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Biomedical subjects

Shree Bhalerao

Publications and source records attributed to Shree Bhalerao.

11 recordsLinked to original sources
PubMed2005

Review of awakening agents.

Brain injuries are a serious burden of illness to Canada and the US. Advances in managing head trauma have allowed more patients to emerge from decreased levels of consciousness and helped them cope with neurocognitive, neurobehavioural, and neuropsychiatric deficits. In this article, we review the current (1986-2002) evidence surrounding the pharmacological management of arousal states and the aforementioned neurological sequelae of head injury in either acute or chronic conditions. This article will review the evidence for the use of psychostimulants (methylphenidate), antidepressants (amitriptyline, selective serotonin reuptake inhibitors, and buproprion), Parkinson's medications (amantadine, bromocriptine, carbidopa/levodopa), anticonvulsants (valproic acid), modafinil (Provigil), lactate, hyperbaric oxygen chamber, electroconvulsive therapy, and transmagnetic stimulation, in patients following a head injury. The review did not include all anticonvulsants, neuroleptics, beta-blockers, benzodiazepines, azospirones or cognitive enhancers. Unfortunately, the quality of the evidence is generally poor, and sometimes conflicting, which in turn results in indecisive guidelines for treating patients. Accepting the inherent flaws in the evidence we feel that this paper may serve as a stepping-stone for future researchers to improve data gathering that targets neurocognitive, neurobehavioural and neuropsychiatric symptoms following a head injury.

Brain Injuries↗
PubMed2003

Loxapine versus olanzapine in the treatment of delirium following traumatic brain injury.

The use of typical neuroleptics has always been the mainstay of treatment for delirium following traumatic brain injury (TBI). Given the recent application of atypical neuroleptics to various psychiatric conditions formerly treated with typical neuroleptics, one questions whether this new class of drugs is superior to its predecessor in treating delirium post-TBI. We present a case of one patient with TBI-induced delirium where in fact the use of the typical mid-potency neuroleptic, loxapine, appeared to have a better clinical effect over the atypical neuroleptic, olanzapine.

Adult↗
PubMed2003

Folie à deux: an old diagnosis with a new technology.

The implantable cardioverter defibrillator (ICD) is the treatment of choice for life-threatening ventricular tachyarrhythmias. Despite this, indications for explantation have been described. Psychiatric complications have been considered in the decision to not re-implant a previously explanted device but never as a primary indication for explantation. The case of a woman who requested ICD explantation amidst concerns that the titanium used in its construction was absorbing harmful negative electromagnetic field energy from the environment resulting in intermittent bouts of fatigue, diaphoresis and an overall sense of impending doom is presented. She and her husband had significant psychosocial impairment because of this belief system. The present case is the first known report of a psychiatric complication as the primary indication for ICD explantation. It is illustrative of diagnostic dilemmas, competency and the importance of quality of life.

Aged↗
PubMedDate not supplied

Cardiac angiography and conversion disorder.

BACKGROUND: Somatoform disorders are disorders in which "psychic energy" is transferred to somatic symptoms secondary to stressors. The concept of somatoform disorders and their associations among patients with cardiac disease is a relatively unfamiliar area. OBJECTIVE: The authors present a case that illustrates how conversion disorder, a specific type of somatoform disorder, may be associated with the psychologic stressor involved with cardiac angiography. The authors will discuss the literature concerning the identification and treatment of this disorder. METHODS: The relevant literature in the area of conversion disorder and cardiac angiography was reviewed. RESULTS: This report is the first documented case of a woman who developed conversion disorder after coronary catheterization. Using the case, a summary of diagnostic and treatment modalities used in this disorder is provided. CONCLUSIONS: The case highlights how conversion disorder can occur as a sequelae of coronary catheterization. The principles involved in the diagnosis and treatment of conversion disorder were successful in managing this patient. It is hoped that the case can aid cardiologists in becoming cognizant of this uncommon psychiatric disorder.

Angina, Unstable↗