Monitoring of Long-Term Motor Activity in Depressed Patients

Wrist motor activity was continuously recorded by a solid-state monitor in 12 patients with major depression throughout their stay in hospital; their clinical state was evaluated using three scales. During the day, activity troughs and immobility peaks occurred before noon and around 1500 hrs. Activity level progressively increased, while the duration of immobility decreased, with clinical improvement. The immobility measurement appeared to be a valuable index of depression and is more sensitive than the activity level, mainly for agitated depressed patients. Immobility episodes during the day could suggest the release of an ultradian sleep-wake rhythm in depression.

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Ascending-Descending Threshold Difference and Internal Subjective Judgment in CFF Measurements of Depressed Patients before and after Clinical Improvement

Perceptual and Motor Skills ◽

10.2466/pms.1993.77.2.435 ◽

1993 ◽

Vol 77 (2) ◽

pp. 435-439 ◽

Cited By ~ 8

Author(s):

A. Ghozlan ◽

D. Widlöcher

Keyword(s):

Major Depression ◽

Clinical Improvement ◽

The Other ◽

Response Criterion ◽

Subjective Judgment ◽

Mean Values ◽

Threshold Difference ◽

Depressed Patients ◽

Before And After

The purpose of this study was to measure, using the method of limits, the ascending-descending threshold difference, Δ = fa - fd, in subjects with major depression. 28 patients were given two sessions, one before treatment and the other after recovery. Mean values of Δ measured in the second session were significantly smaller than those scored before treatment. The two sets of values were positively correlated. The ascending-descending threshold difference was suggested previously as likely related to the internal subjective judgment of subjects. The present results are consistent with the hypothesis of a more conservative response criterion in depressed patients before than after clinical improvement.

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Short-term SSRI treatment normalises amygdala hyperactivity in depressed patients

Psychological Medicine ◽

10.1017/s0033291712000591 ◽

2012 ◽

Vol 42 (12) ◽

pp. 2609-2617 ◽

Cited By ~ 107

Author(s):

B. R. Godlewska ◽

R. Norbury ◽

S. Selvaraj ◽

P. J. Cowen ◽

C. J. Harmer

Keyword(s):

Clinical Improvement ◽

Emotional Processing ◽

Neural Response ◽

Clinical State ◽

Clinical Effects ◽

Healthy Controls ◽

Short Term ◽

Depressed Patients ◽

Significant Difference ◽

Ssri Treatment

BackgroundAntidepressant drugs such as selective serotonin re-uptake inhibitors (SSRIs) remediate negative biases in emotional processing in depressed patients in both behavioural and neural outcome measures. However, it is not clear if these effects occur before, or as a consequence of, changes in clinical state.MethodIn the present study, we investigated the effects of short-term SSRI treatment in depressed patients on the neural response to fearful faces prior to clinical improvement in mood. Altogether, 42 unmedicated depressed patients received SSRI treatment (10 mg escitalopram daily) or placebo in a randomised, parallel-group design. The neural response to fearful and happy faces was measured on day 7 of treatment using functional magnetic resonance imaging. A group of healthy controls was imaged in the same way.ResultsAmygdala responses to fearful facial expressions were significantly greater in depressed patients compared to healthy controls. However, this response was normalised in patients receiving 7 days treatment with escitalopram. There was no significant difference in clinical depression ratings at 7 days between the escitalopram and placebo-treated patients.ConclusionsOur results suggest that short-term SSRI treatment in depressed patients remediates amygdala hyperactivity in response to negative emotional stimuli prior to clinical improvement in depressed mood. This supports the hypothesis that the clinical effects of antidepressant treatment may be mediated in part through early changes in emotional processing. Further studies will be needed to show if these early effects of antidepressant medication predict eventual clinical outcome.

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Faculty Opinions recommendation of Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression: seven-year follow-up of SADHART participants.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1164863.626714 ◽

2009 ◽

Author(s):

Robert Carney

Keyword(s):

Acute Coronary Syndrome ◽

Major Depression ◽

Coronary Syndrome ◽

Long Term Mortality

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Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121994919 ◽

2021 ◽

Vol 9 (5) ◽

pp. 232596712199491

Author(s):

Alberto Grassi ◽

Gian Andrea Lucidi ◽

Giuseppe Filardo ◽

Piero Agostinone ◽

Luca Macchiarola ◽

...

Keyword(s):

Survival Rate ◽

Case Series ◽

Final Analysis ◽

Activity Level ◽

Long Term Results ◽

Level Of Evidence ◽

Unicompartmental Knee Arthroplasties ◽

Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

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149. Efficacy of Cochleated Amphotericin B (CAMB) in Mouse and Human Mucocutaneous Candidiasis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.459 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S204-S205

Author(s):

Jigar V Desai ◽

Amanda Urban ◽

Doris Z Swaim ◽

Elise Ferre ◽

Benjamin Colton ◽

...

Keyword(s):

Amphotericin B ◽

Clinical Improvement ◽

Clinical Efficacy ◽

Chronic Mucocutaneous Candidiasis ◽

Vaginal Tissue ◽

Dose Escalation Study ◽

Fungal Burden ◽

Mucocutaneous Candidiasis ◽

Inherited Susceptibility

Abstract Background Candida albicans causes debilitating mucosal infections in patients with inherited susceptibility to chronic mucocutaneous candidiasis (CMC), often requiring long-term azole-based treatment. Due to increasing azole resistance, alternative treatments are desirable. Acquired resistance to amphotericin B (AMB) is rare but AMB use is limited by parenteral administration and nephrotoxicity. Cochleated AMB (CAMB) is a new oral formulation of AMB and thus an attractive option for oropharyngeal candidiasis (OPC), esophageal candidiasis (EC) and vulvovaginal candidiasis (VVC). We assessed the efficacy of CAMB in mouse models of OPC and VVC and in 4 patients with azole resistant CMC manifesting as OPC, EC or VVC. Methods Act1 -/- mice were infected with C. albicans in models of OPC and VVC and were treated once daily via oral gavage with CAMB or vehicle or intraperitoneal AMB-deoxycholate (AMBd) from day 1 through 4 post-infection (pi). At day 5 pi, the tongue or vaginal tissue was harvested to quantify fungal burden. Patients with azole resistant CMC enrolled in a phase 2A CAMB dose escalation study. The primary endpoint was clinical improvement at 2 weeks based on an efficacy scale, followed by optional extension for long-term suppression of CMC to assess safety and efficacy. Results CAMB-treated mice had significantly reduced tongue and vaginal tissue fungal burden compared to vehicle-treated mice, while they exhibited comparable fungal control relative to AMBd-treated mice. Among 4 CAMB-treated patients, 3 reached clinical efficacy by 2 weeks at a dose of 400 mg twice daily and one reached clinical efficacy at 200 mg twice daily. Three of 4 patients continued on the extension phase past 48 months with sustained clinical improvement of OPC and EC; patient #3 had relapse of esophageal symptoms at week 24 and was withdrawn from further study. Clinical response was not seen for onychomycosis or VVC. CAMB was safe and well-tolerated without renal toxicity. Conclusion Oral administration of CAMB in IL-17-signaling deficient mice resulted in reduced tongue and vaginal tissue fungal burden during mucosal C. albicans infections. A proof-of-concept clinical trial in humans with inherited CMC showed efficacy in OPC and EC with good tolerability and safety. Disclosures Benjamin Colton, PharmD, Merck (Shareholder)Pfizer (Shareholder) Ruying Lu, n/a, Matinas BioPharma Inc. (Employee)Matinas BioPharma Inc. (Employee, Shareholder) Theresa Matkovits, PhD, Matinas BioPharma (Employee, Shareholder) Raphael J. Mannino, n/a, Matinas BioPharma Inc. (Employee, Shareholder) Michail Lionakis, MD, ScD, Matinas BioPharma (Research Grant or Support)

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332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

International Psychogeriatrics ◽

10.1017/s104161022000232x ◽

2020 ◽

Vol 32 (S1) ◽

pp. 91-91

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Major Depression ◽

Cognitive Decline ◽

Electroconvulsive Therapy ◽

Antidepressant Treatment ◽

Community Sample ◽

Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

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Tofacitinib: An Option for Acute Severe Ulcerative Colitis?

GE Portuguese Journal of Gastroenterology ◽

10.1159/000514781 ◽

2021 ◽

pp. 1-3

Author(s):

Sara Santos ◽

Verónica Gamelas ◽

Rita Saraiva ◽

Guilherme Simões ◽

Joana Saiote ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Improvement ◽

Rescue Therapy ◽

New Drugs ◽

Multiple Drug ◽

Disease Course ◽

Efficacy And Safety ◽

Severe Ulcerative Colitis ◽

Rapid Absorption

Tofacitinib has emerged as a new option for ulcerative colitis. Its rapid absorption, metabolism, and clinical improvement make it an interesting option for rescue therapy in acute severe ulcerative colitis (ASUC), a situation with limited therapeutic options in patients with a long-term disease course and multiple drug failure. The management of ASUC in this setting becomes challenging, underlying the need for new drugs and data on their efficacy and safety. We describe 2 cases of acute episodes in which tofacitinib was used as a rescue therapy.

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