Biological component of the NIMH Clinical Research Branch Collaborative Program on the psychobiology of depression: I. Background and theoretical considerations

1980 ◽  
Vol 10 (4) ◽  
pp. 759-776 ◽  
Author(s):  
James W. Maas ◽  
Stephen H. Koslow ◽  
John M. Davis ◽  
Martin M. Katz ◽  
Joseph Mendels ◽  
...  
Keyword(s):  
Clinical Research ◽  
Biological Systems ◽  
Reliability And Validity ◽  
Research Centre ◽  
State Variables ◽  
Diagnostic Categories ◽  
Collaborative Program ◽  
Number Of Patients ◽  
Theoretical Considerations ◽  
Biological Component

SYNOPSISThere are many reports which suggest that patients with affective illness (mania and/or depression) have abnormalities in the functioning of one or more neurobiological systems. At a conference convened by the Clinical Research Branch, Division of Extramural Research Programs, National Institute of Mental Health, these findings were reviewed and some of the factors impeding movement towards a more complete and integrated view of the functioning of neurobiological systems in patients with mania or depression were identified. As a result, a multi-research centre, collaborative approach to the study of the psychobiology of affective disorders was developed. In this collaborative programme, which has now been underway for several years, the focus has been upon: (a) the assessment of the functioning of several different types of biological systems in the same patient, both before and during treatment; (b) obtaining a reasonably large number of patients and comparison subjects; and (c) the use within and across centres of standardized diagnostic categories and behavioural rating methodologies. In this paper the history, background, and rationale for this collaborative effort are reviewed. Those biological systems chosen for study are noted, and issues such as reliability and validity of diagnoses, measurement of state variables, assessment of change with treatment, and logistical and coordinating problems are discussed.

Effects of Observer Variation on Performance in Probabilistic Diagnosis of Jaundice

1981 ◽  
Vol 20 (03) ◽  
pp. 163-168 ◽  
Author(s):  
G. Llndberg
Keyword(s):  
Physical Examination ◽  
System Performance ◽  
Transition Matrix ◽  
Bayes Theorem ◽  
Observer Variation ◽  
Kappa Statistics ◽  
Diagnostic Categories ◽  
Number Of Patients ◽  
Probability Transition Matrix ◽  
Probabilistic Diagnosis

A system for probabilistic diagnosis of jaundice has been used for studying the effects of taking into account the unreliability of diagnostic data caused by observer variation. Fourteen features from history and physical examination were studied. Bayes’ theorem was used for calculating the probabilities of a patient’s belonging to each of four diagnostic categories.The construction sample consisted of 61 patients. An equal number of patients were tested in the evaluation sample. Observer variation on the fourteen features had been assessed in two previous studies. The use of kappa-statistics for measuring observer variation allowed the construction of a probability transition matrix for each feature. Diagnostic probabilities could then be calculated with and without the inclusion of weights for observer variation. Tests of system performance revealed that discriminatory power remained unchanged. However, the predictions rendered by the variation-weighted system were diffident. It is concluded that taking observer variation into account may weaken the sharpness of probabilistic diagnosis but it may also help to explain the value of probabilistic diagnosis in future applications.

scholarly journals Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go

2019 ◽  
Vol 8 (4) ◽  
pp. 555 ◽  
Author(s):  
Cátia Caneiras ◽  
Cristina Jácome ◽  
Sagrario Mayoralas-Alises ◽  
José Ramon Calvo ◽  
João Almeida Fonseca ◽  
...  
Keyword(s):  
Clinical Research ◽  
Patient Experience ◽  
Clinical Care ◽  
Research Priorities ◽  
Specific Patient ◽  
Quality Healthcare ◽  
Body Of Knowledge ◽  
Number Of Patients ◽  
Patient Reported ◽  
System Sustainability

The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.

Residential Treatment of Disturbed Delinquents: Description of a Centre and Identification of Therapeutic Factors*

1987 ◽  
Vol 32 (7) ◽  
pp. 579-583 ◽  
Author(s):  
D.P. Harris ◽  
J.E. Cote ◽  
E.M. Vipond
Keyword(s):  
Residential Treatment ◽  
Clinical Work ◽  
Therapeutic Factors ◽  
Diagnostic Categories ◽  
Different Types ◽  
Using Data ◽  
Theoretical Considerations

Residential treatment for disturbed, particularly delinquent, adolescents has been described several decades ago by the founders and leaders of institutions. Theoretical considerations in treatment were prominent. The importance of structured milieu and the control of aggression came to acquire recognition. This study describes a structured centre, known to be effective in treating disturbed delinquents, using data gathered over twelve years of clinical work, observation and research. Factors considered essential in defining this institution are isolated and made compatible with the factors indicated by Rutter in his review of the residential treatment of delinquents. These factors are being used in a further study which compares the effectiveness of different types of facilities for a range of diagnostic categories.

scholarly journals Factors associated with virological non-suppression among HIV-positive children receiving antiretroviral therapy at the Joint Clinical Research Centre in Lubowa, Kampala Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246140
Author(s):  
Sarah Nabukeera ◽  
Joseph Kagaayi ◽  
Fredrick Edward Makumbi ◽  
Henry Mugerwa ◽  
Joseph K. B. Matovu
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Clinical Research ◽  
Clinical Stage ◽  
Research Centre ◽  
Hiv Positive ◽  
Factors Associated ◽  
Art Initiation ◽  
Stage 4

Background While the proportion of HIV-positive children (under 15 years) enrolled on antiretroviral therapy (ART) has increased in recent years, up to 60% of children started on ART do not achieve virological suppression. We set out to determine the factors associated with virological non-suppression among children living with HIV receiving ART at a peri-urban HIV care clinic in Kampala, Uganda. Method This was a retrospective cohort study conducted at the pediatric HIV/AIDS clinic at the Joint Clinical Research Centre (JCRC) in Kampala, Uganda. Three hundred (300) HIV-positive children (0–14 years) were randomly selected from existing medical records and data on children’s socio-demographic and clinical characteristics (age at ART initiation, WHO clinical staging, and ART-induced side effects) were abstracted using a data abstraction form. Virological non-suppression was defined as a viral load ≥1000 copies/Ml of blood after six months of ART initiation. Incident rate ratios (IRRs) were determined as a measure of association between virological non-suppression and child/patient characteristics. The IRRs were obtained via a modified Poisson regression with corresponding 95% confidence intervals (95%CI). All analyses were done using statistical package, Stata version 15. Results The overall non-suppression rate among HIV-positive children on ART was 23%. Being at WHO clinical stage 4 at ART initiation [adj. IRR 2.74; 95%CI: 1.63, 4.61] and ART-induced side effects [adj. IRR 1.77; 95%CI: 1.06, 2.97] were significantly associated with non-suppression. Older age at ART initiation (age 5–9 years: [adj. IRR 0.42; 95%CI: 0.28, 0.65]; age 10–14 years: [adj. IRR 0.34; 95%CI: 0.18, 0.64] was less likely to be associated with virological non-suppression. Conclusion Nearly a quarter of HIV-positive children on ART had a non-suppressed viral load after six months of treatment. Being at WHO clinical stage 4 at ART initiation and ART-induced side effects were significantly associated with virological non-suppression while older age at ART initiation was protective. Our findings suggest a need for age-specific interventions, particularly those targeting children below five years of age, to improve virological suppression among HIV-positive children receiving ART in this setting.

scholarly journals Liver Radioembolization: a New Chapter in Russian Oncology

2019 ◽  
Vol 29 (5) ◽  
pp. 7-12
Author(s):  
A. D. Kaprin ◽  
S. A. Ivanov ◽  
V. V. Kucherov ◽  
A. P. Petrosyan ◽  
K. V. Mayorov ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Average Energy ◽  
Hepatocellular Cancer ◽  
Beta Particle ◽  
Research Centre ◽  
Gamma Line ◽  
Average Particle ◽  
Liver Tumours ◽  
Number Of Patients ◽  
Yttrium 90

Recent years have seen an increase in the number of patients with malignant tumours of the liver. In this context, new treatment methods are being actively introduced into practice, one of which is liver radioembolization utilizing microspheres embedded with yttrium-90 (90Y).Aim. To review literature data on the history of radioembolization and its application for liver tumours.Key findings. Annually, over 200 thousand patients with inoperable primary liver cancer and over 270 thousand patients with inoperable metastatic liver cancer are registered globally, for whom radioembolization is considered as the most suitable treatment method. 90Y is a pure beta emitter without its own gamma line, which is characterized by a small average particle path in the tissue of 2.5 mm (the maximum level is 11 mm), a maximum beta particle energy of 2.27 MeV (average energy of 0.937 MeV) and a half-life of 64.1 hours. Clinical research into microspheres containing 90Y has been actively conducted since 1977 all over the world. However, it was only in 2004 that the US FDA authorized the clinical use of glass microspheres containing 90Y for the treatment of hepatocellular cancer and liver colorectal cancer metastases. Until recently, radioembolization has not been applied in Russia. In 2018, the joint efforts of the A. Tsyb Medical Radiological Research Centre (MRRC) — branch of the National Medical Research Radiological Centre and BEBIG LLC resulted in the production of Russian microspheres containing yttrium-90, which were subsequently introduced into routine clinical practice. The first liver embolization in Russia using microspheres containing domestic yttrium-90 (BEBIG LLC) to a patient with hepatocellular cancer was carried out by V.V. Kucherov and A.P. Petrosyan at the A. Tsyb RMMC on April, 25 in 2019.Conclusion. The production of microspheres containing 90Y in Russia, as well as a technical improvement of the procedure, will facilitate the introduction of liver radioembolization into the routine management of patients with malignant liver tumours.

scholarly journals Clinical spectrum of facial hypermelanosis: a descriptive study from a tertiary care centre

2020 ◽  
Vol 6 (2) ◽  
pp. 212
Author(s):  
Mohammed Thoyyib ◽  
Roshni Menon ◽  
Brinda G. David
Keyword(s):  
Tertiary Care ◽  
Clinical History ◽  
Climatic Conditions ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Pigmentary Disorders ◽  
Number Of Patients ◽  
The Face ◽  
Detailed Clinical History

<p class="abstract"><strong>Background:</strong> Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.</p><p class="abstract"><strong>Methods:</strong> This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.<strong></strong></p><p class="abstract"><strong>Results:</strong> The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.</p><p><strong>Conclusions:</strong> FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.</p>

Concentration of Certain Trace Elements in the Soils of Dagestan Lowlands and Its Medical and Ecological Significance

2021 ◽  
pp. 69-76
Author(s):  
Patimat M. Ibnumaskhudova ◽  
◽  
Patimat D. Kazanbieva ◽  
Umiyat A. Magomedova ◽  
Khadizhat N. Abdurazakova ◽  
...  
Keyword(s):  
Trace Elements ◽  
Trace Element Composition ◽  
Economic Problem ◽  
Research Centre ◽  
Morbidity Rate ◽  
State Budget ◽  
Number Of Patients ◽  
Copper Zinc ◽  
The Republic ◽  
Cobalt Copper

Neurological and endocrine diseases, being widespread and producing significant impact on peopleʼs health as well as increasing the risk of disability of the working population (thus burdening the state budget), remain a most important medical and economic problem today. The study aimed to establish a link between these pathologies and the content of trace elements (cobalt, copper, zinc and manganese) in the soils of Dagestan plains. The concentration of active forms of cobalt, copper, zinc and manganese in the soil was established using the atomic absorption spectrophotometer model 170-70 (Hitachi, Japan) at the Biogeochemistry Laboratory of the Caspian Institute of Biological Resources, Dagestan Federal Research Centre, Russian Academy of Sciences. To determine the morbidity rate in the population, we turned to the data of the Ministry of Health of the Republic of Dagestan. The study revealed that the relevant pathologies in Dagestanʼs population, leading to disability, are caused by the trace element composition of the soil. Having compared the data on the content of cobalt, copper, zinc and manganese in the soils of the republicʼs lowland districts (Kizilyurt, Khasavyurt, Babayurt) and the prevalence of endocrine and neurological pathologies, we found a high correlation. The number of patients was in direct proportion to the content of manganese and in inverse proportion to the content of cobalt, copper and zinc. However, in Kizlyar District endocrine pathologies only correlated with zinc in the soil, which, apparently, can be explained by the local diet, fish products playing an important role, and by the fact that the territory is often flooded with coastal waters, changing the elementsʼ concentration in the soil.

Proposed siting of the new national clinical research centre

BMJ ◽  
1987 ◽  
Vol 295 (6610) ◽  
pp. 1414-1414
Author(s):  
E Kohner
Keyword(s):  
Clinical Research ◽  
Research Centre
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