News

Signals

Noninvasive ventilation (NIV) has been shown to ameliorate respiratory impairment, which, as the disease worsens, is often responsible for death in patients with amyotrophic lateral sclerosis (ALS). Its use, however, is uncommon, and its overall value in improving quality of life and survival has been debated. Findings of a randomized controlled study by a team from the University of Newcastle upon Tyne, UK, may shift clinicians' attitudes about the intervention.

About 25% of patients seen in epilepsy clinics and monitoring units who do not respond to antiepileptic drugs (AEDs) have received a misdiagnosis.1-3 The eventual diagnosis for most of these patients will be psychogenic nonepileptic seizure (PNES)1,4-a somatoform conversion disorder. It is treatable, but diagnosis, delivery of the diagnosis, and management present significant challenges. A major barrier to care has been the stigma associated with the label "psychogenic."

Measuring amyloid-beta (Abeta) protein levels in cerebrospinal fluid (CSF) and using positron emission tomography (PET) to image amyloid in the brain might become the best diagnostic test for presymptomatic Alzheimer disease (AD), according to a study published online in December 2005 and appearing in the March issue of Annals of Neurology.

The most comprehensive evidence-based recommendations for preventing a second stroke have been released by the American Heart Association and the American Stroke Association's Stroke Council.1 In contrast with previous clinical practice guidelines, the new guidelines tie transient ischemic attack (TIA) with stroke, said Ralph Sacco, MD, chair of the American Stroke Association's Secondary Stroke Prevention Guidelines Committee.

When Medicare enrollees became entitled to the first-ever outpatient prescription drug benefit in January, the program was introduced with great fanfare and with the mission of Medicare Part D programs to make drugs more affordable for the elderly and disabled. The Medicare drug benefit issue, however, has been mired in controversy since Congress took it up years ago.

Mental Notes

When a stroke occurs, transportation to the emergency department (ED) by ambulance will get a patient care faster-a factor that so often makes a difference about whether tissue plasminogen activator will be administered-according to poster studies presented at the International Stroke Conference in February in Kissimmee, FL.

Dementia is characterized as a progressive and chronic decline in cognitive function, not limited to memory impairment, which significantly interferes with baseline daily functioning and frequently involves behavioral disturbances. It is known that behavioral problems in dementia negatively affect patients and caregivers. These disturbances lead to institutionalization, increased costs and caregiver burden, and a poorer prognosis.

The focus of this Special Report on anxiety disorders is not accidental. Anxiety disorders are, probably next to substance abuse, the most common mental disorders in the general population, and definitely the most common mental disorders among children and adolescents.

Aware that mental illness generally begins early in life and that four teenagers commit suicide every day, several organizations and agencies are stepping up efforts to expand voluntary mental health screening and suicide prevention initiatives for youth--but they are doing so in the face of stigma and vocal opposition.

Anxiety disorders are the most common mental conditions in the general population, including in children and adolescents. Young people can present with a pattern of anxiety symptoms somewhat different from that typically seen in adults. One of the most common aspects of this difference is that children (especially younger ones) may not report overt worries or fears, but instead manifest pronounced physical symptoms.

Signals

Is AD Type 3 Diabetes?

In the late 1890s, Joseph Francois Felix Babinski (1857-1932), a French neurologist of Polish descent, discovered that if noxious stimulation of the sole of a patient's foot caused the big toe to rise and the other toes to splay, the reflex was indicative of corticospinal tract damage. "

Well into the 1970s, we psychiatrists believed that depression came from anger turned inward-and we acted on this notion. Psychiatrists spent countless hours trying to get depressed patients to talk about their anger. Enterprising psychologists and psychiatrists devised schemes to make such patients angry.

Mental Notes

Prescriptions for psychotropic drugs for adolescents aged 14 to 18 years increased by 250% between 1994 and 2001. The bulk of the momentum occurred from 1999 onward, according to a study by a team from Brandeis University in Waltham, MA.

Perceptions

I haven't conducted a scientific poll on this, but it seems as if more studies are being published lately on how stress takes a toll on our health. One study concluded that chronic stress at work is a risk factor for metabolic syndrome.1 Another showed how stressful effects of marital conflicts at home can slow wound healing and suggested that hospitals find ways to minimize stress in patients before surgery.2 And another study described how multiple negative life events can even be a risk factor for death, especially in people with low levels of income and education.3