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101.
Marco Menchetti Cecilia Sighinolfi Vittorio Di Michele Paolo Peloso Claudia Nespeca Pier Venanzio Bandieri Maria Bologna Angelo Fioritti Roberta Fravega Lucio Ghio Simona Gotelli Paolo Levantesi Maria Amparo Ortega Micaela Savorani Luigi Simoni Ilaria Tarricone Mara Morini Linda Gask Domenico Berardi 《General hospital psychiatry》2013
Trial design
This was a multicenter cluster-randomized controlled trial.Participants
A total of 227 patients ≥ 18 years old with a new onset of depressive symptoms who screened positive on the first two items of the Patient Health Questionnaire-9 (PHQ-9) were recruited by primary care physicians (PCPs) of eight health districts of three Italian regions from September 2009 to June 2011.Intervention
PCPs of the intervention group received a specific collaborative care program including 2 days of intensive training, implementation of a stepped care protocol, depression management toolkit and scheduled meetings with a dedicated consultant psychiatrist.Objective
The objective was to determine whether a collaborative care program for depression management in primary care leads to higher remission rate than usual PCP care.Outcomes
Outcome was clinical remission as expressed on PHQ-9 < 5 at 3 months.Randomization
An independent researcher used computer-generated randomization to assign involved primary care groups to the two alternative arms.Blinding
PCPs and research personnel were not blinded.Results
The 223 PCPs enrolled recruited 227 patients (128 in collaborative care arm, 99 in the usual care arm). At 3 months (n= 210), the proportion of patients who achieved remission was higher, though the difference was not statistically significant, in the collaborative care group. The effect size was of 0.11. When considering only patients with minor/major depression, collaborative care appeared to be more effective than usual care (P= .015).Conclusions
The present intervention for managing depression in primary care, designed to be applicable to the Italian context, appears to be effective and feasible. 相似文献102.
Simona Portaro Olimpia Musumeci Vincenzo Rizzo Carmelo Rodolico Mary G. Sweeney Maria Buccafusca Michael G. Hanna Antonio Toscano 《Neuromuscular disorders : NMD》2013,23(1):52-55
A 24-year-old woman complained of a 4-year history of muscle cramps, stiffness of the right lower limb and walking difficulties. After clinical and laboratory investigations, a diagnosis of multiple sclerosis was made. However, her family history revealed that her father and an older sister had lifelong symptoms of impaired muscle relaxation following contraction, improving with physical exercise. Molecular genetic studies in both sisters confirmed the diagnosis of myotonia congenita, due to a c.568GG>TC (Gly190Ser) pathogenic mutation in CLCN1 gene. Occurrence of two different neurological conditions in the same patient, both manifesting with stiffness, is quite unusual and suggests the opportunity of an accurate differential diagnosis. 相似文献
103.
Nicola Montano Fabio Papacci Beatrice Cioni Simona Gaudino Giuseppe Maria Della Pepa Giulio Conforti Rina Di Bonaventura Mariangela Novello Libero Lauriola Mario Meglio 《Journal of clinical neuroscience》2013,20(11):1605-1608
Pleomorphic xanthoastrocytoma (PXA) is a rare tumor with good prognosis after surgery. Few cases of anaplastic PXA (either de novo or secondary to transformation of a recurrent low grade PXA) have been reported. Moreover, primary anaplastic PXA with dissemination at diagnosis has been described only in two patients, to our knowledge. We report the first case of primary multicentric anaplastic PXA and discuss its atypical features and the pertinent literature. 相似文献
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Raffaella Rinaldi Giuseppe Bersani Enrico Marinelli Simona Zaami 《Human psychopharmacology》2020,35(3):e2727
The ever-growing number of novel psychoactive substances (NPS) that have been surfacing globally, as well as related changes in drug abuse trends, undoubtedly constitute a difficult and multifaceted challenge for psychiatry. The intake and abuse of such substances has been linked to a risk of psychopathological disturbances, which stem from imbalances of a range of neurotransmitter pathways and receptors. Through an analysis of relevant research articles and reviews (particularly those outlining NPS neurological and cerebral mechanisms of action and psychopathological consequences arising from NPS abuse; research papers more closely focused on chemical/pharmacological aspects have been ruled out), through a systematic analysis of Pubmed, Medline, PsycLIT and EMBASE literature, as well as data released by health care institutions and drug enforcement agencies (among which the World Health Organization, the United Nations Office on Drugs and Crime, the European Monitoring Centre for Drugs and Drug Addiction, Eurojust, the Novel Psychoactive Treatment UK Network, the Court of Justice of the European Union), the authors aimed to elaborate on the most relevant data relative to NPS-related psychiatric effects, focusing on the conceptual and definition-related complexities inherent to NPS, clinical management and motivations for NPS use; moreover, an effort has been made to highlight the possible measures in order to tackle the unremitting rise of such elusive and potentially harmful substances. 相似文献
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