New Onset Chest Pain in a Long-Term Care Resident With Dementia: First, Believe the Patient!
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.
Conclusions: The caregivers of patients with cancer or chronic severe illnesses experience high levels of fatigue: the longer the disease duration, the greater the degrees of depression, anxiety, and physical fatigue experienced by the caregivers. Such caregivers need strategies to manage their fatigue and depression. PMID: 32963657 [PubMed - in process]
CONCLUSION: The wide spectrum of secondary complications after a stroke constitutes a complex, sustained and multidisciplinary challenge, which requires a cross-sectoral interaction of various and numerous actors in outpatient poststroke care. PMID: 32914296 [PubMed - as supplied by publisher]
CONCLUSIONS: Trials of antidepressants may be driven mainly by commercial interests, focusing on prevalent diseases and everyday problems. No one can live a full life without experiencing several of the problems for which these drugs were tested. Antidepressants, sometimes called happy pills, could be seen as the modern version of Aldous Huxley's soma pill intended to keep everyone happy in the "Brave New World". PMID: 32444565 [PubMed - as supplied by publisher]
We describe a clinical case of a female patient diagnosed with AD with continuous cognitive decline and dementia-related behavioral symptoms. Between 2008 and 2019, the patient was examined half-yearly at the memory clinic of the Medical University of Innsbruck. At each visit, cognitive state and pharmacological treatment were evaluated. In addition, NPs were assessed by using the neuropsychiatric inventory (NPI). In 2018, the patient progressed to severe AD stage and presented with progressive NPs (anxiety, suspected delusions, agitation, aggressive behavior, and suspected pain due to long immobility). Consequently, off-l...
Conclusions: No clear conclusion can be drawn on the effectiveness of psychoactive cannabinoids in the treatment of psychiatric manifestations, in particular agitation and aggression, in AD. In the future, large randomized controlled trial with adequate designs, without crossover and for longer duration, adapted to cannabinoid pharmacokinetics, is required to establish the real efficacy and safety of these drugs in aggressive and/or agitated patients with AD.
This study is consistent with other research, as well as with reports from physicians who recommend cannabis in their daily practices. What might be behind this trend? A confluence of factors seems to be responsible, including the decrease in stigma associated with cannabis use and the increased interest in the use of medical marijuana by older patients. Stigma is a complicated issue, but most would agree that the stigma associated with cannabis use is lessening, especially for medical cannabis. In a recent poll, 94% of Americans voiced support for legal access to medical marijuana, and most states have approved some form ...
CONCLUSION: The cost to patients, family, and society of behavioral problems in IWD, along with modest efficacy of most pharmacologic and nonpharmacologic interventions, calls for more study of novel preventive approaches. PMID: 32115311 [PubMed - as supplied by publisher]
Conclusions: Differences in symptom perception, diagnostic tests, and pharmacological procedures were found between patients with and without dementia. Specific diagnostic tools need to be developed for patients with dementia.
ConclusionsAED use was common in nursing homes, with gabapentin most commonly used (presumably for pain). That multiple comorbidities were associated with AED use underscores the need for future studies to investigate the safety and effectiveness of AED use in nursing home residents.
__________ Just a heads-up about a great event later this week in Dublin, Ireland, for those working on virtual and augmented reality and healthcare innovation. When: Thu Dec 5, 2019 8:00 am — Fri Dec 6, 2019 5:00 pm. Where: Davenport Hotel Featured sessions include: Day 1 – Thursday, December 5th, 2019 9:00am‑9:30am Introductions, Welcome and Setting The Stage Robert Fine, Executive Director, International Virtual Reality and Healthcare Association (IVRHA) 9:30am-10:30am Keynote Presentation: Virtual Reality and Healthcare: The Past, The Present and The Future Dr. Walter Gree...