Comorbid Insomnia and Psychiatric Disorders: An Update
This article reviews this relationship and provides recommendations for management. Keywords: Insomnia, sleep disorder, psychiatric disorder, depression, psychosis, schizophrenia, anxiety disorder Insomnia affects 25 million people in the United States annually and leads to an estimated $100 billion health care burden. Insomnia has also been shown to be a causal factor in other medical and psychiatric disorders, cognitive impairments, accidents, absenteeism, and reduced quality of life.1 The cost of not treating insomnia is more than the cost of treating insomnia.2 Insomnia as a symptom is seen in up to one third of the United States population, while the disorder is seen in up to 20 percent.3 The diagnostic criteria of insomnia have been updated in the International Classification of Sleep Disorders, Third Edition (ICSD-3) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The distinction between primary and secondary insomnia was removed from both classifications. Insomnia is a disorder unto itself that needs independent clinical attention. Viewing insomnia mainly as a symptom of another disorder prompted many clinicians to direct the bulk of their treatment efforts at the so-called primary disorder. Studies have shown that treating insomnia leads to better outcomes and improvement in co-existing psychiatric disorders. To achieve optimal treatment outcomes in people with comorbid psychiatric illness and insomnia, the clinician should...
Authors: Gentile E, Ricci K, Delussi M, Brighina F, de Tommaso M Abstract Previous studies indicated changes of motor cortex excitability in fibromyalgia (FM) patients and the positive results of transcranial stimulation techniques. The present study aimed to explore the metabolism of motor cortex in FM patients, in resting state and during slow and fast finger tapping, using functional Near-Infrared Spectroscopy (fNIRS), an optical method which detects in real time the metabolism changes in the cortical tissue. We studied 24 FM patients and 24 healthy subjects. We found a significant slowness of motor speed in FM ...
We present the first case of a newborn female patient diagnosed with isolated microgastria caused by a vascular accident in utero with absence of the left gastric artery. The patient had a 2 month history of gastroesophageal reflux, postprandial emesis, diarrhea, and failure to thrive. It was sequentially treated with nutritional optimization via a Bishop-Koop type proximal jejunal feeding stoma, and subsequent Hunt-Lawrence gastric augmentation. The patient has recovered from surgery and caught up in terms of weight expectancy for age.
TYPE 2 diabetes sufferers are advised to eat healthily in order to control the condition, but everyone deserves a treat every now and then. Burgers are generally considered an unhealthy food, but if you have diabetes and love a burger, this is the type you should opt for.
The indications for cryoablation in pediatric patients has been slowly growing over the last few years. Vascular anomalies and solid tumors are being treated with this modality. However, cryoablation can be associated with local complications. This is of high relevance in children due to smaller body surface area, more compact anatomy and less subcutaneous fat. Additionally, these patients have lower tolerance to pain and inflammation. It is critical to understand these factors when using cryoablation to treat pediatric patients.
Appropriate pre-procedure communication is critical to a successful interventional radiology procedure. In the traditional approach, a healthcare professional contacts the patient to discuss issues such as pre-procedure fasting, blood thinners, and medication/contrast allergies. We use machine learning to create a virtual agent that can perform these tasks in an automated way.
The American Society of Anesthesiologists (ASA) standards were updated in 2011 to recommend end-tidal carbon dioxide (EtCO2) monitoring during moderate sedation, which is now common practice in IR. Studies show EtCO2 monitoring improves detection of respiratory depression and hypoxemia. The purpose of this study was to evaluate the incidence of respiratory depression and hypoxemia from oversedation during IR procedures before and after implementation of EtCO2 monitoring.
Knee OA is a common cause of pain and disability, with many patients relying on chronic pain medications and/or joint injections. These options unfortunately result in short-term relief, or have associated increased morbidity, and knee replacement surgery may ultimately be performed. Researchers have postulated that synovial neovascularity develops as a result of inflammation and subsequently leads to knee pain. While previous overseas reports of success with GAE have been published, we present our final results from a prospective US multicenter clinical trial.
There are no reported descriptions of motor nerve cryoablation in humans. As a result, physicians faced with inadvertent motor nerve cryoablation during palliative or therapeutic procedures for established indications are forced to rely on preclinical studies to manage patient expectations. (1, 2) In addition, potential applications of motor nerve cryoablation, such as for management of spasticity and pain, have been avoided because of the unknown prognosis following cryoneurolysis of mixed or motor nerves.
Ultrasound image-guided procedures (USGP) are common and often cause mild to moderate pain both during the procedure and during lidocaine injection. This 110 participant randomized clinical trial evaluated the effectiveness of vapocoolant topical anesthetic application prior to lidocaine injection at reducing pain during the USGP.
To explore the national trends for inpatient utilization of transcatheter and endoscopic treatments of gastric and duodenal bleedings, and to evaluate patient characteristics associated with each type of treatment and compare hospitalization outcomes between the treatment groups.
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