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Risk Management: Fires, Floods, Hurricanes, Oh My! The Importance of Disaster Planning. 风险管理:火灾、洪水、飓风,哦,我的天!灾害规划的重要性。
Q3 Medicine Pub Date : 2024-09-01 eCollection Date: 2024-07-01
Akemini Kem Isang

This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation and other resources offered to health care providers to help improve patient outcomes and reduce professional liability risk. The answers published in this column represent those of only one risk management consulting company. Other risk management consulting companies or insurance carriers might provide different advice, and readers should take this into consideration. The information in this column does not constitute legal advice. For legal advice, contact your personal attorney. Note: The information and recommendations in this article are applicable to physicians and other health care professionals so "clinician" is used to indicate all treatment team members.

本栏目致力于为读者提供与医疗实践相关的法律风险管理信息。我们诚邀读者提问。答案由 PRMS (www.prms.com) 提供,PRMS 是一家医疗专业责任保险计划管理公司,其服务包括为医疗服务提供者提供风险管理咨询和其他资源,以帮助改善患者治疗效果并降低专业责任风险。本专栏公布的答案仅代表一家风险管理咨询公司的答案。其他风险管理咨询公司或保险公司可能会提供不同的建议,读者应对此加以考虑。本专栏中的信息不构成法律建议。如需法律建议,请联系您的个人律师。注:本文中的信息和建议适用于医生和其他医疗保健专业人员,因此 "临床医生 "用于指所有治疗团队成员。
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引用次数: 0
Overview of Psychiatric Medications in the Pipeline in Phase III Trials as of June 1, 2024: A Systematic Review. 截至 2024 年 6 月 1 日正在进行 III 期临床试验的精神科药物概览:系统回顾。
Q3 Medicine Pub Date : 2024-09-01 eCollection Date: 2024-07-01
Waguih William IsHak, Ashley Meyer, Luiza Freire, Jayant Totlani, Nathalie Murphy, Sabrina Renteria, Mohamed Salem, Tiffany Chang, Rasha Abdelsalam, Rida Khan, Thomas Chandy, Thomas Parrish, Drew Hirsch, Bhumika Patel, Alexander J Steiner, Sarah Kim, Rebecca Hedrick, Robert N Pechnick, Itai Danovitch

Objective: This systematic review provides an overview of psychiatric medications in the late stages of development (Phase III clinical trials) as of June 1, 2024. It details the mechanisms of action, efficacy, dosing, and adverse effects of these medications.

Methods: We searched the PubMed database for Phase III studies of psychiatric medications published until June 1, 2024, using the keywords "psychiatric" OR "psychopharm*" AND "medic*" OR "pharm*". Our review encompassed medications currently undergoing Phase III clinical trials and those that have completed Phase III but are awaiting approval from the United States Food and Drug Administration (FDA). We independently analyzed the identified studies and reached a consensus on the medications to be included in this systematic review.

Results: As of June 1, 2024, a total of 89 pipeline drug trials were identified, including nine for schizophrenia, five for bipolar disorders, 25 for depressive disorders, 11 for anxiety disorders, five for post-traumatic stress disorder (PTSD), one for obsessive compulsive disorder (OCD), two for eating disorders, two for sleep-wake disorders, three for sexual dysfunctions, one for substance-related and addictive disorders, 22 for neurocognitive disorders, and three for neurodevelopmental disorders, specifically attention deficit hyperactivity disorder (ADHD).

Conclusion: The psychiatric medications in the pipeline as of June 1, 2024, demonstrate significant promise in treating psychiatric disorders.

目的:本系统综述概述了截至 2024 年 6 月 1 日处于开发后期(III 期临床试验)的精神科药物。它详细介绍了这些药物的作用机制、疗效、剂量和不良反应:我们使用关键词 "psychiatric "或 "psychopharm*"和 "medic*",在 PubMed 数据库中检索了截至 2024 年 6 月 1 日发表的精神科药物 III 期临床研究。和 "medic*"或 "pharm*"。我们的研究包括目前正在进行 III 期临床试验的药物,以及已经完成 III 期临床试验但正在等待美国食品药品管理局 (FDA) 批准的药物。我们对确定的研究进行了独立分析,并就纳入本系统综述的药物达成了共识:截至 2024 年 6 月 1 日,共确定了 89 项管线药物试验,其中包括 9 项精神分裂症试验、5 项双相情感障碍试验、25 项抑郁障碍试验、11 项焦虑障碍试验、5 项创伤后应激障碍试验、1 项强迫症试验、2 项进食障碍试验、2 项创伤后应激障碍试验、1 项强迫症试验、2 例进食障碍、2 例睡眠-觉醒障碍、3 例性功能障碍、1 例药物相关和成瘾性障碍、22 例神经认知障碍和 3 例神经发育障碍,特别是注意力缺陷多动障碍(ADHD)。结论截至 2024 年 6 月 1 日,正在研发中的精神科药物在治疗精神障碍方面大有可为。
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引用次数: 0
Activation of the serotonergic neurotransmission is a double-edged sword in the treatment of burning mouth syndrome. 激活血清素能神经递质是治疗灼口综合征的一把双刃剑。
Q3 Medicine Pub Date : 2024-09-01 eCollection Date: 2024-07-01
Takahiko Nagamine
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引用次数: 0
Literary Prescriptions: Applying Bibliotherapy in a Psychotherapeutic Context. 文学处方:在心理治疗背景下应用书目疗法。
Q3 Medicine Pub Date : 2024-09-01 eCollection Date: 2024-07-01
Andrew B Correll, Terry L Correll, Matthew C Correll

Bibliotherapy, a relatively underutilized lifestyle intervention in psychotherapy, is a unique cost-effective avenue of treatment that empowers patients by integrating therapeutic reading into their treatment plan. This approach strategically uses empirically validated cognitive-behavioral and self-help literature to facilitate the application of therapeutic topics outside of psychotherapy sessions. Bibliotherapy's range of administration styles highlights its potential as an adjunct to medication, psychotherapy, and/or healthy lifestyle interventions in a comprehensive treatment plan. Most meta-analyses conducted so far regarding bibliotherapy in a clinical setting consist of studies that use minimal patient interaction via short phone calls or emails. Despite this, meta-analyses show medium-to-large effect sizes that are comparable to traditional psychotherapy modalities for common disorders, most notably depression. This article explores the practical implementation of bibliotherapy research via an example psychotherapy session with a patient who has a diagnosis of major depressive disorder (MDD). An evidence-based reading list is proposed alongside a decision tree and actionable clinical insights for the effective implementation of bibliotherapy.

书目疗法是心理疗法中一种利用率相对较低的生活方式干预方法,它是一种独特的、具有成本效益的治疗途径,通过将治疗性阅读融入治疗计划,增强患者的能力。这种方法策略性地使用经过经验验证的认知行为和自助文献,以促进治疗主题在心理治疗疗程之外的应用。书目疗法的多种管理方式凸显了它在综合治疗计划中作为药物治疗、心理治疗和/或健康生活方式干预的辅助手段的潜力。迄今为止,有关临床环境中书目疗法的大多数荟萃分析都是通过简短的电话或电子邮件与患者进行最少互动的研究。尽管如此,荟萃分析表明,在常见疾病(尤其是抑郁症)的治疗方面,荟萃分析表明了与传统心理治疗模式相当的中大型效应。本文通过一个与被诊断为重度抑郁障碍(MDD)的患者进行心理治疗的实例,探讨了书目疗法研究的实际应用。为有效实施书目疗法,本文提出了一份循证阅读清单,同时还提供了决策树和可操作的临床见解。
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引用次数: 0
Study of Clinical Characteristics of Intellectual Disability in Morocco. 摩洛哥智力残疾临床特征研究。
Q3 Medicine Pub Date : 2024-09-01 eCollection Date: 2024-07-01
Houda Bekkari, Yousra Benmakhlouf, Naima Ghailani Nourouti, Amina Barakat, Mohcine Bennani Mechita

Objective: Intellectual disability (ID) is considered one of the most common human disorders characterized by significant deficits in cognition and functional and adaptive skills. The aims of this study were to describe the demographic and clinical features of a group of Moroccan individuals with ID living in the Tangier-Tetouan region.

Design: This was a retro-prospective and descriptive exploratory monocentric study realized between November 2020 and August 2023. A total of 109 patients with ID were included. They were selected at four mental health centers in the Tangier-Tetouan region. Our data were treated and analyzed using the IBM SPSS version 26.

Results: A male predominance of patients with ID was observed in our series (54.4% male vs. 42.6% female). The male-to-female ratio was 1.34. The mean±standard deviation (SD) age of our patients was 11.75±4.87 years, ranging from 1 to 35 years. The mean ages of mothers and fathers at the births of their children with ID were 28.36 and 35.6 years, respectively. Many co-occurring medical conditions were noted in our data (speech delay: 20.5%, concentration problems: 15.1%, hyperactivity: 11.1%, ambulation difficulties: 8.8%, aggressiveness: 8%, vision problems: 6.3%, epileptic seizures: 4%). The consanguinity rate was 26.9 percent.

Conclusion: ID associated with genetic causes was significantly correlated with the consanguinity rate in the Moroccan population.

目的:智障(Intellectual Disability,ID)被认为是人类最常见的疾病之一,其特点是在认知、功能和适应能力方面存在严重缺陷。本研究旨在描述生活在丹吉尔-特图安地区的一组摩洛哥智障人士的人口统计学和临床特征:这是一项回顾性和描述性的探索性单中心研究,研究时间为 2020 年 11 月至 2023 年 8 月。共纳入 109 名智障患者。这些患者均来自丹吉尔-特图安地区的四家精神健康中心。我们使用 IBM SPSS 26 版本对数据进行了处理和分析:在我们的系列研究中发现,ID 患者中男性居多(男性占 54.4%,女性占 42.6%)。男女比例为 1.34。患者的平均年龄为(11.75±4.87)岁,标准差(SD)为 1 至 35 岁。智障子女出生时,母亲和父亲的平均年龄分别为 28.36 岁和 35.6 岁。在我们的数据中发现了许多并发症(语言发育迟缓:20.5%;注意力不集中:15.1%;多动:11.1%;行走困难:8.8%;攻击性:8.8%):8.8%、攻击性:8%、视力问题:6.3%、癫痫发作:4%):4%).近亲结婚率为 26.9%:结论:在摩洛哥人口中,与遗传原因相关的智障与近亲结婚率密切相关。
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引用次数: 0
Neuropsychological Functioning Among Patients with OCD in Asian Countries: A Systematic Review. 亚洲国家强迫症患者的神经心理功能:系统回顾
Q3 Medicine Pub Date : 2024-09-01 eCollection Date: 2024-07-01
Uzma Ilyas, Sabeela Saher, Ayesha Ahmad Khan, Anam Shahid, Zarmeen Tariq

Objective: This systematic review aimed to identify the effect of obsessive compulsive disorder (OCD) on cognitive processes, such as memory, executive functioning, and cognitive flexibility, among the adult populations of Asian countries.

Methods: The systematic review progressed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It is comprised of articles sourced from Asian countries published from 2018 to 2022, and literature about deficits in memory, executive functioning, and cognitive flexibility in the OCD population was gathered from five electronic databases, including Google Scholar, PubMed, Research Gate, Science Direct, and Wiley Online Library. Full-text impact factor articles in the English language were considered in this study.

Results: This study screened 44 articles; five were included based on the eligibility criteria for the present systematic review. Four articles found cognitive deficits in the domains of executive functioning, memory, and cognitive flexibility among patients with OCD, whereas results of one article showed normal cognitive performance of the patients. Demographic variables showed no significant differences between patients with OCD and healthy controls.

Conclusion: This systematic review indicated deficits specifically in the cognitive functioning and flexibility of patients with OCD. Despite a noticeable prevalence of OCD in Asian countries, the literature on correlates and neurological functioning is scarce. Further studies are required to examine the effects on the larger population and provide knowledge in those countries and areas where people are suffering because of minimal knowledge regarding OCD.

目的:本系统综述旨在确定强迫症对亚洲国家成年人的认知过程(如记忆、执行功能和认知灵活性)的影响:本系统综述旨在确定强迫症(OCD)对亚洲国家成年人的记忆、执行功能和认知灵活性等认知过程的影响:本系统综述根据系统综述和元分析首选报告项目(PRISMA)指南进行。它由2018年至2022年发表的来自亚洲国家的文章组成,从谷歌学术、PubMed、Research Gate、Science Direct和Wiley Online Library等五个电子数据库中收集了有关强迫症人群记忆力、执行功能和认知灵活性缺陷的文献。本研究考虑的是具有影响因子的英文全文:本研究筛选了 44 篇文章,根据本系统综述的资格标准,有 5 篇文章被纳入其中。四篇文章发现强迫症患者在执行功能、记忆力和认知灵活性方面存在认知缺陷,而一篇文章的结果显示患者的认知表现正常。人口统计学变量显示,强迫症患者与健康对照组之间没有明显差异:本系统综述表明,强迫症患者在认知功能和灵活性方面存在缺陷。尽管强迫症在亚洲国家的发病率很高,但有关其相关因素和神经功能的文献却很少。我们需要进一步研究强迫症对更多人群的影响,并为那些因对强迫症知之甚少而饱受折磨的国家和地区提供相关知识。
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引用次数: 0
Response to "ChatGPT and Transcranial Direct Current Stimulation for Chronic Pain". 回应 "ChatGPT 和经颅直流电刺激治疗慢性疼痛"。
Q3 Medicine Pub Date : 2024-06-01 eCollection Date: 2024-04-01
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
Responding to Commentary: Addressing Points Raised in the Correspondence About "ChatGPT and Transcranial Direct Current Stimulation for Chronic Pain". 回应评论:解决 "ChatGPT 和经颅直流电刺激治疗慢性疼痛 "通信中提出的问题。
Q3 Medicine Pub Date : 2024-06-01 eCollection Date: 2024-04-01
Edson Silva-Filho, Rodrigo Pegado
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引用次数: 0
The Impact of High-density Lipoprotein Cholesterol (HDL-C) Levels and Risk of Movement Disorders in Patients Taking Antipsychotics. 高密度脂蛋白胆固醇 (HDL-C) 水平与服用抗精神病药物患者运动障碍风险的影响。
Q3 Medicine Pub Date : 2024-06-01 eCollection Date: 2024-04-01
Carolyn O'Donnell, Tammie Lee Demler, Eileen Trigoboff, Claudia Lee

Introduction: Well-known adverse events of antipsychotics are movement disorders, or extrapyramidal symptoms, such as drug-induced parkinsonism and tardive dyskinesia.

Objective: With new evidence suggesting a link between low high-density lipoprotein cholesterol (HDL-C) and risk of Parkinson's disease, this study sought to investigate if that link also translated to patients taking antipsychotics with low HDL-C and an increased risk for developing a movement disorder.

Design: Adult patients (n=89) at an inpatient state psychiatric facility taking at least one antipsychotic with at least one HDL-C level were assessed for signs of a movement disorder through their history and physical, progress notes, and Abnormal Involuntary Movement Scale (AIMS) score.

Results: There was no statistical significance when comparing a patient's movement disorder, AIMS scores, and HDL-C levels to suggest that the HDL-C level influenced a patient's movement disorder.

Conclusion: This study did not show a correlation between HDL-C levels and a patient's risk of developing a movement disorder while taking an antipsychotic.

简介:抗精神病药物的著名不良反应是运动障碍或锥体外系症状,如药物引起的帕金森病和迟发性运动障碍:众所周知,抗精神病药物的不良反应是运动障碍或锥体外系症状,如药物引起的帕金森病和迟发性运动障碍:有新证据表明,低高密度脂蛋白胆固醇(HDL-C)与帕金森病的患病风险存在联系,本研究试图调查这种联系是否也会导致服用抗精神病药物的患者因低HDL-C而增加患运动障碍的风险:通过病史和体格检查、病程记录以及异常不自主运动量表(AIMS)评分,评估州立精神病院住院患者(89 人)是否出现运动障碍症状:在比较患者的运动障碍、AIMS 评分和 HDL-C 水平时,没有统计学意义表明 HDL-C 水平会影响患者的运动障碍:结论:本研究并未显示高密度脂蛋白胆固醇水平与患者在服用抗精神病药物期间出现运动障碍的风险之间存在相关性。
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引用次数: 0
Response to "Clinical Outcome Assessment Instruments in Schizophrenia: A Scoping Literature Review with a Focus on the Potential of Patient-reported Outcomes". 对 "精神分裂症的临床结果评估工具:以患者报告结果的潜力为重点的范围界定文献综述"。
Q3 Medicine Pub Date : 2024-06-01 eCollection Date: 2024-04-01
Sílvia Zaragoza Domingo
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引用次数: 0
期刊
Innovations in clinical neuroscience
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