Mullenborup1880

Cariprazine 1.5-3 mg/d consistently improved depressive symptoms in all patient subgroups without regard to differences in baseline demographic and clinical characteristics, suggesting broad efficacy across a spectrum of patients with bipolar I depression.Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived appearance flaw or flaws that are not observable to others. BDD is associated with distress and impairment of functioning. Psychiatric comorbidities, including depression, social anxiety, and obsessive-compulsive disorder are common and impact treatment. Treatment should encompass psychoeducation, particularly addressing the dangers associated with cosmetic procedures, and may require high doses of selective serotonin reuptake inhibitors* (SSRI*) and protracted periods to establish full benefit. If there is an inadequate response to SSRIs, various adjunctive medications can be employed including atypical antipsychotics*, anxiolytics*, and the anticonvulsant levetiracetam*. However, large-scale randomized controlled trials are lacking and BDD is not an approved indication for these medications. Oxytocin* may have a potential role in treating BDD, but this requires further exploration. Cognitive-behavioural therapy has good evidence for efficacy for BDD, and on-line and telephone-assisted forms of therapy are showing promise. CBT for BDD should be customized to address such issues as mirror use, perturbations of gaze, and misinterpretation of others' emotions, as well as overvalued ideas about how others view the individual.Lurasidone, an atypical antipsychotic, is currently approved for treatment of schizophrenia and bipolar depression. Little is known about whether lurasidone might also cause pedal edema. A 55-year-old female patient had been diagnosed with bipolar I disorder from the age of 26. She had been prescribed escitalopram and quetiapine 300 mg/day for her persistent depressive mood. Later, she took lurasidone plus escitalopram to treat depressive episode. Consequently, she developed mild bilateral swelling over the lower legs and ankles. After lurasidone was discontinued, the bilateral pedal edema was completely resolved, and no further recurrence of edema occurred. Resolution of the edema after discontinuation of lurasidone indicates that the edema may have been caused by lurasidone. Caution should be needed when prescribing lurasidone for patients, as pedal edema may affect patients' adherence to the prescription.

A joint infectious disease-podiatry clinic (JIDPC) in which an infectious diseases physician and a podiatrist see patients with diabetic foot infections together once a week was initiated in January 2017. This study was designed to investigate if the JIDPC can improve patient adherence and reduce recurrent infections.

A retrospective analysis of patients with diabetic foot infection admitted to Wheeling Hospital from March 2013 to December 2018 was performed. Initially, the patients were followed by infectious diseases and podiatry in their clinics separately (preintervention group). Beginning January 2017, they were followed together at the JIDPC (postintervention group). Recurrent infection, mortality, and loss to follow-up were compared using logistic regression models.

Surgeries were performed in 52.5% of preintervention group participants (n = 99) and 81.9% of postintervention group participants (n = 55; P < .001). The preintervention group was more likely to be lost to follow-up (30.3% vs 9.1%; odds ratio [OR], 4.35 [confidence interval (CI), 1.58-11.99]), but the association was attenuated with further adjustment for surgery (OR 3.35 [CI, 1.17-9.62]). The risk of infection recurrence in 6 months was significantly higher in the preintervention group (36.1% vs 20.8%; OR, 2.16 [CI, 0.99-4.71]), but with further adjustment for surgery, this was not significant (P = .067; OR, 2.17 [CI, 0.95-4.94]). Mortality and 90-day readmission were not significantly different.

Implementation of JIDPCs may decrease the incidence of recurrent infections among patients with diabetic foot infections.

Implementation of JIDPCs may decrease the incidence of recurrent infections among patients with diabetic foot infections.

The aim of this study was to understand the associations between hypertensive disorders of pregnancy (HDP) and postpartum complications throughout the newly defined 12-week postpartum transition.

We conducted a retrospective cohort study of the associations of HDP (any/subtype) with postpartum complications among 2.5 million California births, 2008-2012. We identified complications from discharge diagnoses from maternal hospital encounters (emergency department visits and readmissions) in the 12 weeks after giving birth. We compared rates of complications, overall and by diagnostic category, between groups defined by HDP. In survival analyses, we calculated the adjusted hazard ratios of postpartum complications associated with HDP. We adjusted for maternal age, race/ethnicity, prepregnancy obesity, chronic diabetes, gestational diabetes, insurance, delivery mode, gestational age and birth outcome (term and size).

Among women with and without HDP, 12.8 and 7.7%, respectively, had a hospital encounter witcluding those not related to hypertension, and may benefit from enhanced and comprehensive postpartum care.

The model of end-stage liver disease (MELD) score has been shown to predict 3-month prognosis following transjugular intrahepatic portosystemic stent shunt (TIPS) in liver cirrhosis; however, that score was derived from a mixed cohort, including patients with refractory ascites and variceal bleeding. This study re-evaluates the role of the MELD score and focuses on differences between both groups of patients.

A total of 301 patients (192 male and 109 female) received TIPS, 213 because of refractory ascites and 88 because of variceal bleeding. Univariate and multivariate Cox analyses were performed to identify predictors of mortality and area under the receiver operator characteristics (AUROC) were used to assess the prognostic capacity of the MELD score and of the results of predictors of the multivariate analyses.

In refractory ascites, age, bilirubin and albumin were independent predictors of mortality. In variceal bleeding, emergency TIPS during ongoing bleeding, concomitant grade III ascites, historlyses and AUROC calculations corroborate the impact of different prognostic variables in patients undergoing TIPS for ascites and variceal bleeding.

Texture analysis (TA) can quantify intra-tumor heterogeneity using standard medical images. The present study aimed to assess the application of positron emission tomography (PET) TA in the differential diagnosis of gastric cancer and gastric lymphoma.

The pre-treatment PET images of 79 patients (45 gastric cancer, 34 gastric lymphoma) between January 2013 and February 2018 were retrospectively reviewed. Standard uptake values (SUVs), first-order texture features, and second-order texture features of the grey-level co-occurrence matrix (GLCM) were analyzed. The differences in features among different groups were analyzed by the two-way Mann-Whitney test, and receiver operating characteristic (ROC) analysis was used to estimate the diagnostic efficacy.

InertiaGLCM was significantly lower in gastric cancer than that in gastric lymphoma (4975.61 vs. 11,425.30, z = -3.238, P = 0.001), and it was found to be the most discriminating texture feature in differentiating gastric lymphoma and gastric cancer. The a fluorodeoxyglucose uptake.

InertiaGLCM and entropyGLCM were the most discriminating features in differentiating gastric lymphoma from gastric cancer and low-grade gastric lymphoma from gastric cancer, respectively. PET TA can improve the differential diagnosis of gastric neoplasms, especially in tumors with similar degrees of fluorodeoxyglucose uptake.

This study explored evidence-based testing practices of nurse faculty teaching in baccalaureate programs.

Faculty-developed examinations are important for determining progression in nursing programs. Little is known about faculty who implement such practices most often.

A causal comparative study with a convenience sample of 177 was used to answer the research question. Participants were grouped according to level of teaching experience based on Benner's novice to expert theory. COTI-2 molecular weight Individual/group means were calculated for the best practices in test development survey; one-way analysis of variance was used to identify significant differences between groups.

Expert faculty had higher overall mean scores than the other four groups, with significantly higher scores than both the advanced beginner (p = .007) and proficient (p = .020) groups.

Faculty with more experience seem to implement evidence-based testing practices most often. This information can be used to guide faculty development and peer-mentoring initiatives within nursing programs.

Faculty with more experience seem to implement evidence-based testing practices most often. This information can be used to guide faculty development and peer-mentoring initiatives within nursing programs.

To identify the available published primary research and any relevant policies, guidelines, or protocols regarding how care home staff recognize and respond to an acutely deteriorating resident.

Older people living in care homes have complex health care needs. Chronic illnesses, comorbidities, frailty, cognitive impairment, and physical dependency can contribute to unpredictable changes in their health status that can lead to residents becoming unwell and acutely deteriorating. Exploring how care home staff recognize and respond to acutely deteriorating health among residents is important to understand whether opportunities exist to minimize these unpredictable changes in health.

This scoping review will consider studies that feature the recognition and response to acute deterioration in care home residents. This review will consider qualitative and quantitative primary research. Non-indexed and gray literature such as policies, deterioration tools, and reports from health policy organizations will also of the JBI data extraction form will be used to extrapolate data from included studies. The results will be presented in tabular form, accompanied by a narrative summary related to the objectives of the scoping review.

To determine the effectiveness of educational programs using Diabetes Conversation Map™ on health outcomes of people with type 2 diabetes.

Diabetes Conversation Map™ has been used in the context of diabetes self-management education as a resource for managing type 2 diabetes. There is a need to determine the effectiveness of this non-pharmacological intervention on health outcomes.

This review will consider studies that focus on adults with type 2 diabetes, aged ≥18 years, in any context that implemented educational programs using Diabetes Conversation Map™. The following outcomes will be explored self-care, diabetes knowledge, empowerment, diabetes distress and quality of life, glycated hemoglobin, blood pressure, and body mass index as assessed by any validated instrument.

This systematic review will be conducted in accordance with JBI methodology for systematic reviews of effectiveness. Any published and unpublished sources of information in English, Spanish, and Portuguese will be considered, with no geographical or cultural limitations.