Case Studies: Stahl's Essential Psychopharmacology

2011 ◽  
Author(s):  
Stephen M. Stahl ◽  
Nancy Muntner
Keyword(s):  
Clinical Decision Making ◽  
Real Life ◽  
Clinical Decision ◽  
Clinical Encounter ◽  
Waiting Room ◽  
Clinical Scenarios ◽  
The Everyday ◽  
Representative Selection ◽  
User Friendly ◽  
Selection Of

Designed with the distinctive, user-friendly presentation Dr Stahl's audience know and love, this new stream of Stahl books capitalize on Dr Stahl's greatest strength - the ability to address complex issues in an understandable way and with direct relevance to the everyday experience of clinicians. The book describes a wide-ranging and representative selection of clinical scenarios, making use of icons, questions/answers and tips. It follows these cases through the complete clinical encounter, from start to resolution, acknowledging all the complications, issues, decisions, twists and turns along the way. The book is about living through the treatments that work, the treatments that fail, and the mistakes made along the journey. This is psychiatry in real life – these are the patients from your waiting room – this book will reassure, inform and guide better clinical decision making.

Case Studies: Stahl's Essential Psychopharmacology

2016 ◽  
Author(s):  
Stephen M. Stahl ◽  
Thomas L. Schwartz
Keyword(s):  
Case Studies ◽  
Clinical Decision Making ◽  
Real Life ◽  
Clinical Decision ◽  
Clinical Encounter ◽  
Waiting Room ◽  
Clinical Scenarios ◽  
Representative Selection ◽  
User Friendly ◽  
Selection Of

Following the success of the first collection of Stahl's Case Studies, published in 2011, we are pleased to present this completely new selection of clinical stories. Designed with the distinctive user-friendly presentation readers have become accustomed to and making use of icons, questions/answers and tips, these cases address complex issues in an understandable way and with direct relevance to the everyday experience of clinicians. Covering a wide-ranging and representative selection of clinical scenarios, each case is followed through the complete clinical encounter, from start to resolution, acknowledging all the complications, issues, decisions, twists and turns along the way. The book is about living through the treatments that work, the treatments that fail, and the mistakes made along the journey. This is psychiatry in real life - these are the patients from your waiting room - this book will reassure, inform and guide better clinical decision making. Optional posttests with CME credit are available for a fee (waived for NEI members). For more information, contact the Neuroscience Education Institute.

Case Studies: Stahl's Essential Psychopharmacology

2021 ◽  
Keyword(s):  
Case Studies ◽  
Real Life ◽  
Clinical Encounter ◽  
University Of California ◽  
Clinical Scenarios ◽  
The Everyday ◽  
Representative Selection ◽  
The University ◽  
User Friendly ◽  
Selection Of

Following the success of the first two volumes in Stahl's Case Studies series, a brand new collection of clinical stories have been collated in Volume 3, derived from cases seen by medical students, residents and faculty from the University of California at Riverside (UCR) Department of Psychiatry and Neuroscience. The highly popular and unique user-friendly presentation of previous volumes has been maintained, with extensive use of icons, questions/answers, and tips. The cases address multifaceted issues in an understandable way and with direct relevance to the everyday experience of clinicians. Covering a wide-ranging and representative selection of clinical scenarios, each case is followed through the complete clinical encounter, from start to resolution, acknowledging all the complications, issues, decisions, twists and turns along the way. The book is about living through the treatments that work, the treatments that fail, and the mistakes made along the journey. This is psychiatry in real life.

Clinical Conundrums When Integrating the QbTest into a Standard ADHD Assessment of Children and Young People

2021 ◽  
Author(s):  
Carsten Vogt
Keyword(s):  
Clinical Practice ◽  
Clinical Decision Making ◽  
Ecological Validity ◽  
Neuropsychological Test ◽  
Real Life ◽  
Clinical Decision ◽  
Hyperactivity Disorder ◽  
Standard Clinical Practice ◽  
Novel Method ◽  
The Impact

AbstractThe uptake of the QbTest in clinical practice is increasing and has recently been supported by research evidence proposing its effectiveness in relation to clinical decision-making. However, the exact underlying process leading to this clinical benefit is currently not well established and requires further clarification. For the clinician, certain challenges arise when adding the QbTest as a novel method to standard clinical practice, such as having the skills required to interpret neuropsychological test information and assess for diagnostically relevant neurocognitive domains that are related to attention-deficit hyperactivity disorder (ADHD), or how neurocognitive domains express themselves within the behavioral classifications of ADHD and how the quantitative measurement of activity in a laboratory setting compares with real-life (ecological validity) situations as well as the impact of comorbidity on test results. This article aims to address these clinical conundrums in aid of developing a consistent approach and future guidelines in clinical practice.

scholarly journals Point-of-Care Testing-the Key in the Battle against SARS-CoV-2 Pandemic

Micromachines ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1464
Author(s):  
Florina Silvia Iliescu ◽  
Ana Maria Ionescu ◽  
Larisa Gogianu ◽  
Monica Simion ◽  
Violeta Dediu ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Point Of Care ◽  
Low Cost ◽  
Diagnostic Testing ◽  
Clinical Decision ◽  
Rapid Screening ◽  
Diagnostic Tools ◽  
Point Of Care Testing ◽  
Qrt Pcr ◽  
User Friendly

The deleterious effects of the coronavirus disease 2019 (COVID-19) pandemic urged the development of diagnostic tools to manage the spread of disease. Currently, the “gold standard” involves the use of quantitative real-time polymerase chain reaction (qRT-PCR) for SARS-CoV-2 detection. Even though it is sensitive, specific and applicable for large batches of samples, qRT-PCR is labour-intensive, time-consuming, requires trained personnel and is not available in remote settings. This review summarizes and compares the available strategies for COVID-19: serological testing, Point-of-Care Testing, nanotechnology-based approaches and biosensors. Last but not least, we address the advantages and limitations of these methods as well as perspectives in COVID-19 diagnostics. The effort is constantly focused on understanding the quickly changing landscape of available diagnostic testing of COVID-19 at the clinical levels and introducing reliable and rapid screening point of care testing. The last approach is key to aid the clinical decision-making process for infection control, enhancing an appropriate treatment strategy and prompt isolation of asymptomatic/mild cases. As a viable alternative, Point-of-Care Testing (POCT) is typically low-cost and user-friendly, hence harbouring tremendous potential for rapid COVID-19 diagnosis.

Effects of sleepiness on clinical decision making among paramedic students: a simulated night shift study

2021 ◽  
pp. emermed-2019-209211
Author(s):  
Danielle Bartlett ◽  
Sara Hansen ◽  
Travis Cruickshank ◽  
Timothy Rankin ◽  
Pauline Zaenker ◽  
...  
Keyword(s):  
Decision Making ◽  
Reaction Time ◽  
Shift Work ◽  
Clinical Decision Making ◽  
Clinical Performance ◽  
Night Shift ◽  
Clinical Decision ◽  
Night Shift Work ◽  
Clinical Scenarios ◽  
Perceived Workload

ObjectiveParamedics are at the forefront of emergency healthcare. Quick and careful decision making is required to effectively care for their patients; however, excessive sleepiness has the potential to impact on clinical decision making. Studies investigating the effects of night shift work on sleepiness, cognitive function and clinical performance in the prehospital setting are limited. Here, we aimed to determine the extent to which sleepiness is experienced over the course of a simulation-based 13-hour night shift and how this impacts on clinical performance and reaction time.MethodsTwenty-four second year paramedic students undertook a 13-hour night shift simulation study in August 2017. The study consisted of 10 real-to-life clinical scenarios. Sleepiness, perceived workload and motivation were self-reported, and clinical performance graded for each scenario. Reaction time, visual attention and task switching were also evaluated following each block of two scenarios.ResultsThe accuracy of participants’ clinical decision making declined significantly over the 13-hour night shift simulation. This was accompanied by an increase in sleepiness and a steady decline in motivation. Participants performed significantly better on the cognitive flexibility task across the duration of the simulated night shift and no changes were observed on the reaction time task. Perceived workload varied across the course of the night.ConclusionOverall, increased sleepiness and decreased clinical decision making were noted towards the end of the 13-hour simulated night shift. It is unclear the extent to which these results are reflective of practising paramedics who have endured several years of night shift work, however, this could have serious implications for patient outcomes and warrants further investigation.

Which Biomarkers Can Be Used as Diagnostic Tools for Infection in Suspected Sepsis?

2021 ◽  
Vol 42 (05) ◽  
pp. 662-671
Author(s):  
Pedro Póvoa ◽  
Luis Coelho
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Current Evidence ◽  
Diagnostic Tools ◽  
Suspected Sepsis ◽  
Molecular Tests ◽  
Clinical Scenarios ◽  
Diagnosis Of Infection

AbstractThe diagnosis of infection in patients with suspected sepsis is frequently difficult to achieve with a reasonable degree of certainty. Currently, the diagnosis of infection still relies on a combination of systemic manifestations, manifestations of organ dysfunction, and microbiological documentation. In addition, the microbiologic confirmation of infection is obtained only after 2 to 3 days of empiric antibiotic therapy. These criteria are far from perfect being at least in part responsible for the overuse and misuse of antibiotics, in the community and in hospital, and probably the main drive for antibiotic resistance. Biomarkers have been studied and used in several clinical settings as surrogate markers of infection to improve their diagnostic accuracy as well as in the assessment of response to antibiotics and in antibiotic stewardship programs. The aim of this review is to provide a clear overview of the current evidence of usefulness of biomarkers in several clinical scenarios, namely, to diagnose infection to prescribe antibiotics, to exclude infection to withhold antibiotics, and to identify the causative pathogen to target antimicrobial treatment. In recent years, new evidence with “old” biomarkers, like C-reactive protein and procalcitonin, as well as new biomarkers and molecular tests, as breathomics or bacterial DNA identification by polymerase chain reaction, increased markedly in different areas adding useful information for clinical decision making at the bedside when adequately used. The recent evidence shows that the information given by biomarkers can support the suspicion of infection and pathogen identification but also, and not less important, can exclude its diagnosis. Although the ideal biomarker has not yet been found, there are various promising biomarkers that represent true evolutions in the diagnosis of infection in patients with suspected sepsis.

scholarly journals Direct oral anticoagulant monitoring: what laboratory tests are available to guide us?

Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 194-197 ◽  
Author(s):  
Ravi Sarode
Keyword(s):  
Clinical Decision Making ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Rapid Assessment ◽  
Clinical Decision ◽  
The United States ◽  
Thrombin Inhibitor ◽  
Thrombin Time ◽  
Clinical Scenarios

Abstract Direct oral anticoagulants (DOACs) are increasingly used in the treatment and prophylaxis of thromboembolism because of several advantages over vitamin K antagonists, including no need for laboratory monitoring. However, it has become increasingly important in certain clinical scenarios to know either actual DOAC concentration (quantitative) or presence of DOAC (qualitative). These clinical conditions include patients presenting with major bleeding or requiring urgent surgery who may need a reversal or hemostatic agent, extremes of body weight, failed therapy, etc. Prothrombin time and activated partial thromboplastin time are variably affected by factor Xa inhibitors (FXaIs) and direct thrombin inhibitor (DTI), respectively, depending on reagents’ sensitivity, and hence, they cannot be relied on confidently. Thrombin time is highly sensitive to very low amounts of DTI; thus, normal value rules out a clinically significant amount. Liquid chromatography mass spectrometry accurately measures DOAC levels but is clinically impractical. Dilute thrombin time and ecarin-based assays using appropriate calibrators/controls provide an accurate DTI level. Anti-Xa assay using corresponding FXaI calibrators/controls provides accurate drug levels. However, these assays are not readily available in the United States compared with some other parts of the world. Heparin assays using anti-Xa activity often have a linear relationship with calibrated FXaI assays, especially at the lower end of on-therapy levels, and they may provide rapid assessment of drug activity for clinical decision making. Currently, there is very limited knowledge of DOAC effect on viscoelastic measurements. Although there is uniformity in expression of DOAC concentrations in nanograms per milliliter, a universal FXaI DOAC assay is urgently needed.

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