Dissemination of VMAT-2 Inhibitors: A New Class Drug for Tardive Dyskinesia and Huntington Disease.

Background And Objectives: In 2017, the FDA approved deutetrabenazine (AUSTEDO) for the treatment of tardive dyskinesia (TD) and chorea associated with Huntington disease (HD). Concurrently, valbenazine (INGREZZA) was approved specifically for TD. The adoption of new medications is influenced by various factors, including patient's medical needs, the prescriber's adoption of new practice, and external environmental factors (e.

Methamphetamine Use in Psychiatric Emergency Services and Among Asian American and Pacific Islander Populations.

Objectives: Addressing the methamphetamine epidemic will require a more complete understanding of its effect on healthcare systems and of the populations at risk. The objective of the study was to assess the impact of methamphetamine use on psychiatric emergency services outcomes and on Asian American (AA) and Pacific Islander (PI) populations, a historically overlooked population in substance use research.

Methods: A retrospective chart review was performed for all visits to a large level I trauma center in urban Hawaii from 2007 to 2019 that required psychiatric emergency services and in which urine drug screening was completed (N = 44,658).

Rural Level III centers in an inclusive trauma system reduce the need for interfacility transfer.

Background: Development of Level III trauma centers in a regionalized system facilitates early stabilization and prompt transfer to a higher level center. The resources to care for patients at Level III centers could also reduce the burden of interfacility transfers. We hypothesized that the development and designation of Level III centers in an inclusive trauma system resulted in lower rates of transfer, with no increase in morbidity or mortality among the non-transferred patients.

Promoting Global Health - Prevention and Treatment of Substance Abuse and HIV in Asia.

This special issue contains 20 papers including 3 Perspectives, 1 Brief Report, 6 Invited Reviews, and 10 Original Articles, which highlight the work by presenters at the second meeting of the biennial Conference Series to Promote Global Health held on April 22-24, 2015 in Hangzhou, Zhejiang, China. These papers focused on the prevalent substance misuse of amphetamine-type-stimulants and opioids, and the increasing prevalence of HIV-infection in Asian countries. The Conference Series is sponsored by the National Institute on Drug Abuse of the U.

Gray matter maturation and cognition in children with different APOE ε genotypes.

Objective: The aims of the current study were to determine whether children with the 6 different APOE ε genotypes show differences in gray matter maturation, particularly for those with ε4 and ε2 alleles, which are associated with poorer outcomes in many neurologic disorders.

Methods: A total of 1,187 healthy children (aged 3-20 years, 52.1% boys, 47.

Utilizing a Two-stage Design to Investigate the Safety and Potential Efficacy of Monthly Naltrexone Plus Once-daily Bupropion as a Treatment for Methamphetamine Use Disorder.

Objectives: This 2-stage open-label pilot study evaluated the safety and potential efficacy of naltrexone + bupropion as a pharmacotherapy for methamphetamine (MA) use disorder.

Methods: The study was conducted in 2 stages of recruitment across 3 sites; 20 participants were enrolled in stage 1 and 29 participants were enrolled in stage 2. Eight weeks of open-label pharmacotherapy with a combination of extended-release injectable naltrexone (XR-NTX; Vivitrol) plus extended-release oral bupropion (BRP; Wellbutrin XL) were provided with a smartphone-assisted medication adherence platform.

Risk-Adjusted In-Hospital Mortality Models for Congestive Heart Failure and Acute Myocardial Infarction: Value of Clinical Laboratory Data and Race/Ethnicity.

Objective: To examine the impact of key laboratory and race/ethnicity data on the prediction of in-hospital mortality for congestive heart failure (CHF) and acute myocardial infarction (AMI).

Data Sources: Hawaii adult hospitalizations database between 2009 and 2011, linked to laboratory database.

Study Design: Cross-sectional design was employed to develop risk-adjusted in-hospital mortality models among patients with CHF (n = 5,718) and AMI (n = 5,703).

Family income, parental education and brain structure in children and adolescents.

Socioeconomic disparities are associated with differences in cognitive development. The extent to which this translates to disparities in brain structure is unclear. We investigated relationships between socioeconomic factors and brain morphometry, independently of genetic ancestry, among a cohort of 1,099 typically developing individuals between 3 and 20 years of age.

ERBB4 polymorphism and family history of psychiatric disorders on age-related cortical changes in healthy children.

Genetic variations in ERBB4 were associated with increased susceptibility for schizophrenia (SCZ) and bipolar disorders (BPD). Structural imaging studies showed cortical abnormalities in adolescents and adults with SCZ or BPD. However, less is known about subclinical cortical changes or the influence of ERBB4 on cortical development.

Assessing the Development of Multidisciplinary Care: Experience of the National Cancer Institute Community Cancer Centers Program.

Purpose: The National Cancer Institute Community Cancer Centers Program (NCCCP) began in 2007 with a goal of expanding cancer research and delivering quality care in communities. The NCCCP Quality of Care (QoC) Subcommittee was charged with developing and improving the quality of multidisciplinary care. An assessment tool with nine key elements relevant to MDC structure and operations was developed.

Effects of APOE ε4, age, and HIV on glial metabolites and cognitive deficits.

Objective: We aimed to evaluate the combined effects of HIV and APOE ε4 allele(s) on glial metabolite levels, and on known cognitive deficits associated with either condition, across the ages.

Methods: One hundred seventy-seven participants, primarily of white and mixed race (97 seronegative subjects: aged 44.7 ± 1.

Brain-type natriuretic peptide and right ventricular end-diastolic volume index measurements are imprecise estimates of circulating blood volume in critically ill subjects.

Background: Surrogate indicators have often been used to estimate intravascular volume to guide fluid management. Brain-type natriuretic peptide (BNP) has been used as a noninvasive adjunct in the diagnosis of fluid overload and as a marker of response to therapy, especially in individuals with congestive heart failure. Similarly, right ventricular end-diastolic volume index (RVEDVI) measurements represent another parameter used to guide fluid resuscitation.

Sociodemographic characterization of ECT utilization in Hawaii.

Objectives: Minimal research has been done on sociodemographic differences in utilization of electroconvulsive therapy (ECT) for refractory depression, especially among Asian Americans and Pacific Islanders.

Methods: This study examined sociodemographic and diagnostic variables using retrospective data from Hawaii, an island state with predominantly Asian Americans and Pacific Islanders. Retrospective data were obtained from an inpatient and outpatient database of ECT patients from 2008 to 2010 at a tertiary care community hospital on O'ahu, Hawaii.

Lower cognitive reserve in the aging human immunodeficiency virus-infected brain.

More HIV-infected individuals are living longer; however, how their brain function is affected by aging is not well understood. One hundred twenty-two men (56 seronegative control [SN] subjects, 37 HIV subjects with normal cognition [HIV+NC], 29 with HIV-associated neurocognitive disorder [HAND]) performed neuropsychological tests and had acceptable functional magnetic resonance imaging scans at 3 Tesla during tasks with increasing attentional load. With older age, SN and HIV+NC subjects showed increased activation in the left posterior (reserve, "bottom-up") attention network for low attentional-load tasks, and further increased activation in the left posterior and anterior ("top-down") attention network on intermediate (HIV+NC only) and high attentional-load tasks.

Use of an atriocaval shunt in a trauma patient: first reported case in Hawai'i.

Background: Traumatic injuries to the retrohepatic vena cava are typically fatal. Emergent access to this area is difficult and patients typically exsanguinate before the injury can be identified and fixed.

Objective: To report the use of an atriocaval shunt in the repair of an injury to the retrohepatic vena cava from a gunshot wound.

Declined neural efficiency in cognitively stable human immunodeficiency virus patients.

Objective: To determine whether brain activation changes in clinically and neurocognitively normal human immunodeficiency virus (HIV)-infected and in HIV-seronegative control (SN) participants over a 1-year period.

Methods: Functional magnetic resonance imaging (fMRI) was performed in 32 SN and 31 HIV patients (all with stable combination antiretroviral treatment) at baseline and after 1 year. Each participant performed a set of visual attention tasks with increasing attentional load (from tracking two, three, or four balls).

Greater than age-related changes in brain diffusion of HIV patients after 1 year.

Chronic infection with HIV is associated with neuroinflammation. Prior diffusion tensor imaging (DTI) studies demonstrated increased mean diffusion (MD) and decreased fractional anisotropy (FA) in the white matter (WM) and subcortical brain regions of HIV patients. The current study aims to detect whether there are greater than age-related brain changes in HIV patients after a 1-year follow-up period using DTI.

Pre-existing cardiac disease, troponin I elevation and mortality in patients with severe sepsis and septic shock.

A prospective, observational study was undertaken to determine the frequency of troponin I elevation and the incidence of pre-existing cardiac disease in patients with severe sepsis and septic shock, and to determine their relationship to mortality. The setting was the surgical intensive care unit of a tertiary care medical centre. Sixty-six consecutive patients admitted with severe sepsis or septic shock requiring pulmonary artery catheterisation for haemodynamic monitoring were studied.

Hypothyroidism and adrenal insufficiency in sepsis and hemorrhagic shock.

Hypothesis: We hypothesized that hypothyroidism and adrenal insufficiency frequently occur together in critically ill patients.

Design: A prospective observational study.

Setting: Surgical intensive care unit of a university-affiliated tertiary referral center.

Hip fracture prevention in postmenopausal women.

Unlabelled: Hip fracture is a devastating outcome associated with postmenopausal osteoporosis. This fracture causes considerable pain, disability, diminished quality of life, and mortality. Although bone loss is an important factor associated with hip fracture, there are other demographic and clinical factors such as those that increase the risk of falling (e.

Retinal capillary angioma in familial exudative vitreoretinopathy treated with photodynamic therapy.

Purpose: To report a case of familial exudative vitreoretinopathy with a retinal capillary angioma and persistent macular exudation treated with photodynamic therapy.

Design: Interventional case report.

Methods: A 39-year-old woman with familial exudative vitreoretinopathy presented with an intraretinal capillary angioma temporally with persistent macular exudation despite previous vitrectomy and thermal laser.

Measuring nurses' computer competency: an analysis of published instruments.

The rapid expansion of computer-driven technologies into multiple aspects of modern healthcare suggests that many of the important competencies of the 21st century nurse will encompass mastery of computer technology. This is a comprehensive review of the published measures of computer competence during the past 12 years. Essential knowledge, attitudes, and skills were identified and classified.

Influenza vaccination status of healthcare workers and the extent of their domestic contact with individuals at high risk for influenza-related complications.

Many healthcare workers have frequent household contact with persons at high risk for influenza-related complications. Educating healthcare workers about the risk of domestic transmission of influenza may improve their acceptance of influenza vaccination. Concerns regarding vaccine efficacy and safety also need to be addressed.