A one-year prospective study of the safety, tolerability and pharmacokinetics of the highest available dose of paliperidone palmitate in patients with schizophrenia

Background

Stigma and discrimination present an important barrier to finding and keeping work for individuals with a mental health problem. This paper reviews evidence on: 1) employment-related disclosure beliefs and behaviours of people with a mental health problem; 2) factors associated with the disclosure of a mental health problem in the employment setting; 3) whether employers are less likely to hire applicants who disclose a mental health problem; and 4) factors influencing employers' hiring beliefs and behaviours towards job applicants with a mental health problem.

Methods

A systematic review was conducted for the period 1990-2010, using eight bibliographic databases. Meta-ethnography was used to provide a thematic understanding of the disclosure beliefs and behaviours of individuals with mental health problem.

Results

The searches yielded 8,971 items which was systematically reduced to 48 included studies. Sixteen qualitative, one mixed methods and seven quantitative studies were located containing evidence on the disclosure beliefs and behaviours of people with a mental health problem, and the factors associated with these beliefs and behaviours. In the meta-ethnography four super-ordinate themes were generated: 1) expectations and experiences of discrimination; 2) other reasons for non-disclosure; 3) reasons for disclosure; and 4) disclosure dimensions. Two qualitative, one mixed methods and 22 quantitative studies provided data to address the remaining two questions on the employers perspective.

Conclusions

By presenting evidence from the perspective of individuals on both sides of the employment interaction, this review provides integrated perspective on the impact of disclosure of a mental health problem on employment outcomes.     

Bacteriocin production as a mechanism for the antiinfective activity of Lactobacillus salivarius UCC118

The mechanisms by which probiotic strains enhance the health of the host remain largely uncharacterized. Here we demonstrate that Lactobacillus salivarius UCC118, a recently sequenced and genetically tractable probiotic strain of human origin, produces a bacteriocin in vivo that can significantly protect mice against infection with the invasive foodborne pathogen Listeria monocytogenes. A stable mutant of Lb. salivarius UCC118 that is unable to produce the Abp118 bacteriocin also failed to protect mice against infection with two strains of L. monocytogenes, EGDe and LO28, confirming that bacteriocin production is the primary mediator of protection against this organism. Furthermore, Lb. salivarius UCC118 did not offer any protection when mice were infected with a strain of L. monocytogenes expressing the cognate Abp118 immunity protein AbpIM, confirming that the antimicrobial effect is a result of direct antagonism between Lb. salivarius and the pathogen, mediated by the bacteriocin Abp118.     

The ovate pontic for fixed bridgework

The provision of fixed prosthodontic restorations that meets the patient's functional and aesthetic demands can be challenging, especially in the anterior maxilla. It requires close communication with the technician and knowledge of the available options. This article will outline the options for pontic design and focus on the ovate pontic, which has the potential to provide the most aesthetic outcome. This should equip the practitioner with the knowledge as to which pontic to prescribe if such a challenge arises. CLINICAL RELEVANCE: Fixed bridgework is a commonly prescribed prosthesis for the replacement of missing teeth. In order for this to be provided successfully, the practitioner should have a working knowledge of the available options for pontic design.This is especially important in cases where aesthetic demands are high.     

Duration of Ross River viraemia in a mouse model--implications for transfusion transmission

Background and Objectives There is little data on the duration of viraemia following infection with Ross River virus (RRV), the most common cause of arbovirus disease in Australia. In particular, no accurate estimate exists for the duration of pre‐symptomatic RRV infection, which is important in assessing the potential for transfusion transmission. Materials and Methods We used an established mouse model of RRV infection involving adult Swiss outbred mice to measure viraemia following infection. Applying our experimental data to a published probabilistic model for estimating the risk of dengue transmission by transfused blood, we derived comparable risk estimates for RRV. Results Ross River virus RNA was measured using highly sensitive real‐time PCR in serum samples to determine the duration of asymptomatic viraemia, which typically lasted 5 days, but extended to 9 days in some mice. Assuming the potential for transfusion transmission is proven, the risk of RRV transmission by blood during a 2004 outbreak in Cairns, Australia was retrospectively estimated as 1 in 13 542 (range from 1 in 4765 to 47 563). Conclusion This study provides updated epidemiological data useful to underpin modelling to assess the potential risk of transfusion‐transmitted RRV. Using an established model for dengue, the risk estimate for RRV transmission is comparable in the same geographical region. Should transfusion be proven as a route of transmission, this supports consideration of appropriate mitigation strategies to safeguard blood recipients.     

Assessment of strategies for switching patients from olanzapine to risperidone: A randomized,open-label,rater-blinded study

Background  

In clinical practice, physicians often need to change the antipsychotic medications they give to patients because of an inadequate response or the presence of unacceptable or unsafe side effects. However, there is a lack of consensus in the field as to the optimal switching strategy for antipsychotics, especially with regards to the speed at which the dose of the previous antipsychotic should be reduced. This paper assesses the short-term results of strategies for the discontinuation of olanzapine when initiating risperidone.     

A quantitative cytochemical study of acid phosphatases in hepatocytes of different ploidy classes from aging rats

A quantitative cytochemical study of isolated hepatocytes from young, middle-aged and old adult rats has shown a doubling of acid naphthol AS-BI phosphatase activity as the hepatocytes shift from the diploid to the tetraploid state, and an overall increase in activity in cells from old animals. There was a complete inhibition of all acid phosphatase activity with 10^?2M sodium molybdate, but only a 90% inhibition in hepatocytes from livers of rats of 12–25 months-old animals with 10^?2M sodium fluoride, the resistant activity possibly representing adenyl cyclase activity. In contrast, 10^?2M ouabain inhibited 70–80% of the activity in hepatocytes from 12–15-months-old animals, this level of inhibition decreasing with increasing age, and implying a decrease in transport ATPase activity and an increased lysosomal phosphatase activity with increasing age of the rats.     

Genetic mapping of resistance to Bacillus thuringiensis toxins in diamondback moth using biphasic linkage analysis

Transgenic plants producing environmentally benign Bacillus thuringiensis (Bt) toxins are deployed increasingly for insect control, but their efficacy will be short-lived if pests adapt quickly. The diamondback moth (Plutella xylostella), a worldwide pest of vegetables, is the first insect to evolve resistance to Bt toxins in open-field populations. A recessive autosomal gene confers resistance to at least four Bt toxins and enables survival without adverse effects on transgenic plants. Allelic variants of this gene confer resistance in strains from Hawaii, Pennsylvania, and the Philippines. Here we exploited the biphasic nature of Lepidopteran genetic linkage to map this gene in diamondback moth with 207 amplified fragment length polymorphisms as DNA markers. We also cloned and sequenced an amplified fragment length polymorphism marker for the chromosome containing the Bt resistance gene. The results provide a powerful tool for facilitating progress in understanding, monitoring, and managing resistance to Bt.     

Paliperidone extended-release tablets in patients with recently diagnosed schizophrenia

Aim: Effective early and persistent antipsychotic treatment in recently diagnosed schizophrenia may positively impact long-term outcomes. Paliperidone extended-release (ER) was assessed in this population. Methods: Post hoc analysis of pooled data from three 6-week, double-blind (DB), placebo-controlled, and three 1-year open-label (OL) studies of paliperidone ER in schizophrenia patients. Data stratified by time since diagnosis (≤3 vs. >3 years). Results: At DB (n = 1193) and OL baselines (n = 744), 259 (21.9%) and 188 (25.3%) patients were diagnosed ≤3 years. At DB end point, both populations improved with paliperidone ER versus placebo on Positive and Negative Syndrome Scale (PANSS) total, Clinical Global Impressions–Severity and Personal and Social Performance (PSP) scale scores (all P < 0.05). At OL end point, there were significant improvements from DB baseline in both populations on these scales (P < 0.0001), with greater improvement in the ≤3-year population on PANSS total (P < 0.001) and PSP (P < 0.001) scores. During DB treatment, only the ≤3-year population reported adverse events (AEs) in ≥5% (placebo-adjusted rate) of subjects receiving paliperidone ER: akathisia, extrapyramidal disorder not otherwise specified and somnolence. During OL treatment, akathisia and somnolence occurred more frequently (≥5%) in the ≤3- versus >3-year population. OL study completion rates were 51.1% in ≤3-year, and 48.2% in >3-year subjects. Conclusions: Paliperidone ER significantly improved symptoms and functioning in schizophrenia patients, regardless of time since diagnosis. Recently diagnosed patients who continued treatment exhibited greater symptom reduction and functional benefit over the long term. Results also suggest that these patients may be more susceptible to certain AEs.