Subcutaneous Immunotherapy for Allergic Rhinoconjunctivitis, Allergic Asthma, and Prevention of Allergic Diseases
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2014
When defining the indication for SCIT for inhalant allergies, it is advantageous to recognize that the allergen–IgE reaction results in a multiorgan disease, with symptoms occurring in multiple organs including the eyes, nose, and lungs [11]. Some patients have symptoms predominantly from one organ, which does not indicate an absence of inflammation in other parts of the airway [14]. Consequently, all symptoms should be considered when selecting the most appropriate treatment of the allergic disease [11]. Before instituting SCIT, the following must be considered: 1) the severity and duration of symptoms; 2) the requirement for and the effect of pharmaceutical therapy; 3) the risk incurred by the pharmacological treatment and the risk of the disease; 4) psychological factors; 5) the patient’s attitude related to alleviating symptoms (drugs) versus interfering with the pathophysiological background of the disease (specific treatment), and the potentially long-term cost-saving capacity of SCIT.
Drug Development and the Use of Pharmacokinetics/Toxicokinetics in Selecting the First Dose of Systemically Administered Drugs in Humans—A Nonclinical Perspective
John C. Lipscomb, Edward V. Ohanian in Toxicokinetics and Risk Assessment, 2016
After a lead candidate is selected, the studies agreed to and suggested by the international conference on harmonization (ICH) guidances will be planned and/or conducted. These would include local tolerance, genotoxicity, repeat dose toxicity, developmental/reproductive toxicity, chronic toxicity, carcinogenicity, and safety pharmacology [generally adverse pharmacologic effects on the cardiovascular, central nervous system, and respiratory systems, per the U.S. Food and Drug Administration (FDA) (5,6)]. When these studies need to be submitted to the FDA is dependent on the stage of drug development and duration of the proposed clinical protocol per the FDA (7). Although chronic toxicology or carcinogenicity studies may not be needed at the earliest stages of drug development, they may be planned and initiated early in drug development, if the therapeutic indication for the drug is non-life-threatening and chronic, so as not to delay drug approval if clinical studies are not of long duration.
Augmenting Attention with Brain–Computer Interfaces
Chang S. Nam, Anton Nijholt, Fabien Lotte in Brain–Computer Interfaces Handbook, 2018
We focus mostly on visual attention because of the abundance of neurophysiological and BCI studies in this field. The visual system translates very complex input information from the external world into a stable neural representation. The emergence of such a representation can be described as a process of information reduction, where only behaviorally relevant visual inputs are processed (Sprague et al. 2015). For instance, for a driver moving toward a crossing point, it is essential to have the capacity to recognize traffic lights while disregarding insignificant light sources. Attention is the ability of the brain to suppress the superfluous sources of information and select only the relevant ones. This key brain function can suffer because of neurological conditions. Patients with disorders of attention have difficulty focusing on the relevant pieces of information and get easily distracted. Attention-deficit/hyperactivity disorder (ADHD) is a mental condition characterized by deteriorated attention, hyperactivity, and impulsivity (Biederman et al. 2000; Faraone et al. 2006). Treatment approaches to ADHD have been mostly pharmacological, such as the usage of psychostimulants. However, pharmacological treatment is often associated with unwanted side effects (Conners et al. 2001; Greenhill et al. 2001). There is also an associated substance abuse problem (Kollins 2008; Steiner et al. 2014a). Psychological therapy can be used as an alternative treatment for ADHD, but it is effective only in 30% of cases (Zarin et al. 1998).
PRN Medication Events in a Forensic Psychiatric Hospital: A Document Analysis of the Prevalence and Reasons
Published in International Journal of Forensic Mental Health, 2020
Kirsi Hipp, Eila Repo-Tiihonen, Lauri Kuosmanen, Jouko Katajisto, Mari Kangasniemi
This paper focuses on the prevalence of and reasons for forensic inpatients’ pro re nata (PRN) medication. PRN medication is prescribed so that it can be taken as needed when acute physical and psychiatric health problems arise. It is part of the pharmacological treatment that patients receive and is used in addition to, or instead of, scheduled medication. PRN is prevalent in psychiatric inpatient settings (Douglas-Hall & Whicher, 2015; Vaismoradi et al., 2018) and studies have indicated that 70–90% of patients receive psychotropic PRN, medication used for psychiatric conditions (Baker et al., 2008b; Curtis et al., 2007; Martin et al., 2017; Stewart et al., 2012). PRNs are also frequently used in forensic inpatients’ care, which promotes patients’ wellbeing and daily functioning and protects society from dangerous offenders (Felthous & Saß, 2014; Kumpula et al., 2019; Mental Health Act, 1990). One forensic hospital study found that 37% of patients received sedative PRNs over a two-week period (Haw & Wolstencroft, 2014).
Sex-based differences in pain distribution in a cohort of patients with persistent post-traumatic neck pain
Published in Disability and Rehabilitation, 2018
Hans Westergren, Johan Larsson, Michael Freeman, Anna Carlsson, Anna Jöud, Eva-Maj Malmström
Patients who currently received adequate treatment at the referring institution were referred back with recommendations.In cases where psychological distress was identified as having a major impact on the patient’s health, for example major depression or PTSD, the patients were referred for psychiatric treatment before further in-house interventions.Patients who were treated in-house could be referred to a single-service pain rehabilitation physiotherapy program, a multi-professional pain rehabilitation program based on cognitive behavioral therapy, or a combination of the two.Pharmacological treatment was also considered, using medications such as NSAIDs or Cox2 inhibitors, paracetamol, SSRIs or SNRIs, and in some selected cases low-dose opioids.Of the 745 patients assessed, 542 were treated in-house whilst 203 were either referred to other specialties or referred back to the referring unit with recommendations.
A Systematic Review of Psychosocial Interventions in Treatment of Opioid Addiction
Published in Journal of Social Work Practice in the Addictions, 2018
Pharmacological treatment was compared in all but one of the 14 articles included in this review. The most common type of pharmacological treatment implemented was buprenorphine, which was used in nine of the studies (Barry et al., 2015; Fiellin et al., 2013; Lander et al., 2015; Moore et al., 2016; Smallwood et al., 2016; Stein et al., 2015; Tetrault et al., 2012; Weiss et al., 2011). Buprenorphine was typically used in combination with naloxone for maintenance induction. Methadone was used in four of the included studies (Marsch et al., 2014; Otto et al., 2014; Schwartz et al., 2012; Stotts et al., 2012). In all but one of the studies, pharmacological treatment was implemented for induction and maintenance. In one study (Stotts et al., 2012), instead of induction and maintenance, the groups were compared during methadone dose reduction with the goal of detoxification from methadone.
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