1,720,969 research outputs found
NEUROINFLAMMATORY BIOMARKERS: CLINICAL AND PHARMACOLOGICAL IMPLICATIONS IN BIPOLAR DISORDER
Full text linkSeveral studies have attempted to identify the neuroinflammatory mechanisms of bipolar disorder, with the aim of understanding the degree to which these mechanisms could impact on the progression of the disease and on the efficacy of drug treatment. Most of the results pointed to a low-grade inflammatory state of central nervous system during the acute phases of bipolar disorder (depressive or manic episode). The present study aimed to evaluate the levels of protein C reactive (CRP) and leukocytes during the acute phase of bipolar disorder. Our hypothesis was that patients with bipolar disorder would show increased neuroinflammatory biomarkers during the acute phase of the disease. Therefore, we recruited 104 patients with bipolar disorder, consecutively admitted to our inpatient unit, and evaluated the blood levels of protein C reactive (CRP) and the white blood cell count at the following time points: 1) admission to the inpatient unit (T0), a setting where all patients are experiencing acute symptoms; 2) 7 ± 4 days after admission (T1), 3) in the stabilized-post-acute phase (T2).
Consistent with our hypothesis, we found significantly higher levels of inflammatory biomarkers at T0, compared to T1. T2 was performed on a smaller sample both for CRP (n=40) and leukocytes (n=57). Specifically, at T0 we found that 21,5% of subjects had CRP values greater than 0,5 mg/dl, and 11,5 % of subjects had leukocyte alteration. At T1: we found that 14,4 % of subjects had CRP values greater than 0,5 mg/dl, and 13,46% of subjects had leukocyte alteration. At T2, 72,7% of patients who had abnormal CRP and 75% of patients who had abnormal leukocytes at T0, reverted to normal values.
Patients who were already in treatment with one or more mood stabilizers (valproic acid, carbamazepine, lithium) at T0 had mean values of CRP of 0,22 mg/dl (DS ±0,32). Patients who were not already treated with mood stabilizers (valproic acid, carbamazepine, lithium) at T0 had mean values of CRP of 0,42 mg/dl (DS ±0,52). The difference was statistically significant (p=0.026).
CRP and leukocytes average values tended to decrease from T0 to T2 and this was statistically significant (p 0,0036 for CRP and p 0,0039 for leukocytes) for those patients who showed abnormal values upon intake to the inpatient unit. Patients with increased leukocytes at T0 and started a mood stabilizers therapy upon admission, showed a statistically significant decrease in leukocytes count (p 0,0037).
We conclude that a sub-population of bipolar patients shows a low-grade of systemic inflammation during the acute phase of illness. Mood stabilizers may exert a protective role against CRP and leukocytes alterations, as suggested by the lower levels of CRP and lower degree of leukocyte alteration in patients who were already treated with this drugs at intake to the inpatient unit and as suggested by their improvement in those patients who were not already treated with mood stabilizers and started these medications at admission. It remains to be established if the improvement was due to the mood stabilizers or, more in general, to the amelioration of their psychiatric symptoms.
The limits of our study include: relatively small sample size, short duration, inability to control for all the other variables that may have influenced our study results
Trazodone Contramid® in clinical practice: personalizing antidepressant intervention
No full textThis paper examines the use of Trazodone Contramid® in major depressive disorder (MDD), with a focus on practical guidance regarding real world challenges. The paper includes clinical case reports, developed for didactic reasons, which detail the practical management with Trazodone Contramid® of patients with MDD and either insomnia or anxiety or dementia or isolated (ipo)manic symptoms, which often fulfill the criteria for a diagnosis of MDD with with anxious distress or MDD with mixed features, according to the new DSM-5 classification
Older and Newer Strategies for the Pharmacological Treatment of Agitation in Schizophrenia and Bipolar Disorder
No full textBACKGROUND: The management of acute agitation in patients with bipolar disorder or schizophrenia is a multifaceted and dynamic task, which presents unique and complex challenges to healthcare providers.
OBJECTIVE: To ascertain and describe which medications are best to use in patients with agitation, affected by bipolar disorder or schizophrenia.
METHOD: Selective review of current literature and guidelines referred to the treatment of agitation in individuals affected with bipolar disorder or schizophrenia Results: When possible, the pharmacologic management of agitation should be preceded by a in-depth evaluation of the possible causes of the agitation. The use for of first and second-generation antipsychotic medications, of benzodiazepines and of the newer inhaled antipsychotic loxapine, is reviewed and commented.
CONCLUSION: The mainstay of medication treatment of acute agitation should be based on a thotough assessment cause. If agitation is due to delirium or to another physial condition, an attempt to address the underlying causes should be always considered. When agitation is primarily due to schizophrenia or bipolar disorder, antipsychotics and/or benzodiazepines are usually the mainstay of treatment. Newer inhaled formulation of loxapine has shown ability to rapidly reduce the agitation in mild to moderate patients with schizophrenia or bipolar disorder, with a decrease in agitation that was evident since the first assessment, 10 minutes after the first dose
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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