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Refractory depression

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https://www.readbyqxmd.com/read/29122526/extracorporeal-myocardial-shockwave-therapy-a-precious-blast-for-refractory-angina-patients
#1
Massimo Slavich, Giuseppe Pizzetti, Anna Maria Vella, Claudia Carlucci, Davide Margonato, Roberto Spoladore, Gabriele Fragasso, Alberto Margonato
INTRODUCTION: Refractory Angina Pectoris (RAP) dramatically affects patients' life quality and medical costs. External Shockwave Myocardial Revascularization (ESMR) improves the cardiac blood flow thanks to its pro-angiogenetic action on ischaemic tissues. We hereby describe our experience of ESMR in RAP patients. MATERIALS AND METHODS: This is a retrospective study encompassing all patients referred to OSR for RAP treatment. Efficacy of ESMR was assessed considering the difference between pre and post therapy data in SAQ score and CCS, stress test performance, 24h ECG monitoring, NT-proBNP and echocardiographic measures...
October 3, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29101095/smartphone-cognitive-behavioral-therapy-as-an-adjunct-to-pharmacotherapy-for-refractory-depression-randomized-controlled-trial
#2
Akio Mantani, Tadashi Kato, Toshi A Furukawa, Masaru Horikoshi, Hissei Imai, Takahiro Hiroe, Bun Chino, Tadashi Funayama, Naohiro Yonemoto, Qi Zhou, Nao Kawanishi
BACKGROUND: In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. OBJECTIVE: The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. METHODS: A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan...
November 3, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29089909/effects-of-anterior-capsulotomy-on-decision-making-in-patients-with-refractory-obsessive-compulsive-disorder
#3
Chencheng Zhang, Yilin Chen, Shuaiwei Tian, Tao Wang, Yile Xie, Haiyan Jin, Guozhen Lin, Hengfen Gong, Kristina Zeljic, Bomin Sun, Tianming Yang, Shikun Zhan
Despite various lines of evidence implicating impaired decision-making ability in individuals with obsessive-compulsive disorder (OCD), neuropsychological investigation has generated inconsistent findings. Although the cortico-striato-thalamo-cortical (CSTC) circuitry has been suggested, the involvement of the cortex has not yet been fully demonstrated. Moreover, it is unknown whether surgical intervention on the CSTC circuitry results in a predicted improvement of decision-making ability of OCD. Here we present a study of decision making based on the Iowa Gambling Task (IGT) to investigate decision making in a large sample of individuals with treatment-resistant OCD with and without anterior capsulotomy (AC)...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29077707/a-novel-controller-based-on-state-transition-models-for-closed-loop-vagus-nerve-stimulation-application-to-heart-rate-regulation
#4
Hector M Romero-Ugalde, Virginie Le Rolle, Jean-Luc Bonnet, Christine Henry, Alain Bel, Philippe Mabo, Guy Carrault, Alfredo I Hernández
Vagus nerve stimulation (VNS) is an established adjunctive therapy for pharmacologically refractory epilepsy and depression and is currently in active clinical research for other applications. In current clinical studies, VNS is delivered in an open-loop approach, where VNS parameters are defined during a manual titration phase. However, the physiological response to a given VNS configuration shows significant inter and intra-patient variability and may significantly evolve through time. VNS closed-loop approaches, allowing for the optimization of the therapy in an adaptive manner, may be necessary to improve efficacy while reducing side effects...
2017: PloS One
https://www.readbyqxmd.com/read/29077140/-deep-brain-stimulation-in-psychiatry
#5
M Figee, C Bervoets, D Denys
BACKGROUND: Deep brain stimulation (DBS) is now used regularly to treat therapy-refractory obsessive-compulsive disorders, and is being applied experimentally for refractory depression, Tourette syndrome, addiction, eating disorders, post-traumatic stress disorder, autism and schizophrenia. AIM: To review the effects and mechanisms of dbs and to consider the future opportunities for this type of treatment in psychiatry. METHOD: We reviewed the literature using PubMed...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29058822/omalizumab-rapidly-improves-angioedema-related-quality-of-life-in-adult-patients-with-chronic-spontaneous-urticaria-x-act-study-data
#6
Petra Staubach, Martin Metz, Nadine Chapman-Rothe, Christian Sieder, Matthias Bräutigam, Marcus Maurer, Karsten Weller
BACKGROUND: The X-ACT study aims to examine the effect of omalizumab treatment on quality of life (QoL) in chronic spontaneous urticaria (CSU) patients with angioedema refractory to high doses of H1 -antihistamines. METHODS: In X-ACT, a phase III, double-blind, placebo-controlled study, CSU patients (18-75 years) with ≥4 angioedema episodes during the 6 months before inclusion were randomized (1:1) to receive omalizumab 300 mg or placebo every 4 weeks for 28 weeks...
October 23, 2017: Allergy
https://www.readbyqxmd.com/read/29057261/aprepitant-for-the-treatment-of-chronic-refractory-pruritus
#7
REVIEW
Alice He, Jihad M Alhariri, Ronald J Sweren, Madan M Kwatra, Shawn G Kwatra
Chronic pruritus is a difficult condition to treat and is associated with several comorbidities, including insomnia, depression, and decreased quality of life. Treatment for chronic itch includes corticosteroids, antihistamines, and systemic therapies such as naltrexone, gabapentin, UV light therapy, and immunomodulatory treatments, including azathioprine, methotrexate, and cellcept. However, some patients still remain refractory to conventional therapy. Aprepitant is a neurokinin-1 receptor antagonist approved for the prevention of chemotherapy-induced and postoperative nausea and vomiting (CINV, PONV)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29042816/incidence-and-predictive-factors-of-spinal-cord-stimulation-treatment-after-lumbar-spine-surgery
#8
Merja Vakkala, Voitto Järvimäki, Hannu Kautiainen, Maija Haanpää, Seppo Alahuhta
INTRODUCTION: Spinal cord stimulation (SCS) is recommended for the treatment of postsurgical chronic back and leg pain refractory to other treatments. We wanted to estimate the incidence and predictive factors of SCS treatment in our lumbar surgery cohort. PATIENTS AND METHODS: Three questionnaires (a self-made questionnaire, the Oswestry Low Back Pain Disability Questionnaire, and the Beck Depression Inventory) were sent to patients aged 18-65 years with no contraindications for the use of SCS, and who had undergone non-traumatic lumbar spine surgery in the Oulu University Hospital between June 2005 and May 2008...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29033442/efficacy-of-oxycodone-for-dyspnea-in-end-stage-heart-failure-with-renal-insufficiency-a-case-report
#9
Masayuki Tanaka, Hirofumi Maeba, Takeshi Senoo, Junji Iwasaka, Aki Ohkita, Haruna Kita, Kazuki Uchitani, Yasuhiko Hirota
A 67-year-old man with dilated cardiomyopathy and renal insufficiency was admitted to our hospital with dyspnea secondary to end-stage heart failure. We introduced oxycodone for medically refractory dyspnea instead of morphine because of the patient's renal insufficiency. After the administration of oxycodone, his dyspnea was alleviated without any adverse opioid effects, such as respiratory depression. After treating his heart failure, he was able to leave the intensive care unit. Oxycodone may therefore be a reliable agent for the treatment of dyspnea in patients with end-stage heart failure and renal insufficiency...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#10
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29018404/socioeconomic-outcome-and-quality-of-life-in-adults-after-status-epilepticus-a-multicenter-longitudinal-matched-case-control-analysis-from-germany
#11
Lena-Marie Kortland, Susanne Knake, Felix von Podewils, Felix Rosenow, Adam Strzelczyk
BACKGROUND: There is a lack of data concerning socioeconomic outcome and quality of life (QoL) in patients after status epilepticus (SE) in Germany. PATIENTS AND METHODS: Adult patients treated between 2011 and 2015 due to SE at the university hospitals in Frankfurt, Greifswald, and Marburg were asked to fill out a questionnaire regarding long-term outcome of at least 3 months after discharge. The SE cohort consisted of 25.9% patients with an acute symptomatic, 42% with a remote symptomatic and previous epilepsy, 22...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29018010/unusual-complications-from-amitriptyline-intoxication
#12
Takeshi Nishimura, Hayato Maruguchi, Atsunori Nakao, Shinichi Nakayama
Althoughtricyclic antidepressants(TCAs) are frequently prescribed to patients with depression, these drugs can also be misused. A 21-year-old comatose patient was referred to our hospital presenting with ventricular tachycardia. Despite initial treatment including intravascular lipid emulsion, ventricular fibrillation occurred soon after arrival. Venoarterial extracorporeal membrane oxygenation and therapeutic hypothermia were administered. Refractory arrhythmia disappeared on the next day. A high concentration of amitriptyline was identified in his blood samples on arrival...
October 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29016792/antidepressant-like-actions-of-inhibitors-of-poly-adp-ribose-polymerase-in-rodent-models
#13
Gregory A Ordway, Attila Szebeni, Liza J Hernandez, Jessica D Crawford, Katalin Szebeni, Michelle J Chandley, Katherine C Burgess, Corwin Miller, Erol Bakkalbasi, Russell W Brown
Background: Many patients suffering from depressive disorders are refractory to treatment with currently available antidepressant medications, while many more exhibit only a partial response. These factors drive research to discover new pharmacological approaches to treat depression. Numerous studies demonstrate evidence of inflammation and elevated oxidative stress in major depression. Recently, major depression has been shown to be associated with elevated levels of DNA oxidation in brain cells, accompanied by increased gene expression of the nuclear base excision repair enzyme, poly(ADP-ribose) polymerase-1...
August 3, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28977038/computational-model-of-interictal-discharges-triggered-by-interneurons
#14
Anton V Chizhov, Dmitry V Amakhin, Aleksey V Zaitsev
Interictal discharges (IIDs) are abnormal waveforms registered in the periods before or between seizures. IIDs that are initiated by GABAergic interneurons have not been mathematically modeled yet. In the present study, a mathematical model that describes the mechanisms of these discharges is proposed. The model is based on the experimental recordings of IIDs in pyramidal neurons of the rat entorhinal cortex and estimations of synaptic conductances during IIDs. IIDs were induced in cortico-hippocampal slices by applying an extracellular solution with 4-aminopyridine, high potassium, and low magnesium concentrations...
2017: PloS One
https://www.readbyqxmd.com/read/28971900/pan-phosphatidylinositol-3-kinase-inhibition-with-buparlisib-in-patients-with-relapsed-and-refractory-non-hodgkin-lymphoma
#15
Anas Younes, Gilles Salles, Giovanni Martinelli, Robert Gregory Bociek, Dolores Caballero Barrigon, Eva González Barca, Mehmet Turgut, John Gerecitano, Oliver Kong, Chaitali Babanrao Pisal, Ranjana Tavorath, Won Seog Kim
Phosphatidylinositol 3-kinase mechanistic target of rapamycin pathway activation plays a role in the pathogenesis of non-Hodgkin lymphoma. This multicenter, open-label Phase II study evaluated buparlisib (BKM120), a pan-class I Phosphatidylinositol 3-kinase inhibitor, in patients with relapsed or refractory non-Hodgkin lymphoma. Patients received buparlisib 100 mg once daily in three separate cohorts (diffuse large B-cell lymphoma, mantle cell lymphoma, or follicular lymphoma) until progression, intolerance, or withdrawal of consent...
September 29, 2017: Haematologica
https://www.readbyqxmd.com/read/28968341/differential-effect-of-motor-cortex-stimulation-on-unit-activities-in-the-ventral-posterior-lateral-thalamus-in-cats
#16
Sandra Kobaïter-Maarrawi, Joseph Maarrawi, Nayef Saadé, Luis Garcia-Larrea, Michel Magnin
Although motor cortex stimulation (MCS) is being increasingly used to treat chronic refractory neuropathic pain in humans, its mechanisms of action remain elusive. Studies in animals have suggested the involvement of subcortical structures, in particular the thalamus. Most of these studies have been carried out in rats, a species presenting significant differences in thalamic anatomy and function relative to primates, in particular a very limited number of thalamic GABA interneurons. The aim of this study was to investigate the effects of MCS on single-unit activities of the thalamic ventral posterior lateral (VPL) nucleus in cats, which contains substantial numbers of GABA interneurons...
September 29, 2017: Pain
https://www.readbyqxmd.com/read/28945886/long-term-follow-up-study-of-mri-guided-bilateral-anterior-capsulotomy-in-patients-with-refractory-anorexia-nervosa
#17
Wei Liu, Dianyou Li, Fafa Sun, Xiaoxiao Zhang, Tao Wang, Shikun Zhan, Yixin Pan, Peng Huang, Haiyan Jin, Yongchao Li, Bomin Sun
BACKGROUND: Anorexia nervosa (AN) is one of the most challenging psychiatric disorders to treat. The poor clinical outcomes warrant novel treatments for AN, especially in severe and persistent cases. OBJECTIVE: To explore the feasibility of magnetic resonance imaging-guided bilateral anterior capsulotomy in the treatment of refractory AN. METHODS: Seventy-four patients diagnosed with refractory AN who underwent capsulotomy completed this 3-yr follow-up study...
August 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28936808/impact-of-tocilizumab-monotherapy-on-clinical-and-patient-reported-quality-of-life-outcomes-in-patients-with-rheumatoid-arthritis
#18
Leslie R Harrold, Ani John, George W Reed, Tmirah Haselkorn, Chitra Karki, YouFu Li, Jennie Best, Steve Zlotnick, Joel M Kremer, Jeffrey D Greenberg
INTRODUCTION: Tocilizumab (TCZ) monotherapy has been proven as an effective treatment for rheumatoid arthritis (RA) in clinical trials. However, there are limited data available regarding the effectiveness of TCZ monotherapy in real-world clinical settings in the United States. The objective of this study was to evaluate the impact of TCZ monotherapy on disease activity and patient-reported outcomes (PROs) in a US-based observational cohort of patients with RA seen in routine clinical practice...
September 21, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28926830/a-distinctive-ictal-amplitude-integrated-electroencephalography-pattern-in-newborns-with-neonatal-epilepsy-associated-with-kcnq2-mutations
#19
Ana Vilan, José Mendes Ribeiro, Pasquale Striano, Sarah Weckhuysen, Lauren C Weeke, Eva Brilstra, Linda S de Vries, Maria Roberta Cilio
BACKGROUND: Recurrent and prolonged seizures are harmful for the developing brain, emphasizing the importance of early seizure recognition and effective therapy. Amplitude-integrated electroencephalography (aEEG) has become a valuable tool to diagnose epileptic seizures, and, in parallel, genetic etiologies are increasingly being recognized, changing the paradigm of the workup and management of neonatal seizures. OBJECTIVE: To report the ictal aEEG pattern in neonates with KCNQ2-related epilepsy...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28926735/ketamine-metabolites-with-antidepressant-effects-fast-economical-and-eco-friendly-enantioselective-separation-based-on-supercritical-fluid-chromatography-sfc-and-single-quadrupole-ms-detection
#20
Georg M Fassauer, Robert Hofstetter, Mahmoud Hasan, Stefan Oswald, Christina Modeß, Werner Siegmund, Andreas Link
Increasing evidence accumulates that metabolites of the dissociative anesthetic ketamine contribute considerably to the biological effects of this drug and could be developed as next generation antidepressants, especially for acute treatment of patients with therapy-refractory major depression. Analytical methods for the simultaneous determination of the plethora of hydroxylated, dehydrogenated and/or demethylated compounds formed after administration of ketamine hydrochloride are a prerequisite for future clinical investigations and a deeper understanding of the individual role of the isomers of these metabolites...
September 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
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