Consortium for the lifespan examination of ADHD registry (Clear): An update on methodology and recruitment

IntroductionADHD is often unrecognised and untreated, particularly in Europe. There is a need for improved understanding of ADHD in adults and its impact on patients across the lifespan. Registries allow for multiple real-world comparisons based on assessment of patients that are typically excluded from clinical studies. Data describing the cost, burden and consequences of ADHD are essential to inform clinicians, regulatory agencies, payers and patients about the condition.ObjectivesTo address the gaps in our current understanding of the care and cost of treating adult patients with ADHD by documenting real-life experiences.MethodsA prospective, longitudinal, observational study of adults > 18 years with ADHD, designed to follow 2500 patients in the USA, UK, Germany, The Netherlands and Canada for a minimum of 5 years.In year one, patients will be asked questions regarding:the impact of childhood diagnosis and/or treatment on adult ADHD, long- and short-term treatment patterns and their consequences, differences between ADHD treatments, the relationship between disease severity and compliance with treatment, increased tendency to risk behaviour/substance abuse, costs.In subsequent years, topics may be expanded to include the transition into adulthood and healthcare access for young adults.ResultsTen sites are currently recruiting, with 45 patients enrolled up to 7 October 2010. Challenges associated with initiating a global registry in North America and Europe will be discussed.ConclusionData generated from CLEAR will help improve the global understanding of the longitudinal impact of ADHD.Supported by Shire Development, Inc.

Download Full-text

Evaluation of a calculation model to estimate the impact of the COVID-19 pandemic lockdown on visual acuity in neovascular AMD

European Journal of Ophthalmology ◽

10.1177/11206721211052389 ◽

2021 ◽

pp. 112067212110523

Author(s):

Martin Stattin ◽

Anna-Maria Haas ◽

Daniel Ahmed ◽

Alexandra Graf ◽

Katharina Krepler ◽

...

Keyword(s):

Visual Acuity ◽

Real Life ◽

Treatment Interruption ◽

Term Treatment ◽

Calculation Model ◽

Life Outcomes ◽

Short Term ◽

Short Term Treatment ◽

The Real ◽

The Impact

Purpose A model was calculated during the first Austrian coronavirus disease-2019 (COVID-19) pandemic lockdown to estimate the effect of a short-term treatment interruption due to healthcare restrictions on visual acuity (VA) in neovascular age-related macular degeneration (nAMD). The model was compared to the real-life outcomes before treatment re-started. Methods Retrospective data-collection of 142 eyes in 142 patients receiving repeated intravitreal injections with anti-VEGF at a retina unit in Vienna in a personalized pro-re-nata regimen prior to the COVID-19 associated lockdown, when treatment was deferred between March 16 and May 4, 2020. During the lockdown, the preliminary data was integrated into pre-existing formulae based on the natural course of the disease in untreated eyes in the long term. Patients were re-scheduled and treated after gradually opening operating rooms. The calculation model was compared to the effective VA change. Results The model calculated an overall VA loss of 3.5 ± 0.8 letters early treatment diabetes retinopathy study (ETDRS) ( p < 0.001 [95% CI:3.3;3.6]) on average compared to 2.5 ± 6 letters ETDRS ( p < 0.001 [95% CI:1.5;3.5]) as measured with a mean treatment delay of 61 ± 14 days after previously scheduled appointments. The total difference between the model exercise and the real-life outcomes accounted for 1 ± 5.9 letters ETDRS ( p = 0.051 [95% CI: 0.1;1.9]). Conclusion The herein presented calculation model might not be suitable to estimate the effective VA loss correctly over time, although untreated eyes and eyes under therapy show similarities after short-term treatment interruption. However, this study demonstrated the potentially negative impact of the COVID-19 pandemic lockdown on patients compromised by nAMD.

Download Full-text

The Impact of ADHD Treatment on Intimate Partner Violence in a Forensic Psychiatry Setting

Journal of Attention Disorders ◽

10.1177/1087054719879502 ◽

2019 ◽

pp. 108705471987950

Author(s):

Nannet J. L. Buitelaar ◽

Jocelyne A. Posthumus ◽

Denise Bijlenga ◽

Jan K. Buitelaar

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Forensic Psychiatry ◽

Adult Adhd ◽

Combined Treatment ◽

Intimate Partner ◽

Longitudinal Impact ◽

Adhd Symptoms ◽

Adhd Treatment ◽

The Impact

Objective: The current longitudinal impact of treatment of ADHD on intimate partner violence (ITAP) study aims to investigate whether decrease of ADHD symptoms is associated with reduction of intimate partner violence (IPV) frequency in IPV offenders with ADHD in a forensic psychiatry setting. Method: Of n = 209 offenders of IPV with ADHD, frequency of IPV and ADHD symptoms were assessed at the 8th, 16th, 24th, and 52nd weeks of their combined treatment for ADHD and IPV. Results: We observed a significant decrease of self-reported ADHD symptoms (large effect size, d ≥ 0.80) and all IPV outcomes (small, d > 0.20, to large, d > 0.80, effect sizes). The decrease in IPV was mainly associated with the decrease in ADHD symptoms. Conclusion: As IPV treatment alone is not effective in the reduction of IPV in forensic psychiatry, we now have strong indications that the combined treatment of adult ADHD and IPV is more effective in offenders with ADHD.

Download Full-text

The Impact of Choice of NNRTI on Short-Term Treatment Outcomes among HIV-Infected Patients Prescribed Tenofovir and Lamivudine in Johannesburg, South Africa

PLoS ONE ◽

10.1371/journal.pone.0071719 ◽

2013 ◽

Vol 8 (8) ◽

pp. e71719 ◽

Cited By ~ 7

Author(s):

Kate Shearer ◽

Matthew P. Fox ◽

Mhairi Maskew ◽

Rebecca Berhanu ◽

Lawrence Long ◽

...

Keyword(s):

South Africa ◽

Treatment Outcomes ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

The Impact

Download Full-text

Health-Related Quality of Life Under Six Months' Treatment of Migraine-An Open Clinic-Based Longitudinal Study

Cephalalgia ◽

10.1046/j.1468-2982.1995.1505414.x ◽

1995 ◽

Vol 15 (5) ◽

pp. 414-422 ◽

Cited By ~ 5

Author(s):

CGH Dahlöf

Keyword(s):

Quality Of Life ◽

Well Being ◽

Term Treatment ◽

Health Related Quality ◽

Short Term ◽

Short Term Treatment ◽

Related Quality ◽

Health Related ◽

The Impact

Health-related quality of life (HQL) assessment in the clinical setting have distinguished subjective perceptions (e.g. well-being), signs/symptoms of the disease, and functional capacity as three major components. The impact of short-term treatment for migraine attacks on these variables was evaluated in an open prospective 6-month study at the Gothenburg Migraine Clinic. Socio-economic factors, subjective symptoms, and general well-being/quality of life were evaluated by self-administered questionnaires in 99 patients with migraine with or without aura in accordance with the classification of the International Headache Society. Short-term treatment comprising conventional therapy or subcutaneous sumatriptan reduced number of days per month with migraine and absenteeism from work, migraine-associated symptoms, but did not significantly improve general well-being between attacks. Future assessment of the patients' HQL in accordance with this approach would enable us to consider all the advantages and disadvantages of current therapies of particular interest in the field of migraine.

Download Full-text

A Novel Systems Model to Simulate the Dynamics for the Analytical Study of the Proliferation of COVID-19

10.21203/rs.3.rs-968078/v1 ◽

2021 ◽

Author(s):

Arpita Welling ◽

Abhilasha Patel ◽

Padmaj Kulkarni ◽

Vinay G. Vaidya

Keyword(s):

Infection Rate ◽

Systems Approach ◽

Secondary Infection ◽

Real Life ◽

Population Exposure ◽

Virus Growth ◽

Individual Patient Level ◽

Systems Model ◽

The Usa ◽

The Impact

Abstract In this paper, we present a systems model for COVID-19 called ‘Multilevel Integrated Model with a Novel Systems Approach’ or MIMANSA for short. This model goes to the individual patient level and mimics small steps in the process of virus spread. Despite many models simulating the growth of COVID-19 cases, it is rare to see a comprehensive model that takes into account the transmissibility of variants, the prevalence of multiple variants, growth of the variants, percentage of vaccinated population, exposure rate, infection rate, silent carrier rate, secondary infection rate, mask usage, and people mobility all in one model.We begin by categorizing the in-person social interactions of an individual into three areas: household, workplace, and public places. With each interaction, the virus spreads from an infectiousperson to a healthy individual. We build the model, one level at a time, covering daily person-to-person interactions. Further, MIMANSA forms a new layer of network for every new day. These layers form a part of the virus proliferation network.MIMANSA models the virus incubation period using a Weibull distribution. Once the network starts building, the virus growth can be curtailed only through increased vaccinations or through non-pharmaceutical interventions such as mask usage, reduced mobility, and/or quarantine.MIMANSA takes the mobility data, mask usage data, variant prevalence data, and vaccination data as inputs. Despite the model being intricate, it uses only 5 parameters for training. Once the model is trained, it can be slightly adjusted by the daily environmental variable. This variable corrects for day to events as well as varying environmental conditions in a given location.We present the results of the training and validation for the USA, California, and the UK. It is seen that during the validation stage, the model accuracy is within 2%. Further, projections are made for about 3 weeks. In the end, we have presented the results of a study on the effect of vaccination on the number of COVID cases in the USA. It shows how MIMANSA can be used for studying the impact of multiple scenarios. Additionally, the model is not only useful for making predictions in the number of cases but also useful as an educational aid for explaining the proliferation network of the virus in real life. Although MIMANSA is originally developed for the SARS-CoV-2, it can be modified to study the spread of any other virus, and in any region.

Download Full-text

Long-term, Real-life, Observational Study in Treating Outpatient Ulcerative Colitis with Golimumab

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-3992 ◽

2021 ◽

Author(s):

Antonio Tursi ◽

Giammarco Mocci ◽

Walter Elisei ◽

Leonardo Allegretta ◽

Raffaele Colucci ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Response ◽

Clinical Remission ◽

Real Life ◽

Mucosal Healing ◽

Term Treatment ◽

Short Term Treatment ◽

Mayo Score

Background and Aims: Several studies have found Golimumab (GOL) effective and safe in the short-term treatment of ulcerative colitis (UC), but few long-term data are currently available from real world. Our aim was to assess the long-term real-life efficacy and safety of GOL in managing UC outpatients in Italy. Methods: A retrospective multicenter study assessing consecutive UC outpatients treated with GOL for at least 3-month of follow-up was made. Primary endpoints were the induction and maintenance of remission in UC, defined as Mayo score ≤2. Several secondary endpoints, including clinical response, colectomy rate, steroid free remission and mucosal healing, were also assessed during the follow-up. Results: One hundred and seventy-eight patients were enrolled and followed up for a median (IQR) time of 9 (3-18) months (mean time follow-up: 33.1±13 months). Clinical remission was achieved in 57 (32.1%) patients: these patients continued with GOL, but only 6 patients (3.4%) were still under clinical remission with GOL at the 42nd month of follow-up. Clinical response occurred in 64 (36.4%) patients; colectomy was performed in 8 (7.8%) patients, all of them having primary failure. Steroid-free remission occurred in 23 (12.9%) patients, and mucosal healing was achieved in 29/89 (32.6%) patients. Adverse events occurred in 14 (7.9%) patients. Conclusions: Golimumab does not seem able to maintain long-term remission in UC in real life. The safety profile was good.

Download Full-text

Ventricular arrhythmia burden during the coronavirus disease 2019 (COVID-19) pandemic

European Heart Journal ◽

10.1093/eurheartj/ehaa893 ◽

2020 ◽

Author(s):

Catherine J O’Shea ◽

Gijo Thomas ◽

Melissa E Middeldorp ◽

Curtis Harper ◽

Adrian D Elliott ◽

...

Keyword(s):

Ventricular Arrhythmia ◽

Remote Monitoring ◽

Ventricular Arrhythmias ◽

Control Period ◽

Real Life ◽

Secondary Outcome ◽

Clinical Trial Registry ◽

Unique Identifier ◽

The Usa ◽

The Impact

Abstract Aims Our objective was to determine the ventricular arrhythmia burden in implantable cardioverter-defibrillator (ICD) patients during COVID-19. Methods and results In this multicentre, observational, cohort study over a 100-day period during the COVID-19 pandemic in the USA, we assessed ventricular arrhythmias in ICD patients from 20 centres in 13 states, via remote monitoring. Comparison was via a 100-day control period (late 2019) and seasonal control period (early 2019). The primary outcome was the impact of COVID-19 on ventricular arrhythmia burden. The secondary outcome was correlation with COVID-19 incidence. During the COVID-19 period, 5963 ICD patients underwent remote monitoring, with 16 942 episodes of treated ventricular arrhythmias (2.8 events per 100 patient-days). Ventricular arrhythmia burden progressively declined during COVID-19 (P < 0.001). The proportion of patients with ventricular arrhythmias amongst the high COVID-19 incidence states was significantly reduced compared with those in low incidence states [odds ratio 0.61, 95% confidence interval (CI) 0.54–0.69, P < 0.001]. Comparing patients remotely monitored during both COVID-19 and control periods (n = 2458), significantly fewer ventricular arrhythmias occurred during COVID-19 [incident rate ratio (IRR) 0.68, 95% CI 0.58–0.79, P < 0.001]. This difference persisted when comparing the 1719 patients monitored during both the COVID-19 and seasonal control periods (IRR 0.69, 95% CI 0.56–0.85, P < 0.001). Conclusions During COVID-19, there was a 32% reduction in ventricular arrhythmias needing device therapies, coinciding with measures of social isolation. There was a 39% reduction in the proportion of patients with ventricular arrhythmias in states with higher COVID-19 incidence. These findings highlight the potential role of real-life stressors in ventricular arrhythmia burden in individuals with ICDs. Trial registration Australian New Zealand Clinical Trial Registry; URL: https://www.anzctr.org.au/; Unique Identifier: ACTRN12620000641998

Download Full-text

Coping with COVID-19: Longitudinal Impact of the Pandemic on Adjustment and Links with Coping for Adolescents with and without ADHD

10.31234/osf.io/q6jzg ◽

2021 ◽

Author(s):

Melissa Dvorsky ◽

Rosanna Breaux ◽

Caroline Cusick ◽

Joseph Fredrick ◽

Cathrin Green ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Coping Strategies ◽

Longitudinal Impact ◽

Coping Behaviors ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Positive Coping ◽

Prospective Longitudinal ◽

The Impact

Understanding factors that foster resilience and buffer against the negative psychological impact of COVID-19 is critical to inform efforts to promote adjustment, reduce risk, and improve care, particularly for adolescents with neurodevelopmental disorders. This prospective longitudinal study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health and substance use, and by assessing specific positive coping strategies among adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Using multi-group autoregressive cross-lagged path models, the present study explored the reciprocal influence of positive coping behaviors on multiple adjustment outcomes including mental health symptoms, substance use, stress, and worry. Participants included 238 adolescents (132 males; ages 15–17; 118 with ADHD). Parents provided ratings of adolescent routines, and adolescents provided ratings of coping behaviors and psychological adjustment in spring (May/June), summer (July/August), and fall (October/November) 2020. All models included the effects of adjustment at the prior timepoint as well as relevant covariates including adolescent race, ethnicity, sex, medication status, and family income. Adolescents with ADHD were at greater risk for experiencing increases in mental health symptoms and substance use throughout the pandemic, relative to adolescents without ADHD. The use of positive coping strategies and adolescent routines buffered against increases in substance use and mental health problems for adolescents with ADHD. These findings have important clinical and public policy relevance for parents, schools, and employers who may aim to prioritize keeping schedules as consistent as possible to promote healthy adjustment.

Download Full-text

The Use of Antidepressants in the Long-Term Treatment Should not Improve the Impact of Fibromyalgia on Quality of Life

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901309010120 ◽

2013 ◽

Vol 9 (1) ◽

pp. 120-124 ◽

Cited By ~ 11

Author(s):

MG Carta ◽

V Ruggiero ◽

F Sancassiani ◽

F Cutrano ◽

AR Manca ◽

...

Keyword(s):

Quality Of Life ◽

Rating Scale ◽

Short Form ◽

Term Treatment ◽

Observational Research ◽

Short Term Treatment ◽

Long Term Treatment ◽

The Impact

Background: Antidepressant (AD) drugs are effective in the short term treatment of fibromyalgia (FM). It may be useful to study the long-term impact of AD on patients with FM. Methods: One-year follow-up study on 23 females with FM divided into groups on AD (ADg-N=7), and not taking AD (NADg-N=11). Evaluation at t1 and at the end (t2) with the Fibromyalgia Impact Questionnaire (FIQ); at t2 with: SCID-IV; Mood Disorder Questionnaire (MDQ); Short Form-12; Hamilton Depression Rating Scale (HAM-D); Functioning Assessment Short Test (FAST) Results: After a year the AD group showed a worst impact of the disease by FIQ (p=0.017), worsened quality of life by SF-12 (p<0.01), and disability linked to bipolar symptoms by FAST (p=0.05). About 40% of the sample was screened positive at MDQ without difference in the two groups. The patients who recovered from a depressive episode did not differ between ADg and NADg (20% vs 33.3%), and were fewer than expected from the literature (40-60%). The HAM-D score at the end of the trial was worse in the ADg (p<0.03). Limitations: Observational research on few patients, not specifically designed to test the hypothesis. The results have a heuristic value only. Discussion: The results should be read in the light of the high prevalence of patients screened positive for Bipolar Disorders and of the well-known poor response of the mood symptoms to antidepressants in Bipolar Depression. The deterioration in the long-term management of FM patients following AD treatments suggests the need for new and robust studies.

Download Full-text

Effect of fenofibrate on plasma apolipoprotein C-III levels: a systematic review and meta-analysis of randomised placebo-controlled trials

BMJ Open ◽

10.1136/bmjopen-2018-021508 ◽

2018 ◽

Vol 8 (11) ◽

pp. e021508 ◽

Cited By ~ 4

Author(s):

Amirhossein Sahebkar ◽

Luis E Simental-Mendía ◽

Niki Katsiki ◽

Željko Reiner ◽

Maciej Banach ◽

...

Keyword(s):

Clinical Trials ◽

Random Effects ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Term Treatment ◽

Controlled Trials ◽

Short Term Treatment ◽

Apolipoprotein C ◽

Significant Difference ◽

The Impact

ObjectivesThis meta-analysis of randomised placebo-controlled clinical trials aimed to assess the effect of fenofibrate on apolipoprotein C-III (apo C-III), a key regulator of triglyceride metabolism.Materials and methodsRandomised placebo-controlled trials investigating the impact of fenofibrate treatment on apo C-III levels were searched in PubMed-Medline, Scopus, Web of Science and Google Scholar databases from inception to 18 August 2017. Quantitative data synthesis was determined by a random-effects model and generic inverse variance method. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate glycaemic parameter confounders.ResultsMeta-analysis of 10 clinical trials involving 477 subjects showed fenofibrate therapy decreased apo C-III levels (weighted mean difference (WMD) −4.78 mg/dL, 95% CI −6.95 to –2.61, p<0.001; I266.87%). Subgroup analysis showed that fenofibrate reduced plasma apo C-III concentrations in subgroups of trials with treatment durations of either <12 weeks (WMD −4.50 mg/dL, p=0.001) or ≥12 weeks (WMD: −4.73 mg/dL, p=0.009) and doses of fenofibrate <200 mg/day (WMD −6.33 mg/dL, p<0.001) and >200 mg/day (p=0.006), with no significant difference between the subgroups.ConclusionThis meta-analysis found that fenofibrate therapy significantly decreases apo C-III levels, an effect evident with both short-term treatment and doses less than 200 mg/day.

Download Full-text