Search

A good understanding of cutaneous nerve entrapment syndromes is important for physicians to provide early and accurate diagnosis and treatment. These syndromes have traditionally been managed with analgesics, antidepressants or antiepileptic medication but this approach is often inadequate and causes frequent adverse medication effects. With early diagnosis and treatment, many nerve entrapment syndromes can be successfully managed with physical, non-pharmacological approaches including stretches, exercises and physiotherapy.

We analysed participants with type 2 diabetes (n = 46) within a larger weight loss trial (n = 146) who were randomized to 48 weeks of a low-carbohydrate diet (LCD; n = 22) or a low-fat diet + orlistat (LFD + O; n = 24). At baseline, mean body mass index (BMI) was 39.5 kg/m(2) (s.d. 6.5) and haemoglobin A1c (HbA1c) 7.6% (s.d. 1.3). Although the interventions reduced BMI similarly (LCD -2.4 kg/m(2) ; LFD + O -2.7 kg/m(2) , p = 0.7), LCD led to a relative improvement in HbA1c: -0.7% in LCD versus +0.2% in LFD + O [difference -0.8%, 95% confidence interval (CI) = -1.6, -0.02; p = 0.045]. LCD also led to a greater reduction in antiglycaemic medications using a novel medication effect score (MES) based on medication potency and total daily dose; 70.6% of LCD versus 30.4% LFD + O decreased their MES by ≥50% (p = 0.01). Lowering dietary carbohydrate intake demonstrated benefits on glycaemic control beyond its weight loss effects, while at the same time lowering antiglycaemic medication requirements.

The task of medication monitoring in the schools has increased for school psychologists, yet there is little research specific to pediatric psychoactive medication. The current article reviews issues pertinent to school-based medication monitoring. Feasibility, acceptability, and perception of effectiveness are reviewed as fundamental considerations before implementing a medication-monitoring plan in the schools. The importance of individualization, ecological implementation, and development of socially valid objectives is stressed along with the need for additional research, tools, and measures in this area. Practical considerations for school psychologists include discussion of parental consent and confidentiality, multilevel assessment and monitoring, data recording, and determining clinical significance. © 2009 Wiley Periodicals, Inc.

Background The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations. The central theme is a review of the biological measures (e.g. labs, drug levels), behavioural rating scales and direct observation measures that are often used to evaluate medication effects. Issues related to how the side effects of medication can affect behaviour will also be discussed. Conclusion The importance of encouraging communication and collaboration across all systems of care and the use of socially valid measures are discussed.

Functional analysis methods were used to monitor medication used to reduce vocal and physical tics of a child with Tourettes Syndrome. An initial functional analysis suggested that the tics were maintained by automatic reinforcement. Given this result, the participant's physician prescribed Orap 1mg per day to reduce the tics. Post-medication results demonstrated a reduced level of tics by the participant. Although preliminary, the findings suggest that functional analysis methods can be used to monitor the effects of medication in outpatient and school settings. Thus, more research using functional analyses to assess medication effects is needed. © 2002 John Wiley & Sons, Inc.

Treatment for aberrant behavior in persons diagnosed with developmental disabilities typically involves either behavioral interventions or medication. Often, the treatment is a combination of the two. Schroeder and coworkers (Schroeder et al. [1983] Adv Learn Behav Disabil 2:179–225) outlined criteria for the evaluation of the combination of behavioral and drug interventions in persons with developmental disabilities. A review of the research that examined the combination of drug and behavior interactions since 1983, using the Schroeder et al. criteria, is provided. An evaluation of research since 1983 that examined medication effects on multiple dependent measures and between multiple medications, using the criteria for medication research by Sprague and Werry (Sprague and Werry [1971] Int Rev Res Ment Retard vol. 5) is also provided. Additionally, the final section provides a list of recommendations and criteria for practitioners and researchers when conducting or evaluating research designed to examine medication effects on multiple variables in persons with developmental disabilities. MRDD Research Reviews 1999;5:322–334. © 1999 Wiley-Liss, Inc.

ProblemDo migraine prophylactic medications effect the vestibular rehabilitation of individuals with Post-Traumatic Migraine Associated Dizziness (PTMAD)?MethodsTraumatic Brain Injury (TBI) is a co...

In a multicentre pilot study of the treatment of 551 elderly patients with isolated systolic hypertension (SHEP), the effects on behavioural dimensions were also investigated. The presence and severity of depression, dementia and disability was measured by the SHORT-CARE at baseline, annual follow up and, in a random half of subjects at bimonthly intervals. Remarkably low rates and levels of depression were noted in comparison with community norms; neither demographic characteristics, rates of dementia nor medication effects explained this finding. However, controlling for disability largely resolved the discrepancy in depression rates between SHEP and the community norms.

Hyperactive boys on methylphenidate (Ritalin), hyperactive boys on placebo, and comparison boys were observed in quasi-naturalistic classroom settings. Ambient stimulation (quiet versus noisy conditions) and source of regulation (self-paced versus other-paced activities) were varied in a 2 x 2 design. Compared to their peers, hyperactive boys on placebo showed lower rates of task attention and higher rates of gross motor movement, regular and negative verbalization, noise-making, physical contact, social initiation, disruption, and acts that were perceived as energetic, inappropriate, or unexpected. Self-paced activities resulted in increased rates of verbalization, social initiation, and high-energy episodes. High ambient noise levels reduced task attention and increased the rates of many other behaviors including verbalization, physical contact, gross motor movement, and high-energy acts. Medication-by-situation interactions emerged for both classroom dimensions, with hyperactive boys on placebo being readily distinguishable from their peers under some classroom conditions and indistinguishable under other conditions. Moderate relationships were found between teacher ratings and many individual behavior categories. Discussion focused on (a) the merits and limitations of a social ecological research perspective, and (b) the implications of these findings for the design of intervention strategies.

Instrumentation and methods are described for measuring and recording in an eight-channel system a variety of muscular and electromyographic variables that are regarded as appropriate to the objective study of spasticity and other related neurophysiologic responses. These variables include resistive forces developed in extensor and flexor muscles elicited by passive stretching through the full arc of motion, tensive forces developed in response to tendon tap in eliciting deep muscle myotatic reflexes, and angle of swing in unrestricted responses of the same type. Correlated electromyographic potentials are recorded in both extensor and flexor muscles concurrently with the muscular resistive forces and the angle of motion. A case study is presented to illustrate the sen8itivity and Consistency of the procedures in detecting effects from spasmolytic medication in altering the responses of a patient with clinically evident spasticity. Conclusions are particularized for the individual case presented. Numerous problems, including statistical methods and experimental designs, are being studied with a view toward planning systematic investigation of medication effects in patients with clinical manifestations of hypertonicity and hyperreflexia.