Hurstcurran1531

Migraine headaches remain a significant medical concern; lots of people are adversely affected. Many existing pharmacotherapies have disappointing results. The pathophysiology is related to calcitonin gene-related peptide (CGRP) pathways. There is hope for better efficacy from the now-available CGRP inhibitor drugs made available to patients suffering these cephalgias.Objective This paper sought to identify the instruments used to measure depression in heart failure (HF) and elucidate the impact of treatment interventions on depression in HF. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. Studies published from 1988 to 2018 covering depression and HF were identified through the review of the PubMed and PsycINFO databases using the keywords "depres*" AND "heart failure." Two authors independently conducted a focused analysis, identifying 27 studies that met the specific selection criteria and passed the study quality checks. Results Patient-reported questionnaires were more commonly adopted than clinician-rated questionnaires, including the Beck Depression Inventory, the Patient Health Questionnaire (PHQ-9), and the Hospital Anxiety and Depression Scale. Six common interventions were observed antidepressant medications, collaborative care, psychotherapy, exercise, education, and other nonpharmacological interventions. Except for paroxetine, selective serotonin reuptake inhibitors failed to show a significant difference from placebo. However, the collaborative care model including the use of antidepressants showed a significant decrease in PHQ-9 score after one year. All of the psychotherapy studies included a variation of cognitive behavioral therapy and patients showed significant improvements. The evidence was mixed for exercise, education, and other nonpharmacological interventions. Conclusion This study suggests which types of interventions are more effective in addressing depression in heart failure patients.Psychiatry is one of the first medical specialties to move to the practice of telehealth. Social distancing in the time of COVID-19 has prompted many face-to-face practices, including psychotherapy, to transition to virtual formats. Patients and physicians may have reservations about the change in approach and may have concerns about privacy and the security of protected health information. By utilizing telepsychiatry, patients and psychiatrists can have increased access to one another, bringing a host of benefits and challenges along with it. Addressing these concerns is an important part of telepsychiatry in psychotherapy practice. Here, we discuss practical solutions to challenges clinicians might encounter when moving a psychotherapy practice to telehealth, such as privacy issues, health information security, and developing/maintain a therapeutic bond.Objective Current research validates the use of lithium as a first-line agent in bipolar disorder, yet it remains underutilized. This might, in part, be the result of lithium's risk of toxicity. A lower serum lithium concentration would decrease the risk of toxicity. This study examined whether lithium serum concentrations are associated with an additional medication burden resulting from psychiatric polypharmacy. Methods The retrospective data of adult inpatients receiving lithium who had at least one serum lithium concentration recorded were extracted from the computerized patient record system, bar code medication administration, and mental health automated health record system. Results 38 patient charts were reviewed and a total of 192 individual serum lithium concentrations were analyzed. There was no statistically significant difference (increase or decrease) in the number of psychiatric medications prescribed or the number of scheduled psychiatric medication doses administered. There was a statistically significant increase in the number of psychiatric medications prescribed over the Food and Drug Administration (FDA) recommended maximum daily dose (MDD) following a serum lithium concentration record. Individuals with a serum lithium concentration below 0.6mEq/L were more likely to be prescribed medications over the MDD. Conclusion Serum lithium concentrations did not increase or decrease the overall psychiatric pill burden. The number of psychiatric medications an individual is prescribed remained the same regardless of their serum lithium concentration. Overall pill burden did not change with the serum lithium concentration; however, lower serum lithium concentrations might necessitate prescribing of psychiatric medications in doses exceeding the MDD.Coronavirus-19 (COVID-19) is a novel severe acute respiratory syndrome (SARS), which is caused by coronavirus-2 (CoV-2). The World Health Organization has declared COVID-19 to be a global pandemic. Standard public health measures, such as "stay-at-home" orders, quarantine, social distancing, and community containment, are being used to manage the pandemic, and these measures are changing social relationships, including those between doctors and patients. The mental health effects of this confinement can include feelings of isolation and stress-related fear of contamination and death, and psychiatric and/or psychotherapeutic help using telehealth could be beneficial. In Italy, psychological telecounseling has been an effective method of supporting the physical and psychosocial needs of all patients, regardless of their geographical locations. In this commentary, the authors promote the use of telehealth as an effective means of treating patients with mental health issues.Background. Coronavirus infectious disease 2019 (COVID-19) has spread rapidly around the world and has been declared a pandemic by World Health Organization. Neurological manifestations are being reported in patients with COVID-19 but clinical guidelines and effective treatments remain unclear. Angiogenesis inhibitor Objective In this brief review, the authors examine the latest available evidence to date regarding the neurological implications of COVID-19 and how the novel coronavirus might possibly impact patients with pre-existing neurological conditions. COVID-19-specific recommendations from the American Academy of Neurology and and other neurologic disease-specific organizations are summarized. Results Current retrospective case series and cohort studies from Wuhan, China, are indicating that almost one-third of the patients with COVID-19 have shown neurological manifestations; older age and comorbid conditions are associated worsened outcomes. Abnormal laboratory findings are being reported in acute cases of patients with COVID-19.