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91.
92.
Pim Cuijpers Ph.D. Annemieke van Straten Ph.D. Lisanne Warmerdam M.A. Gerhard Andersson Ph.D. 《Depression and anxiety》2009,26(3):279-288
Background: A large number of studies have shown that psychological treatments have significant effects on depression. Although several studies have examined the relative effects of psychological and combined treatments, this has not been studied satisfactorily in recent statistical meta‐analyses. Method: We conducted a meta‐analysis of randomized studies in which a psychological treatment was compared to a combined treatment consisting of the same psychological treatment with a pharmacological therapy. For each of these studies we calculated the effect size indicating the difference between the psychological and the combined treatment. Results: All inclusion criteria were met by 18 studies, with a total of 1,838 subjects. The mean effect size indicating the difference between psychological and combined treatment was 0.35 (95% CI: 0.24~0.45; P<0.001), with low heterogeneity. Subgroup analyses indicated that the difference between psychological and combined treatments was significantly smaller in studies in which cognitive behavior therapy was examined. We also found a trend (P<0.1) indicating that the difference between psychological and combined treatment was somewhat larger in studies aimed at specific populations (older adults, chronic depression, HIV patients) than in studies with adults, and in studies in which Trycyclic antidepressants or SSRIs were examined, compared to studies in which a medication protocol or another antidepressant was used. At follow‐up, no difference between psychological and combined treatments was found. Conclusion: We conclude that combined treatment is more effective than psychological treatment alone. However, it is not clear whether this difference is relevant from a clinical perspective. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc. 相似文献
93.
Houtveen JH Kavelaars A Heijnen CJ van Doornen LJ 《Brain, behavior, and immunity》2007,21(8):1075-1082
It has been suggested that dysregulation of immune-to-brain communication plays a role in the biopsychological process underlying medically unexplained symptoms (MUS). Immune and non-immune stressors can both be involved in the activation of the central sickness-behavioural-system leading to complaints like malaise, pain and fatigue. We hypothesized increased pro-inflammatory and/or reduced anti-inflammatory cytokine activity to exist in MUS patients. Twenty-seven participants (4 male; 23 female) with heterogeneous MUS were compared with 27 healthy controls (6 male; 21 females). Blood samples were analysed for leukocyte subset cell counts, in vitro T-cell mitogen-stimulated cytokine production (IL-2, IL-4, IL-5, IL-6, IL-10, TNF-alpha and IFN-gamma) and in vitro monocyte cytokine release (IL-1beta, IL-6, IL-8, IL-10 and TNF-alpha) in response to increasing concentrations of LPS. No significant group differences were found for any of the cytokines measured. One unexpected exception was an elevation in the number of circulating B and NK-cells in participants high on MUS. Nonetheless, no support was found for the hypothesized immunological dysregulation in peripheral blood leukocyte function of MUS patients. 相似文献
94.
Roos A Bakker SJ Links TP Gans RO Wolffenbuttel BH 《The Journal of clinical endocrinology and metabolism》2007,92(2):491-496
CONTEXT: Thyroid disease and the metabolic syndrome are both associated with cardiovascular disease. OBJECTIVE: The aim of this study was to explore the hypothesis that thyroid function, in euthyroid subjects, is associated with components of the metabolic syndrome, including serum lipid concentrations and insulin resistance. METHODS: A total of 2703 adult inhabitants of a middle-sized city in The Netherlands participated in this cross-sectional study. Subjects who were not euthyroid were excluded, as were subjects taking thyroid medication, medication for diabetes, and subjects for whom medication data were not available (n = 1122). Homeostasis model assessment for insulin resistance (HOMA-IR) (mU*mmol/liter2) was calculated as fasting insulin (mU/liter) times fasting glucose (mmol/liter) divided by 22.5. The metabolic syndrome was defined according to National Cholesterol Education Program's Adult Treatment Panel III criteria. RESULTS: After adjustment for age and sex, free T4 (FT4) was significantly associated with total cholesterol [standardized beta (beta) = -0.059; P = 0.014], low-density lipoprotein cholesterol (beta = -0.068; P = 0.004), high-density lipoprotein cholesterol (beta = 0.100; P < 0.001), and triglycerides (beta = -0.102; P < 0.001). Both FT4 and TSH were significantly associated with HOMA-IR (beta = -0.133; P < 0.001 and beta = 0.055; P = 0.024, respectively). Median HOMA-IR increased from 1.42 in the highest tertile of FT4 to 1.66 in the lowest tertile of FT4. FT4 was significantly related to four of five components of the metabolic syndrome (abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and blood pressure), independent of insulin resistance. CONCLUSIONS: We have demonstrated an association between FT4 levels within the normal reference range and lipids, in accordance with the earlier observed association between (sub)clinical hypothyroidism and hyperlipidemia. Moreover, low normal FT4 levels were significantly associated with increased insulin resistance. These findings are consistent with an increased cardiovascular risk in subjects with low normal thyroid function. 相似文献
95.
Green MD van Eijk AM van Ter Kuile FO Ayisi JG Parise ME Kager PA Nahlen BL Steketee R Nettey H 《The Journal of infectious diseases》2007,196(9):1403-1408
BACKGROUND: Sulfadoxine-pyrimethamine (SP) is among the most commonly used antimalarial drugs during pregnancy, yet the pharmacokinetics of SP are unknown in pregnant women. HIV-infected (HIV(+)) women require more frequent doses of intermittent preventive therapy with SP than do HIV-uninfected (HIV(-)) women. We investigated whether this reflects their impaired immunity or an HIV-associated alteration in the disposition of SP. METHODS: Seventeen pregnant HIV(-) women and 16 pregnant HIV(+) women received a dose of 1500 mg of sulfadoxine and 75 mg of pyrimethamine. Five HIV(-) and 6 HIV(+) postpartum women returned 2-3 months after delivery for another dose. The pharmacokinetics of sulfadoxine and pyrimethamine were compared between these groups. RESULTS: HIV status did not affect the area under the curve (AUC(0-->infinity)) or the half-lives of sulfadoxine or pyrimethamine in prepartum or postpartum women, although partum status did have a significant affect on sulfadoxine pharmacokinetics. Among prepartum women, the median half-life for sulfadoxine was significantly shorter than that observed in postpartum women (148 vs 256 h; P<.001), and the median AUC(0-->infinity) was ~40% lower (22,816 vs 40,106 microg/mL/h, P<.001). HIV status and partum status did not show any significant influence on pyrimethamine pharmacokinetics. CONCLUSION: Pregnancy significantly modifies the disposition of SP, whereas HIV status has little influence on pharmacokinetic parameters in pregnant women. 相似文献
96.
It is still largely unknown which actions people take to improve their mood when they feel they are getting depressed. Using the five-factor model of personality, we explore coping actions in a population of older adults in residential homes in relation to personality traits. A total of 350 non-cognitively impaired inhabitants of residential homes in the Netherlands participated in this study (mean age 85 years). They indicated which of 22 actions to cope with depression they had used in the past three months, and which of these they considered to be helpful in reducing depression. Other measures included the NEO-FFI, CES-D and MINI. Almost 60% of all subjects had used one or more actions to reduce depression in the past three months, and almost 90% considered one or more actions to be helpful in reducing depression. People scoring high on neuroticism had used more coping actions, including relaxing, eating chocolate, praying, seeking professional help, engaging in more pleasant activities, and talking to friends and relatives. People scoring high on openness considered many of the actions to be helpful. We conclude that actions taken to cope with depression and their helpfulness differ considerably for subjects with differing personality traits. 相似文献
97.
Nomenclature for neuropathologic subtypes of frontotemporal lobar degeneration: consensus recommendations 总被引:6,自引:5,他引:1
Ian R. A. Mackenzie Manuela Neumann Eileen H. Bigio Nigel J. Cairns Irina Alafuzoff Jillian Kril Gabor G. Kovacs Bernardino Ghetti Glenda Halliday Ida E. Holm Paul G. Ince Wouter Kamphorst Tamas Revesz Annemieke J. M. Rozemuller Samir Kumar-Singh Haruhiko Akiyama Atik Baborie Salvatore Spina Dennis W. Dickson John Q. Trojanowski David M. A. Mann 《Acta neuropathologica》2009,117(1):15-18
98.
Irina Alafuzoff Dietmar R. Thal Thomas Arzberger Nenad Bogdanovic Safa Al-Sarraj Istvan Bodi Susan Boluda Orso Bugiani Charles Duyckaerts Ellen Gelpi Stephen Gentleman Giorgio Giaccone Manuel Graeber Tibor Hortobagyi Romana Höftberger Paul Ince James W. Ironside Nikolaos Kavantzas Andrew King Penelope Korkolopoulou Gábor G. Kovács David Meyronet Camelia Monoranu Tatjana Nilsson Piero Parchi Efstratios Patsouris Maria Pikkarainen Tamas Revesz Annemieke Rozemuller Danielle Seilhean Walter Schulz-Schaeffer Nathalie Streichenberger Stephen B. Wharton Hans Kretzschmar 《Acta neuropathologica》2009,117(3):309-320
β-Amyloid (Aβ) related pathology shows a range of lesions which differ both qualitatively and quantitatively. Pathologists,
to date, mainly focused on the assessment of both of these aspects but attempts to correlate the findings with clinical phenotypes
are not convincing. It has been recently proposed in the same way as ι and α synuclein related lesions, also Aβ related pathology
may follow a temporal evolution, i.e. distinct phases, characterized by a step-wise involvement of different brain-regions.
Twenty-six independent observers reached an 81% absolute agreement while assessing the phase of Aβ, i.e. phase 1 = deposition
of Aβ exclusively in neocortex, phase 2 = additionally in allocortex, phase 3 = additionally in diencephalon, phase 4 = additionally
in brainstem, and phase 5 = additionally in cerebellum. These high agreement rates were reached when at least six brain regions
were evaluated. Likewise, a high agreement (93%) was reached while assessing the absence/presence of cerebral amyloid angiopathy
(CAA) and the type of CAA (74%) while examining the six brain regions. Of note, most of observers failed to detect capillary
CAA when it was only mild and focal and thus instead of type 1, type 2 CAA was diagnosed. In conclusion, a reliable assessment
of Aβ phase and presence/absence of CAA was achieved by a total of 26 observers who examined a standardized set of blocks
taken from only six anatomical regions, applying commercially available reagents and by assessing them as instructed. Thus,
one may consider rating of Aβ-phases as a diagnostic tool while analyzing subjects with suspected Alzheimer’s disease (AD).
Because most of these blocks are currently routinely sampled by the majority of laboratories, assessment of the Aβ phase in
AD is feasible even in large scale retrospective studies. 相似文献
99.
Staging/typing of Lewy body related α-synuclein pathology: a study of the BrainNet Europe Consortium
Irina Alafuzoff Paul G. Ince Thomas Arzberger Safa Al-Sarraj Jeanne Bell Istvan Bodi Nenad Bogdanovic Orso Bugiani Isidro Ferrer Ellen Gelpi Stephen Gentleman Giorgio Giaccone James W. Ironside Nikolaos Kavantzas Andrew King Penelope Korkolopoulou Gábor G. Kovács David Meyronet Camelia Monoranu Piero Parchi Laura Parkkinen Efstratios Patsouris Wolfgang Roggendorf Annemieke Rozemuller Christine Stadelmann-Nessler Nathalie Streichenberger Dietmar R. Thal Hans Kretzschmar 《Acta neuropathologica》2009,117(6):635-652
100.
Equivalent drug doses may lead to wide interpatient variability in drug response to anticancer therapy. Known determinants that may affect the pharmacological response to a drug are, among others, nongenetic factors, including age, gender, use of comedication, and liver and renal function. Nonetheless, these covariates do not explain all the observed interpatient variability. Differences in genetic constitution among patients have been identified to be important factors that contribute to differences in drug response. Because genetic polymorphism may affect the expression and activity of proteins encoded, it is a key covariate that is responsible for variability in drug metabolism, drug transport, and pharmacodynamic drug effects. We present a series of four reviews about pharmacogenetic variability. This third part in the series of reviews is focused on genetic variability in phase II drug-metabolizing enzymes (glutathione S-transferases, uridine diphosphoglucuronosyl transferases, methyltransferases, sulfotransferases, and N-acetyltransferases) and discusses the effects of genetic polymorphism within the genes encoding these enzymes on anticancer drug therapy outcome. Based on the literature reviewed, opportunities for patient-tailored anticancer therapy are proposed. 相似文献