Treating Malignant Catatonia With Liquid Amantadine: A Case Report and Literature Review.

Malignant catatonia (MC) is a complex, life-threatening condition characterized by motor dysregulation and autonomic instability, which requires prompt and effective treatment. There are some limitations to the current recommendations for treating MC, including barriers to receiving ECT, failure to respond to benzodiazepines, or benzodiazepine intolerance. To the authors' knowledge, there are 3 case reports in the literature describing the use of amantadine in the treatment of MC.

The Impact of an Educational Intervention on Nursing Staff Attitudes Toward Patients Experiencing Homelessness and Mental Illness.

Objective: Patients who experience homelessness and have mental illness can have frequent and challenging hospitalizations. Nurses caring for this vulnerable population may have negative attitudes, which can be mitigated by education and improved for the benefit of patients. This study aimed to assess the impact of an educational intervention on the attitudes of nursing staff toward individuals experiencing homelessness and mental illness.

Against Medical Advice Discharge: A Narrative Review and Recommendations for a Systematic Approach.

Approximately 1%-2% of hospitalizations in the United States result in an against medical advice discharge. Still, the practice of discharging patients against medical advice is highly subjective and variable. Discharges against medical advice are associated with physician distress, patient stigma, and adverse outcomes, including increased morbidity and mortality.

Radiation Therapy Adherence Among Patients Experiencing Homelessness.

Purpose: Radiation therapy is a valuable, yet time- and resource-intense therapy. Patients experiencing homelessness (PEH) face many barriers related to the timely receipt of radiation therapy. Owing to a paucity of data regarding cancer treatment and homelessness, clinicians have a limited evidence base when recommending therapy to PEH.

Medical Care of the Homeless: An American and International Issue.

Homeless persons die significantly younger than their housed counterparts. In many cases, relatively straightforward primary care issues escalate into life-threatening, expensive emergencies. Poor health outcomes driven by negative interactions between comorbid symptoms meet the definition of a health syndemic in this population.

Identifying and Addressing the Hidden Reasons Why Patients Refuse Discharge From the Hospital.

Background: Consultation-liaison psychiatrists are often asked to evaluate patients who refuse discharge from a medical facility. Literature to guide clinicians on the management of these patients is very limited.

Objective: This article seeks to explain this phenomenon through a case series, provide a differential diagnosis of patients who request to stay in the hospital, as well as provide clinicians with direction in the management of these difficult situations.

Ethics and the Treatment of the Mentally Ill, Homeless Person: a Perspective on Psychiatry Resident Training.

Objective: The authors outline the unique ethical challenges that psychiatry residents face in working with individuals who are homeless and mentally ill. The authors also propose steps to develop effective teaching methods with residents working with these patients.

Methods: The authors reviewed literature relevant to the training of psychiatry residents in ethics and treating individuals who are homeless and mentally ill.

Psychogenic pseudosyncope: diagnosis and management.

Psychogenic pseudosyncope (PPS) is the appearance of transient loss of consciousness (TLOC) in the absence of true loss of consciousness. Psychiatrically, most cases are classified as conversion disorder, which is hypothesized to represent the physical manifestation of internal stressors. The incidence of PPS is likely under-recognized and the disorder is under investigated in the unexplained syncope population, yet it can be diagnosed accurately with a focused history and confirmed with investigations including head-up tilt testing (HUTT), electroencephalogram (EEG; sometimes combined with video) or, in some centers, transcranial Doppler (TCD).

Corticosteroid injections in the treatment of trigger finger: a level I and II systematic review.

Trigger finger is a tendinitis (stenosing tenosynovitis) with multiple management approaches. We conducted an evidence-based medicine systematic review of level I and II prospective randomized controlled trials to determine the effectiveness of corticosteroid injection in managing trigger finger. MEDLINE, Cochrane database, and secondary references were reviewed to locate all English-language prospective randomized controlled trials evaluating trigger finger treatment.

Clinical outcome at a minimum of five years after reconstruction of the anterior cruciate ligament.

Background: We are not aware of any previous studies in which independent measurements of function with validated outcome questionnaires such as the Knee Injury and Osteoarthritis Outcome Score and the International Knee Documentation Committee score were evaluated five years after reconstruction of the anterior cruciate ligament. We hypothesized that patient demographics, mechanism of injury, and intra-articular injuries and their treatment are factors associated with function five years after reconstruction of the anterior cruciate ligament.

Methods: A consecutive series of unilateral, arthroscopically assisted primary reconstructions of the anterior cruciate ligament performed by one surgeon using a patellar tendon graft was evaluated.