Cannabis and Neuropsychiatric Disorders: An Updated Review.
Cannabis and Neuropsychiatric Disorders: An Updated Review. Acta Neurol Taiwan. 2019 Jun 15;28(2):27-39 Authors: Chayasirisobhon S Abstract Cannabis plant has the scientific name called Cannabis sativa L. Cannabis plant has many species, but there are three main species including Cannabis sativa, Cannabis indica and Cannabis ruderalis. Over 70 compounds isolated from cannabis species are called cannabinoids (CBN). Cannabinoids produce over 100 naturally occurring chemicals. The most abundant chemicals are delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD). THC is psychotropic chemical that makes people feel "high" while CBD is nonpsychotropic chemical. However, cannabinoid chemicals are not found only in the cannabis plant, they are also produced by the mammalian body, called endocannabinoids and in the laboratory, called synthesized cannabinoids. Endocannabinoids are endogenous lipid-based retrograde neurotransmitters that bind to cannabinoid receptors, and cannabinoid receptor proteins that are expressed throughout the mammalian central nervous system including brain and peripheral nervous system. There are at least two types of endocannabinoid receptors (CB1 and CB2) which are G-protein coupled receptors. CB1 receptors are particularly abundant in the frontal cortex, hippocampus, basal ganglia, hypothalamus and cerebellum, spinal cord and peripheral nervous system. They are present in inhibitory GABA-ergic neurons and excitatory glutama...
Parkinson ’s Disease is a condition characterized by degeneration of the nigrostriatal pathways resulting in marked bradykinesia. Studies have reported that nearly 25% of Medicare beneficiaries with Parkinson’s Disease reside in long-term care facilities (LTCFs). Residents of LTCFs are older and may also have other age-related mobility disorders. It is important for providers to know that Parkinsonism symptoms can also occur as a result of natural aging and will not respond to standard therapy for Parkinson’s Disease.
Atypical chest pain is of diverse origin. Typically, we initially consider cardiac etiology. When pain appears non-cardiac, there is a tendency to underestimate the illness, especially if the patient has neuropsychiatric illness. Our resident with dementia and anxiety disorder had chest pain; the diagnosis was unexpected.
West Nile Virus (WNV) infection is the most common mosquito-borne illness in the United States. Most cases are asymptomatic or with mild symptoms. Older adults are more likely to have central nervous system (CNS) involvement, and a higher risk for mortality.
Chronic pain is common among older adults, as is the use of medications to treat these symptoms. Aging physiology, in combination with a higher likelihood of medication use and declining renal function, makes older adults more susceptible to adverse drug effects. As such, monitoring for side effects and changes in renal function is important to avoid drug toxicity, especially during acute illness when medication errors and acute changes in renal function are more likely to occur among older adults.
Many patients are discharged to post-acute care facilities (PACFs) following surgery. These patients have either had major surgery and require close monitoring and intensive rehabilitation, or have significant medical co-morbidities. Currently they are transported, sometimes at considerable cost, to the surgeon ’s office for post-surgery visits (PSVs). These trips can be painful and uncomfortable. A staff member from the PACF may need to accompany the patient. During PSVs surgeons observe the patient's incision(s), and assess potential complications following surgery, pain, and functional recovery.
Parkinson ’s disease (PD) is a multifaceted condition that impacts a wide range of functions, including speech. The effect of loss of communication ability creates a cascade of effects which includes decreased participation in social events, social isolation, and potentially depression. If improvements in v oice occur, the cascade can be diverted. A physiological basis, as well as research evidence, supports use of singing to improve voice of those with PD. The implementation of a choir for those with PD has the potential to provide a socially engaging intervention, which is cost effective.
Chronic pain is among the most common reasons for seeking medical attention. In the United States, 1 in 5 adults had chronic pain in 2016 and it is estimated to cost over $500 billion annually in direct medical costs and disability. It is a prevalent problem among residents in the nursing home. Non-pharmacologic therapies are the most preferred treatment for chronic pain as pharmacological therapies, such as opioids, have proven to be less effective and associated with numerous side effects among older adults.
I love my work as a post-acute and long-term care geriatrician, and as a hospice and palliative medicine specialist. I freely admit that. Yes, there are plenty of headaches, including administrative and regulatory burdens, and there ’s the unfortunate reality that lots of the patients I become fond of die. But I believe that most of Caring’s readers feel the same way. In fact, I believe most people who choose to devote their life’s work to providing care to the vulnerable, dependent, and ill patients we look after love th eir work and consider it a calling — including arguably the most important mem...
Population health has been around for decades, but it is now taking center stage in Alzheimer ’s disease (AD) and dementia care. The Centers for Disease Control and Prevention (CDC) are encouraging and empowering these efforts with a Public Health Approach to Alzheimer’s Disease and Dementia curriculum. “This is an important strategy,” said Arif Nazir, MD, FACP, AGSF, CMD, Signature HealthCARE chief medical officer and president of AMDA – The Society for Post-Acute and Long-Term Care Medicine. “We have millions of patients with dementia, and these numbers will increase.
The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD. METHODS.: A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive batte...
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