Laboratory Testing in Psychiatry

2020 ◽  
Author(s):  
Royce P Gray ◽  
Alexander W Thompson
Keyword(s):  
Eating Disorders ◽  
Laboratory Testing ◽  
Psychiatric Hospitals ◽  
Mood Stabilizers ◽  
Blood Dyscrasia ◽  
Urine Drug Screen ◽  
Metabolic Monitoring ◽  
Urine Drug ◽  
Common Laboratory

We review common laboratory testing encountered in psychiatric practice. It seems likely that in areas where the most evidence exists driving laboratory testing (e.g., metabolic monitoring for people on atypical antipsychotics), testing still is not universally done, and we often do not adequately address the results. However, in areas where there is little evidence supporting the practice (extensive laboratory testing on people being admitted to a psychiatric hospitals), we order tests extensively. We cover common tests encountered in the use of antipsychotics, antidepressants, mood stabilizers, antiepileptic drugs, and lithium. We also discuss the role of thyroid, vitamin B12, and folate testing and the special circumstance of caring for those with eating disorders. This review contains 2 highly rendered figures, 20 tables, and 44 references. Key words: agranulocytosis, antidepressant, antiepileptic drug, antipsychotic, blood dyscrasia, clozapine, eating disorders, metabolic monitoring, QT interval, urine drug screen 

Epidemiology and antimicrobial resistance of Acinetobacter

2018 ◽  
Vol 2 (4) ◽  
pp. 46-59
Author(s):  
A.G. Salmanov ◽  
O.M. Verner ◽  
L.F. Slepova
Keyword(s):  
Antibiotic Resistance ◽  
Laboratory Testing ◽  
Immunocompromised Host ◽  
Clinical Problem ◽  
Healthcare Associated Infections ◽  
Opportunistic Bacteria ◽  
Acinetobacter Spp ◽  
Healthcare Associated ◽  
Major Clinical Problem

Species of the Acinetobacter represent opportunistic bacteria with a growing clinical significance for Healthcare-associated infections (HAIs). In this literature review, we focus on the current role of Acinetobacter in infectious pathology and describe taxonomy, pathogenicity, and antibiotic resistance of these bacteria. Pathogenesis and regulation of virulence factors in Acinetobacter spp. are described in detail. The majority of acinetobacterial infections are associated with A. baumannii and occur predominantly in an immunocompromised host. Usually, acinetobacterial  infections  are characterized by local purulent inflammation; in severe cases, meningitis and sepsis may develop. Antibiotic resistance of Acinetobacter is a major clinical problem; therefore we give special attention to laboratory testing of resistance to antibiotics as well as identification of Acinetobacter.

scholarly journals Evaluation of an opioid risk mitigation initiative for veterans undergoing hip or knee arthroplasty at San Francisco Veterans Affairs Heath Care System

2020 ◽  
Author(s):  
Tessa Rife ◽  
Christina Tat ◽  
Mahsa Malakootian
Keyword(s):  
San Francisco ◽  
Knee Arthroplasty ◽  
Risk Mitigation ◽  
Opioid Therapy ◽  
Veterans Affairs ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
Urine Drug ◽  
Medication Disposal ◽  
Urine Drug Screening

Abstract Purpose Guidelines recommend evaluating the risk of opioid-related adverse events prior to initiating opioid therapy. The orthopedic service at San Francisco Veterans Affairs Health Care System (SFVHCS) has not routinely used risk assessment tools such as the Stratification Tool for Opioid Risk Mitigation, prescription drug monitoring program data, and urine drug screening prior to opioid prescribing. A quality improvement project was conducted to evaluate the number of pharmacist-provided opioid risk mitigation recommendations implemented by orthopedic providers for patients who underwent total hip or knee arthroplasty at SFVHCS. Summary A pharmacist-led workflow for completing risk mitigation reviews was developed in collaboration with orthopedic providers, and urine drug screening was added to the preoperative laboratory testing protocol. The following recommendations were communicated via electronic medical record: limit postoperative opioids to a 7- or 14-day supply based on risk of suicide and/or overdose, offer naloxone and a medication disposal bag, and order a urine drug screen if not already completed. Risk reviews were completed for 75 patients. Among 64 patients with 2-month postdischarge data available, 88% (7 of 8) of 7-day and 79% (44 of 56) of 14-day opioid supply recommendations were implemented; 41% (26 of 59) of recommendations to issue a medication disposal bag, 17% (2 of 12) recommendations to order a missing urine drug screen, and 9% (5 of 55) of recommendations to offer naloxone were implemented. Conclusion Pharmacist-performed risk mitigation reviews paired with individualized recommendations led to high rates of orthopedic provider acceptance of limiting postdischarge opioid day supplies for patients who had total hip or knee arthroplasty. Alternative strategies may increase access to naloxone. Future research should examine the impact of risk mitigation tools in reducing prescribing of long-term opioid therapy and adverse events among orthopedic surgical patients.

Gatifloxacin Interference with Opiate Urine Drug Screen

2006 ◽  
Vol 26 (3) ◽  
pp. 435-439 ◽  
Author(s):  
Craig M Straley ◽  
Eric J Cecil ◽  
Mark P Herriman
Keyword(s):  
Drug Screen ◽  
Urine Drug Screen ◽  
Urine Drug

Leptin Functioning in Eating Disorders

CNS Spectrums ◽  
2004 ◽  
Vol 9 (7) ◽  
pp. 523-529 ◽  
Author(s):  
Palmiero Monteleone ◽  
Antonio DiLieto ◽  
Eloisa Castaldo ◽  
Mario Maj
Keyword(s):  
Physical Activity ◽  
Eating Disorders ◽  
Body Weight ◽  
Eating Behaviors ◽  
Clinical Manifestations ◽  
Immune Functions ◽  
Abnormal Eating ◽  
The Brain

AbstractLeptin is an adipocyte-derived hormone, which is involved predominantly in the long-term regulation of body weight and energy balance by acting as a hunger suppressant signal to the brain. Leptin is also involved in the modulation of reproduction, immune function, physical activity, and some endogenous endocrine axes. Since anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by abnormal eating behaviors, dysregulation of endogenous endocrine axes, alterations of reproductive and immune functions, and increased physical activity, extensive research has been carried out in the last decade in order to ascertain a role of this hormone in the pathophysiology of these syndromes. In this article, we review the available data on leptin physiology in patients with eating disorders. These data support the idea that leptin is not directly involved in the etiology of AN or BN. However, malnutrition-induced alterations in its physiology may contribute to the genesis and/or the maintenance of some clinical manifestations of AN and BN and may have an impact on the prognosis of AN.

The Role of Non-Suicidal Self-Injury and Binge-Eating/Purging Behaviours in Family Functioning in Eating Disorders

2015 ◽  
Vol 23 (5) ◽  
pp. 413-416 ◽  
Author(s):  
Lies Depestele ◽  
Laurence Claes ◽  
Eva Dierckx ◽  
Imke Baetens ◽  
Katrien Schoevaerts ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Family Functioning ◽  
Binge Eating ◽  
Self Injury

Treatment of Antidepressant-Resistant Bulimia with Naltrexone

1987 ◽  
Vol 16 (4) ◽  
pp. 305-309 ◽  
Author(s):  
Jeffrey M. Jonas ◽  
Mark S. Gold
Keyword(s):  
Eating Disorders ◽  
Preliminary Data ◽  
Endogenous Opioids ◽  
Opiate Antagonist ◽  
Percent Reduction ◽  
Bulimic Symptoms ◽  
Long Acting ◽  
Insight Into

Ten individuals with antidepressant-resistant bulimia were treated with the long-acting opiate antagonist naltrexone. Seven of the ten experienced at least a 75 percent reduction of their bulimic symptoms, and have maintained their improvment on three to five month follow-up. These preliminary data suggest that naltrexone may be of use in bulimia unresponsive to standard antidepressant therapy, and may provide insight into the role of endogenous opioids in the etiology of eating disorders.

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