Neuroimaging is an invaluable diagnostic tool for sorting through the vast array of etiologies that underlie altered mental status (AMS). Head computed tomography (CT) without contrast is the primary modality for evaluation of AMS and should be complemented by MR imaging in cases of negative CT but high clinical concern. Studies to maximize brain imaging efficiency and improve the yield of positive scans through the utilization of clinical and laboratory pre-scan diagnostics are ongoing. However, imaging remains the gold standard due to its rapidity with which certain diagnoses can be made or excluded.
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http://dx.doi.org/10.1016/j.rcl.2019.08.002 | DOI Listing |
Can Assoc Radiol J
January 2025
North York General Hospital, Toronto, ON, Canada.
The Canadian Association of Radiologists (CAR) Central Nervous System Expert Panel is made up of physicians from the disciplines of radiology, emergency medicine, neurosurgery, and neurology, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 24 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 55 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 51 recommendation statements across the 24 scenarios.
View Article and Find Full Text PDFHypertension
January 2025
Cardio-Renal Physiology and Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, AL (C.E.K., G.C.K., J.S.P.).
The term early life stress encompasses traumatic events occurring before the age of 18 years, such as physical abuse, verbal abuse, household dysfunctions, sexual abuse, childhood neglect, child maltreatment, and adverse childhood experiences. Adverse psychological experiences in early life are linked to enduring effects on mental and physical health in adulthood. In this review, we first describe the effects and potential mechanisms of early life stress on the components of the vasculature.
View Article and Find Full Text PDFJ Investig Med
January 2025
Children's National Health System, Washington, DC, USA.
While pediatric mental health emergencies are increasing in frequency and severity, psychiatric resources remain concentrated in tertiary care facilities. Telepsychiatry has successfully mitigated these challenges in rural emergency departments (EDs), suggesting potential benefits for urban EDs that lack psychiatric resources. We implemented telepsychiatry in an urban ED to reduce ED length of stay and the need for transferring pediatric patients with mental and behavioral health complaints.
View Article and Find Full Text PDFTher Adv Drug Saf
January 2025
Pharmacology Department, School of Medicine, University of Valladolid, Valladolid, Spain.
In 2019, intranasal esketamine gained approval as a promising therapy for those individuals grappling with treatment-resistant depression. Both clinical trials and real-world studies have underscored its efficacy in alleviating and remitting depressive symptoms, with sustained benefits observed for nearly 4.5 years.
View Article and Find Full Text PDFSubst Abuse Rehabil
January 2025
Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Health Sciences, Niger Delta University Wilberforce Island Bayelsa State, Amassoma, Nigeria.
Background: Datura metel is reported to induce hallucinations and mental disorders.
Objective: This study investigates the neurotoxic effects of stramonium hydroethanolic root extract on the hippocampus and cerebral cortex of adult rats using biochemical, histological and immunohistochemical techniques.
Methodology: Twenty five adult rats were assigned to 5 groups (n = 5 each).
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