Neuroplasticity In The Mesolimbic Dopamine System And Cocaine Addiction

July 16, 2015

Neuroplasticity In The Mesolimbic Dopamine System And Cocaine Addiction

Cocaine is the most addictive of all forms substance abuse. It is characterized by a high compulsion and relapse. Despite several years of clinical research, scientists are yet to find an effective medication. However some studies indicate the activity of neurons in the mesolimbic dopamine system, which comprises cells in the Ventral Tegmental Area (VTA) that develop into the medial and detour prefrontal cortex, amygdala, and accumbent, motivates cocaine reward thereby contributing to high compulsion.

Based on these research activities often called neuropharmacological studies, the addiction of cocaine is caused by neuroadaptations induced by the drug. This is so reportedly because of the learning, reward-related and memory processes of the mesolimbic dopamine systems’ circuitry where dopamine projections are developed.

Neuroadaptation Cause of Cocaine Compulsion

Neuroadaptations are understood to cause very high sensitivity to cocaine. They are also believed to cause hypersensitivity to cocaine-associated electrochemical signals such as irrational decision making and irregular cultured behaviors characterized by high insensitivity to dire consequences of addiction. A major characteristics of cocaine addiction is its’s compulsive drug use despite adverse consequences and high rates of relapse during periods of abstinence. A current popular hypothesis is that compulsive cocaine use and cocaine relapse is due to drug-induced neuroadaptations in reward-related learning and memory processes, which cause hypersensitivity to cocaine-associated cues, impulsive decision making and abnormal habit-like learned behaviours that are insensitive to adverse consequences. Here, we review results from studies on the effect of cocaine exposure on selected signalling cascades, growth factors and physiological processes previously implicated in neuroplasticity underlying normal learning and memory. These include the extracellular signal-regulated kinase (ERK) signalling pathway, brain-derived neurotrophic factor (BDNF), glutamate transmission, and synaptic plasticity (primarily in the form of long-term potentiation and depression, LTP and LTD). We also discuss the degree to which these cocaine-induced neuroplasticity changes in the mesolimbic dopamine system mediate cocaine psychomotor sensitization and cocaine-seeking behaviours, as assessed in animal models of drug addiction. Finally, we speculate on how these factors may interact to initiate and sustain cocaine psychomotor sensitization and cocaine seeking.

mesolimbic dopamine system

The premise that cocaine has a neuroadaptation effect to the chemical composition of certain parts of the brain has motivated various studies on the part of cellular actions and signaling forces that altogether causes neuro-synaptic plasticity. Effects of long-term exposure to cocaine on signaling forces, growth elements, psychosocial and physiological processes of reward transmission initially linked to neuroplasticity as a cause of mental recovery are a substantial number. They include extracellular-controlled kinase, distortion of normal neuron pathways and other neurotrophic factors, neuro-synaptic plasticity, and glutamate factors.

Neuroplasticity in Mesolimbic Dopamine System

Neuroplasticity is the brain’s ability to adjust to new environments or needs by developing new nerve cells throughout the body. It is the brain’s way of recovery. Neuroplasticity allows the cells to compensate for any injuries or diseases in the nerve system. It also allows the neurons reorganize themselves to perform new functions of the brain depending on changes in their working environment, also involves recovery from drug addiction such as that of cocaine.

Cocaine-induced neurochemical changes in glutamate transmissions and synaptic plasticity in the mesolimbic dopamine system facilitates cocaine psychomotor high sensitivity, compulsion, self-injection, and reinstatement, being interesting aspects of study in shedding light into cocaine addiction menace has been reviewed time and again.

Experimental Evidence of Neuroplasticity on Long-Term Exposure to Cocaine

A key consideration in the above reviews has been what experimental evidence are needed to derive a conclusion of the particular effects of long-term exposure to cocaine on neuroplasticity and how those effects facilitate the learned behavioral symptoms associated with that.

Given this objective, researchers made a strict condition that if so cocaine-induced neuroplasticity causes certain attributer learned behavior then a reversal of the physiological processes that led to that state should, therefore, guarantee a reduced exhibition of such behavior.

After further intense studies on the same, the condition is continuously being met. This has led to yet another attempt to evaluate the role of cocaine-induced neurochemical alterations in glutamate transmissions, synaptic plasticity in VTA, accumbens and amyglada in as earlier mentioned psychomotor hypersensitivity and compulsive behavioral characteristic of the drug.

Many of those studies found out repeated cocaine administration amplified the rate of activity of ERK in the development areas of the mesolimbic dopamine system, which includes the accumbens, amygdala and the prefrontal cortex of the brain.

ERK Phosphorylation in Mesolimbic Dopamine System

Triggers of increased ERK phosphorylation includes D1 dopamine receptors, (PKA) the dependent protein kinase and methyl-D-aspartic acid (NMDA). On the other hand it was observed triggers of reduced ERK phosphorylation include CREB the transcription factor, mitogen-and stress-activated protein kinase-1 (MSK-1), and immediate early genes Fos and Zif268.

Extracellular signal-controlled kinase activity and the subsequent ERK-mediated reduced gene transcription are crucial for increased cocaine-induced psych as a result of exposure to the drug. On the other hand increased cocaine-induced ERK activity in the mesolimbic dopamine system does not facilitate the development of psych after a considerable time of withdrawal. Injection of either SL327 or VTA therefore before cocaine administration lessens sensitized the drug-induced movement during experimental tests for expression of psychomotor sensitization if done some time after withdrawal.

mesolimbic dopamine system

Cocaine Psychomotor Sensitization

More recent reports indicated psychomotor cocaine sensitization after several weeks of withdrawal from the drug increased ERK2 activity. This was linked to increased acumen α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), and the receptor’s (AMPAR’s) surface appearance. However, no increases in ERK2 activity nor AMPAR surface expressions were observed in the specimens that did not exhibit psychomotor cocaine sensitization even after repeated non-dependent cocaine exposure and after some time of withdrawal.

Acumen’s ERK rate of activity possibly serves two specific roles in facilitating rewarding effects of the psychostimulant in a CPP procedure. During CPP training, the accumben’s rate of activity mediates consolidation of the learned behavior between the drug’s unconditioned rewarding effects and the drug’s related context during the CPP testing, ERK movement mediates serious expression of cocaine’s other habituated responses.

Systemic SL327 inoculations before cocaine CPP training prevented cocaine-induced accumbens, ERK phosphorylation and the subsequent expression of cocaine CPP. PD98059 accumben injections are given either before or after CPP training sessions blocked subsequent amphetamine CPP expression.

The relevance of the above fascinating correlational findings of cocaine’s compulsive characteristic, its’ psychomotor sensitization, and the ERK phosphorylation in the mesolimbic dopamine system is, however, a subject for further scientific, clinical research. Please sign up for this year’s August Integrative Addiction Medicine Conference to learn more about the same. Click the following link to get your chance to participate in the event: http://www.integrativeaddiction2015.com.

Neuroplasticity In The Mesolimbic Dopamine System And Cocaine Addiction

Medical consequences beyond highs of drug addiction

July 10, 2015

Medical consequences beyond highs of drug addiction: It is never too late to quit

The threats of substance abuse are real and Medical consequences beyond highs of drug addiction speaks for themselves

Drug addiction is no respecter of persons and people who are struggling with addiction can attest to this. The most painful thing with addiction is that even when help is within reach, many times the individuals are in denial and are very secretive. Keeping secretes of this problem only succeed in compounding the problem both to the direct and indirect victims. It is therefore worthy that timely action is taken to have this problem arrested in good time before it escalates to serious medical consequences beyond highs of drug addiction. Speaking to the experts at AWAREmed Health and Wellness Resource Center under the able leadership of doctor Dalal Akoury MD and founder of the facility, it is evident from the professionals point of view that the individuals who are struggling with addiction have multiple complain of medical issues including lung or cardiovascular disease, stroke, cancer, and mental disorders. These are not simple health condition and can be very fatal if not addressed in good time. The bad news is that the problem does not end there, findings from tests and scans, chest X-rays, and blood tests reveals damaging effects of long-term drug abuse throughout the body. Like for instance studies have established that tobacco smoke causes cancer of the mouth, throat, larynx, blood, lungs, stomach, pancreas, kidney, bladder, and cervix. In addition, some drugs of abuse, such as inhalants, are toxic to nerve cells and may damage or destroy them either in the brain or the peripheral nervous system. Wait a minute, is that the kind of life you want? Not really, the medical consequences beyond highs of drug addiction are not your portion and that is why doctor Akoury is here to offer remedies that will permanently deal with all these complications associated with drugs. Talk to us today by scheduling for an appointment with the experts for the real solutions.

Medical consequences beyond highs of drug addiction: The impact of addiction can be far-reaching

Just like I have mentioned the impact of drug addiction on human life can be very frustrating owing to the diseases that come with addiction some of which may include the following:

Cardiovascular disease
Stroke
Cancer
HIV/AIDS
Hepatitis B and C
Lung disease
Mental disorders

Medical consequences beyond highs of drug addiction: Does drug abuse cause mental disorders?

Doctor Akoury is very categorical that drug abuse and mental illness often co-exist. In some cases, mental disorders such as anxiety, depression, or schizophrenia may precede addiction and yet in other cases, drug abuse may trigger or exacerbate those mental disorders, particularly in people with specific vulnerabilities. Therefore the right response to the question is drug abuse causes mental disorders and when that happens treatment must be sought for immediately.

Medical consequences beyond highs of drug addiction: How can addiction harm other people?

Beyond the harmful consequences for the direct addiction victim, drug abuse can cause serious health problems for others in three very devastating and troubling consequences of addiction as follows:

Negative effects of prenatal drug exposure on infants and children – Take for example a mother who abuses heroin or prescription opioids during pregnancy can cause a withdrawal syndrome (called neonatal abstinence syndrome, or NAS) in her infant. It is also likely that some drug-exposed children will need educational support in the classroom to help them overcome what may be subtle deficits in developmental areas such as behavior, attention, and thinking. Ongoing research is investigating whether the effects of prenatal drug exposure on the brain and behavior extend into adolescence to cause developmental problems during that time period.

Negative effects of secondhand smoke – Secondhand tobacco smoke also called environmental tobacco smoke (ETS) is a significant source of exposure to a large number of substances known to be hazardous to human health, particularly to children. According to the Surgeon General’s 2006 Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke involuntary exposure to secondhand smoke increases the risks of heart disease and lung cancer in people who have never smoked by 25–30 percent and 20–30 percent, respectively.

Medical consequences beyond highs of drug addiction: Hazard of Spreading Infectious Diseases

Increased spread of infectious diseases – Injection of drugs such as heroin, cocaine, and methamphetamine in unsafe environment with unsterilized needles is currently accounting for about 12 percent of new AIDS cases. Injection drug use is also a major factor in the spread of hepatitis C, a serious, potentially fatal liver disease. Injection drug use is not the only way that drug abuse contributes to the spread of infectious diseases. All drugs of abuse cause some form of intoxication, which interferes with judgment and increases the likelihood of risky sexual behaviors. This, in turn, contributes to the spread of HIV/AIDS, hepatitis B and C, and other sexually transmitted diseases.

At the beginning of the discussion I did mentioned that drug addiction is no respecter to persons and the problem of second smoke is just one of the many ways that we can be affected even if you are not using any drug directly. It therefore means that everyone is vulnerable and so action must be taken by all of use and not just the direct victims and their close confidants. This is a motivation for you and me to jump into the wagon of finding solution to bring up a healthy society.

Medical consequences beyond highs of drug addiction: The future of integrative addiction

In the journey of finding solution, doctor Akoury is not only addressing the direct victims but also the indirect ones including their healthcare professionals in various ways. In that respect AWAREmed Health and Wellness Resource Center, one of the leading pioneers in natural and holistic addiction treatment, will be conducting the first Educational, Functional and Integrative Addiction conference tailored for addiction professionals including doctors, counselors, nurses and addiction therapists. The conference is schedule for August 23-25 in Myrtle Beach, South Carolina. This new frontier in Addiction Medicine will be conducted by the most influential group of leading visionaries specializing in the latest advances in natural and integrative addiction medicine, under the theme “The Future of Integrative Addiction”. We all have a duty to fight this scourge and as professionals let’s join hands in this fight by attending this conference. For more information about the conference you can reach the event planner Sharon Philips on Tel: 954 540 1896 or drop an email with all your queries to sharon@integrativeaddiction2015.com, you can also login to the event web site www.integrativeaddiction2015.com

Medical consequences beyond highs of drug addiction: It is never too late to quit

What do you know about food addiction

July 3, 2015

What do you know about food addiction: Can food be addictive like other substances?

What do you know about food addiction. This this kind of behavior, the consequences can be very fatal if a rescue mission is not adopted immediately.

Generally the body of any human being needs sufficient fuel to remain operational. It is no secret that all the fuel for energies we need come from the food we eat meaning that food is very essential for human survival. So if food is that essential, then what is this madness called food addiction? Can food be addictive? Ever since scientific evidence associated food with other addictive substances, the debate of food addiction has been on going and we are not lest out and so we ask “what do you know about food addiction?” and are you addicted to any kind of food? I believe these concerns you too and that is why we are choosing this platform to inform you by way of explaining to you something about food addiction. doctor Dalal Akoury MD and founder of AWAREmed Health and Wellness Resource Center says that, currently there are so many studies that have suggested that food and drug addiction have some common similarities more in relation to the way both reacts in the disruption of the brain which is involved in the pleasure and self-control.

What do you know about food addiction? It will interest you to know that with the many discoveries; today the idea that an individual can be addicted to food has been receiving a lot of support from the scientific findings to the extent that experiments in animals and humans now shows that, for some people, the same reward and pleasure centers of the brain that are triggered by addictive drugs like cocaine and heroin are also activated by food, especially highly palatable foods which may include foods rich in sugar, fat and salt.

According to the experts at AWAREmed Health and Wellness Resource Center, in the same way addictive drugs reacts, highly palatable foods can also trigger the feel-good brain chemicals such as dopamine. Therefore the moment people experience pleasures associated with increased dopamine transmission in the brain’s reward pathway from eating certain foods, they quickly feel the need to eat again. The reward signals from highly palatable foods may override other signals of fullness and satisfaction. As a result, people keep eating, even when they’re not hungry and that is one of the reasons as to why food addiction is real today. Besides that individuals who demonstrate signs of food addiction may also develop tolerance to food. That way they will be eating excessively more units of food only to find that they are not really getting the satisfaction from the food they eat despite the quantity and the frequency.

What do you know about food addiction? With the advent of scientific findings, it is believed that food addiction may play an important role in obesity and weight related complications. Nonetheless people of normal-weight are not immune to this either they are also likely to struggle with food addiction as well. This may not be reflected in their weigh because many at times their bodies will be genetically programmed to better handle the extra calories they may take in. besides their body responding in their favor, they may also increase their physical activity to compensate for overeating. Doctor Akoury is very categorical that once addicted to food, such people will continue with their habits despite negative consequences like weight gain and dented relationships. And just like people who are addicted to other substances or gambling, food addicts will also have difficulties in stopping their behavior, even if there is evidence of willingness to cut back.

What do you know about food addiction: Signs of food addiction?

Before you can attempt to treat the problem of food addiction, you must be well informed of the possible signs of food addiction. Therefore how do we know that we are now at risk of food addictions? The following are some of the questions that can help determine if you have a food addiction. Are you able to identify any of these actions in your life? In other words do you …

End up eating more than planned when you start eating certain foods
Keep eating certain foods even if you’re no longer hungry
Eat to the point of feeling ill
Worry about not eating certain types of foods or worry about cutting down on certain types of foods
When certain foods aren’t available, go out of your way to obtain them

What do you know about food addiction? Questions in relation to the impact caused in your relationship with food on your personal life. Do these situations apply to you when:

You eat certain foods so often or in such large amounts that you start eating food instead of working, spending time with the family, or doing recreational activities.
You avoid professional or social situations where certain foods are available because of fear of overeating.
You have problems functioning effectively at your job or school because of food and eating.

What do you know about food addiction? Questions in relation to psychological withdrawal symptoms like for example, when you cut down on certain foods (excluding caffeinated beverages), do you have symptoms such as anxiety, agitation and other physical symptoms? Remember that these questions are not just tailored to trigger you if you are being addicted to food but also to gauge the impact of food decisions on your emotions. Therefore do these situations apply to you?

Eating food causes problems such as depression, anxiety, self-loathing, or guilt.
You need to eat more and more food to reduce negative emotions or increase pleasure.
Eating the same amount of food doesn’t reduce negative emotions or increase pleasure the way it used to.

What do you know about food addiction: Help for food addiction?

Even though there is evidence that food addiction is real, its treatment is still under investigation and the experts are working towards getting a scientific treatment solution for food addiction. At the moment a lot of debate around this is going on with some arguing that recovery from food addiction may be more complicated than recovery from other kinds of addictions. Alcoholics, for example, can ultimately abstain from drinking alcohol. But people who are addicted to food still need to eat. This is very interesting however while these studies are still being conducted, there are avenues of hope that you can get from experts at AWAREmed Health and Wellness Resource Center under the able leadership of doctor Dalal Akoury. All you need to do to access this help is to schedule for an appointment with her today and all your addiction concerns will be professionally addressed without any hesitation.

What do you know about food addiction: Can food be addictive like other substances?

Stem Cells Acting as “Little Doctors”

June 11, 2015

Stem Cells as “Little Doctors”

A stem cell can be defined as an undifferentiated cell of a multi-cellular organism that is capable of giving rise to indefinitely more cells of the same type and from which other kinds of cell arise by differentiation. They are mother cells that have the potential to become any type of cell in the body. One of the main characteristics of stem cells is their ability to self-renew or multiply while maintaining the potential to develop into other types of cells. They can become cells of the blood, heart, bones, skin, muscles, brain etc. There are different sources of stem cells but all types of stem cells have the same capacity to develop into multiple types of cells.

Commonly, stem cells come from two main sources:

Embryos formed during the blastocyst phase of embryological development (embryonic stem cells) and
Tissue (adult stem cells).

Since stem cells have remarkable potential to develop into many different cell types in the body during early life and growth, this unique characteristic that give them their very essence of internal repair systems. They are described as little doctors due to their microscopic sizes and their repair functions.

Therefore, we may ask ourselves, how then does this come about?

What Are The Potential Uses Of Human Stem Cells?

There are many ways in which human stem cells can be used in research and the clinic. Studies of human embryonic stem cells will yield information about the complex events that occur during human development. A primary goal of this work is to identify how undifferentiated stem cells become the differentiated cells that form the tissues and organs. Scientists know that turning genes on and off is central to this process.

Some of the most serious medical conditions, such as cancer and birth defects, are due to abnormal cell division and differentiation. A more complete understanding of the genetic and molecular controls of these processes may yield information about how such diseases arise and suggest new strategies for therapy.

Human stem cells are currently being used to test new drugs. New medications are tested for safety on differentiated cells generated from human multicellular cell lines. Other kinds of cell lines have a long history of being used in this way. Cancer cell lines, for example, are used to screen potential anti-tumor drugs. The availability of multicellular stem cells would allow drug testing in a wider range of cell types. However, to screen drugs effectively, the conditions must be identical when comparing different drugs

Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including macular degeneration, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.

A few small studies have also been carried out in humans, usually in patients who are undergoing open-heart surgery. Several of these have demonstrated that stem cells that are injected into the circulation or directly into the injured heart tissue appear to improve cardiac function and/or induce the formation of new capillaries.

Cardiovascular disease (CVD), which includes hypertension, coronary heart disease, stroke, and congestive heart failure are some of the heart diseases that can are under study by scientists to be treated using the stem cells replication idea.

In people who suffer from type 1 diabetes, the cells of the pancreas that normally produce insulin are destroyed by the patient’s own immune system. New studies indicate that it may be possible to direct the differentiation of human embryonic stem cells in cell culture to form insulin-producing cells that eventually could be used in transplantation therapy for persons with diabetes.

Stem cells serve as internal repair systems to living organisms as they replenish through cell division essentially without limit as long as the person or animal is alive. This cause the damaged cells are disposed while news one is created.

The stem cells have also been found to be capable to treat eye defects. This has been one of the breakthroughs of using the stem cells as new medicine.

The following is a list of steps in successful cell-based treatments that scientists will have to learn to control to bring such treatments to the clinic. To be useful for transplant purposes, stem cells must be reproducibly made to:

Proliferate extensively and generate sufficient quantities of cells for making tissue.
Differentiate into the desired cell type(s).
Survive in the recipient after transplant.
Integrate into the surrounding tissue after transplant.
Function appropriately for the duration of the recipient’s life.
Avoid harming the recipient in any way.

Also, to avoid the problem of immune rejection, researchers are experimenting with different research strategies to generate tissues that will not be rejected.

To summarize, stem cells offer exciting promise for future therapies. For more information about this topic and others visit www.awaremednetwork.com. Dr Dalal. Akoury is an expert in integrative medicine. While at it, visit http://www.integrativeaddiction2015.com for information about the integrative addiction conference 2015 that she be holding, the conference will provide information on holistic approaches to issues of addiction and how to deal with patients of addiction.

Stem Cells Acting as “Little Doctors”

Clinical Trials For Heart Failure

June 6, 2015

What’s Heart Failure?

Heart failure is an intricate clinical condition of symptoms and signs that suggest malfunction of the heart. This is often caused by structural and or functional defects of the heart. A good number of patients have heart failures as a result of left ventricular systolic dysfunction (LVSD).

“More often than not, LVSD is associated with reduced left ventricular blood ejection fraction. Some patients have heart failure as a result of a preserved ejection fraction (HFPEF). Whereas the most popular cause of heart failure in the United States (US) is coronary artery disease, many patients have had a myocardial infarction,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

Heart failure and or related diseases often increase steadily with age, a typical age at first diagnosis being at 76 years. Prevalence of heart failure is even expected to rise in the near future as a result of an increased ageing population. Improved survival of people with heart disease and more effective treatments of the same are more reasons for such increased prevalence.

“Heart failure has a poor prognosis: 30–40% of persons diagnosed with the condition die within a year, after which the mortality rate is less than 10% for every succeeding year. However, there has been better prognosis in the past 10 years. The 6-month mortality rate further decreased from 26% in 1995 to 14% in 2005 and even further now,” Petersen S, Rayner M, and Wolstenholme J. (2002).

“Heart failure accounts for over a million inpatient bed-days 2% of all NHS inpatient bed-days in the US and 5% of all emergency medical admissions to hospital. The admissions because of the heart condition are even projected to rise by 50% over the next two decades, largely as a result of the ageing population,” Hobbs FD, Roalfe AK, and Davis R.C., et al. (2007).

This article provides acceptable and standard practices on adults with heart failures, especially those with chronic heart failures. Such trials entail diagnosis, treatment, and rehabilitation.

Clinical Trials For Heart Failure

Clinical trials as well as therapeutic care should take into account the patients’ needs and preferences. A patient with acute heart failure for instance should be able to make or rather should be given an opportunity to make an informed decision about his/her therapeutic care together with the healthcare professionals.

If the patient does not have the ability to make reliable decision about his/her the trials and or therapeutic care, the healthcare professional should follow established guidelines set by the Department of Health on consent and the professional code of practice as set out in the Mental Capacity Act.

Also important is good communication between the patient and the professional. These may be in different forms but a recommended practice involves a written document that suits the patient’s unique clinic diagnosis and can also act as evidence. Clinical trials and therapeutic care given and information communicated to the patients should be appropriate to the latter’s medical history and culture.

Such information should be accessible to people with special needs such as physical, sensory, learning disabilities, and or to those who neither speak nor read English. Family members, guardians and or care-takers should also have an opportunity to contribute in the decisions about the trials and care.

“During clinical examinations, it is important to refer patients with supposed heart failures and or previous myocardial infarction (MI) urgently to have transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

“Clinical trials on treatment should measure serum natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal pro-B type natriuretic peptide [NTproBNP]) in patients with suspected heart failure without previous MI. Because very high levels of serum natriuretic peptides carry a poor prognosis, refer patients with suspected heart failure and a BNP level above 400 pg/ml (116 pmol/litre) or an NTproBNP level above 2000 pg/ml (236 pmol/litre) urgently, to have the 2D echocardiography and assessment within 2 weeks,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

Trials on treatment involve offering both angiotensin-converting enzyme (ACE) inhibitors and beta-blockers licensed for heart failure to all patients with heart failure due to left ventricular systolic dysfunction. It is also advisable to use clinical judgments when deciding which drug to use first.

Offer only beta-blockers licensed for heart failure to all patients with the heart condition due to left ventricular systolic dysfunction, including: adults and those patients with other vascular diseases, erectile dysfunction, diabetes mellitus, interstitial pulmonary disease, and or chronic obstructive pulmonary disease (COPD) without reversibility.

Professionals are also advised to seek specialist guidance to offer one of the following alternatives if the patient fails to respond to treatment despite optimum therapy with an ACE inhibitor and a beta-blocker. They may include: an aldosterone antagonist licensed to handle heart failure patients and an angiotensin II receptor antagonist (ARB) licensed for heart failure.

Clinical trials about rehabilitation should involve a supervised exercise-based rehabilitation program designed for patients with heart failure in groups. While at it, it is advisable to ensure the patient is stable and does not have a condition or device that would immaturely conclude the rehabilitation program.

During the program, you could also include a psychological and or educational component. The program may be incorporated within an existing exercise-based or other cardiac rehabilitation program.

“It should be noted patients with chronic heart failure require monitoring. This monitoring should include; a clinical assessment of functional capacity, fluid status, cardiac rhythm, nutritional status, cognitive status and a review of medication; including need for changes and possible side effects, serum urea, electrolytes, and creatinine. Also, when a patient is admitted to hospital because of heart failure, the professional should seek advice on their management plan from a specialist in heart failure,” Petersen S, Rayner M, and Wolstenholme J. (2002).

Lastly, patients with this kind of heart condition should generally be discharged from hospital only when their clinical condition is stable and the management plan is optimized. The timing should take into account patient and career wishes, and the level of community care and support.

Dr. Dalal Akoury, M.D., M.P.H. is a family physician with a wealth of knowledge and years of experience in integrative medicine. She will highly be of assistance.

Also, don’t miss an opportunity to learn and interact with professionals during this year’s Integrative Addiction Conference 2015. For more information, visit http://www.integrativeaddiction2015.com. The conference will also deliver unique approaches to telling symptoms of addiction and how to assist patients of addiction.

Clinical Trials For Heart Failure

Category Archives: addiction