:

Sex differences are often observed in psychiatric patients, especially major depressive disorders (MDD), schizophrenia, and developmental disorders, including autism spectrum disorders (ASDs). The prevalence rates between males and females seem variate according to the clinical condition. Although the findings are still incipient, it is suggested that these differences can involve neuroanatomical, neurochemical, and physiological sex differences. Read More

View Article and Full-Text PDF

United States internet searches for "infertility" following COVID-19 vaccine misinformation.

J Osteopath Med 2021 Apr 12. Epub 2021 Apr 12.

Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.

Context: On December 1, 2020, Drs. Wolfgang Wodarg and Micheal Yeadon petitioned to withhold emergency use authorization of the BNT162b2 messenger ribonucleic acid vaccine for coronavirus disease 2019 (COVID-19) manufactured by BioNTech and Pfizer, raising concern for female infertility risks but acknowledging the lack of evidence. The European Medicines Agency and the US Food and Drug Administration ultimately issued emergency use authorizations, but misinformation claiming that COVID-19 vaccines cause female infertility began circulating on social media, potentially influencing public perception and medical decision making among pregnant patients or those seeking to become pregnant. Read More

View Article and Full-Text PDF

Exosome Transplantation From Patients With Schizophrenia Causes Schizophrenia-Relevant Behaviors in Mice: An Integrative Multi-omics Data Analysis.

Schizophr Bull 2021 Apr 10. Epub 2021 Apr 10.

Key Laboratory of Ethnomedicine of Ministry of Education, Center on Translational Neuroscience, School of Pharmacy, Minzu University of China, Beijing, China.

Exosomes are involved in the pathophysiology of neuropsychiatric diseases, but the role of exosomes in schizophrenia (SCZ) is unclear. Here, we demonstrate that transplantation of serum exosomes from SCZ patients into mice caused behavioral abnormalities such as deficits in prepulse inhibition and sociability, hyperactivity, and anxiogenesis. A comparative bioinformatics analysis suggested shared and distinct differentially expressed genes (DEGs) and enriched molecular pathways in the brains of SCZ exosome-recipient mice, methylazoxymethanol acetate-treated rats, and SCZ patients, which correlates evidence of altered prefrontal-hippocampal functional coherence in SCZ. Read More

View Article and Full-Text PDF

Impact of smoking behavior on survival following allogeneic hematopoietic stem cell transplantation - smoking cessation matters.

Nicotine Tob Res 2021 Apr 10. Epub 2021 Apr 10.

Division of Pulmonology, Department of Internal Medicine, Medical University of Graz.

Introduction: There are only few data on the impact of smoking and smoking cessation on outcome of patients treated with allogeneic hematopoietic stem cell transplantation, a well established therapy for hematologic malignancies.

Methods: In a retrospective cohort study design we examined impact of smoking and smoking cessation on survival among 309 eligible consecutive adults who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity (n=179) or myeloablative (n=130) conditioning between 1999 and 2018.

Results: Smoking and was independently associated with increased mortality with a five-year overall survival of 25% in current smokers vs. Read More

View Article and Full-Text PDF

Commentary on: Comparison of Reconstructive Plastic Surgery Rates and Thirty-Day Postoperative Complications Between Patients With and Without Psychiatric Diagnoses.

Aesthet Surg J 2021 Apr 10. Epub 2021 Apr 10.

Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA, USA.

View Article and Full-Text PDF

Association of gender and systemic therapy treatment outcomes in psoriasis: a two-country, multi-centre, prospective, non-interventional registry study.

Br J Dermatol 2021 Apr 10. Epub 2021 Apr 10.

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

Background: Psoriasis is a stigmatizing disease that often affects female patients more negatively than male patients. Very little systematic data on the treatment responses related to gender exists.

Objectives: This two-country, multi-centre, prospective, non-interventional registry study aimed to evaluate potential gender differences with respect to systemic anti-psoriatic treatment. Read More

View Article and Full-Text PDF

Actionable druggable genome-wide Mendelian randomization identifies repurposing opportunities for COVID-19.

Nat Med 2021 Apr 9. Epub 2021 Apr 9.

Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.

Drug repurposing provides a rapid approach to meet the urgent need for therapeutics to address COVID-19. To identify therapeutic targets relevant to COVID-19, we conducted Mendelian randomization analyses, deriving genetic instruments based on transcriptomic and proteomic data for 1,263 actionable proteins that are targeted by approved drugs or in clinical phase of drug development. Using summary statistics from the Host Genetics Initiative and the Million Veteran Program, we studied 7,554 patients hospitalized with COVID-19 and >1 million controls. Read More

View Article and Full-Text PDF

T cell reactivity to regulatory factor X4 in type 1 narcolepsy.

Sci Rep 2021 Apr 9;11(1):7841. Epub 2021 Apr 9.

Department of Psychiatry and Behavioral Sciences, Stanford University Center for Sleep Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.

Type 1 narcolepsy is strongly (98%) associated with human leukocyte antigen (HLA) class II DQA1*01:02/DQB1*06:02 (DQ0602) and highly associated with T cell receptor (TCR) alpha locus polymorphism as well as other immune regulatory loci. Increased incidence of narcolepsy was detected following the 2009 H1N1 pandemic and linked to Pandemrix vaccination, strongly supporting that narcolepsy is an autoimmune disorder. Although recent results suggest CD4+ T cell reactivity to neuropeptide hypocretin/orexin and cross-reactive flu peptide is involved, identification of other autoantigens has remained elusive. Read More

View Article and Full-Text PDF

Possible actions of cannabidiol in obsessive-compulsive disorder by targeting the WNT/β-catenin pathway.

Mol Psychiatry 2021 Apr 9. Epub 2021 Apr 9.

Centre Hospitalier Universitaire (CHU) Amiens Picardie, Université Picardie Jules Verne (UPJV), Amiens, France.

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by recurrent and distinctive obsessions and/or compulsions. The etiologies remain unclear. Recent findings have shown that oxidative stress, inflammation, and glutamatergic pathways play key roles in the causes of OCD. Read More

View Article and Full-Text PDF

Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury.

Sci Rep 2021 Apr 9;11(1):7834. Epub 2021 Apr 9.

Department of Surgery, Division of Vascular and Endovascular Surgery, Eastern Virginia Medical School, 600 Gresham Dr, Norfolk, VA, 23507, USA.

Both endovascular repair (EVR) and open repair (OR) surgery of thoraco-abdominal aortic aneurysms cause spinal cord (SC) injury that can lead to paraparesis or paraplegia. It has been assumed that mechanisms responsible for SC damage after EVR are similar to those after OR. This pilot study compared the pathophysiology of SC injury after EVR versus OR using a newly developed EVR dog model. Read More

View Article and Full-Text PDF

Searching for a paradigm shift in the research on the epilepsies and associated neuropsychiatric comorbidities. From ancient historical knowledge to the challenge of contemporary systems complexity and emergent functions.

Epilepsy Behav 2021 Apr 6:107930. Epub 2021 Apr 6.

Departamento de Psicologia, Universidade Federal de Sergipe, Brazil. Electronic address:

In this review, we will discuss in four scenarios our challenges to offer possible solutions for the puzzle associated with the epilepsies and neuropsychiatric comorbidities. We need to recognize that (1) since quite old times, human wisdom was linked to the plural (distinct global places/cultures) perception of the Universe we are in, with deep respect for earth and nature. Plural ancestral knowledge was added with the scientific methods; however, their joint efforts are the ideal scenario; (2) human behavior is not different than animal behavior, in essence the product of Darwinian natural selection; knowledge of animal and human behavior are complementary; (3) the expression of human behavior follows the same rules that complex systems with emergent properties, therefore, we can measure events in human, clinical, neurobiological situations with complexity systems' tools; (4) we can use the semiology of epilepsies and comorbidities, their neural substrates, and potential treatments (including experimental/computational modeling, neurosurgical interventions), as a source and collection of integrated big data to predict with them (e. Read More

View Article and Full-Text PDF

Ultrasound features of medullary thyroid cancer as predictors of biological behavior.

Cancer Imaging 2021 Apr 9;21(1):33. Epub 2021 Apr 9.

Departments of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, P. R. China.

Background: Medullary thyroid cancer (MTC) has more aggressive behavior and poor prognosis. Ultrasound (US) has facilitated the qualitative diagnosis of thyroid nodules, however, some MTC may be diagnosed as a benign nodule on ultrasound because ultrasound features of malignancy are lacking. The aim of the study was to investigate the association between ultrasound features and biological behavior of MTC. Read More

View Article and Full-Text PDF

A novel protein encoded by circMAPK1 inhibits progression of gastric cancer by suppressing activation of MAPK signaling.

Mol Cancer 2021 Apr 9;20(1):66. Epub 2021 Apr 9.

Division of Gastric Surgery, Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, People's Republic of China.

Background: A novel type of noncoding RNA, circRNA has been reported to participate in the occurrence and development of diseases through many mechanisms. The MAPK pathway is a common signal transduction pathway involved in cell proliferation, inflammation and apoptosis and plays a particularly important role in cancers. However, the role of circRNAs related to the MAPK pathway in gastric cancer has not been explored. Read More

View Article and Full-Text PDF

How safe is it to use ultrasound in prenatal medicine? Facts and contradictions - Part 2 - Laboratory experiments regarding non-thermal effects and epidemiological studies.

Ultraschall Med 2021 Apr 9. Epub 2021 Apr 9.

Centre for Ultrasound and Prenatal Medicine Frankfurt/Main, Germany.

The first part of this CME article (issue 5/20) provided a detailed examination of the biophysical effects of ultrasound waves, the exposure values, and in particular the thermal effect. In vivo and in vitro measurements have shown that the temperature increase in tissue associated with B-mode ultrasound is far too low to pose a potential risk. Even experiments with exposure values in the range of pulsed Doppler have shown that temperature increases of over 1. Read More

View Article and Full-Text PDF

Discriminating cognitive motor dissociation from disorders of consciousness using structural MRI.

Neuroimage Clin 2021 Mar 29;30:102651. Epub 2021 Mar 29.

Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address:

An accurate evaluation and detection of awareness after a severe brain injury is crucial to a patient's diagnosis, therapy, and end-of-life decisions. Misdiagnosis is frequent as behavior-based assessments often overlook subtle signs of consciousness. This study aimed to identify brain MRI characteristics of patients with residual consciousness after a severe brain injury and to develop a simple MRI-based scoring system according to the findings. Read More

View Article and Full-Text PDF

The impact of Covid-19 on patients with suspected cancer: An analysis of ED presentation and referrals to a quick diagnosis unit.

Am J Emerg Med 2021 Apr 2;48:1-11. Epub 2021 Apr 2.

Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain.

Purpose: Patients evaluated in the emergency department (ED) who have concerning symptoms suggestive of a cancer diagnosis are mostly referred to the quick diagnosis unit of our tertiary hospital. This study analyzed the impact of the Covid-19 pandemic on the volume, disease patterns, and accessibility to essential investigations of patients with suspected cancer referred by the ED to this unit.

Methods: Trends in referrals were analyzed from January 1 to July 8, 2020 and the corresponding dates of 2019. Read More

View Article and Full-Text PDF

Psychoeducation for caregivers of patients with bipolar disorder-Lessons learned from a feasibility study.

J Affect Disord 2021 Mar 31;287:367-371. Epub 2021 Mar 31.

McGovern Medical School, Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States.

Introduction: The purpose of this study was to test the feasibility and potential efficacy of a 7-week psychoeducation intervention implemented in a group setting. The intervention was based on Miklowitz's (2008) psychoeducation component of Family-Focused Therapy.

Method: This was a feasibility randomized controlled trial study using a 2-group design (intervention and wait-list control). Read More

View Article and Full-Text PDF

Up-regulation of the long non-coding RNA Xist and the imbalance sex/ratio of pulmonary arterial hypertension.

Am J Pathol 2021 Apr 6. Epub 2021 Apr 6.

Pulmonary arterial hypertension (PAH) is a sex-biased disease. Recent studies demonstrated that the increased expression and activity of the long-noncoding (lnc)RNA-Xist, essential for X-chromosome (X-Chr) inactivation and dosage compensation of X-linked genes, may explain the imbalance sex/ratio of PAH. The present studies, using a murine model of plexiform PAH, the intersectin-1s (ITSN) heterozygous (KO) mouse transduced with an ITSN fragment (EH) possessing endothelial cell proliferative activity, in conjunction with molecular, cell biology, biochemical, morphological and functional approaches, demonstrate significant sex-centered differences with regard to EH-induced alterations in pulmonary artery remodeling, lung hemodynamics and p38/Elk1/c-Fos signaling, altogether leading to a more severe female lung PAH phenotype. Read More

View Article and Full-Text PDF

Older adults in skilled nursing facilities demonstrate low physical activity during and after discharge.

Disabil Rehabil 2021 Apr 9:1-6. Epub 2021 Apr 9.

Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.

Purpose: This study sought to quantify physical activity and sedentary time among older adults during a skilled nursing facility (SNF) stay and after the transition home, a critical period when patients are at high risk for adverse events.

Materials And Methods: We performed an observational cohort study of physical activity and sedentary behavior during the last 3-5 days before discharge from SNF and the initial 3-5 days at home using accelerometers. Participants answered questions about perceived physical activity in the SNF and at home. Read More

View Article and Full-Text PDF

Tryptophan Probes of TDP-43 C-Terminal Domain Amyloid Formation.

J Phys Chem B 2021 Apr 9. Epub 2021 Apr 9.

Laboratory of Protein Conformation and Dynamics, Biochemistry and Biophysics Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, United States.

Aggregated TAR DNA-binding protein 43 (TDP-43) forms the cytoplasmic hallmarks associated with patients suffering from amyotrophic lateral sclerosis and frontotemporal lobar degeneration with ubiquitin. Under normal conditions, TDP-43 is a 414-amino acid protein; however, aggregates are enriched with N-terminal truncations which contain residues 267-414, known as the C-terminal domain of TDP-43 (TDP-43). To gain residue-specific information on the aggregation process of TDP-43, we created three single-Trp containing mutants (W385F/W412F, W334F/W412F, and W334F/W385F) by substituting two of the three native Trp residues with Phe, yielding fluorescent probes at W334, W385, and W412, respectively. Read More

View Article and Full-Text PDF

Synthesis and Comparative Evaluation of Site-Specifically Labeled Radioimmunoconjugates for DLL3-Targeted ImmunoPET.

Bioconjug Chem 2021 Apr 9. Epub 2021 Apr 9.

Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States.

Delta-like ligand 3 (DLL3) is a therapeutic target for the treatment of small cell lung cancer, neuroendocrine prostate cancer, and isocitrate dehydrogenase mutant glioma. In the clinic, DLL3-targeted Zr-immunoPET has the potential to aid in the assessment of disease burden and facilitate the selection of patients suitable for therapies that target the antigen. The overwhelming majority of Zr-labeled radioimmunoconjugates are synthesized via the random conjugation of desferrioxamine (DFO) to lysine residues within the immunoglobulin. Read More

View Article and Full-Text PDF

Unmet needs of the oldest old primary care patients with common somatic and psychiatric disorders-A psychometric evaluation.

Int J Methods Psychiatr Res 2021 Apr 9. Epub 2021 Apr 9.

Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.

Objectives: Unmet needs are common in older patients and should be assessed via suitable instruments. The adapted German version of the Camberwell Assessment of Need for the Elderly (CANE) represents an often used tool to determine the needs in older individuals. Evidence on the psychometric properties of the CANE is still pending. Read More

View Article and Full-Text PDF

Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial.

J Gen Intern Med 2021 Apr 9. Epub 2021 Apr 9.

Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA, USA.

Background: Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts.

Objective: To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change.

Design: A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U. Read More

View Article and Full-Text PDF

Radiomics in pancreatic neuroendocrine tumors: methodological issues and clinical significance.

Eur J Nucl Med Mol Imaging 2021 Apr 9. Epub 2021 Apr 9.

Vita-Salute San Raffaele University, Via Olgettina 58, Milan, 20132, Italy.

Purpose: To present the state-of-art of radiomics in the context of pancreatic neuroendocrine tumors (PanNETs), with a focus on the methodological and technical approaches used, to support the search of guidelines for optimal applications. Furthermore, an up-to-date overview of the current clinical applications of radiomics in the field of PanNETs is provided.

Methods: Original articles were searched on PubMed and Science Direct with specific keywords. Read More

View Article and Full-Text PDF

Pharmaceutical Opioid Use Patterns and Indicators of Extramedical Use and Harm in Adults With Chronic Noncancer Pain, 2012-2018.

JAMA Netw Open 2021 Apr 1;4(4):e213059. Epub 2021 Apr 1.

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

Importance: Despite concern about harms related to long-term prescribed opioid use among individuals with chronic noncancer pain (CNCP), no study has examined whether the same patients engage in a risky pattern of use consistently for the long term.

Objective: To examine the prevalence, incidence, persistence, and cessation of a range of opioid behaviors, indicators of extramedical use, and harm among individuals who are prescribed opioids.

Design, Setting, And Participants: This 5-year prospective cohort study in communities across Australia included 1514 adults who were prescribed opioids for CNCP. Read More

View Article and Full-Text PDF