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  • August 11, 2014
  • 11:42 AM
  • 662 views

Clinical Drug Trials for Pathological Gambling

by William Yates, M.D. in Brain Posts

Several drug classes hold promise for reduction in pathological gambling behavior.However, there are very few published randomized and controlled clinical drug trials in gambling subjects.Searching clinical trials and gambling on PubMed yields only one small open-label proof of concept trial for the drug tolcapone within the last year.This study found evidence that this COMT inhibitor drug reduced gambling symptoms and was accompanied by fronto-parietal activation on fMRI imaging.However, on sea........ Read more »

Grant JE, Odlaug BL, Chamberlain SR, Hampshire A, Schreiber LR, & Kim SW. (2013) A proof of concept study of tolcapone for pathological gambling: relationships with COMT genotype and brain activation. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 23(11), 1587-96. PMID: 23953269  

  • August 6, 2014
  • 12:01 PM
  • 1,241 views

Brain Striatum and Loss-Chasing in Gambling

by William Yates, M.D. in Brain Posts

Pathological gambling (PG) is a pattern of gambling characterized by loss of control and large gambling debts.The near-miss phenomenon in gambling is the gaming scenario where gamblers sense they were very close to winning.This near-miss phenomenon can be programmed into slot machines. For example, a gambler might be presented frequently with four cherries when five cherries would result in a huge payout.The response to the near-miss in PG is often a sense that a big win is just around the corne........ Read more »

  • August 5, 2014
  • 11:00 PM
  • 1,198 views

What is the Best Way to Manage Cardiac Arrest According to the Evidence?

by Rogue Medic in Rogue Medic

There is an excellent review article by Dr. Bentley Bobrow and Dr. Gordon Ewy on the best management of sudden cardiac arrest from the bystander to the ICU (Intensive Care Unit).

They point out something that we tend to resist learning. Cardiac arrest that is not due to respiratory causes does not need respiratory treatment. A person who is unresponsive and gasping is exhibiting signs of cardiac arrest, not signs of respiratory problems.... Read more »

  • August 4, 2014
  • 07:29 AM
  • 1,326 views

Interview: Battling HIV-treatment With Computer Simulation

by Pieter Carriere in United Academics

Prof. Mancini computationally models HIV and other viruses’ dynamics and explains its clinical relevance.... Read more »

  • August 3, 2014
  • 05:00 PM
  • 1,471 views

Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest

by Rogue Medic in Rogue Medic

This study is interesting for several reasons.

In a system that claims excellence, the most consistent way to identify the study group is by documentation of a protocol violation - but it is not intended as a study of protocol violations.

This may hint at some benefit from epinephrine (Adrenaline in Commonwealth countries), but that would require some study and we just don't study epinephrine. We only make excuses for not studying epinephrine.

The atropine results suggest that the ........ Read more »

  • July 31, 2014
  • 11:35 PM
  • 1,145 views

Fall With Dementia and No Change from Baseline Mental Status

by Rogue Medic in Rogue Medic

This happens many times every day. A patient falls and may have hit her head, but there is no change from her normal mental status. To complicate matter, she takes an anticoagulant.

There are no clear signs of serious trauma. so should we automatically go to the trauma center?

What can help us decide?... Read more »

  • July 30, 2014
  • 11:24 AM
  • 1,019 views

Violent Death Rates Increased After Traumatic Brain Injury

by William Yates, M.D. in Brain Posts

Anecdotal reports have linked traumatic brain injury with later violent death including death by suicide.Few large epidemiological studies have been published on this association.However, a recent Swedish population study published in JAMA Psychiatry provides valuable insight into this issue.Seena Fazel and colleagues from the University of Oxford, University College London and the Karolinksa Institute examined a large database of over 200,000 patients with TBI.Cases of TBI were identified from ........ Read more »

  • July 29, 2014
  • 11:17 AM
  • 863 views

Treating Sleep Problems Following Traumatic Brain Injury

by William Yates, M.D. in Brain Posts

Sleep problems are common following traumatic brain injury (TBI).In a previous post, I reviewed a study of the risk factors for sleep disorders following TBI.The most severe TBI is a risk factor for hypersomnia. Anxiety and depression following TBI increase risk for insomnia complaints.Few large studies of treatment for sleep problems after TBI exist. However, a recent manuscript outlined the potential benefit of treatment of sleep disorders in a series of 12 subjects.Catherine Wiseman-Hake........ Read more »

  • July 28, 2014
  • 03:10 PM
  • 1,344 views

This Month In Blastocystis Research (JUL 2014)

by Christen Rune Stensvold in Blastocystis Parasite Blog

A new study from Colombia sees Blastocystis as a quasi-ubiquitous organism.... Read more »

  • July 25, 2014
  • 11:02 AM
  • 769 views

Risk Factors For Sleep Disturbance After Traumatic Brain Injury

by William Yates, M.D. in Brain Posts

Sleep disturbance following traumatic brain injury (TBI) is a common clinical challenge.Hypersomnia and insomnia can both been seen in the TBI population.The risk factors related to TBI-related sleep disturbance are not well known. Identification of risk factors can provide insight into clinical assessment and management.Lijun Hou and colleagues recently examined risk factors related to subjective sleep complaints in a series of 98 TBI subjects.The study sample include adults admitted to a ........ Read more »

  • July 22, 2014
  • 07:04 PM
  • 804 views

Over the counter drug addiction

by DJMac in Recovery Review

In many countries around the world, codeine is available only on prescription. It’s a weak opioid, but can still cause addiction. Low dose codeine is also available in the UK, over-the-counter (OTC) in pharmacies. It’s sold in combination with paracetamol (co-codamol, e.g. Solpadol), in combination with ibuprofen (e.g. Nurofen Plus), and in combination with dihydrocodeine (co-dydramol, e.g. [...]
The post Over the counter drug addiction appeared first on Recovery Review.
... Read more »

  • July 22, 2014
  • 01:48 PM
  • 1,616 views

Fasting Improves Recovery of Bone Marrow Stem Cells after Chemotherapy

by Jalees Rehman in The Next Regeneration

Fasting is defined as either completely abstaining from or minimizing food intake for a defined period time - ranging from about 12 hours to even a few weeks. Calorie restriction, on the other hand, refers to an overall reduction in the daily calorie intake by about 20%-40% without necessarily reducing the meal intake frequency. Although calorie restriction is well-suited for weight loss and thus also reduces the risk of chronic diseases such as diabetes or heart disease, proponents of fasting c........ Read more »

  • July 14, 2014
  • 10:44 AM
  • 687 views

Cognitive Reserve Boosts Traumatic Brain Injury Recovery

by William Yates, M.D. in Brain Posts

Cognitive reserve (high educational attainment, high IQ) is known to reduce or delay the risk for Alzheimer's disease.However, the effect of cognitive reserve on recovery from traumatic brain injury (TBI) is less well studied.Two recent research studies support the beneficial effects of cognitive reserve on TBI.Schneider and colleagues examined a series of 769 adult TBI subjects using the TBI Model Systems Database.This cohort was followed during rehabilitation for a period of at least one year......... Read more »

Schneider EB, Sur S, Raymont V, Duckworth J, Kowalski RG, Efron DT, Hui X, Selvarajah S, Hambridge HL, & Stevens RD. (2014) Functional recovery after moderate/severe traumatic brain injury: a role for cognitive reserve?. Neurology, 82(18), 1636-42. PMID: 24759845  

  • July 12, 2014
  • 07:02 PM
  • 1,008 views

Legal highs – not for human consumption

by DJMac in Recovery Review

Legal highs in Lothian The UK has the largest market for new psychoactive substances (NSP or “legal highs”) in Europe. Scotland is no stranger to them and, as a seminar in Edinburgh heard last week, the Lothian area is seeing a surge in demand, some worrying trends in injecting and significant new presentations due to problems [...]
The post Legal highs – not for human consumption appeared first on Recovery Review.
... Read more »

  • July 9, 2014
  • 12:06 PM
  • 1,109 views

Brain Hippocampus Atrophy in Traumatic Brain Injury

by William Yates, M.D. in Brain Posts

Understanding the specific brain regions vulnerable to traumatic brain injury (TBI) is important for assessment and intervention research.Two areas of active research include studies of brain white matter using diffusion tensor imaging and assessment of regional brain atrophy using magnetic resonance imaging (MRI).Two recent MRI studies have suggested the brain hippocampus may be a region of vulnerability to TBI.A Canadian study by Robin Green and colleagues used brain MRI to examine a cohort of........ Read more »

Green RE, Colella B, Maller JJ, Bayley M, Glazer J, & Mikulis DJ. (2014) Scale and pattern of atrophy in the chronic stages of moderate-severe TBI. Frontiers in human neuroscience, 67. PMID: 24744712  

Singh R, Meier TB, Kuplicki R, Savitz J, Mukai I, Cavanagh L, Allen T, Teague TK, Nerio C, Polanski D.... (2014) Relationship of collegiate football experience and concussion with hippocampal volume and cognitive outcomes. JAMA : the journal of the American Medical Association, 311(18), 1883-8. PMID: 24825643  

  • July 8, 2014
  • 11:15 AM
  • 929 views

Millions Lack Level I Trauma Care Access in the U.S.

by William Yates, M.D. in Brain Posts

Trauma results in 180,000 deaths per year in the U.S. and disproportionately affects children and young adults. The Centers for Disease Control (CDC) recently published a review highlighting unintentional injury and violence as the leading cause of death in the U.S. for those in the one to 30 year old age group. Additionally, trauma produces significant disability through residual effects such as like that often seen following traumatic brain injury.Trauma centers are hospital-affiliat........ Read more »

Haegerich, T., Dahlberg, L., Simon, T., Baldwin, G., Sleet, D., Greenspan, A., & Degutis, L. (2014) Prevention of injury and violence in the USA. The Lancet, 384(9937), 64-74. DOI: 10.1016/S0140-6736(14)60074-X  

Garwe T, Cowan LD, Neas B, Cathey T, Danford BC, & Greenawalt P. (2010) Survival benefit of transfer to tertiary trauma centers for major trauma patients initially presenting to nontertiary trauma centers. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 17(11), 1223-32. PMID: 21175521  

Bukur M, Felder SI, Singer MB, Ley EJ, Malinoski DJ, Margulies DR, & Salim A. (2013) Trauma center level impacts survival for cirrhotic trauma patients. The journal of trauma and acute care surgery, 74(4), 1133-7. PMID: 23511156  

MacKenzie, E., Weir, S., Rivara, F., Jurkovich, G., Nathens, A., Wang, W., Scharfstein, D., & Salkever, D. (2010) The Value of Trauma Center Care. The Journal of Trauma: Injury, Infection, and Critical Care, 69(1), 1-10. DOI: 10.1097/TA.0b013e3181e03a21  

  • July 7, 2014
  • 11:05 AM
  • 1,225 views

Florida Clampdown on Pain Pills Lowers Drug-Related Mortality

by Pranab Chatterjee in Scepticemia

Ever since I started working with the homeless youth of Delhi, I have noticed their drug and substance dependence issues and how, despite knowing the ill-effects, they have not been able to get out from under the chemical spell. Thus, when I came across a short report in the CDC’s Morbidity and Mortality Weekly Reports that Florida…... Read more »

Johnson H, Paulozzi L, Porucznik C, Mack K, Herter B, & Hal Johnson Consulting and Division of Disease Control and Health Promotion, Florida Department of Health. (2014) Decline in drug overdose deaths after state policy changes - Florida, 2010-2012. MMWR. Morbidity and mortality weekly report, 63(26), 569-74. PMID: 24990490  

  • July 7, 2014
  • 10:50 AM
  • 833 views

The Geography of Traumatic Brain Injury Death in U.S.

by William Yates, M.D. in Brain Posts

In the last post, I examined some recent research in the epidemiology of traumatic brain injury (TBI).Two studies showed the top two causes of TBI to be motor vehicle crashes and falls.In this post, I will review some recent data on the geographic variability of TBI in the United States.The Centers for Disease Control provides an online tool called WISQARS that allows users to search for a variety of statistics related to unintentional injury by state in the U.S.They have recently added a iPad a........ Read more »

Centers for Disease Control and Prevention (CDC). (2013) CDC grand rounds: reducing severe traumatic brain injury in the United States. MMWR. Morbidity and mortality weekly report, 62(27), 549-52. PMID: 23842444  

  • July 7, 2014
  • 10:33 AM
  • 1,536 views

MERS CoV: Can it spread from camels to man?

by Pranab Chatterjee in Scepticemia

The Middle Eastern Respiratory Syndrome coronavirus (MERS CoV) is a novel single stranded RNA virus that has been doing the rounds in the Middle East, bits of Europe and North America. Given our experiences the last time we had a new respiratory virus (remember the pandemic?), things have moved rather fast this time once the…... Read more »

Azhar, E., El-Kafrawy, S., Farraj, S., Hassan, A., Al-Saeed, M., Hashem, A., & Madani, T. (2014) Evidence for Camel-to-Human Transmission of MERS Coronavirus. New England Journal of Medicine, 370(26), 2499-2505. DOI: 10.1056/NEJMoa1401505  

  • July 3, 2014
  • 11:50 AM
  • 633 views

Epidemiology of Traumatic Brain Injury (TBI)

by William Yates, M.D. in Brain Posts

Traumatic brain injury (TBI) contributes significantly to mortality and long-term disability.In the U.S. there are an estimated 52,000 deaths yearly due to TBI with over 1,000,000 emergency room (ER) visits.Understanding the epidemiology of TBI can provides clues to designing prevention programs.Four relevant recent research studies provide insight about the epidemiology of TBI.TBI in hospitalized patients in Scotland Tara Shivaji and colleagues in Scotland examined the prevalence and patte........ Read more »

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