Libri: "Pharmacological intervention"

1

Beard, Jonathan C. Illicit drug use: Acute and chronic pharmacological intervention. Salisbury, Wiltshire: Quay Books, 1995.

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2

Al-Nimer, Marwan S. M. Pharmacological intervention in management of neck pain disorders: A review. Hauppauge, N.Y: Nova Science Publishers, 2010.

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3

Ninot, Gregory. Non-Pharmacological Interventions. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-60971-9.

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4

Ken'ichi, Kitani, Goto S e Aoba A, a cura di. Pharmacological intervention in aging and age-associated disorders: Proceedings of the Sixth Congress of the International Association of Biomedical Gerontology. New York: New York Academy of Sciences, 1996.

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5

Naranjo, Claudio A., e Edward M. Sellers, a cura di. Novel Pharmacological Interventions for Alcoholism. New York, NY: Springer New York, 1992. http://dx.doi.org/10.1007/978-1-4612-2878-3.

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6

Ryan, Kirk R. Pharmacologic intervention in the treatment of AIDS. A cura di Friday Lynn E. McLean, Va: Remco, 1992.

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7

Sammons, Morgan T., e Norman B. Schmidt, a cura di. Combined treatment for mental disorders: A guide to psychological and pharmacological interventions. Washington: American Psychological Association, 2001. http://dx.doi.org/10.1037/10415-000.

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8

Dieppe, P. A., e R. G. Russell. Osteoarthritis: Current Research and Prospects for Pharmacological Intervention. Hyperion Books, 1991.

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9

Moulton, Calum D. Novel pharmacological targets. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198789284.003.0013.

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There is a bidirectional relationship between depression and type 2 diabetes (T2D). Patients with comorbid depression and T2D are at high risk of complications and premature mortality. Conventional treatments for depression do not consistently improve diabetes outcomes, despite improving depressive symptoms. Shared mechanisms may underpin both depression and T2D, providing novel pharmacological targets to treat both conditions simultaneously. There are several candidate pathways. For inflammation and vitamin D deficiency, there is good cross-sectional evidence to support an association with depression in T2D. Prospective epidemiological studies are needed to test biological pathways as predictive biomarkers of depression and T2D. Intervention studies are needed to test the modifiability of these pathways. Repurposing of established diabetes treatments may provide a ‘multiple hit’ strategy. The identification and modification of novel biological targets has the potential to treat both depression and T2D, as well as reducing longer term morbidity and mortality.

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10

Osteoarthritis: current research and prospects for pharmacological intervention: Conference documentation : London, 1988. London: IBC Technical Services, 1988.

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11

J, Goetzl Edward, Lewis Robert A, Rola-Pleszczynski Marek e New York Academy of Sciences., a cura di. Cellular generation, transport, and effects of eicosanoids: Biological roles and pharmacological intervention. New York: New York Academy of Sciences, 1994.

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12

A, Dormandy J., e Royal Society of Medicine (Great Britain), a cura di. The Pathophysiology of critical ischaemia and pharmacological intervention with a stable prostacyclin analogue, iloprost. Royal Society of Medicine Services, 1989.

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13

Goetzl, Edward J., Robert A. Lewis e ma Rola-Pleszczynski. Cellular Generation, Transport, and Effects of Eicosanoids: Biological Roles and Pharmacological Intervention (Annals of the New York Academy of scie. New York Academy of Sciences, 1994.

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14

(Editor), Edward J. Goetzl, Robert A. Lewis (Contributor, Editor), New York Academy of Sciences (Corporate Author) e Marek Rola-Pleszczynski (Editor), a cura di. Cellular Generation, Transport, and Effects of Eicosanoids: Biological Roles and Pharmacological Intervention (Annals of the New York Academy of Sciences). New York Academy of Sciences, 1994.

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15

Vranckx, Pascal, Wilfried Mullens e Johan Vijgen. Non-pharmacological therapy of acute heart failure: when drugs alone are not enough. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0053.

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Acute heart failure syndrome has been defined as new-onset or a recurrence of worsening signs and symptoms of heart failure, necessitating urgent or emergency management. The management of acute heart failure syndrome is challenging, given the heterogeneity of the patient population, in terms of the clinical presentation, pathophysiology, prognosis, and therapeutic options. The management of acute heart failure syndrome is a dynamic process, requiring ongoing simultaneous diagnosis (monitoring) and treatment. Pharmacological agents remain the mainstay of therapy for acute heart failure syndrome. However, at all time, during the early diagnostic, aetiologic, and therapeutic work-up, non-pharmacologic therapy may be indicated and should be considered. The management of the complex cardiac patient with acute heart failure syndrome and/or (potential) haemodynamic compromise has become a special dimension for specialized myocardial intervention centres, providing 24 hours per day and 7 days per week state-of-the-art facilities for (primary) percutaneous coronary intervention and cardiac intensive care, including mechanical ventilation, ultrafiltration, with or without dialysis, and short-term percutaneous mechanical circulatory support. Through the understanding of the underlying pathophysiology and approaches into the problems of acute heart failure syndrome, one should be better prepared to understand and treat its many facets.

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16

Baracos, Vickie E., Sharon M. Watanabe e Kenneth C. H. Fearon. Aetiology, classification, assessment, and treatment of the anorexia-cachexia syndrome. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0205.

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Anorexia-cachexia is a heterogeneous and multifactorial syndrome most likely driven by systemic inflammation and neuroendocrine activation. Key diagnostic features include reduced appetite, weight loss, and muscle wasting. Key clinical problems include management of anorexia without resort to artificial nutritional support, and muscle wasting that cannot be completely arrested/reversed even with such intervention. Assessment should cover domains such as body stores of energy and protein, food intake, performance status, and factors resulting in excess catabolism. Intervention should be early rather than late, informed by the assessment process and focused on a multimodal approach (nutrition, exercise, and pharmacological agents). This chapter aims to discuss these issues and provide (a) the reader with some background principles to classification, (b) a simple approach to patient assessment and a robust algorithm for basic multimodal treatment, and (c) an overview of the evidence base for different pharmacological interventions.

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17

Strenges, Stephen, e Glenn W. Currier. Interventions for Acute Agitation. A cura di Phillip M. Kleespies. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199352722.013.41.

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Given the constant and often increasing risks for violence against mental health professionals, the effective evaluation, management, and treatment of patients with psychotic agitation is of critical importance to ensuring safety. This chapter builds upon several articles of the American Association for Emergency Psychiatry’s Project BETA, which proposes guidelines and best practices for the treatment of agitation. We suggest that clinicians use a tiered, progressive approach to treating agitation in which they attempt less-invasive methods such as verbal de-escalation before drug intervention, when medically appropriate. It is argued that treatment should be proportionate to the severity of agitation, and pharmacological intervention should be used as a last resort.

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18

Markus, Hugh, Anthony Pereira e Geoffrey Cloud. Secondary prevention of stroke. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198737889.003.0010.

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In the secondary prevention of stroke chapter the case is made for preventing recurrent stroke by targeted evidence-based intervention based on the aetiological cause of stroke. Lifestyle measures such as smoking cessation as well as pharmacological prevention strategies are discussed. Blood pressure treatment, lipid lowering, and antiplatelet therapy are all examined. Since the last edition there has been a major advance in the stroke prevention treatment of atrial fibrillation with the licensing of new anticoagulant agents and the evidence for their use is reviewed. Surgical and endovascular interventions for extracranial and intracranial stenosis are also outlined, including carotid endarterectomy, carotid stenting, extracranial-intracranial bypass, and intervention for vertebral artery disease.

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19

Naranjo, Claudio A., e Kathrin M. Nelson. Novel Pharmacological Interventions for Alcoholism. Springer, 2011.

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20

Novel Pharmacological Interventions for Alcoholism. Springer, 2011.

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21

A, Naranjo C., e Sellers E. M, a cura di. Novel pharmacological interventions for alcoholism. New York: Springer, 1992.

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22

Blisard, Deanna, e Ali Al-Khafaji. Diagnosis and management of variceal bleeding in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0178.

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Cirrhosis is the most common cause of portal hypertension, which subsequently leads to development of gastroesophageal varices (GEV). Generally, presence of GEV correlates with the severity of cirrhosis and variceal haemorrhage can develop when hepatic venous pressure gradient exceeds 10–12 mmHg. The gold standard for diagnosis and often treatment of GEV is oesophagogastroduodenoscopy (OGD). Management of GEV is divided into primary prophylaxis, acute haemorrhage control, and secondary prophylaxis. Primary prophylaxis includes surveillance OGD and endoscopic intervention based on the size of the varices. Management of acute variceal haemorrhage includes resuscitation and endoscopic interventions. Basic resuscitative measures to maintain haemodynamic stability, vasoconstricting agents to decrease portal pressure, and the use of prophylactic antibiotics. Endoscopic intervention includes any of variceal band ligation, variceal sclerotherapy, and variceal obturation. Radiological or surgical portosystemic shunting markedly reduces portal pressure and are clinically effective therapy for patients who fail endoscopic or pharmacological therapy. Balloon tamponade is effective in temporarily controlling oesophageal variceal haemorrhage in over 80% of patients. Its use should be restricted to patients with uncontrollable bleeding, where more definitive therapy is planned within 24 hours. Secondary prophylaxis includes endoscopy plus pharmacological therapy of non-selective β‎−blockers.

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23

G, Herman A., a cura di. Antithrombotics: Pathophysiological rationale for pharmacological interventions. Dordrecht: Kluwer Academic Publishers, 1991.

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24

Silk, Kenneth R. Pharmacological Interventions for Borderline Personality Disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199997510.003.0013.

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Although no medication is indicated to specifically treat symptoms of borderline personality disorder (BPD), medications are used frequently in the treatment of patients with BPD. This chapter reviews a number of reasons why medications are frequently prescribed in this patient population, then goes on to discuss eight systematic reviews or meta-analyses of 23 double-blind placebo-controlled randomized trials of the psychopharmacologic treatment of patients with BPD. The author attempts to make some sense of these reviews, which at times come to different conclusions despite examining essentially the same dataset. The chapter also addresses how to proceed with and manage the psychopharmacologic treatment of patients with BPD.

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25

Burhenn, Peggy S. Delirium. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190204709.003.0007.

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This chapter provides an overview of delirium, differentiating among hyperactive, hypoactive, and mixed subtypes. Delirium is a common, serious medical problem that is underrecognized by healthcare providers. Evidence suggests that frequent assessment of patients can result in increased recognition of delirium, which will allow for earlier intervention. Limited data are available on effective interventions for delirium once it begins; however, proactive prevention strategies have been successful. Various screening tools are recommended to identify patients with delirium. The multiple predisposing and precipitating factors that can complicate determining the cause are explored. There is a review of the assessment and interventions for delirium management and prevention protocols that target its risk factors, as well as a brief discussion of the principles of pharmacological management and previously cited recommendations. Education of staff, patients, and family members is vital.

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26

Muralidharan, Anjana, David J. Miklowitz e W. Edward Craighead. Psychosocial Treatments for Bipolar Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0010.

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Pharmacological interventions remain the primary treatment for bipolar disorder. However, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, decrease severity of symptoms, improve quality of life, and enhance mechanisms for coping with stress. Group psychoeducation, designed to provide information to bipolar patients about the disorder and its treatment, leads to lower rates of recurrence and greater adherence to medication among remitted bipolar patients at both short- and long-term follow-up. Cognitive-behavioral therapy as an ancillary treatment has found mixed results but generally supportive evidence indicating that it is useful in preventing relapse to depression in remitted patients. Family-based intervention, such as Family-Focused Therapy (FFT), may be combined with pharmacotherapy to reduce recurrences and hospitalization rates in adult patients.

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27

A, De Leon-Casasola Oscar, a cura di. Cancer pain: Pharmacological, interventional and palliative care approaches. Philadelphia: Saunders, 2006.

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28

Leon-Casasola, Oscar A. de. Cancer Pain: Pharmacological, Interventional, and Palliative Care Approaches. Saunders, 2006.

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29

Zhang, Hai-Gang, Ya Liu e Xiongwen Chen, a cura di. Cardiac Hypertrophy: From Compensation to Decompensation and Pharmacological Interventions. Frontiers Media SA, 2021. http://dx.doi.org/10.3389/978-2-88966-909-7.

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30

Chappell, Michael, Bradley MacIntosh e Thomas Okell. Using ASL to Measure Perfusion Changes in an Individual: Task-Based ASL and Beyond. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198793816.003.0007.

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Arterial spin labeling (ASL) MRI measurements of perfusion provide a flexible and unique way to study the brain’s physiology and function. They enable experimental designs in neuroimaging that can complement widely used blood oxygen level dependent functional MRI (BOLD fMRI) experiments, or even enable experiments not possible with BOLD fMRI. This chapter explores ways in which ASL can be used to detect changes in perfusion in an individual, including those that involve stimulation of neuronal activity or pharmacological intervention.

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31

Murtagh, Fliss E. M. End-stage kidney disease. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0156.

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End-stage kidney disease (ESKD) accounts for 1-2% of all deaths. Ageing populations means that this proportion will grow steadily over the coming years. Symptom burden in ESKD exceeds advanced cancer, with added renal-specific symptoms, such as itch and restless legs. Pain and depression are also more prevalent. Many renal symptoms go under-recognized and under-treated, especially as they arise from co-morbid conditions, rather than the renal disease itself. The most useful intervention to address symptoms is regular assessment of symptoms, using a valid and reliable global symptom score. Pharmacological interventions to alleviate symptoms need to take account of the severe constraints on using renally cleared drugs, and the high risk of toxicity from accumulation of parent compound or metabolites. The population with ESKD has extensive palliative care needs, and need significant medical, nursing, psychological, and social care to address these as their illness advances towards the end of life.

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32

Cancer pain: Pharmacologic, interventional and palliative approaches. Philadelphia, PA: Saunders Elsevier, 2006.

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33

Passalent, Laura, e Salih Ozgocmen. Non-pharmacological management in axial spondyloarthritis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198734444.003.0019.

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The ASAS/EULAR panel recommends a multidisciplinary and patient-centred approach that includes a combination of pharmacological and non-pharmacological treatment modalities. These updated recommendations describe a number of non-pharmacological interventions as the cornerstone of treatment in patients with ankylosing spondylitis (AS). The aims of such treatment are to: (1) reduce pain and discomfort; (2) maintain or improve muscle strength, endurance, flexibility, mobility, balance, physical fitness, and social participation; and (3) prevent spinal abnormalities, joint contractures, and deformities. This chapter presents the evidence in support of common non-pharmacological interventions for axial spondyloarthritis (axSpA) and provides recommendations regarding the implementation of such treatment strategies.

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34

Atkins, Roger M. Complex regional pain syndrome. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.0011.

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♦ Complex regional pain syndrome (CRPS) is a disabling chronic pain condition of unknown aetiology♦ Traditionally it was thought to be rare; however, prospective studies demonstrate it to be common following both trauma and operative procedures involving the upper and lower limbs♦ The condition is usually self-limiting over a maximum period of 2 years, although minor abnormalities may remain♦ In a minority of cases it does not resolve and is responsible for severe chronic disability♦ Treatment is aimed at functional restoration of limb function supported by pharmacological intervention.

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35

Pittenger, Christopher. The Pharmacological Treatment of Refractory OCD. A cura di Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0041.

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Evidence-based interventions for OCD, both psychotherapeutic and pharmacological, are of benefit to many. However, even when optimally deployed, first- and second-line treatments leave a substantial fraction of patients—perhaps as many as 20% to 25%—without meaningful improvement. Furthermore, many who are classified as “responders” to first- and second-line treatments continue to have substantial residual symptoms and attendant morbidity. This chapter reviews various pharmacological strategies that have been used for the treatment of refractory OCD, including agents targeting serotonin, dopamine, and glutamate neurotransmission. Although the evidence base supporting the use of these agents is not as robust as it is for first-line interventions, many have shown promise in some studies. The prevalence of refractory OCD symptoms means that such pharmacological strategies must frequently be considered in clinical practice, despite the lack of definitive guidance from controlled studies.

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36

Mandeville, Anna L. Non-pharmacological methods of acute pain management. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199234721.003.0003.

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Psychological factors are a key part of pain perception as articulated in the neuromatrix model of pain. Psychoeducational interventions are of significant value in acute pain management and have reduced pain severity, distress, and length of hospital stay. Mood, beliefs about pain and illness, previous experience of pain, and the behaviour of health care professionals all influence pain perception and response to pain. Helping patients reappraise the threat value of pain through tailored information giving and where needed cognitive behavioural interventions are practical strategies. Attention control methods, including clinical hypnosis, are effective in reducing procedural pain.

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37

Abhishek, Abhishek, e Michael Doherty. Placebo, nocebo, and contextual effects. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0027.

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Placebo effect is an example of ‘contextual’ effect and is the symptomatic improvement experienced by patients who have unknowingly received a placebo (inactive treatment) instead of an active drug. It occurs due to patient-specific factors such as expectation of improvement and is influenced by the context in which the treatment is delivered. Nocebo effect is the opposite of placebo effect and includes worsening of symptoms or incident adverse effects due to expectancy or negative contextual or practitioner influence. Placebo effect has been demonstrated in a range of musculoskeletal conditions, including osteoarthritis (OA), as well as other conditions such as Parkinson’s disease, irritable bowel syndrome, and asthma. In OA, the placebo effect is strongest for subjective outcomes like pain. In fact, the effect size (ES) of placebo analgesia in OA clinical trials (0.51) is clinically significant and higher than the ES (defined by the additional improvement above placebo) obtained from non-pharmacological (0.25) and pharmacological (0.39) treatments. A number of patient- and intervention-specific and contextual factors influence the magnitude of placebo-induced improvements. Placebo analgesia is real, not a ‘trick of the mind’, and results from central mechanisms that increase descending inhibition of pain. Contextual effects are an integral part of everyday clinical practice. While patient- and intervention-specific determinants cannot be changed easily, healthcare practitioners should optimize the physician-specific factors that enhance positive contextual response and minimize nocebo response. Such a strategy that will increase the overall improvement is particularly relevant for OA where there is no ‘cure’ and a predominance of negative beliefs.

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38

Chan, Kin-Sang, Doris M. W. Tse e Michael M. K. Sham. Dyspnoea and other respiratory symptoms in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0082.

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Dyspnoea is prevalent among palliative care patients with increased severity over time. There are two patterns of dyspnoea-breakthrough dyspnoea and constant dyspnoea-and three separate qualities of dyspnoea-air hunger, work or effort, and tightness. The measurement of dyspnoea includes three domains: sensory-perceptual experience, affective distress, and symptom impact. The management of dyspnoea includes specific disease management, non-pharmacological intervention, pharmacological treatment, and palliative non-invasive ventilation. Cough is prevalent and disturbing in patients with cancer and chronic lung diseases, and is often associated with airway hypersecretion and impaired mucociliary clearance. Management includes specific treatments for underlying non-cancer and cancer-related causes, symptomatic treatment by antitussives, mucoactive agents, and airway clearance techniques for expectoration and reduction in mucus production. Anticholinergics may be indicated for death rattles to facilitate a peaceful death. Haemoptysis occurs in 30-60% of lung cancer patients and initial management of haemoptysis includes airway protection and volume resuscitation. Localization of the site and source of bleeding may determine the choice of treatment. If a life-threatening haemoptysis occurs, sedation should be given as soon as possible. Support should be given to the family, and debriefing provided to team members.

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39

Kitay, Brandon M., e Rajesh R. Tampi. Memantine in Patients with Moderate to Severe Alzheimer’s Disease Already Receiving Donepezil. A cura di Ish P. Bhalla, Rajesh R. Tampi, Vinod H. Srihari e Michael E. Hochman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190625085.003.0018.

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This chapter provides a summary of a landmark study on the pharmacological management of cognitive disorders. In patients with moderate to severe Alzheimer disease treated with a cholinesterase inhibitor (donepezil), is the addition of a N-methyl-D-aspartate receptor inhibitor (memantine) a safe and efficacious augmentation strategy? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and controversy within the field, concluding with a discussion of implications, and an exemplary clinical case applying the study evidence.

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40

(Editor), Morgan T. Sammons, e Norman B. Schmidt (Editor), a cura di. Combined Treatments for Mental Disorders: A Guide to Psychological and Pharmacological Interventions. American Psychological Association (APA), 2001.

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41

Andreou, Christina, e Steffen Moritz, a cura di. Non-Pharmacological Interventions for Schizophrenia: How Much Can Be Achieved and How? Frontiers Media SA, 2017. http://dx.doi.org/10.3389/978-2-88945-009-1.

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42

Thiele, Holger, e Uwe Zeymer. Cardiogenic shock in patients with acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0049.

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Cardiogenic shock complicating an acute coronary syndrome is observed in up to 10% of patients and is associated with high mortality still approaching 50%. The extent of ischaemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis of the cardiogenic shock patient. Careful risk assessment for each patient, based on clinical criteria, is mandatory, to decide appropriately regarding revascularization by primary percutaneous coronary intervention or coronary artery bypass grafting, drug treatment by inotropes and vasopressors, mechanical left ventricular support, additional intensive care treatment, triage among alternative hospital care levels, and allocation of clinical resources. This chapter will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of cardiogenic shock complicating acute coronary syndromes, including mechanical complications and shock from right heart failure. There will be a major focus on potential therapeutic issues from an interventional cardiologist’s and an intensive care physician’s perspective on the advancement of new therapeutical arsenals, both mechanical percutaneous circulatory support and pharmacological support. Since studying the cardiogenic shock population in randomized trials remains challenging, this chapter will also touch upon the specific challenges encountered in previous clinical trials and the implications for future perspectives in cardiogenic shock.

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43

Thiele, Holger, e Uwe Zeymer. Cardiogenic shock in patients with acute coronary syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0049_update_001.

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Abstract (sommario):

Cardiogenic shock complicating an acute coronary syndrome is observed in up to 10% of patients and is associated with high mortality still approaching 50%. The extent of ischaemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis of the cardiogenic shock patient. Careful risk assessment for each patient, based on clinical criteria, is mandatory, to decide appropriately regarding revascularization by primary percutaneous coronary intervention or coronary artery bypass grafting, drug treatment by inotropes and vasopressors, mechanical left ventricular support, additional intensive care treatment, triage among alternative hospital care levels, and allocation of clinical resources. This chapter will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of cardiogenic shock complicating acute coronary syndromes, including mechanical complications and shock from right heart failure. There will be a major focus on potential therapeutic issues from an interventional cardiologist’s and an intensive care physician’s perspective on the advancement of new therapeutical arsenals, both mechanical percutaneous circulatory support and pharmacological support. Since studying the cardiogenic shock population in randomized trials remains challenging, this chapter will also touch upon the specific challenges encountered in previous clinical trials and the implications for future perspectives in cardiogenic shock.

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44

Thiele, Holger, e Uwe Zeymer. Cardiogenic shock in patients with acute coronary syndromes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0049_update_002.

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Abstract (sommario):

Cardiogenic shock complicating an acute coronary syndrome is observed in up to 10% of patients and is associated with high mortality still approaching 50%. The extent of ischaemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis of the cardiogenic shock patient. Careful risk assessment for each patient, based on clinical criteria, is mandatory, to decide appropriately regarding revascularization by primary percutaneous coronary intervention or coronary artery bypass grafting, drug treatment by inotropes and vasopressors, mechanical left ventricular support, additional intensive care treatment, triage among alternative hospital care levels, and allocation of clinical resources. This chapter will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of cardiogenic shock complicating acute coronary syndromes, including mechanical complications and shock from right heart failure. There will be a major focus on potential therapeutic issues from an interventional cardiologist’s and an intensive care physician’s perspective on the advancement of new therapeutical arsenals, both mechanical percutaneous circulatory support and pharmacological support. Since studying the cardiogenic shock population in randomized trials remains challenging, this chapter will also touch upon the specific challenges encountered in previous clinical trials and the implications for future perspectives in cardiogenic shock.

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45

Thiele, Holger, e Uwe Zeymer. Cardiogenic shock in patients with acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0049_update_003.

Testo completo

Abstract (sommario):

Cardiogenic shock complicating an acute coronary syndrome is observed in up to 10% of patients and is associated with high mortality still approaching 50%. The extent of ischaemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis of the cardiogenic shock patient. Careful risk assessment for each patient, based on clinical criteria, is mandatory, to decide appropriately regarding revascularization by primary percutaneous coronary intervention or coronary artery bypass grafting, drug treatment by inotropes and vasopressors, mechanical left ventricular support, additional intensive care treatment, triage among alternative hospital care levels, and allocation of clinical resources. This chapter will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of cardiogenic shock complicating acute coronary syndromes, including mechanical complications and shock from right heart failure. There will be a major focus on potential therapeutic issues from an interventional cardiologist’s and an intensive care physician’s perspective on the advancement of new therapeutical arsenals, both mechanical percutaneous circulatory support and pharmacological support. Since studying the cardiogenic shock population in randomized trials remains challenging, this chapter will also touch upon the specific challenges encountered in previous clinical trials and the implications for future perspectives in cardiogenic shock.

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46

Steinbrecher, Henrik. Urinary incontinence and bladder dysfunction. A cura di David F. M. Thomas. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0119.

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Abstract (sommario):

Urinary incontinence is one of the commonest problems encountered in paediatric practice. Recent advances in our understanding of the causes, coupled with the introduction of newer pharmacological agents have expanded the treatment options. This chapter summarizes the terminology and classification of urinary incontinence and describes the development of normal bladder control and the causes of urinary incontinence and bladder dysfunction in children. Although most children experience a favourable long-term outcome, a small minority will require urological intervention for intractable incontinence. The commonly held belief that children will simply ‘grow out it’ can result in years of distressing incontinence with a harmful impact on social, emotional, and psychological well-being. For this reason, the investigation and treatment of urinary incontinence should be commenced at an early age.

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Golier, Julia A., Andreas C. Michaelides, Maya Genovesi, Emily Chapman e Rachel Yehuda. Pharmacological Treatment of Posttraumatic Stress Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0019.

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Although psychotherapy is considered first-line treatment for posttraumatic stress disorder (PTSD), advances have been made in pharmacological treatment. Based on controlled clinical trials, antidepressants remain the first-line pharmacological treatment. Studies suggest that selective serotonin reuptake inhibitors reduce PTSD-specific symptoms and improve global outcome. Emerging evidence suggests efficacy for venlafaxine. Other individual agents found to be efficacious include imipramine and phenelzine. Prazosin is emerging as a beneficial adjunct for PTSD-related sleep disturbances and nightmares. Some evidence suggests that atypical antipsychotics may be efficacious against a broad range of symptoms, although the risk of metabolic side effects may limit widespread use. Trials are needed to assess whether anticonvulsants, cortisol-based treatments, sympatholytics, or other novel approaches are efficacious, and how pharmacotherapy can enhance psychotherapy outcomes. These studies should consider the goals of pharmacotherapy in PTSD and the subgroups of patients or clinical presentations most likely to benefit from pharmacological interventions.

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Strada, E. Alessandra. The Second Domain of Palliative Care. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199798551.003.0003.

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This chapter proposes palliative psychology competencies in the second domain of palliative care: physical aspects of care. It discusses the importance of interdisciplinary work in assessment and management of pain and other physical symptoms. Palliative psychologists with the necessary knowledge, skills, and attitudes can contribute greatly to team work by identifying and managing psychological factors that can contribute to the patient’s physical suffering. This chapter also briefly describes relevant approaches to dyspnea and constipation. Clinical examples of pain assessment and intervention are provided based on real case scenarios. The basics of pharmacological approaches to pain management in advanced illness are discussed, in order to facilitate the role of palliative psychologists in promoting communication and treatment adherence. The use of integrative medicine modalities to improve physical symptoms is highlighted.

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Torrent, Carla, Caterina del Mar Bonnin e Anabel Martinez-Arán. Functional remediation therapy for bipolar disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0014.

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Impairment in functional outcome is commonly observed even when patients are euthymic and includes multiple areas of functioning. Many factors such as sociodemographic, clinical, pharmacological, and neurocognitive variables have been associated with functional impairment. The term ‘functional remediation’ has been coined to define an innovative strategy aimed at targeting the critical factors for full psychosocial adjustment and functional recovery in the context of psychoses and more specifically bipolar disorders. Functional remediation involves not only neurocognitive techniques and training but also psychoeducation on cognition-related issues and problem-solving within an ecological framework. The inclusion of context processing, performance monitoring, encoding, and manipulation of the information as well as fostering compensatory strategies must be included in the functional remediation intervention. In this regard, real-world problems affecting daily functioning are used for bipolar disorder to be transferred to daily practice.

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Shaw, Thomas L. Preoperative Anxiety Management. A cura di Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel e Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0001.

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Children presenting for surgery are often significantly more anxious compared to adults. This may occur during a new exposure to an unfamiliar environment or repeat exposures to the hospital setting. Pediatric anesthesiologists must utilize a variety of creative and traditional and nontraditional strategies to help alleviate this feeling of anxiety prior to proceeding to the operating room. Knowledge of the consequences of preoperative emotional distress, combined with knowledge of available pharmacological and behavioral interventions, can help enhance the patient’s and the parents’ experience, as well as perioperative outcomes. Both pharmacologic and nonpharmacologic strategies have been successfully utilized perioperatively.

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