scholarly journals Effectiveness of Varenicline in Psychiatric Patients with Co-Morbid Polysubstance Dependence

2014 ◽  
Vol 11 (1) ◽  
pp. 1-4
Author(s):  
Jungjin Kim ◽  
Prashant Kaul ◽  
Thomas L. Schwartz ◽  
James Megna

Introduction: Individuals with substance use disorders (SUDs) and mental health disorders (MHDs) have greater prevalence of smoking and suffer greater tobacco-related morbidity and mortality. Varenicline is the latest FDA-approved smoking-cessation agent and few studies have investigated the use of varenicline in this difficult-to-treat population.Aims: This study examines the smoking cessation outcomes and tolerability of varenicline when used to help quit smoking in 16 patients enroled in both psychiatric and substance abuse programme.Methods: A retrospective chart review was conducted on 16 patient charts. Patient demographics, psychiatric disorder diagnoses, substance use history, dosing, side effects, number of cigarettes used pre/post varenicline use and the number of complete smoking cessation outcomes were tabulated.Results: After varenicline intervention, 25% of those who completed treatment completely quit smoking. Thirty-one per cent were able to substantially cut back the amount that they smoked to one cigarette per day. The average reduction in cigarettes was 16 per day (64%), and all but one patient tolerated varenicline.Conclusions: The authors observed reasonable clinical benefit when varenicline was used to help quit smoking in patients with comorbid SUDs and MHDs. Better-controlled future studies with larger sample sizes will help further determine clinical utility of varenicline in this difficult-to-treat nicotine-dependent population.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S339-S340
Author(s):  
Kathleen R Sheridan ◽  
Joshua Wingfield ◽  
Lauren McKibben ◽  
Natalie Clouse

Abstract Background OPAT is a well-established model of care for the monitoring of patients requiring long-term IV antibiotics1. We have previously reported a reduction in the 30-day readmission rate to our facility for patients managed in our OPAT program. However, little has been published to date regarding outcomes in OPAT patients over 80 years of age 2–3. Our OPAT program was established in 2013. Patients can be discharged to a facility or home to complete their course of antibiotics. Methods We conducted a retrospective chart review of all OPAT patients discharged from our facility from 2015 to 2018. Patients were divided into two groups based on age, <80 (n = 4618) and >80 (n = 562). Results Patient demographics are listed in Table 1. The overall 30-day readmission rate for patients older than 80 was 27.8%. For patients over 80 that had a follow-up ID clinic appointment, the 30-day readmission rate decreased to 15.7%. For patients younger than 80, the 30-day readmission rate was 36.0% with a decrease to 16.2% if patients were evaluated in the outpatient clinic. Figure 1. Staphylococcus Aureus was the predominant organism in both age categories. Vancomycin was the most common antibiotic used in both age groups followed by β lactams. Conclusion In general, patients aged over 80 years were more likely to be discharged to a facility to complete their antibiotic course than younger patients. These patients also were more likely to have other comorbidities. The 30-day readmission rate in each age group was relatively similar. OPAT in patients over age 80 can have similar 30-day readmission rates as for patients less than 80 years of age Disclosures All authors: No reported disclosures.


2020 ◽  
Vol 17 (4) ◽  
pp. 320-330
Author(s):  
Yubeen Bae ◽  
Yoanna Seong ◽  
Seok Hyeon Kim ◽  
Sojung Kim

Objective Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study, we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts.Methods We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric department of a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of three groups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristics and psychological assessments.Results Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likely to be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorder than the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8, RC9 in MMPI-2.Conclusion Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychological disturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.


2008 ◽  
Vol 9 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Eric M. Horn ◽  
Peter Nakaji ◽  
Stephen W. Coons ◽  
Curtis A. Dickman

Spinal meningeal melanocytomas are rare lesions that are histologically benign and can behave aggressively, with local infiltration. The authors present their experience with intramedullary spinal cord melanocytomas consisting of 3 cases, which represents the second largest series in the literature. A retrospective chart review was performed following identification of all spinal melanocytomas treated at the author's institution, based on information obtained from a neuropathology database. The charts were reviewed for patient demographics, surgical procedure, clinical outcome, and long-term tumor progression. Three patients were identified in whom spinal melanocytoma had been diagnosed between 1989 and 2006. The patients' ages were 37, 37, and 48 years, and the location of their tumor was C1–3, T9–10, and T-12, respectively. All 3 had complete resection with no adjuvant radiotherapy during follow-up periods of 16, 38, and 185 months, respectively. One patient demonstrated a recurrence 29 months after resection and the other 2 patients have demonstrated asymptomatic recurrences on imaging studies obtained at 16 and 38 months following resection. With these cases added to the available literature, the evidence strongly suggests that complete resection is the treatment of choice for spinal melanocytomas. Even with complete resection, recurrences are common and close follow-up is needed for the long term in these patients. Radiation therapy should be reserved for those cases in which complete resection is not possible or in which there is recurrence.


2007 ◽  
Vol 1 (4) ◽  
pp. 191-197 ◽  
Author(s):  
Jaimee L. Heffner ◽  
Thomas J. Blom ◽  
Elaine Camerota ◽  
Linda E. Sansone ◽  
Linda Bodie ◽  
...  

1983 ◽  
Vol 53 (3_suppl) ◽  
pp. 1119-1122
Author(s):  
Charles S. Newmark ◽  
Pamela Chassin ◽  
Lee Gentry ◽  
Dwight L. Evans

DSM-III diagnoses of 55 hospitalized psychiatric male patients who produced “floating” MMPI profiles were obtained via retrospective chart review. A prospective study of 16 then was conducted to cross-validate the initial diagnostic findings The results from both investigations suggested that at least half of these hospitalized psychiatric patients received a DSM-III diagnosis of either borderline personality disorder or major depressive disorder. A paucity of schizophrenic diagnoses was noted.


2017 ◽  
Vol 131 (6) ◽  
pp. 529-533 ◽  
Author(s):  
M Y Lan ◽  
J P Park ◽  
Y J Jang

AbstractObjective:Conchal cartilage is frequently used in rhinoplasty, but donor site morbidity data are seldom reported. This study aimed to investigate the complications of conchal cartilage harvesting in rhinoplasty.Methods:A retrospective chart review of 372 patients who underwent conchal cartilage harvesting for rhinoplasty was conducted. Data regarding patient demographics, types of nasal deformities, graft usage and complications were analysed.Results:A total of 372 patients who underwent conchal cartilage harvesting for rhinoplasty were enrolled. The harvested conchal cartilage tissues were used in a variety of applications: tip graft, dorsal graft, septal reinforcement and correction of nostril asymmetry. Nine cases (2.4 per cent) with donor site morbidities were identified, including four cases (1.1 per cent) with keloids and five cases (1.3 per cent) with haematomas.Conclusion:Conchal cartilage harvesting is a safe and useful technique for rhinoplasty, with a low complication rate. However, patients should be informed about the possibility of donor site morbidities such as keloids and haematomas.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Major ◽  
Katherine Rittenbach ◽  
Frank MacMaster ◽  
Hina Walia ◽  
Stephanie D. VandenBerg

Abstract Background This study quantifies the frequency of adverse events (AEs) experienced by psychiatric patients while boarded in the emergency department (ED) and describes those events over a broad range of categories. Methods A retrospective chart review (RCR) of adult psychiatric patients aged 18–55 presenting to one of four Calgary EDs (Foothills Medical Centre (FMC), the Peter Lougheed Centre (PLC), the Rockyview General Hospital (RGH), and South Health Campus (SHC)) who were subsequently admitted to an inpatient psychiatric unit between January 1, 2019 and May 15, 2019 were eligible for review. A test of association was used to determine the odds of an independent variable being associated with an adverse event. Results During the study time period, 1862 adult patients were admitted from EDs (city wide) to the psychiatry service. Of the 200 charts reviewed, the average boarding time was 23.5 h with an average total ED length of stay of 31 h for all presentations within the sample. Those who experienced an AE while boarded in the ED had a significantly prolonged average boarding time (35 h) compared to those who did not experience one (6.5 h) (p = 0.005). Conclusions The length of time a patient is in the emergency department and the length of time a patient is boarded after admission significantly increases the odds that the patient will experience an AE while in the ED. Other significant factors associated with AEs include the type of admission and the hospital the patient was admitted from.


2008 ◽  
Vol 24 (suppl 4) ◽  
pp. s621-s634 ◽  
Author(s):  
André Salem Szklo

This paper reviews published articles describing several instruments used currently to "capture" the attention of smokers for quit-smoking interventions and emphasizes the distinction between the strategies used to reach eligible individuals and those used to recruit them for the proposed smoking cessation intervention. The search for articles was conducted using MEDLINE, PsychARTICLE, and LILACS. Key words for the search included recruitment, enrollment, reach, smoking cessation, quitline, and helpline mentioned in the abstracts and titles of the articles. Articles published in English, Portuguese, and Spanish through November 2006 that emphasized capture instruments related to different populations and specific interventions were included in this review. Twenty-nine studies met the inclusion criteria. Studies that used active and mixed strategies reached, on average, a smaller and less diverse possible number of eligible individuals and had greater participation proportions than those that used reactive strategies. Future studies are needed to evaluate the effectiveness of new associations between current interventions and reactive capture strategies, in view of the potential for increasing the population impact related to reactive capture.


Author(s):  
P. V. Asharani ◽  
Vanessa Ai Ling Seet ◽  
Edimansyah Abdin ◽  
Fiona Devi Siva Kumar ◽  
Peizhi Wang ◽  
...  

This study aims to understand (a) the prevalence and correlates of smoking in a psychiatric population, (b) factors that encourage smoking cessation, and (c) awareness towards cessation programmes. This study captured data (n = 380) through a modified version of the Global Adult Tobacco Survey (GATS). A descriptive analysis of the data was performed. The prevalence of smoking was 39.5% (n = 150) and 52.3% of the smokers were dependent on nicotine. More than half of the smokers had made at least one attempt to quit in the past 12 months and 56% reported no immediate plans to quit smoking. The awareness towards institutional smoking cessation programmes was fair (44%), with 49.7% of smokers having indicated that they were willing to use the service upon referral. Smokers endorsed that increasing the cost of cigarettes, restricting availability, and increasing knowledge of health harms could encourage smoking cessation. Past smokers reported that self-determination/willpower followed by substitution of smoking with other types of foods and drinks were factors that helped them achieve successful cessation. Given that the readiness to quit and awareness towards cessation programmes are low among the smokers, concerted efforts through educational programmes and policy changes are crucial to achieve successful cessation.


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