Jodi A Worrel PharmD , Steven C Stoner PharmD, BCPP
{"title":"Eradication of Helicobacter Pylori","authors":"Jodi A Worrel PharmD , Steven C Stoner PharmD, BCPP","doi":"10.1016/S1082-7579(98)00012-0","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00012-0","url":null,"abstract":"<div><p>Since the discovery of <span><span>Helicobacter pylori</span></span><span> just over 15 years ago, the treatment of peptic ulcer disease has been revolutionized. </span><em>H. pylori</em> is an important causative factor for the development of duodenal and gastric ulcers. Because <em>H. pylori</em><span> can be eradicated with very low rates of ulcer recurrence, antibiotic therapy is now recommended by the National Institutes of Health (NIH) and the American College of Gastroenterology for all </span><em>H. pylori-</em><span>positive ulcer patients. Bismuth subsalicylate<span><span><span>, antibiotics (amoxicillin, tetracycline, </span>metronidazole, and clarithromycin), </span>proton pump inhibitors, and H</span></span><sub>2</sub> blockers are the standards for treatment. They are combined in dual, triple, and quadruple therapy regimens to produce <em>H. pylori</em> eradication. All of the phamacologic agents currently prescribed for <em>H. pylori</em> eradication are associated with bothersome adverse effects and numerous documented and potential drug interactions. Because no gold standard for <em>H. pylori</em><span> eradication exists, the treatment decision must be on the basis of efficacy, cost, compliance, tolerability, antimicrobial resistance, and potential drug interactions.</span></p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 4","pages":"Pages 99-104"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00012-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91722691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melisa M Holmes MD , Elizabeth J Letourneau MD , Stephen T Vermillion MD
{"title":"A Psychiatrist’s Guide to Sexual Dysfunction in Women","authors":"Melisa M Holmes MD , Elizabeth J Letourneau MD , Stephen T Vermillion MD","doi":"10.1016/S1082-7579(98)00013-2","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00013-2","url":null,"abstract":"<div><p>Sexuality is an integral component of a woman’s global well-being. Sexual dysfunction not only contributes to personal and interpersonal stress<span> but also may herald other medical or psychosocial problems that significantly affect a woman’s health. Many physicians feel uncomfortable or inadequately trained to discuss sexuality issues with their patients, but the vast majority of patients believe that it is appropriate for physicians to address sexual function within the context of routine physical and mental health assessments. While many women experience sexual dissatisfaction or dysfunction, they may feel uncomfortable volunteering the information. It is crucial that health care providers, particularly psychiatrists, avoid making assumptions about a patient’s sexual behaviors or preferences and ask directly about sexual functioning and concerns. The psychiatrist can become more comfortable discussing sexual issues with patients by gaining an understanding of the normal sexual response and developing an approach to the evaluation and treatment of common sexual dysfunctions. Asking about sexual concerns and problems will provide an opportunity to educate patients and dispel sexual misconceptions. Furthermore, it will give patients “permission” to address sexual issues in a professional, confidential, and non-judgmental setting. The information provided in this manuscript is considered to be relevant for psychiatrists who practice in in-patient, out-patient and community care settings.</span></p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 4","pages":"Pages 105-112"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00013-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91722689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gastroenteritis","authors":"Barbara B Bennett MD","doi":"10.1016/S1082-7579(98)00010-7","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00010-7","url":null,"abstract":"<div><p><span>Gastroenteritis<span> is inflammation of the gastrointestinal tract caused by ingestion<span> of pathogens or their toxins in contaminated food or water. The most common etiologic agents in the United States are viruses, especially Rotaviruses in children and Norwalk-type viruses in adults. Common bacteria that cause gastroenteritis include </span></span></span><em>Escherichia coli</em>, <span><em>Campylobacter jejuni</em></span>, <em>Salmonella</em> species, <span><em>Shigella sonnei</em></span>, and <span><em>Vibrio</em></span> species. The toxins of <span><em>Staphylococcus aureus</em></span>, <span><em>Bacillus cereus</em></span>, and <span><em>Clostridium difficile</em></span><span> may also cause disease. Patients with gastroenteritis experience abdominal pain and diarrhea with or without vomiting or fever. In the majority of cases, symptoms are brief, and patients do not require medical attention. If symptoms are prolonged or severe, diagnostic testing and treatment may be indicated. Microscopic examination of stool for leukocytes, stool culture, and testing for </span><em>C. difficile</em><span><span><span><span> toxin are the most valuable diagnostic studies. Oral rehydration therapy is the mainstay of treatment of </span>acute gastroenteritis<span>, and antibiotics are seldom required. When necessary, the most useful choices for treatment of acute infectious diarrhea include trimethoprim-sulfamethoxazole, quinolones, and macrolide antibiotics. </span></span>Metronidazole<span> is efficacious for treatment of pseudomembranous colitis. Treatment with nonantibiotic medications, such as </span></span>bismuth subsalicylate<span>, loperamide<span> or diphenoxylate with atropine offers symptomatic relief in cases of noninflammatory infectious diarrhea.</span></span></span></p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 4","pages":"Pages 95-98"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00010-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91722690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William T Dauer MD , Stanley Fahn MD , Robert E Burke MD
{"title":"The Diagnosis and Treatment of Tardive Disorders","authors":"William T Dauer MD , Stanley Fahn MD , Robert E Burke MD","doi":"10.1016/S1082-7579(98)00016-8","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00016-8","url":null,"abstract":"<div><p>Drugs that block dopamine receptors (dopamine receptor blocking agents; DRBA) may cause a variety of movement disorder syndromes. Among these syndromes are the tardive disorders, which are characterized by an onset weeks to years after the start of DRBA therapy and persist or even worsen after DRBA discontinuation. The tardive disorders may sometimes be permanent. The most common tardive disorders are oral–buccal–lingual dyskinesia, tardive dystonia, and tardive akathisia. The clinical characteristics and treatment of these syndromes are reviewed. Initial evaluation of a patient with a tardive disorder should focus on whether the offending DRBA may be discontinued, and whether the symptoms are severe enough to warrant symptomatic therapy. If it is necessary to continue antipsychotic therapy, consideration should be given to the novel antipsychotic clozapine, which does not cause tardive syndromes and may even ameliorate them. In general, the dopamine depletors reserpine and tetrabenazine are the most effective agents in the symptomatic treatment of the tardive syndromes. Other medications used in the treatment of the tardive syndromes are also reviewed.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 4","pages":"Pages 119-125"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00016-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91722692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Diagnosis and Treatment of Tardive Disorders","authors":"W. Dauer, S. Fahn, R. Burke","doi":"10.1016/S1082-7579(98)00016-8","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00016-8","url":null,"abstract":"","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"75 1","pages":"119-125"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74311888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael L Pearl MD , Gulnaz Talgat MD , Fidel A Valea MD , Eva Chalas MD
{"title":"Psychiatric Symptoms Due to Brain Metastases","authors":"Michael L Pearl MD , Gulnaz Talgat MD , Fidel A Valea MD , Eva Chalas MD","doi":"10.1016/S1082-7579(98)00011-9","DOIUrl":"10.1016/S1082-7579(98)00011-9","url":null,"abstract":"<div><p><span>Brain metastases account for nearly 170,000 new cases annually in the United States. Although the majority of patients present with </span>neurological symptoms, a minority will develop psychiatric symptoms. Misdiagnosis and delayed treatment are common, with potentially serious consequences. Appropriate intervention may improve the patient’s prognosis and quality of life; thus, early and accurate diagnosis is crucial. This article provides an overview of the diagnosis and management of patients with psychiatric symptoms due to brain metastases.</p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 4","pages":"Pages 91-94"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00011-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84130888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Myasthenia Gravis","authors":"James M Gilchrist MD","doi":"10.1016/S1082-7579(98)00014-4","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00014-4","url":null,"abstract":"<div><p><span><span>Myasthenia gravis is an autoimmune disease caused by antibodies directed against the </span>acetylcholine receptor<span> at the neuromuscular junction, resulting in fatigable weakness of </span></span>skeletal muscles<span><span>. Effects on central cholinergic pathways and neuropsychologic function are controversial. This article will review the diagnosis of myasthenia gravis, using clinical, historical, pharmacologic, </span>electrodiagnostic<span>, and immunologic methods, and the treatment of myasthenia, both symptomatic and immunosuppressive. The effect of various medications on myasthenia gravis will also be reviewed to help prevent inadvertant acute exacerbation or unmasking of the disease.</span></span></p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 4","pages":"Pages 113-118"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00014-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91757507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Depression in the Post-Myocardial Infarction Patient","authors":"B. Felker, M. Shores, Karen Gibbon R Ph","doi":"10.1016/S1082-7579(98)00015-6","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00015-6","url":null,"abstract":"","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"96 1","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73627266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Psychiatrist’s Guide to Sexual Dysfunction in Women","authors":"M. Holmes, Elizabeth J. Letourneau, S. Vermillion","doi":"10.1016/S1082-7579(98)00013-2","DOIUrl":"https://doi.org/10.1016/S1082-7579(98)00013-2","url":null,"abstract":"","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"39 1","pages":"105-112"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78033497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W.Victor R Vieweg MD , Linda M Dougherty PhD , Nelson L Bernardo MD
{"title":"Mental Stress and the Cardiovascular System Part VI. Chronic Mental Stress and Cardiovascular Disease: Psychosocial Factors","authors":"W.Victor R Vieweg MD , Linda M Dougherty PhD , Nelson L Bernardo MD","doi":"10.1016/S1082-7579(98)00005-3","DOIUrl":"10.1016/S1082-7579(98)00005-3","url":null,"abstract":"<div><p>This paper extends our review of mental stress and the cardiovascular system. We focus on the psychosocial factors<span> of life events, socioeconomic status (SES), and social isolation or disruption. Life events (positive or negative) bring changes in baseline emotional state. Change, in and of itself, may adversely affect the cardiovascular system. Thus, subjects exposed to an increased number of life events over a short time may develop clinical manifestations of coronary artery disease independent of the nature of the life events. SES incorporates many lifestyle issues. Subjects with low SES may have many cardiac risk factors because of their location within the SES hierarchy and are more likely to suffer adverse cardiovascular events than subjects with high SES. Therefore, this psychosocial risk factor should be assessed in any investigation of the relationship between mental stress and cardiovascular disease. Social isolation or disruption may adversely affect the origin, course, and outcome of coronary artery disease. Also, this psychosocial factor may act synergistically with other cardiac risk factors such as high cholesterol diet to accelerate the course of coronary atherosclerosis.</span></p></div>","PeriodicalId":100909,"journal":{"name":"Medical Update for Psychiatrists","volume":"3 3","pages":"Pages 82-85"},"PeriodicalIF":0.0,"publicationDate":"1998-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1082-7579(98)00005-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80948855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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