Paolo Fusar-Poli, Dominic Oliver, Giulia Spada, Andres Estrade, Philip McGuire
BACKGROUND: Improving outcomes of a First Episode of Psychosis (FEP) relies on the ability to detect most individuals with emerging psychosis and treat them in specialised Early Intervention (EI) services. Efficacy of current detection strategies is undetermined. METHODS: RECORD-compliant clinical, 6-year, retrospective, transdiagnostic, lifespan-inclusive, Electronic Health Record (EHR) cohort study, representing real-world secondary mental healthcare in South London and Maudsley (SLaM) NHS...
November 21, 2020: Schizophrenia Research
Mary A Fristad
Irritability is ubiquitous and therefore nonspecific. Evans and colleagues conducted an international study to test clinicians' ability to differentiate chronic irritability from four 'boundary' presentations: nonirritable oppositionality, episodic bipolar disorder irritability, depressive disorders, and normative irritability. Clinicians assigned to rate vignettes according to the International Classification of Diseases and Related Health Problems-Eleventh Revision (ICD-11) fared best, while those assigned to the Diagnostic and Statistical Manual-5th Edition (DSM-5) condition had the most false positives and false negatives...
November 23, 2020: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Joanne Salas, Mary Beth Miller, Jeffrey F Scherrer, Rachel Moore, Christina S McCrae, Mark D Sullivan, Kathleen K Bucholz, Laurel A Copeland, Brian K Ahmedani, F David Schneider, Patrick J Lustman
OBJECTIVE: Insomnia commonly co-occurs with depression, chronic pain, and opioid use. Both insomnia and chronic opioid analgesic use (OAU) are independent risk factors for a new depression episode (NDE). This study determined if the association between longer OAU duration and NDE was stronger in those with versus without insomnia. DESIGN: Retrospective cohort. SETTING: Veterans Health Administration electronic medical records (2000-2012). PARTICIPANTS: New opioid users in follow-up (2002-2012), free of depression for two years prior to follow-up, and aged 18-80 (n = 70,997)...
September 2020: Journal of Opioid Management
F M Ucar, M A Yilmaztepe
Background: Although implantable cardioverter-defibrillator (ICD) reduces mortality in heart failure patients with reduced left ventricle function, arrhythmic episodes are related with increased mortality. Aim: The aim of this study was to investigate whether low patient activity predicts arrhythmic events in the heart failure patients with primary prevention ICD. Methods: We examined 206 heart Failure (HF) patients (mean age: 61.3 ± 10.9 years, 77.7% male) with primary prevention implanted ICD who referred to our outpatient clinic for pacemaker control...
November 2020: Nigerian Journal of Clinical Practice
Line Hofmann Frederiksen, Niels Bilenberg, Lene Andersen, Natasha Henriksen, Jan Jørgensen, Hans-Christoph Steinhausen, Rikke Wesselhoeft
OBJECTIVE: This study examined the validity of childhood depression diagnoses in the Danish Psychiatric Central Research Register (DPCRR) and identified predictors of validity. METHODS: A nationwide random sample of 500 children (6-17 years) diagnosed with depression between 1996 and 2016 was identified in the DPCRR. Psychiatric hospital records were reviewed and rated using an online checklist. The primary outcome was, whether depressive symptoms and functional impairment documented in hospital records justified a depressive disorder diagnosis based on ICD-10 or DSM-5 diagnostic criteria...
November 20, 2020: Acta Psychiatrica Scandinavica
Hugo De Oliveira, Martin Prodel, Ludovic Lamarsalle, Matt Inada-Kim, Kenny Ajayi, Julia Wilkins, Sara Sekelj, Sue Beecroft, Sally Snow, Ruth Slater, Andi Orlowski
Objective: The "Bow-tie" optimal pathway discovery analysis uses large clinical event datasets to map clinical pathways and to visualize risks (improvement opportunities) before, and outcomes after, a specific clinical event. This proof-of-concept study assesses the use of NHS Hospital Episode Statistics (HES) in England as a potential clinical event dataset for this pathway discovery analysis approach. Materials and Methods: A metaheuristic optimization algorithm was used to perform the "bow-tie" analysis on HES event log data for sepsis (ICD-10 A40/A41) in 2016...
October 2020: JAMIA Open
Martin C Burke, Johan D Aasbo, Mikhael F El-Chami, Raul Weiss, Jay Dinerman, Sam Hanon, Gauthem Kalahasty, Eric Bass, Michael R Gold
OBJECTIVES: This study evaluated spontaneous arrhythmias and clinical outcomes in the S-ICD System PAS (Subcutaneous Implantable Cardioverter-Defibrillator Post Approval Study) cohort. BACKGROUND: The U.S. S-ICD PAS trial patient population more closely resembles transvenous ICD cohorts than earlier studies, which included many patients with little structural heart disease and few comorbidities. Early outcomes and low peri-operative complication rates were demonstrated in the S-ICD PAS cohort, but there are no data detailing spontaneous arrhythmias and clinical outcomes...
November 2020: JACC. Clinical Electrophysiology
Yanan Xie, Jingzhe Han, Jinming Liu, Jie Hao, Xiuguang Zu, Yuming Hao
BACKGROUND: Bidirectional ventricular tachycardia (BVT) is a rare, but serious, arrhythmia. Hypokalemia is commonly found in clinical practice, but hypokalemia-induced BVT has rarely been reported. CASE PRESENTATION: A 74-year-old male patient with the symptoms of chest distress and palpitations was admitted owing to frequent discharge of his implantable cardioverter defibrillator (ICD) for 4 days. Before admission, the patient experienced diarrhea after intake of crabs, and felt frequent discharge of his ICD with a total of approximately 17 discharges in 4 days...
November 2020: Journal of International Medical Research
Anil-Martin Sinha, Jens Bense, Wolfgang Hohenforst-Schmidt
PURPOSE: Large-scale multi-center studies have reported on efficacy of the wearable cardioverter-defibrillator (WCD). However, outcomes focused on WCD patients treated at community-based acute care centers are lacking. METHODS: Patients with cardiomyopathy were included when left ventricular ejection fraction (LVEF) at baseline was ≤ 35%. There were 120 patients meeting the criteria who also had LVEF measured at baseline and after 90 days of WCD use. RESULTS: After 90 days of WCD use, there were 44 (37%) patients in whom LVEF improved to > 35%...
November 17, 2020: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Tobias Schupp, Michael Behnes, Seung-Hyun Kim, Julian Müller, Kathrin Weidner, Linda Reiser, Aydin Huseynov, Armin Bollow, Martin Borggrefe, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Muharrem Akin, Dirk Große Meininghaus, Thomas Bertsch, Ibrahim Akin
This study sought to assess the prognostic impact of treatment with beta-blocker (BB) compared to combined therapy with BB plus amiodarone (BB-AMIO) on recurrences of ventricular tachyarrhythmias in implantable cardioverter-defibrillator (ICD) recipients. A large retrospective registry was used including consecutive ICD recipients with episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with BB were compared to patients treated with BB-AMIO. Kaplan-Meier- and Cox regression analyses were applied for the evaluation of the primary endpoint defined as first recurrences of ventricular tachyarrhythmias at five years...
November 10, 2020: Basic & Clinical Pharmacology & Toxicology
J Bradford Rice, Mary P Panaccio, Alan White, Mark Simes, Emma Billmyer, Nathaniel Downes, John Niewoehner, George J Wan
INTRODUCTION: Repository corticotropin injection (RCI; Acthar® Gel) is indicated for the treatment of acute exacerbations of multiple sclerosis (MS) in adults. Despite the well-documented clinical and economic benefits of RCI, many patients are denied use of the therapy by third-party payers. This study aims to understand the demographic and clinical characteristics of MS relapse patients who received a prescription for RCI from their physicians and then were either approved or denied treatment by their insurers...
November 10, 2020: Neurology and Therapy
N Stulz, W Kawohl, M Jäger, S Mötteli, U Schnyder, U Hepp
BACKGROUND: In line with previous findings, in a recent randomized controlled trial (RCT), we found that home treatment (HT) for acute mental health care can reduce (substitute) hospital use among severely ill patients in crises. This study examined whether the findings of the RCT generalize to HT services provided under routine care conditions. METHODS: We compared patients who received HT during the RCT study phase with patients who received the same HT service after it had become part of routine mental health services in the same catchment area...
October 13, 2020: European Psychiatry: the Journal of the Association of European Psychiatrists
Sandip Vyas, Christopher Monkhouse, Neil Srinivasan, Pier D Lambiase
A 52-year-old gentleman with a subcutaneous implantable defibrillator (S-ICD) implanted in 2015 for primary prevention and a background of hypertrophic cardiomyopathy presented via remote monitoring alert (Boston Scientific Latitude NXT) with an aborted charge episode. The episode showed myopotential noise with baseline wander, and an urgent outpatient follow up was arranged. Upon investigation the S-ICD lead had retracted to the pocket of the generator via a reel mechanism, wrapping the lead around the can...
November 2, 2020: Pacing and Clinical Electrophysiology: PACE
Kevin Willy, Florian Reinke, Benjamin Rath, Christian Ellermann, Julian Wolfes, Nils Bögeholz, Julia Köbe, Lars Eckardt, Gerrit Frommeyer
AIM: The subcutaneous ICD (S-ICD) has evolved to a potential first option for many patients who have to be protected from sudden cardiac death. Many trials have underlined a similar performance regarding its effectiveness in relation to transvenous ICDs and have shown the expected benefits concerning infective endocarditis and lead failure. However, there have also been problems due to the peculiarities of the device, such as oversensing and myopotentials. In this study, we present patients from a large tertiary centre suffering from complications with an S-ICD and propose possible solutions...
November 1, 2020: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Claudia Grellmann, Wojciech Dombrowsky, Volker Fabricius, Robert Suruki, Anna Sheahan, Lars Joeres
INTRODUCTION: Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and psoriasis (PSO) are chronic inflammatory diseases that have a substantial impact on patients' health. This retrospective database study aimed to assess the epidemiology, comorbidities, diagnosis and treatment patterns of RA, PsA and PSO in the German population. METHODS: Data were extracted from the Deutsche Forschungsdatenbank für Abrechnungsinformationen der Krankenversicherung database from 2012 to 2016 for patients aged ≥ 18 years holding full health coverage in the reporting year at least...
October 30, 2020: Advances in Therapy
Nicola R Jones, Matthew Hickman, Sarah Larney, Suzanne Nielsen, Robert Ali, Thomas Murphy, Timothy Dobbins, David A Fiellin, Louisa Degenhardt
BACKGROUND: To examine, among a cohort of opioid dependent people with a history of opioid agonist treatment (OAT), the frequency and incidence rates of non-fatal overdose (NFOD) hospital separations over time, by age and sex. METHODS: Retrospective cohort study of people with a history of OAT using state-wide linked New South Wales (NSW) data. The incidence of NFOD hospital separations involving an opioid, sedative, stimulant or alcohol was defined according to the singular or combination of poisoning/toxic effect using ICD-10-AM codes...
October 18, 2020: Drug and Alcohol Dependence
Amir Sarayani, Xi Wang, Thuy Nhu Thai, Yasser Albogami, Nakyung Jeon, Almut G Winterstein
Background: Before October 2015, pregnancy cohorts assembled from US health insurance claims have relied on medical encounters with International Classification of Diseases-ninth revision-clinical modification (ICD-9-CM) codes. We aimed to extend existing pregnancy identification algorithms into the ICD-10-CM era and evaluate performance. Methods: We used national private insurance claims data (2005-2018) to develop and test a pregnancy identification algorithm...
2020: Clinical Epidemiology
Sabine Tong, Caroline Amand, Alexia Kieffer, Moe H Kyaw
Background: Respiratory Syncytial Virus (RSV) is one of the most frequent causes of acute respiratory infection worldwide. Understanding age-specific health care utilization is necessary to guide effective prevention strategies. This retrospective database analysis assessed the incidence rates of RSV-related health care utilization in the USA over a 7-year period. Methods: Episodes of RSV were identified in the Truven Health MarketScan® Commercial Claims and Encounters database between 2008 and 2014 using ICD-9-CM codes for pneumonia, bronchiolitis and RSV (480-486, 487...
December 2020: Journal of Global Health
Viktor Wintzell, Henrik Svanström, Mads Melbye, Jonas F Ludvigsson, Björn Pasternak, Martin Kulldorff
BACKGROUND AND OBJECTIVES: Tumor necrosis factor-alpha (TNF-α) inhibitors are efficacious and considered generally safe in adults. However, pediatric-specific safety evidence is scarce. The aim of this study was to screen for signals of previously unknown adverse events of TNF-α inhibitors in pediatric patients. METHODS: We conducted a data-mining study based on routinely collected, nationwide Danish healthcare data for 2004-2016. Using tree-based scan statistics to identify events with unexpectedly high incidence during TNF-α inhibitor use among patients with inflammatory bowel disease or juvenile idiopathic arthritis, two analyses were performed: comparison with episodes of no use and with other time periods from the same patient...
October 26, 2020: Clinical Drug Investigation
Michael R Gold, Pier D Lambiase, Mikhael F El-Chami, Reinoud E Knops, Johan D Aasbo, Maria Grazia Bongiorni, Andrea M Russo, Jean Claude Deharo, Martin C Burke, Jay Dinerman, Craig S Barr, Naushad Shaik, Nathan Carter, Thomas Stoltz, Kenneth M Stein, Amy J Brisben, Lucas V Boersma
Background: The Subcutaneous ICD (S-ICD) is safe and effective for sudden cardiac death prevention. However, patients in previous S-ICD studies had fewer comorbidities, less left ventricular dysfunction and received more inappropriate shocks (IAS) than in typical transvenous (TV)-ICD trials. The UNTOUCHED trial was designed to evaluate the IAS rate in a more typical, contemporary ICD patient population implanted with the S-ICD using standardized programming and enhanced discrimination algorithms. Methods: Primary prevention patients with left ventricular ejection fraction (LVEF) ≤ 35% and no pacing indications were included...
October 19, 2020: Circulation
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