It is now well established that digoxin is an effective drug for the treatment of heart failure. Since treatment with angiotensin-converting enzyme (ACE) inhibitors reduces mortality in congestive heart failure, digoxin should be added to ACE inhibitors in patients with moderate or severe heart failure. The beneficial effects of digoxin may be due, in part, to its well-documented sympathoinhibitory effects that can avert the adverse effects of long-term excessive sympathetic adrenergic stimulation in heart failure.
{"title":"Congestive heart failure.","authors":"V. Jenkinson","doi":"10.32388/6t55d1","DOIUrl":"https://doi.org/10.32388/6t55d1","url":null,"abstract":"It is now well established that digoxin is an effective drug for the treatment of heart failure. Since treatment with angiotensin-converting enzyme (ACE) inhibitors reduces mortality in congestive heart failure, digoxin should be added to ACE inhibitors in patients with moderate or severe heart failure. The beneficial effects of digoxin may be due, in part, to its well-documented sympathoinhibitory effects that can avert the adverse effects of long-term excessive sympathetic adrenergic stimulation in heart failure.","PeriodicalId":74327,"journal":{"name":"Nursing times","volume":"58 1","pages":"1220-2"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41616498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01Epub Date: 2019-10-16DOI: 10.1016/j.bpsc.2019.09.010
Adam Hampshire, Ana Zadel, Stefano Sandrone, Eyal Soreq, Naomi Fineberg, Edward T Bullmore, Trevor W Robbins, Barbara J Sahakian, Samuel R Chamberlain
Background: Obsessive-compulsive disorder (OCD) is a prevalent neuropsychiatric condition, with biological models implicating disruption of cortically mediated inhibitory control pathways, ordinarily serving to regulate our environmental responses and habits. The aim of this study was to evaluate inhibition-related cortical dysconnectivity as a novel candidate vulnerability marker of OCD.
Methods: In total, 20 patients with OCD, 18 clinically asymptomatic first-degree relatives of patients with OCD, and 20 control participants took part in a neuroimaging study comprising a functional magnetic resonance imaging stop signal task. Brain activations during the contrasts of interest were cluster thresholded, and a three-dimensional watershed algorithm was used to decompose activation maps into discrete clusters. Functional connections between these key neural nodes were examined using a generalized psychophysiological interaction model.
Results: The three groups did not differ in terms of age, education level, gender, IQ, or behavioral task parameters. Patients with OCD exhibited hyperactivation of the bilateral occipital cortex during the task versus the other groups. Compared with control participants, patients with OCD and their relatives exhibited significantly reduced connectivity between neural nodes, including frontal cortical, middle occipital cortical, and cerebellar regions, during the stop signal task.
Conclusions: These findings indicate that hypoconnectivity between anterior and posterior cortical regions during inhibitory control represents a candidate vulnerability marker for OCD. Such vulnerability markers, if found to generalize, may be valuable to shed light on etiological processes contributing not only to OCD but also obsessive-compulsive-related disorders more widely.
{"title":"Inhibition-Related Cortical Hypoconnectivity as a Candidate Vulnerability Marker for Obsessive-Compulsive Disorder.","authors":"Adam Hampshire, Ana Zadel, Stefano Sandrone, Eyal Soreq, Naomi Fineberg, Edward T Bullmore, Trevor W Robbins, Barbara J Sahakian, Samuel R Chamberlain","doi":"10.1016/j.bpsc.2019.09.010","DOIUrl":"10.1016/j.bpsc.2019.09.010","url":null,"abstract":"<p><strong>Background: </strong>Obsessive-compulsive disorder (OCD) is a prevalent neuropsychiatric condition, with biological models implicating disruption of cortically mediated inhibitory control pathways, ordinarily serving to regulate our environmental responses and habits. The aim of this study was to evaluate inhibition-related cortical dysconnectivity as a novel candidate vulnerability marker of OCD.</p><p><strong>Methods: </strong>In total, 20 patients with OCD, 18 clinically asymptomatic first-degree relatives of patients with OCD, and 20 control participants took part in a neuroimaging study comprising a functional magnetic resonance imaging stop signal task. Brain activations during the contrasts of interest were cluster thresholded, and a three-dimensional watershed algorithm was used to decompose activation maps into discrete clusters. Functional connections between these key neural nodes were examined using a generalized psychophysiological interaction model.</p><p><strong>Results: </strong>The three groups did not differ in terms of age, education level, gender, IQ, or behavioral task parameters. Patients with OCD exhibited hyperactivation of the bilateral occipital cortex during the task versus the other groups. Compared with control participants, patients with OCD and their relatives exhibited significantly reduced connectivity between neural nodes, including frontal cortical, middle occipital cortical, and cerebellar regions, during the stop signal task.</p><p><strong>Conclusions: </strong>These findings indicate that hypoconnectivity between anterior and posterior cortical regions during inhibitory control represents a candidate vulnerability marker for OCD. Such vulnerability markers, if found to generalize, may be valuable to shed light on etiological processes contributing not only to OCD but also obsessive-compulsive-related disorders more widely.</p>","PeriodicalId":74327,"journal":{"name":"Nursing times","volume":"88 22 1","pages":"222-230"},"PeriodicalIF":5.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88965351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01DOI: 10.1093/med/9780198831426.003.0011
This chapter provides an outline of some of the specific issues that primary care teams see in general practice and aids the practitioner in recognizing some of the causes that may be related to an underlying musculoskeletal condition or side effects of treatment. Examination tips and red flags to guide the primary care teams are provided and the management of patients with co-morbidities and joint pain is also briefly discussed. Managing the frail and elderly and those with skin and continence issues are also a challenge in care and these topics are discussed in the context of musculoskeletal conditions. When referral is not required and yet there are practical issues that the patient would like help with, the chapter offers tips on what can be offered to the patient and signposting to supports such as the social and voluntary sector, exercises, and access to aids and devices. The use of telephone advice lines and support for the primary care teams are then covered with some patient scenarios for the primary care team to consider how they would manage such patients in their clinical setting.
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