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Find video protocols related to scientific articles indexed in Pubmed.
Long-Term Colorectal-Cancer Mortality after Adenoma Removal.
N. Engl. J. Med.
PUBLISHED: 11-20-2014
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To the Editor: The study of colorectal-cancer mortality by Løberg et al. (Aug. 28 issue)(1) provides no data on the quality of the colonoscopies performed. This limitation outweighs the merits of the large population size and prolonged follow-up in this study, and it precludes meaningful inferences regarding the protective effect of colonoscopy against colorectal cancer. We think the results are best explained by polyps left behind or incompletely removed because of the use of a suboptimal technique.(2),(3) The timing of colonoscopy may explain the modest mortality benefit among patients with low-risk adenomas versus no benefit among patients with multiple . . .
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Association of Inpatient vs Outpatient Onset of ST-Elevation Myocardial Infarction With Treatment and Clinical Outcomes.
JAMA
PUBLISHED: 11-17-2014
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Reperfusion times for ST-elevation myocardial infarction (STEMI) occurring in outpatients have improved significantly, but quality improvement efforts have largely ignored STEMI occurring in hospitalized patients (inpatient-onset STEMI).
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M-path: A Compass for Navigating Potential Metabolic Pathways.
Bioinformatics
PUBLISHED: 11-16-2014
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Construction of synthetic metabolic pathways promises sustainable production of diverse chemicals and materials. In order to design synthetic metabolic pathways of high value, computational methods are needed to expand present knowledge by mining comprehensive chemical and enzymatic information databases. Several computational methods have been already reported for the metabolic pathway design, but until now computation complexity has limited the diversity of chemical and enzymatic data used.
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Pursuing Perfection: Distress and Interpersonal Functioning Among Adolescent Boys in Single-Sex and Co-Educational Independent Schools.
Psychol Sch
PUBLISHED: 11-15-2014
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This study extends past findings of heightened problems among affluent youth by examining adjustment patterns among boys in two academically elite, independent high schools: one for boys only and the other coeducational. Both samples manifested disproportionately high rates of internalizing and externalizing symptoms, but only the co-educational boys showed elevations in substance use. Boys in both schools showed elevations in a new outcome domain examined: exhibitionistic narcissism. Multivariate analyses of predictors showed that parent criticism -- a defining feature of youths' maladaptive perfectionism -- and perceived maternal depression emerged as major vulnerability factors for both samples in relation to symptom levels. On other parenting dimensions, boys in the single-sex school seemed to be particularly sensitive to feelings of alienation from their fathers and perceived paternal depression. Envy of peers' attractiveness was associated with adolescent distress in both samples, but appeared to be especially critical for co-educational boys. Results are discussed, focusing on the costs and benefits of boys' attendance at a single-sex versus co-educational school, along with implications for practice and future research.
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Bupivacaine Mandibular Nerve Block Affects Intraoperative Blood Pressure and Heart Rate in a Yucatan Miniature Swine Mandibular Condylectomy Model: A Pilot Study.
J Invest Surg
PUBLISHED: 11-14-2014
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ABSTRACT Purpose/Aim: The primary objective was to evaluate the effect of a bupivacaine mandibular nerve block on intraoperative blood pressure (BP) and heart rate (HR) in response to surgical stimulation and the need for systemic analgesics postoperatively. We hypothesized that a mandibular nerve block would decrease the need for systemic analgesics both intraoperatively and postoperatively. Materials and Methods: Fourteen adult male Yucatan pigs were purchased. Pigs were chemically restrained with ketamine, midazolam, and dexmedetomidine and anesthesia was maintained with isoflurane inhalant anesthesia. Pigs were randomized to receive a mandibular block with either bupivacaine (bupivacaine group) or saline (control group). A nerve stimulator was used for administration of the block with observation of masseter muscle twitch to indicate the injection site. Invasive BP and HR were measured with the aid of an arterial catheter in eight pigs. A rescue analgesic protocol consisting of fentanyl and lidocaine was administered if HR or BP values increased 20% from baseline. Postoperative pain was quantified with a customized ethogram. HR and BP were evaluated at base line, pre-rescue, 10 and 20 min post-rescue. Results: Pre-rescue mean BP was significantly increased (p = .001) for the bupivacaine group. Mean intraoperative HR was significantly lower (p = .044) in the bupivacaine versus saline group. All other parameters were not significant. Conclusion: Addition of a mandibular nerve block to the anesthetic regimen in the miniature pig condylectomy model may improve variations in intraoperative BP and HR. This study establishes the foundation for future studies with larger animal numbers to confirm these preliminary findings.
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A Phase Shift Granger Causality Measure of Directed Connectivity in EEG Recordings.
Brain Connect
PUBLISHED: 11-14-2014
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Cortical activity is maintained by neural networks working in tandem. Electroencephalographic (EEG) signals across two sites are said to be coherent with one another when they show consistent phase relations. However, periods of desynchrony beginning with a shift in phase relations are a necessary aspect of information processing. Traditional measures of EEG coherence lack the temporal resolution required to divide the relationship between two signals into periods of synchrony and desynchrony and are unable to specify the direction of information transmission (i.e., which site is leading and which is lagging), a goal referred to as directed connectivity. In this paper, we introduce a novel method of measuring directed connectivity by applying the framework of Granger causality to phase shift events which are estimated with high temporal resolution. A simulation study is used to verify that the proposed method is able to identify connectivity patterns in situations similar to EEG recordings, such as high levels of noise and linear source mixing. Our method is able to correctly identify both the existence and direction of information transfer, and that the existence of spatio-temporal noise serves to reduce the spread of shift identification due to volume conduction. To demonstrate the method on real data, it is applied to EEG recordings from 18 adolescents during a resting period and auditory and visual vigilance tasks. Our new measure, Phase Shift Granger Causality (PSGC), is able to clearly distinguish between the resting task and the active tasks. The latter have higher rates of connectivity overall and specifically more long range connections. As expected, the resting task appears to activate more localized neural circuitry while the active tasks appear to increase communication across several neural regions involved in vigilance tasks. The vigilance tasks also showed significantly higher clustering coefficients than the resting task, a property associated with small world networks.
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A Polypill Strategy to Improve Adherence: Results From the FOCUS Project.
J. Am. Coll. Cardiol.
PUBLISHED: 09-01-2014
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Adherence to evidence-based cardiovascular (CV) medications after an acute myocardial infarction (MI) is low after the first 6 months. The use of fixed-dose combinations (FDC) has been shown to improve treatment adherence and risk factor control. However, no previous randomized trial has analyzed the impact of a polypill strategy on adherence in post-MI patients.
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Expert consensus document: World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI.
Nat Rev Cardiol
PUBLISHED: 08-26-2014
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Guideline recommendations on the use of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes and in those undergoing percutaneous coronary intervention (PCI) have been formulated by both the ACC/AHA and the ESC. These recommendations are based primarily on large, phase III, randomized, controlled trials of the P2Y12 inhibitors clopidogrel, prasugrel, and ticagrelor. However, few East Asian patients have been included in the trials to assess the use of these agents, particularly the newer agents prasugrel and ticagrelor. Additionally, an increasing body of data suggests that East Asian patients have differing risk profiles for both thrombophilia and bleeding compared with white patients, and that a different 'therapeutic window' of on-treatment platelet reactivity might be appropriate in East Asian patients. Furthermore, a phenomenon referred to as the 'East Asian paradox' has been described, in which East Asian patients have a similar or even a lower rate of ischaemic events after PCI compared with white patients, despite a higher level of platelet reactivity during DAPT. Recognizing these concerns, the World Heart Federation has undertaken this evidence-based review and produced this expert consensus statement to determine the antiplatelet treatment strategies that are most appropriate for East Asian patients.
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GENDER AS PREDICTOR AND MODERATOR OF OUTCOME IN COGNITIVE BEHAVIOR THERAPY AND PHARMACOTHERAPY FOR ADULT DEPRESSION: AN "INDIVIDUAL PATIENT DATA" META-ANALYSIS.
Depress Anxiety
PUBLISHED: 07-14-2014
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It has yet to be established whether gender moderates or predicts outcome of psychological and pharmacological treatments for adult depression because: (1) individual randomized trials typically lack sufficient statistical power to detect moderators and predictors and (2) meta-analyses cannot examine such associations directly.
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The effect of bupropion XL and escitalopram on memory and functional outcomes in adults with major depressive disorder: Results from a randomized controlled trial.
Psychiatry Res
PUBLISHED: 07-10-2014
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Decrements in cognitive function are a common feature of Major Depressive Disorder (MDD), and whether distinct classes of antidepressants differentially affect memory in these individuals has not been sufficiently evaluated. In this study we sought to determine the effect of escitalopram and bupropion XL on memory and psychosocial function.
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Implications of ongoing neural development for the measurement of the error-related negativity in childhood.
Dev Sci
PUBLISHED: 06-27-2014
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Event-related potentials (ERPs) have been proposed as biomarkers capable of reflecting individual differences in neural processing not necessarily detectable at the behavioral level. However, the role of ERPs in developmental research could be hampered by current methodological approaches to quantification. ERPs are extracted as an average waveform over many trials; however, actual amplitudes would be misrepresented by an average if there was high trial-to-trial variability in signal latency. Low signal temporal consistency is thought to be a characteristic of immature neural systems, although consistency is not routinely measured in ERP research. The present study examined the differential contributions of signal strength and temporal consistency across trials in the error-related negativity (ERN) in 6-year-old children, as well as the developmental changes that occur in these measures. The 234 children were assessed annually in kindergarten, 1st, and 2nd grade. At all assessments signal strength and temporal consistency were highly correlated with the average ERN amplitude, and were not correlated with each other. Consistent with previous findings, ERN deflections in the averaged waveform increased with age. This was found to be a function of developmental increases in signal temporal consistency, whereas signal strength showed a significant decline across this time period. In addition, average ERN amplitudes showed low-to-moderate stability across the three assessments whereas signal strength was highly stable. In contrast, signal temporal consistency did not evidence rank-order stability across these ages. Signal strength appears to reflect a stable individual trait whereas developmental changes in temporal consistency may be experientially influenced.
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2013 ACC/AHA guideline recommends fixed-dose strategies instead of targeted goals to lower blood cholesterol.
J. Am. Coll. Cardiol.
PUBLISHED: 06-27-2014
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The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines recently issued the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. This new guideline endorses a paradigm shift in strategies for reducing atherosclerotic cardiovascular disease (ASCVD) events by lowering blood cholesterol. Whereas previous guidelines focused on therapy to decrease low-density lipoprotein and non-high-density lipoprotein cholesterol to specific target levels, the new guideline instead proposes implementation of cholesterol-lowering treatment using evidenced-based intensity of statin therapy without such targets. The guideline also provides a new risk estimator for primary prevention decisions, including stroke outcomes and data on African Americans, which will significantly increase the number of patients recommended for outcome-related benefits of cholesterol-lowering therapy. The first section of this paper reviews the process by which the task force developed the new evidence-based guideline, the major findings and recommendations, and their implications. The second section primarily focuses on the question of how much low-density lipoprotein cholesterol should be lowered and on additional considerations in risk assessment.
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Nonantithrombotic medical options in acute coronary syndromes: old agents and new lines on the horizon.
Circ. Res.
PUBLISHED: 06-07-2014
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Acute coronary syndromes (ACS) constitute a spectrum of clinical presentations ranging from unstable angina and non-ST-segment elevation myocardial infarction to ST-segment myocardial infarction. Myocardial ischemia in this context occurs as a result of an abrupt decrease in coronary blood flow and resultant imbalance in the myocardial oxygen supply-demand relationship. Coronary blood flow is further compromised by other mechanisms that increase coronary vascular resistance or reduce coronary driving pressure. The goals of treatment are to decrease myocardial oxygen demand, increase coronary blood flow and oxygen supply, and limit myocardial injury. Treatments are generally divided into disease-modifying agents or interventions that improve hard clinical outcomes and other strategies that can reduce ischemia. In addition to traditional drugs such as ?-blockers and inhibitors of the renin-angiotensin-aldosterone system, newer agents have expanded the number of molecular pathways targeted for treatment of ACS. Ranolazine, trimetazidine, nicorandil, and ivabradine are medications that have been shown to reduce myocardial ischemia through diverse mechanisms and have been tested in limited fashion in patients with ACS. Attenuating the no-reflow phenomenon and reducing the injury compounded by acute reperfusion after a period of coronary occlusion are active areas of research. Additionally, interventions aimed at ischemic pre- and postconditioning may be useful means by which to limit myocardial infarct size. Trials are also underway to examine altered metabolic and oxygen-related pathways in ACS. This review will discuss traditional and newer anti-ischemic therapies for patients with ACS, exclusive of revascularization, antithrombotic agents, and the use of high-intensity statins.
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Attention capacity and self-report of subjective cognitive decline: A P3 ERP study.
Biol Psychol
PUBLISHED: 05-06-2014
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Subjective cognitive decline (SCD) has recently been proposed as the earliest stage of pathologic cognitive decline in older adults. Longitudinal research suggests that many individuals with SCD go on to develop mild cognitive impairment or Alzheimer's disease. However, those with SCD typically appear normal on standardized neuropsychological testing, and as of yet there are no reliable objective measures discriminating those with SCD from healthy peers. Two groups of healthy older adults (ages 65-80), who self-identified as being with (n=17) or without SCD (n=23), completed self-report measures and objective measures of cognition. Groups did not differ on demographic variables, estimated cognitive reserve, or clinical neuropsychological testing. However, self-identifying as having SCD predicted clear differences in the P3 event-related potential in response to an attention control task, over and above any contributions from mood, anxiety, or neuroticism. Results suggest that using direct neural measures of information processing might be useful where standardized clinical tools are insensitive in those with SCD.
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Depression treatment by withdrawal of short-term low-dose antipsychotic, a proof-of-concept randomized double-blind study.
J Affect Disord
PUBLISHED: 03-14-2014
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Because increased dopamine neurotransmission occurs with most antidepressants, and because antipsychotics cause behavioural supersensitivity to dopamine, short-term low-dose antipsychotic treatment was tested on depressed patients with an expectation of clinical improvement in the supersensitive phase following drug withdrawal.
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Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry.
Eur. Heart J.
PUBLISHED: 02-28-2014
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Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic PAD enrolled in the international REACH registry.
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Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline.
Ann. Intern. Med.
PUBLISHED: 01-30-2014
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In November 2013, the American College of Cardiology and American Heart Association (ACC/AHA) released a clinical practice guideline on the treatment of blood cholesterol to reduce cardiovascular risk in adults. This synopsis summarizes the major recommendations.
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A placebo-controlled study of three agomelatine dose regimens (10mg, 25mg, 25-50mg) in patients with major depressive disorder.
Eur Neuropsychopharmacol
PUBLISHED: 01-09-2014
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A randomised placebo-controlled "dose relation study" was conducted in 549 patients who met the criteria for major depressive disorder, to evaluate the efficacy and safety of three doses regimens of agomelatine during 6 weeks: low fixed dosage (10mg/day, n=133), fixed dosage (25mg/day, n=138) and a flexible dosage with up-titration in case of insufficient improvement at week 2 (25-50mg/day, n=137). At last post-baseline assessment, there were significant and incremental placebo-agomelatine differences on mean HAM-D17 total scores in favour of each agomelatine dose regimen (2.46 ± 0.76 points, p=0.001 at 10mg; 4.71+0.75 points, p<0.0001 at 25mg and 4.92 ± 0.76 points, p<0.0001 at 25-50mg) with statistically significant differences between 25mg and 25-50mg dose regimens compared to the 10mg dose. The response rate according to HAM-D17 was significantly higher in patients taking agomelatine than those taking placebo (difference of 16.1% at 10mg p=0.005; 25.9% and 27.4% respectively at 25mg and 25-50mg, p<0.0001). The benefit of agomelatine was demonstrated in the subgroup of severely depressed patients in the 25mg and 25-50mg/day regimens. Consistent clinical response according to CGI variables and better social functioning were found in patients receiving agomelatine. All dose regimens of agomelatine were well tolerated and no unexpected adverse event was reported. This study provides evidence of a dose effect for agomelatine between 10mg and the therapeutic dose regimen of agomelatine 25-50mg: the efficacy of the higher dose regimens being more efficacious than the lowest (10mg) daily dose. The data support a definitive statement regarding the utility of 25mg as the threshold dose for initiating agomelatine in depressed patients.
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Anhedonia and reward-circuit connectivity distinguish nonresponders from responders to dorsomedial prefrontal repetitive transcranial magnetic stimulation in major depression.
Biol. Psychiatry
PUBLISHED: 01-07-2014
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Depression is a heterogeneous mental illness. Neurostimulation treatments, by targeting specific nodes within the brain's emotion-regulation network, may be useful both as therapies and as probes for identifying clinically relevant depression subtypes.
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Statistical mechanical model of coupled transcription from multiple promoters due to transcription factor titration.
Phys Rev E Stat Nonlin Soft Matter Phys
PUBLISHED: 01-06-2014
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Transcription factors (TFs) with regulatory action at multiple promoter targets is the rule rather than the exception, with examples ranging from the cAMP receptor protein (CRP) in E. coli that regulates hundreds of different genes simultaneously to situations involving multiple copies of the same gene, such as plasmids, retrotransposons, or highly replicated viral DNA. When the number of TFs heavily exceeds the number of binding sites, TF binding to each promoter can be regarded as independent. However, when the number of TF molecules is comparable to the number of binding sites, TF titration will result in correlation ("promoter entanglement") between transcription of different genes. We develop a statistical mechanical model which takes the TF titration effect into account and use it to predict both the level of gene expression for a general set of promoters and the resulting correlation in transcription rates of different genes. Our results show that the TF titration effect could be important for understanding gene expression in many regulatory settings.
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Treatment-resistant depression in primary care across Canada.
Can J Psychiatry
PUBLISHED: 01-01-2014
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Treatment-resistant depression (TRD) represents a considerable global health concern. The goal of the InSight study was to investigate the prevalence of TRD and to evaluate its clinical characterization and management, compared with nonresistant depression, in primary care centres.
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Effects of combined pharmacotherapy and psychotherapy for improving work functioning in major depressive disorder.
Br J Psychiatry
PUBLISHED: 09-12-2013
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Major depressive disorder is associated with significant impairment in occupational functioning and reduced productivity, which represents a large part of the overall burden of depression.
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Prosthetic outcomes and survival rates of implants placed with guided flapless surgery using stereolithographic templates: a retrospective study.
Int J Periodontics Restorative Dent
PUBLISHED: 09-03-2013
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Recent technologic advances allow clinicians to place dental implants using computer-generated templates. However, there are limited data regarding treatment outcomes for implants placed using these techniques. The purpose of this retrospective study was to report the 2- to 4-year prosthetic outcomes and survival of dental implants placed by postdoctoral residents with a flapless surgical protocol using computer-based planning and stereolithographic surgical templates. Thirty-six patients were treated using the NobelGuide concept, comprising an image-based three-dimensional implant planning software and flapless implant surgery with stereolithographic templates.
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Predictors of Long-term Adherence to Evidence-based Cardiovascular Disease Medications in Outpatients With Stable Atherothrombotic Disease: Findings From the REACH Registry.
Clin Cardiol
PUBLISHED: 08-08-2013
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Despite overall improvements in cardiovascular-disease therapies and outcomes, medication nonadherence remains an important barrier to effective secondary prevention of atherothrombotic disease.
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NSAID Use and Association with Cardiovascular Outcomes in Outpatients with Stable Atherothrombotic Disease.
Am. J. Med.
PUBLISHED: 07-03-2013
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Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin have been linked to heart failure, salt retention, adverse ventricular remodeling, and thrombosis. We therefore sought to assess their impact on cardiovascular events in outpatients with stable atherothrombotic disease.
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Colorectal cancers soon after colonoscopy: a pooled multicohort analysis.
Gut
PUBLISHED: 06-21-2013
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Some individuals are diagnosed with colorectal cancer (CRC) despite recent colonoscopy. We examined individuals under colonoscopic surveillance for colonic adenomas to assess possible reasons for diagnosing cancer after a recent colonoscopy with complete removal of any identified polyps.
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PromoterCAD: Data-driven design of plant regulatory DNA.
Nucleic Acids Res.
PUBLISHED: 06-12-2013
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Synthetic promoters can control the timing, location and amount of gene expression for any organism. PromoterCAD is a web application for designing synthetic promoters with altered transcriptional regulation. We use a data-first approach, using published high-throughput expression and motif data from for Arabidopsis thaliana to guide DNA design. We demonstrate data mining tools for finding motifs related to circadian oscillations and tissue-specific expression patterns. PromoterCAD is built on the LinkData open platform for data publication and rapid web application development, allowing new data to be easily added, and the source code modified to add new functionality. PromoterCAD URL: http://promotercad.org. LinkData URL: http://linkdata.org.
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The cardiovascular safety profile of escitalopram.
Eur Neuropsychopharmacol
PUBLISHED: 05-17-2013
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The cardiovascular effects of escitalopram were examined in a large group of participants in double-blind, randomized, placebo-controlled studies. Escitalopram (n=3298) was administered at doses between 5 and 20mg/day. Patients were treated in acute (8-12 weeks) and long-term (24 weeks) studies. Assessment of cardiovascular safety included heart rate, blood pressure (BP), treatment-emergent adverse events (TEAEs) and electrocardiograms (ECGs). In the short-term, there was a small, but statistically significant 2 beats per minute decrease in heart rate with escitalopram compared with placebo. The difference compared to placebo in systolic or diastolic BP was not clinically or statistically significant. Valid ECG assessments at both baseline and last assessment were available for 2407 escitalopram patients and 1952 placebo patients. Escitalopram-placebo differences in mean changes in ECG values were not clinically meaningful. The mean difference to placebo in the corrected QT [Fridericias (QTcF)] interval was 3.5 ms (all escitalopram doses); 1.3 ms (escitalopram 10mg) and 1.7 ms (escitalopram 20mg) (p=0.2836 for 10 versus 20 mg). One out of 2407 escitalopram patients had a QTcF interval >500 ms and a change from baseline >60 ms. The incidence and types of cardiac-associated adverse events were similar between patients treated for 8-12 weeks with placebo (2.2%) or escitalopram (1.9%) and for 24 weeks with placebo (2.7%) or escitalopram (2.3%). Analyses of data from long-term studies and studies of the elderly showed similar results. In conclusion, these data demonstrate that escitalopram, like other SSRIs, has a statistically significant effect on heart rate and no clinically meaningful effect on ECG values, BP, with a placebo-level incidence of cardiac-associated adverse events.
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The effect of lisdexamfetamine dimesylate on body weight, metabolic parameters, and attention deficit hyperactivity disorder symptomatology in adults with bipolar I/II disorder.
Hum Psychopharmacol
PUBLISHED: 04-25-2013
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We primarily sought to determine the effect of adjunctive lisdexamfetamine dimesylate (LDX) on anthropometric and metabolic parameters. Our secondary aim was to evaluate the effect of LDX on attention deficit hyperactivity disorder (ADHD) symptom severity in adults with bipolar I/II disorder.
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The effect of personality dimensions on functional outcomes in mood disorders.
Adv Ther
PUBLISHED: 04-19-2013
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Functional impairment associated with mood disorders may be related to a characteristic "profile" of normative personality dimensions.
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EEG Power Asymmetry and Functional Connectivity as a Marker of Treatment Effectiveness in DBS Surgery for Depression.
Neuropsychopharmacology
PUBLISHED: 04-17-2013
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Recently, Deep Brain Stimulation (DBS) has been evaluated as an experimental therapy for treatment-resistant depression (TRD). While there have been encouraging results in open-label trials, about half of the patients fail to achieve meaningful benefit. Although progress has been made in understanding the neurobiology of MDD, the ability to characterize differences in brain dynamics between those who do and do not benefit from DBS is lacking. In this study we investigated EEG resting state data recorded from 12 patients that have undergone DBS surgery. Of those, six patients were classified as responders to DBS, defined as an improvement of 50% or more on the 17-item Hamilton Rating Scale for Depression (HAMD-17). We compared hemispheric frontal theta and parietal alpha power asymmetry and synchronization asymmetry between responders and non responders. Hemispheric power asymmetry showed statistically significant differences between responders and non-responders with healthy controls showing an asymmetry similar to responders but opposite to non-responders. This asymmetry was characterized by an increase in frontal theta in the right hemisphere relative to the left combined with an increase in parietal alpha in the left hemisphere relative to the right in non-responders compared to responders. Hemispheric mean synchronization asymmetry showed a statistically significant difference between responders and non-responders in the theta band, with healthy controls showing an asymmetry similar to responders but opposite to non-responders. This asymmetry resulted from an increase in frontal synchronization in the right hemisphere relative to the left combined with an increase in parietal synchronization in the left hemisphere relative to the right in non-responders compared to responders. Connectivity diagrams revealed long range differences in frontal/central-parietal connectivity between the two groups in the theta band. This pattern was observed irrespective of whether EEG data were collected with active DBS or with the DBS stimulation turned off, suggesting stable functional and possibly structural modifications that may be attributed to plasticity.Neuropsychopharmacology accepted article preview online, 28 November 2013. doi:10.1038/npp.2013.330.
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A review of antidepressant therapy in primary care: current practices and future directions.
Prim Care Companion CNS Disord
PUBLISHED: 04-11-2013
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Objective: To provide general practitioners with a comparison of major depressive disorder treatments received in primary care and psychiatric clinic settings, a focus on treatment outcomes related to currently prescribed antidepressants, and a review of new and emerging therapeutic strategies. Data Sources: English-language evidence-based guidelines and peer-reviewed literature published between January 1, 2005, and December 31, 2011, were identified using PubMed, MEDLINE, and EMBASE. All searches contained the terms major depressive disorder and unipolar depression, and excluded the terms bipolar disorder/manic depressive disorder. The following search terms were also included: naturalistic study, antidepressant, relapse, recurrence, residual symptoms, response, remission, sequential medication trials, and treatment-resistant depression. Study Selection: Meta-analyses, systematic reviews, and practice guidelines were included. Bibliographies were used to identify additional articles of interest. Data Extraction: Abstracts and articles were screened for relevance to primary care practice. Population-based studies and those involving patients treated in primary care were used whenever possible. Data Synthesis: Achieving remission from a major depressive episode is important to improve functional outcomes and to reduce relapse and recurrence. Despite the availability of numerous antidepressants, as many as 50% of patients require treatment modifications beyond first-line therapy. Among remitters, 90% report residual symptoms that may interfere with function. Patients treated in primary care often have chronic depression (symptom duration ? 24 months at presentation) and medical comorbidities. These are clinical predictors of worse outcomes and require individualized attention when treatment is initiated. Antidepressants differ in efficacy, tolerability, and side effects-factors that may affect adherence to treatment. Conclusions: Major depressive disorder is highly prevalent in primary care and is among the most common causes of loss of disability-adjusted life-years worldwide. There are few differences in clinical profiles between depressed patients in primary care and those in specialist clinics, although differences in symptoms and comorbid conditions among individual depressed patients present a challenge for the physician providing individualized treatment. The goal of treatment is remission with good functional and psychosocial outcomes. Physicians in primary care should have expertise in working with a number of current antidepressant approaches and an awareness of new and emerging treatments.
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Acute ST-elevation myocardial infarction in patients hospitalized for noncardiac conditions.
J Am Heart Assoc
PUBLISHED: 04-06-2013
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Major advances have been made in the treatment of ST-elevation myocardial infarction (STEMI) in outpatients. In contrast, little is known about outcomes in STEMI that occur in patients hospitalized for a noncardiac condition.
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Resting-State Cortico-Thalamic-Striatal Connectivity Predicts Response to Dorsomedial Prefrontal rTMS in Major Depressive Disorder.
Neuropsychopharmacology
PUBLISHED: 03-26-2013
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Despite its high toll on society, there has been little recent improvement in treatment efficacy for major depressive disorder (MDD). The identification of biological markers of successful treatment response may allow for more personalized and effective treatment. Here we investigate whether resting-state functional connectivity predicted response to treatment with repetitive transcranial magnetic stimulation (rTMS) to dorsomedial prefrontal cortex (dmPFC). Twenty-five individuals with treatment-refractory MDD underwent a 4-week course of dmPFC-rTMS. Before and after treatment, subjects received resting-state functional MRI scans and assessments of depressive symptoms using the Hamilton Depresssion Rating Scale (HAMD17). We found that higher baseline cortico-cortical connectivity (dmPFC-subgenual cingulate and subgenual cingulate to dorsolateral PFC) and lower cortico-thalamic, cortico-striatal, and cortico-limbic connectivity were associated with better treatment outcomes. We also investigated how changes in connectivity over the course of treatment related to improvements in HAMD17 scores. We found that successful treatment was associated with increased dmPFC-thalamic connectivity and decreased subgenual cingulate cortex-caudate connectivity, Our findings provide insight into which individuals might respond to rTMS treatment and the mechanisms through which these treatments work.
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Adherence to secondary prevention medications and four-year outcomes in outpatients with atherosclerosis.
Am. J. Med.
PUBLISHED: 01-21-2013
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Although nonadherence with evidence-based secondary prevention medications is common in patients with established atherothrombotic disease, long-term outcomes studies are scant. We assessed the prevalence and long-term outcomes of nonadherence to secondary prevention (antiplatelet agents, statins, and antihypertensive agents) medications in stable outpatients with established atherothrombosis (coronary, cerebrovascular, or peripheral artery disease) enrolled in the international REduction of Atherothrombosis for Continued Health registry.
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Neural response to emotional stimuli associated with successful antidepressant treatment and behavioral activation.
J Affect Disord
PUBLISHED: 01-14-2013
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Major Depressive Disorder (MDD) is a leading cause of disability globally. Currently available treatments have limited efficacy and combination strategies are frequently used. Several lines of research have demonstrated that MDD patients experience impairments in various components of affective processing, including regulation of affective states.
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Efficacy of the novel antidepressant agomelatine for anxiety symptoms in major depression.
Hum Psychopharmacol
PUBLISHED: 01-11-2013
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Anxiety in major depression is associated with increased morbidity. The antidepressant, agomelatine, which acts as an agonist at melatonin MT(1) and MT(2) receptors and as an antagonist at serotonin 5-HT(2C) receptors, has demonstrated efficacy and safety in both major depression and generalized anxiety disorder. Here, we investigated the efficacy of agomelatine in anxious depression.
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Neurostimulation therapies for treatment resistant depression: a focus on vagus nerve stimulation and deep brain stimulation.
Int Rev Psychiatry
PUBLISHED: 12-28-2011
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Antidepressant treatments, including pharmacotherapy and psychotherapy, do not result in remission for the majority of patients with major depressive disorder. The high prevalence of treatment resistant depression (TRD) poses a significant issue for patients as well as both societal and economic costs. Due to the limited efficacy of existing therapies in this sub-population, alternative somatic treatments are being explored. Both vagus nerve stimulation (VNS) and deep brain stimulation (DBS) are neurostimulation treatments for TRD. While VNS has Food Drug Administration approval as an adjunctive therapy for MDD, DBS is still in the experimental stages. This article will review the evidence supporting the clinical utility of these therapies.
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Assessing the true effect of active antidepressant therapy v. placebo in major depressive disorder: use of a mixture model.
Br J Psychiatry
PUBLISHED: 12-02-2011
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There is controversy about the implications of relatively small average drug-placebo differences observed in randomised controlled trials of antidepressant medications.
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A multicenter pilot study of subcallosal cingulate area deep brain stimulation for treatment-resistant depression.
J. Neurosurg.
PUBLISHED: 11-18-2011
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Deep brain stimulation (DBS) has been recently investigated as a treatment for major depression. One of the proposed targets for this application is the subcallosal cingulate gyrus (SCG). To date, promising results after SCG DBS have been reported by a single center. In the present study the authors investigated whether these findings may be replicated at different institutions. They conducted a 3-center prospective open-label trial of SCG DBS for 12 months in patients with treatment-resistant depression.
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Increased screening colonoscopy rates and reduced racial disparities in the New York Citywide campaign: an urban model.
Am. J. Gastroenterol.
PUBLISHED: 11-08-2011
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In 2003, in response to low colonoscopy screening rates and significant sociodemographic disparities in colonoscopy screening in New York City (NYC), the NYC Department of Health and Mental Hygiene, together with the Citywide Colon Cancer Control Coalition, launched a multifaceted campaign to increase screening. We evaluated colonoscopy trends among adult New Yorkers aged 50 years and older between 2003 and 2007, the first five years of this campaign.
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Ethnic differences in cardiovascular risks and mortality in atherothrombotic disease: insights from the Reduction of Atherothrombosis for Continued Health (REACH) registry.
Mayo Clin. Proc.
PUBLISHED: 10-04-2011
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To determine whether ethnic-specific differences in the prevalence of cardiovascular risk factors and outcomes exist worldwide among individuals with stable arterial disease.
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The effects of agomelatine on sexual function in depressed patients and healthy volunteers.
Hum Psychopharmacol
PUBLISHED: 07-26-2011
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Selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor antidepressants are associated with high rates of treatment-emergent sexual dysfunction (TESD) due to stimulation of serotonin receptors.
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Risk factors and outcomes for patients with vascular disease and serious bleeding events.
Heart
PUBLISHED: 06-29-2011
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To determine the risk and outcomes of serious bleeding events in patients with atherosclerotic vascular disease or risk factors.
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Inflammatory biomarkers in depression: an opportunity for novel therapeutic interventions.
Curr Psychiatry Rep
PUBLISHED: 06-15-2011
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Currently available antidepressants are effective in less than two thirds of depressed patients, with even lower remission rates in the context of co-morbid medical illness. A rapidly expanding evidence base suggests that maladaptive inflammatory immune responses may be a common pathophysiology underlying depression, particularly in the presence of a general medical condition. The inflammatory hypothesis of depression marks a significant shift away from monoamine-based approaches and is a major step towards developing novel treatments that directly target causal factors of depression. Many antidepressants exert anti-inflammatory effects and there is an emerging literature documenting the efficacy of anti-inflammatory agents as adjunctive treatments for depression. Identification of inflammatory biomarkers in depression will require a re-conceptualization of both the diagnostic phenomenology and the experimental approaches to studying multi-determined psychiatric disorders. In addition to their application in diagnosis, predicting prognosis, and monitoring severity and response to treatment, inflammatory biomarkers may serve as novel therapeutic targets in the treatment of depression.
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The keys to improving depression outcomes.
Eur Neuropsychopharmacol
PUBLISHED: 05-27-2011
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The heterogeneity of symptoms within major depressive disorder poses significant challenges for treatment and it is likely that current pharmacotherapies do not target all symptoms equally, although they have similar efficacy rates. While there is still continuing interest in understanding monoamine interactions and consequent downstream effects, the limited efficacy and tolerability achieved with classical antidepressants provides a compelling argument to move beyond the monoamines. Several lines of biological research in depression exploring immune function, neurotrophins, amino acid and neuropeptide neurotransmitters, neuroanatomical function and circadian rhythms, may lead to novel therapeutic targets and enhance depression outcomes. This review will evaluate the evidence for emerging treatments as well as recommendations from current international guidelines regarding antidepressant management.
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Clinical evaluation of cardiovascular devices: principles, problems, and proposals for European regulatory reform. Report of a policy conference of the European Society of Cardiology.
Eur. Heart J.
PUBLISHED: 05-14-2011
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The European Commission announced in 2008 that a fundamental revision of the medical device directives is being considered in order to clarify and strengthen the current legal framework. The system for testing and approving devices in Europe was established >20 years ago as a New Approach to a previously little-regulated industry. It is recognized by many that the regulatory system has not kept pace with technological advances and changing patterns of medical practice. New legislation will be drafted during 2011, but medical experts have been little involved in this important process. This context makes it an opportune time for a professional association to advise from both clinical and academic perspectives about changes which should be made to improve the safety and efficacy of devices used in clinical practice and to develop more appropriate systems for their clinical evaluation and post-marketing surveillance. This report summarizes how medical devices are regulated and it reviews some serious clinical problems that have occurred with cardiovascular devices. Finally, it presents the main recommendations from a Policy Conference on the Clinical Evaluation of Cardiovascular Devices that was held at the European Heart House in January 2011.
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A multicenter, double-blind, placebo-controlled study of sildenafil citrate in Canadian men with erectile dysfunction and untreated symptoms of depression, in the absence of major depressive disorder.
Int Clin Psychopharmacol
PUBLISHED: 04-08-2011
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Depression and erectile dysfunction (ED) often co-occur. Phosphodiesterase type 5 inhibitors are effective in men with ED and untreated depression, or ED secondary to antidepressants. This study evaluated sildenafil treatment in Canadian men with clinically diagnosed ED (Sexual Health Inventory for Men score ? 21) and mild-to-moderate untreated depressive symptoms [Beck Depression Inventory II (BDI-II) score 14-28], but excluding major depressive disorder. Pretreatment screening using the Sexual Health Inventory for Men and BDI-II showed that men with ED were more likely to have depression than men without ED, and ED severity was a predictor of depression (P=0.0226). Two hundred and two men were randomized to 6 weeks of double-blind treatment with placebo (n=98) or sildenafil (n=104), initial dose of 50 mg, adjustable to 25 or 100 mg. The men were evaluated on all domains of the International Index of Erectile Function and the Sex Effects Questionnaire, Global Efficacy Questions, and Event-log data. Compared with placebo, patients treated with sildenafil had significantly greater changes from baseline in BDI-II scores (P<0.001). All International Index of Erectile Function domains and the Sex Effects Questionnaire components were also significantly improved in sildenafil group (P<0.01). The most common adverse events included headache, dyspepsia, vasodilatation, and respiratory tract infections and were generally mild in intensity.
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Unnatural base pair systems for sensing and diagnostic applications.
Expert Rev. Mol. Diagn.
PUBLISHED: 04-06-2011
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Expansion of the genetic alphabet by an unnatural base pair system provides a platform for the site-specific, enzymatic incorporation of extra, functional components into nucleic acids. Recently, several unnatural base pairs that exhibit high fidelity and efficiency in PCR have been developed. Functional groups of interest, such as fluorescent dyes, can be linked to the unnatural bases, and the modified base substrates are site-specifically incorporated into nucleic acids by polymerases. Furthermore, unique unnatural base pairs between fluorophore and quencher base analogs have been developed for imaging PCR amplification and as molecular beacons. Here, we describe the recent progress in the development of unnatural base pairs that function in PCR amplification and their applications as sensing and diagnostic tools.
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Barriers to achieving treatment goals: a focus on sleep disturbance and sexual dysfunction.
J Affect Disord
PUBLISHED: 03-17-2011
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Patients who meet the criteria for a major depressive episode experience a constellation of symptoms, and different symptom configurations may reflect distinct underlying neurological disturbances. Similarly, the differing receptor profiles of the various antidepressants may explain relatively low remission rates and persistent symptoms even after remission. In particular, depressed patients frequently display altered circadian rhythms, sleep disturbances, and diurnal mood variation. Exploring treatments that can restore mood while having a positive impact on circadian rhythms and sleep would greatly improve the ability to treat this core features of depression.
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Strategies to achieve clinical effectiveness: refining existing therapies and pursuing emerging targets.
J Affect Disord
PUBLISHED: 03-17-2011
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Clinical effectiveness reflects a balance between efficacy and tolerability as well as patient satisfaction and overall improvement in quality of life and function. This is of particular importance when considering the long term use of antidepressant therapies for relapse prevention.
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Association of the malnutrition-inflammation score with clinical outcomes in kidney transplant recipients.
Am. J. Kidney Dis.
PUBLISHED: 02-11-2011
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The combination of chronic malnutrition and inflammation, often termed malnutrition-inflammation complex syndrome or protein-energy wasting, is common in patients with chronic kidney disease. It is associated with increased mortality in patients on maintenance dialysis therapy. We assessed the association of malnutrition-inflammation score (MIS) with all-cause mortality and death-censored transplant loss or death with a functioning transplant in a sample of kidney transplant recipients.
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Cascade colorectal cancer screening guidelines: a global conceptual model.
J. Clin. Gastroenterol.
PUBLISHED: 02-09-2011
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Guidelines should be a catalyst toward achieving, as a universal standard, the most effective possible care. However, guidelines mainly use evidence of effectiveness as the basis for recommendations. This approach may not be the most appropriate for all healthcare settings because of differing levels of available medical and financial resources. This report from the Guidelines Committee of the World Gastroenterology Organization presents a new conceptual model of cascade colorectal cancer screening guidelines that is also evidence based but resource driven. The emphasis in this variation of the model is on colonoscopy resources at the top of the cascade for a screening goal of prevention by finding and removing the colorectal cancer precursor lesions, the adenoma, as well as early detection. This is a concept study for consideration in the development of future guidelines. Various tests can be reordered within the framework of this model. The cascade concept says, "do what you can with what you have," rather than, "do it this way or no way."
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Deep brain stimulation for treatment-resistant depression: follow-up after 3 to 6 years.
Am J Psychiatry
PUBLISHED: 02-01-2011
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A prevalence of at least 30% for treatment-resistant depression has prompted the investigation of alternative treatment strategies. Deep brain stimulation (DBS) is a promising targeted approach involving the bilateral placement of electrodes at specific neuroanatomical sites. Given the invasive and experimental nature of DBS for treatment-resistant depression, it is important to obtain both short-term and long-term effectiveness and safety data. This report represents an extended follow-up of 20 patients with treatment-resistant depression who received DBS to the subcallosal cingulate gyrus (Brodmanns area 25).
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Association between the Malnutrition-Inflammation Score and depressive symptoms in kidney transplanted patients.
Gen Hosp Psychiatry
PUBLISHED: 01-21-2011
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Depressive symptoms and the Malnutrition-Inflammation Complex Syndrome (MICS) are prevalent in patients with chronic kidney disease. The complex relationship between MICS and depression has never been studied in kidney transplanted (Tx) patients. Here we evaluate the association between the Malnutrition-Inflammation Score (MIS) (Kalantar score) and depressive symptoms in Tx patients.
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Nicotine nasal spray as an adjuvant analgesic for third molar surgery.
J. Oral Maxillofac. Surg.
PUBLISHED: 01-21-2011
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To determine the efficacy of preoperatively administered nicotine nasal spray (3 mg) for analgesia after third molar (TM) surgery.
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The sex effects scale: pilot validation in a healthy population.
Psychopharmacol Bull
PUBLISHED: 12-15-2010
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Sexual dysfunction is frequently associated with depression and is often exacerbated by antidepressant treatment. The true prevalence of antidepressant minduced dysfunction during a major depressive episode is generally underreported, due to reliance on spontaneous self-report data and the reluctance of physicians to use standardized rating scales. The aim of this study is to validate the Sex Effects scale (SexFX) in a healthy population, addressing internal and inter-rater reliability, test-retest reliability, as well as convergent and divergent validity.
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Metformin use and mortality among patients with diabetes and atherothrombosis.
Arch. Intern. Med.
PUBLISHED: 11-25-2010
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Metformin is recommended in type 2 diabetes mellitus because it reduced mortality among overweight participants in the United Kingdom Prospective Diabetes Study when used mainly as a means of primary prevention. However, metformin is often not considered in patients with cardiovascular conditions because of concerns about its safety.
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ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the
J. Am. Coll. Cardiol.
PUBLISHED: 11-20-2010
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The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research.
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Neurosurgical treatment of bipolar depression: defining treatment resistance and identifying surgical targets.
Bipolar Disord
PUBLISHED: 11-03-2010
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Bipolar disorder (BD) is a complex psychiatric disorder that is often underrecognized, misdiagnosed, and challenging to detect. During the past decade, substantial progress has been made in the development of pharmacotherapeutic and psychosocial interventions for various phases of BD. Notwithstanding these developments, the majority of BD individuals, and particularly patients with bipolar depression, receiving guideline concordant care do not experience syndromal or functional recovery, underscoring the need for novel treatments. Early success with deep brain stimulation (DBS) in the treatment of major depressive episodes as part of major depressive disorder (MDD) has provided the impetus to explore its application in other treatment-resistant psychiatric disorders, notably BD. Herein, we provide the rationale for employing DBS as an alternative treatment avenue in individuals with bipolar depression.
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Attention-deficit/hyperactivity disorder in adults with bipolar disorder or major depressive disorder: results from the international mood disorders collaborative project.
Prim Care Companion J Clin Psychiatry
PUBLISHED: 10-15-2010
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Relatively few studies have evaluated the clinical implications of lifetime attention-deficit/hyperactivity disorder (ADHD) in adults with bipolar disorder or major depressive disorder (MDD). Herein, we sought to determine the prevalence as well as the demographic and clinical correlates of lifetime ADHD in persons with a mood disorder.
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Long-term safety of duloxetine during open-label compassionate use treatment of patients who completed previous duloxetine clinical trials.
Curr Med Res Opin
PUBLISHED: 10-11-2010
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To provide duloxetine for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), fibromyalgia (FM) and diabetic peripheral neuropathic pain (DPNP) to patients who had previously completed a duloxetine clinical study and for whom, in the opinion of the investigator, no effective alternative therapy was available.
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Frequency and correlates of gambling problems in outpatients with major depressive disorder and bipolar disorder.
Can J Psychiatry
PUBLISHED: 09-16-2010
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To investigate the frequency of gambling in people who have been diagnosed with major depressive disorder (MDD) or bipolar disorder (BD). Secondary objectives were to examine: sex differences in the rates of gambling behaviour, the temporal relation between onset of mood disorders and problem gambling, psychiatric comorbidities associated with problem gambling, and the influences of problem gambling on quality of life.
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Attained educational level and incident atherothrombotic events in low- and middle-income compared with high-income countries.
Circulation
PUBLISHED: 09-07-2010
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Studies report a protective effect of higher attained educational level (AEL) on cardiovascular outcomes. However, most of these studies have been conducted in high-income countries (HICs) and lack representation from low- and middle-income countries (LMICs), which bear >80% of the global burden of cardiovascular disease.
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The association between conventional antidepressants and the metabolic syndrome: a review of the evidence and clinical implications.
CNS Drugs
PUBLISHED: 09-03-2010
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Major depressive disorder is a prevalent recurrent medical syndrome associated with inter-episodic dysfunction. The metabolic syndrome is comprised of several established risk factors for cardiovascular disease (i.e. abdominal obesity, dyslipidaemia, dysglycaemia and hypertension). The criterion items of the metabolic syndrome collectively represent a multi-dimensional risk factor for cardiovascular disease and type 2 diabetes mellitus. Extant evidence indicates that both major depressive disorder and the metabolic syndrome, albeit distinct, often co-occur and are possibly subserved by overlapping pathophysiology and causative mechanisms. Conventional antidepressants exert variable effects on constituent elements of the metabolic syndrome, inviting the need for careful consideration prior to treatment selection and sequencing. Initiating and maintaining antidepressant therapy should include routine surveillance for clinical and/or biochemical evidence suggestive of the metabolic syndrome.
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Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis.
JAMA
PUBLISHED: 08-30-2010
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Clinicians and trialists have difficulty with identifying which patients are highest risk for cardiovascular events. Prior ischemic events, polyvascular disease, and diabetes mellitus have all been identified as predictors of ischemic events, but their comparative contributions to future risk remain unclear.
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Late outcomes after carotid artery stenting versus carotid endarterectomy: insights from a propensity-matched analysis of the Reduction of Atherothrombosis for Continued Health (REACH) Registry.
Circulation
PUBLISHED: 08-30-2010
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In patients with carotid artery disease, carotid endarterectomy (CEA) and carotid stenting (CAS) are treatment options. Controversy exists as to the relative efficacy of the 2 techniques in preventing late events.
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The rate of metabolic syndrome in euthymic Canadian individuals with bipolar I/II disorder.
Adv Ther
PUBLISHED: 07-21-2010
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To report on the rate of metabolic syndrome, as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), in asymptomatic adults with bipolar I/II disorder evaluated at the Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto. To our knowledge, this is the first study reporting on the rate of metabolic syndrome in a Canadian clinical sample and exclusively evaluating asymptomatic individuals.
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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.