About half of the US population doesn't understand their doctors' instructions, according to health literacy advocates within the AMA and the American Academy of Neurology (AAN). Is it any wonder why clinicians are frustrated with patients' lack of compliance with therapy and lack of follow-through filling prescriptions and presenting for diagnostic tests-not to mention litigation issues that may arise, in part, from physician-patient miscommunication?
Parkinson disease practice parameters
Patients with Alzheimer disease (AD) often have Lewy body pathology (LBP). Although the exact significance of LBP is unknown, LBP appears to be more common in persons with familial AD related to gene mutations of presenilin 1 (PSEN1), presenilin 2 (PSEN2), and amyloid precursor protein. To examine the genetics of LBP, the team from Puget Sound HCS, led by James B. Leverenz, MD, associate professor at the University of Washington in Seattle, reviewed 25 familial AD cases that included 9 known PSEN1 mutations and 14 familial AD cases that included a single PSEN2 mutation. The brain stem, limbic cortex, and neocortex were examined for LBP.
impaired glucose tolerance neuropathy, IGTN, impaired glucose tolerance, IGT, diabetic neuropathy, metabolic syndrome
autism, mirror neuron defect
Yes, there's been a changing of the guard. Larry Hand, who played a major role in launching Applied Neurology as a unique source of clinical news and information, has moved on to other challenges. The editorial staff wishes him well. In a relatively short time, Applied Neurology, which debuted in January 2005, has caught the interest of the specialty by providing a comprehensive range of easy-to-read and timely information for neurologists and other specialists. The staff is committed to continuing in this vein.
Neurologists have always faced tough decisions when it comes to sudden unexpected death in epilepsy (SUDEP). Not the least of these is how to explain to bereaved family members what happened to their loved one and how it could have been prevented, because no one really knows.
The use of psychiatric medications in children, including antidepressants (such as selective serotonin reuptake inhibitors) and drugs used to manage attention-deficit/hyperactivity disorder, are continuing to be reviewed by the FDA.
Attention deficit hyperactivity disorder (ADHD) drugs for children won't require . restrictive black box labeling, as the FDA has reversed its earlier ruling.
A psychiatrist in private practice gives guidelines when faced with the prospect of treating multiple members of the same family.
HR 4157, which would establish a federal patient information privacy standard that would pre-empt State patient privacy laws, is being rethought by one of its Congressional cosponsors.
Caregivers in high-pressure medical settings, such as intenstive care units (ICUs), can suffer from high levels of stress, resulting in emotional exhaustion, diminished empathy for patients, and decreased productivity.
A second opinion on the need for new warnings on attention deficit hyperactivity disorder (ADHD) drugs from the FDA advisory committee contradicts The Pediatric Advisory Committee recommendation.
In many situations, patients--even those who are acutely mentally ill--and physicians agree on a treatment regimen. In some cases, however, patients may disagree with the treatment after the fact or refuse treatment altogether. Although the physician's primary concerns are patient care and safety, the legalities of medicine are ever present and must be kept in mind. The following cases illustrate some of the medicolegal challenges that may arise in the emergency care setting.
The author continues his analysis, begun 25 years ago, of the use of polypharmacy versus monotherapy with an antipsychotic agent. Although antipsychotic polypharmacy has been condemned over the years, the practice nevertheless continues and has shown marked increase with the introduction of atypical antipsychotic agents.
Poetry from Dr Richard M. Berlin, professor of psychiatry at the University of Massachusetts Medical School.
The concept of Primum non nocere ("First, do no harm") is a cornerstone of medical education. This Latin phrase reminds physicians that medical treatments can potentially have both good and bad effects. Sometimes, the ultimate net benefit of an intervention is clear to both the physician and the patient, and treatment proceeds unimpeded by doubt. When the net benefit of a treatment is less certain, in most branches of medicine patient choice and self-determination play a major role in determining which "gray zone" treatments are appropriate. For the most part, this is also true in psychiatry.
An overview of the articles in this Special Report on psychopharmacology.
The search in identifying risk factors affecting cognitive health and longevity, including Alzheimer disease and other dementias, has broadened to include genes and lifestyle factors.
Differences between siblings are affected by internal representations and non-shared environmental influences such as gender, birth rank order, different peer influences, illnesses, and accidents.
Somatoform disorders (disorders that are not fully explained by a medical condition or mental disorder) may require psychiatrists to consult with physicians.
Pediatric psychosomatic research shows that emotional, behavioral, and psychiatric symptoms are found more often in children and adolescents with chronic illnesses than in healthy children.
Delirium must be diagnosed accurately, prevented, and treated because of its pervasiveness and the associated risks of morbidity and mortality.
Damage can take biologic, syndromic, social, and personal form, with correlations among the various levels of damage.
Evidence showing the effectiveness of psychopharmacologic and psychotherapeutic management of functional gastrointestinal disorders over standard medical treatment is increasing.
The perinatal period is a high-risk time for some women to experience a new onset or exacerbation of a mood disorder that may require emergency psychiatric care.
A discussion of the recent research on the use of antidepressants in bipolar disorder (BD), and the methodologic principles that should guide this aspect of psychopharmacology.
A discussion of the evidence that the pharmaceutical industry influences how physicians evaluate drugs in ways that encourage sales of their products and that are not always in the best interests of the patient.
Administering drug dosages that are clinically effective while causing minimal side effects is a challenge for physicians. The latest data on antipsychotics, antidepressants, and other psychotropic drugs in relation to brain occupancy and plasma levels are reviewed here.
There is a tendency to avoid psychiatric medications during pregnancy, but the high prevalence of psychiatric disorders in pregnant women means that women and their physicians must make impromptu decisions regarding the initiation or continuation of drug therapy.