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  • June 29, 2014
  • 11:55 PM
  • 1,106 views

Safety of Intranasal Fentanyl in the Out-of-Hospital Setting - A Prospective Observational Study

by Rogue Medic in Rogue Medic

I have been very critical of plans to have first responders treat people they suspect of having a heroin (or other) opioid overdose with naloxone.

Would first responders be safer with fentanyl?

It is not really the same question, but it does highlight the differences and why I think fentanyl is safer. The patient will be seen by someone more likely to recognize when the treatment is inappropriate. This study looked at IN (IntraNasal) fentanyl given by basic EMTs prior to transport to the E........ Read more »

  • June 29, 2014
  • 11:18 AM
  • 896 views

Evidence based medicine – holding things back?

by DJMac in Recovery Review

A drugs worker told me a few years back that he would never refer a patient to a recovery service on the basis that he would not be following the evidence base. I did ask him at the time ‘but what if that’s not what the client wants?’ It seemed the evidence base came first. [...]
The post Evidence based medicine – holding things back? appeared first on Recovery Review.
... Read more »

Greenhalgh T, Howick J, Maskrey N, & Evidence Based Medicine Renaissance Group. (2014) Evidence based medicine: a movement in crisis?. BMJ (Clinical research ed.). PMID: 24927763  

  • June 24, 2014
  • 12:22 PM
  • 584 views

E-cigarettes and Smoking Cessation

by William Yates, M.D. in Brain Posts

Electronic or e-cigarettes are a tobacco cigarette alternative that is growing in popularity.Proponents of e-cigarettes note the product contains no carbon monoxide, tar or other tobacco residue. The inhaled vapor in e-cigarettes is primarily nicotine.Additionally, some proponents of e-cigarettes declare the product is associated with reduction or cessation of tobacco-based cigarette use.Unfortunately, this is an area where public health trends come before scientific research data is collected. ........ Read more »

Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. The Lancet, 382(9905), 1629-1637. DOI: 10.1016/S0140-6736(13)61842-5  

  • June 23, 2014
  • 10:52 AM
  • 619 views

Varenicline for Smoking Cessation

by William Yates, M.D. in Brain Posts

Varenicline is a drug designed to assist smokers in cessation. It is marketed in the U.S. as Chantix.Varenicline is one of the first drugs to target the nicotine receptor. It is classified as a partial agonist, meaning it stimulates the nicotine receptor but to a weaker effect than nicotine itself.The mechanism of action of varenicline differs from that of another smoking cessation drug bupropion marked under trade name Zyban in the U.S.One concern with varenicline is the risk for psychiatric ad........ Read more »

  • June 21, 2014
  • 07:45 AM
  • 1,512 views

West Nile Virus and Polio-like Syndromes: An Emerging Threat

by Pranab Chatterjee in Scepticemia

While the whole nation has been gripped by a media-induced frenzy about the fatal effects of the so-called “litchi virus” (do not get me started on this! This issue deserves a whole post of its own!), another virus-related news has quietly slipped beneath the radars of the cumulative hysteria. This article in the Times of India […]... Read more »

  • June 20, 2014
  • 12:07 PM
  • 667 views

Maternal Smoking and Child Conduct Disorder Risk

by William Yates, M.D. in Brain Posts

Conduct disorder is a serious behavioral disorder of childhood characterized by aggression, destruction of property, lying, theft and violation of rules.A significant number of children with conduct disorder go on to adult antisocial personality disorder.Conduct disorder is known to have genetic as well as environmental risk factors.Darya Gaysina from the United Kingdom and colleagues recently published a review of maternal smoking during pregnancy and offspring conduct problems.This review exam........ Read more »

  • June 19, 2014
  • 11:20 AM
  • 724 views

Smoking and Abnormal Brain Pleasure Response

by William Yates, M.D. in Brain Posts

Smoking cessation in those with nicotine dependence is one of the most difficult challenges for patients and their clinicians.Research targeting the neurobiology of smoking cessation provides hope for designing more effective treatments for nicotine dependence.Takeshi Isomura along with colleagues in the U.S. and Japan recently summarized recent findings in the brain pleasure response in nicotine dependence.The brain ventral striatum region is known to be key in nearly all sensations of pleasure........ Read more »

Peters J, Bromberg U, Schneider S, Brassen S, Menz M, Banaschewski T, Conrod PJ, Flor H, Gallinat J, Garavan H.... (2011) Lower ventral striatal activation during reward anticipation in adolescent smokers. The American journal of psychiatry, 168(5), 540-9. PMID: 21362742  

  • June 18, 2014
  • 11:22 PM
  • 913 views

Cancer Vaccine

by Viputheshwar Sitaraman in Draw Science

Finally, a possible vaccine for cancer. [Infographic]... Read more »

Yukai He,, Yuan Hong,, Yibing Peng,, Lisa Butterfield,, Sheng Guo,, David Bartlett,, David Munn1,, Jose Guevara-Patino,, Junfeng Pang,, & Nahid Mivechi,. (2014) Engineering AFP and GPC3 to create highly immunogenic gene vaccines to prevent carcinogen-induced murine autochthonous hepatocellular carcinoma. The Journal of Immunology, 192(1). info:/

  • June 10, 2014
  • 10:54 AM
  • 978 views

Smoking During Pregnancy and Fetal Growth

by William Yates, M.D. in Brain Posts

Smoking cigarettes during pregnancy is linked to a variety of adverse effects including increased perinatal mortality, gestational bleeding and placenta abruptio and placenta previa.Newborns of smoking mothers weigh less than newborns of nonsmoking mothers.The specific distribution of target organ growth impairment with maternal smoking is less well studied.Devasuda Anblagan and colleagues in the United Kingdom and Canada recently published a study of fetal organ growth in smoking mothers.Using ........ Read more »

Anblagan D, Jones NW, Costigan C, Parker AJ, Allcock K, Aleong R, Coyne LH, Deshpande R, Raine-Fenning N, Bugg G.... (2013) Maternal smoking during pregnancy and fetal organ growth: a magnetic resonance imaging study. PloS one, 8(7). PMID: 23843995  

  • June 9, 2014
  • 11:04 AM
  • 1,168 views

Smoking Linked to Brain White Matter Dysfunction

by William Yates, M.D. in Brain Posts

Tobacco smoking and nicotine dependence produce harmful effects on the brain.Some of these effects are related to direct effects on vascular health. Vascular changes seen with smoking are known to contribute to increased risk for stroke and dementia.Advances in brain imaging techniques allow for more direct study on smoking's effect on specific brain structures.Diffusion tensor imaging (DTI) is a relatively recent imaging tool allowing for study of brain white matter function.Brain white matter ........ Read more »

Umene-Nakano W, Yoshimura R, Kakeda S, Watanabe K, Hayashi K, Nishimura J, Takahashi H, Moriya J, Ide S, Ueda I.... (2014) Abnormal white matter integrity in the corpus callosum among smokers: tract-based spatial statistics. PloS one, 9(2). PMID: 24516568  

  • June 4, 2014
  • 10:12 AM
  • 905 views

Types of Mathematics Learning Disorders

by William Yates, M.D. in Brain Posts

Learning mathematics is a complex process that forms a key element in modern education.Significant mathematics learning difficulties emerge in 5 to 10 per cent of all elementary and secondary education students.Struggling to acquire skills in mathematics is more than a single deficit and appears to involve multiple cognitive skills.Giannis Karagiannakis and colleagures recently summarized what is known about mathematics learning disorders and proposed four subtypes. I will summarize these subtyp........ Read more »

Karagiannakis G, Baccaglini-Frank A, & Papadatos Y. (2014) Mathematical learning difficulties subtypes classification. Frontiers in human neuroscience, 57. PMID: 24574997  

  • June 3, 2014
  • 11:14 AM
  • 817 views

Executive Cognition in Autism Sprectrum Disorder

by William Yates, M.D. in Brain Posts

Executive functions (EF) of the brain are processes used to make complex decisions and plans.Deficits in EF can produce significant impairment in the ability to successfully many daily life challenges.EF are felt to be primarily a reflection of workings of the frontal lobe although additional brain regions contribute this cognitive skill.Simonetta Panerai and colleagues from Italy recently examined the key components of EF in a group of children with autism sprectrum disorder (ASD). They adminis........ Read more »

  • June 3, 2014
  • 09:56 AM
  • 879 views

Gene Scissors

by Viputheshwar Sitaraman in Draw Science

Gene scissors allow scientists to cut out any gene: a dream for gene therapy! [Infographic]... Read more »

  • June 2, 2014
  • 11:52 AM
  • 913 views

Brain Resting Connectivity Deficits in Autism

by William Yates, M.D. in Brain Posts

Resting connectivity is a measure of brain circuitry obtained by functional magnetic resonance imaging (fMRI).This technique is relatively new but there is emerging evidence of the potential value in research and clinical assessment.Research in brain connectivity includes looking for distinct patterns in brain disorders compared to health controls.One such type of study in autism has been published by a group of Japanese researchers.Takashi Itahashi and colleagues recruited 46 adult subjects wit........ Read more »

Itahashi T, Yamada T, Watanabe H, Nakamura M, Jimbo D, Shioda S, Toriizuka K, Kato N, & Hashimoto R. (2014) Altered network topologies and hub organization in adults with autism: a resting-state FMRI study. PloS one, 9(4). PMID: 24714805  

  • June 2, 2014
  • 04:00 AM
  • 978 views

Moderate drinking or abstinence for alcoholics?

by DJMac in Recovery Review

There is evidence that treatment seekers favour abstinence when they come for help, but what does abstinence offer in terms of quality of life (QOL), compared to continued heavy drinking or moderate drinking? My own experience is that many dependent drinkers will first seek to try out controlled drinking. However some have already realised that [...]
The post Moderate drinking or abstinence for alcoholics? appeared first on Recovery Review.
... Read more »

Daeppen, J., Faouzi, M., Sanchez, N., Rahhali, N., Bineau, S., & Bertholet, N. (2014) Quality of Life Depends on the Drinking Pattern in Alcohol-Dependent Patients. Alcohol and Alcoholism. DOI: 10.1093/alcalc/agu027  

  • May 25, 2014
  • 06:00 PM
  • 1,144 views

Does Faster Epinephrine Administration Produce Better Outcomes from PEA-Asystole?

by Rogue Medic in Rogue Medic

If we are going to give epinephrine to patients with rhythms that are not shockable (PEA [Pulseless Electrical Activity] or Asystole), it appears that patients receiving epinephrine earlier have better outcomes than patients who receive epinephrine later in the hospital in the less acute care settings.

Does this mean that patients who receive epinephrine have better outcomes than patients who do not receive epinephrine?

We remain willfully ignorant of the answer to that question.
... Read more »

Bigham BL, Koprowicz K, Aufderheide TP, Davis DP, Donn S, Powell J, Suffoletto B, Nafziger S, Stouffer J, Idris A.... (2010) Delayed prehospital implementation of the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 14(3), 355-60. PMID: 20388032  

  • May 21, 2014
  • 01:04 PM
  • 819 views

Testing Boosts Memory: Brain Region Involvement

by William Yates, M.D. in Brain Posts

Taking tests provides one method to assess the level of learning in a subject matter.Testing may also be an aid to improving memory and learning.Studies support periodic testing as a superior strategy to restudying learned material. Testing may promote learning by activating memory retrieval.The mechanism for the beneficial effects of testing on memory have received limited research attention.However, a recent fMRI study provides some insight into the specific brain regions involved in memory im........ Read more »

  • May 13, 2014
  • 11:05 AM
  • 643 views

Sleep Manipulation to Enhance Cognition

by William Yates, M.D. in Brain Posts

In the next series of posts, I will focus on research related to learning, learning disabilities and education.Sleep is known to play a key role in consolidation of memories and and learning.However, there has been relatively little discussion of how the effect of sleep on learning might be enhanced.Susanne Diekelmann reviewed this issue in a recent manuscript published in the journal Frontiers in Systems Neuroscience.In this review, two theories for sleep enhancement of memories are proposed:Ac........ Read more »

Diekelmann, S. (2014) Sleep for cognitive enhancement. Frontiers in Systems Neuroscience. DOI: 10.3389/fnsys.2014.00046  

  • May 7, 2014
  • 11:01 AM
  • 739 views

Sleep, Inflammation and Risk of Depression

by William Yates, M.D. in Brain Posts

I had the opportunity to attend a presentation by Dr. Michael Irwin at the Warren Neuroscience Lecture Series in Tulsa, OK.Dr. Irwin has been a leader in research related to sleep disturbance, inflammation and depression risk. Here are my notes from the presentation and few related citations.Notes on Irwin PresentationDepression is important because it is prevalent, recurrent and often resistant to treatmentSleep disturbance is common as a symptom of depression, but also may be an independe........ Read more »

  • May 6, 2014
  • 11:12 AM
  • 1,076 views

Prioritizing Variants with Gene and Phenotype Knowledge

by Daniel Koboldt in Massgenomics

Exome and whole-genome sequencing offer powerful assays for disease diagnosis in clinical settings. In theory, they can help uncover the de novo mutations or inherited alleles responsible for rare genetic diseases. Over the past few years, several groups have developed strategies for filtering or prioritizing variants based on their likelihood to cause disease. Our tool, […]... Read more »

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