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PubMed1990

Cycloid psychoses and schizoaffective psychoses--a comparison of different diagnostic classification systems and criteria.

In current psychopathological research there are at least two major groups of concepts in the field of psychoses with good prognosis: the more traditional concepts of 'bouffée délirante', cycloid psychoses and Kasanin's 'schizoaffectives'--on the other hand the modern idea of 'concurrent schizoaffective psychoses' like the operational criteria of Kendell, Welner, RDC, DSM-IIIR and ICD-10. Reviewing previous studies, 'bouffée délirante' and cycloid psychosis were found to form a homogeneous group which is very well delineated from affective and schizophrenic psychosis--to some extent also from the modern criteria of 'concurrent schizoaffective psychoses'.

Bipolar Disorder↗
PubMed1985

Potential drug interactions in surgical patients.

The incidence and frequency of potentially serious drug interactions were evaluated in hospitalized surgical patients. Drug profiles of patients on the general surgical service of a tertiary-care teaching hospital were retrospectively reviewed for two six-month periods to determine how often drugs that are known for major interactions were prescribed concurrently. Interactions were studied that were relatively well documented and potentially harmful to the patients. A total of 1825 patient profiles were reviewed (21,888 patient days). At least one potential drug interaction was found in 17% of the patients. Interactions were found to occur at the rate of 1 for every 59 patient days. Digoxin and cimetidine were the potential interacting drugs in almost 90% of the cases. Hospitalized surgical patients require close monitoring because they frequently receive potentially interacting drugs.

Cimetidine↗
PubMed2002

Integration of synaptic and intrinsic dendritic currents in cat spinal motoneurons.

The results of recent studies designed to reveal some of the 'rules' governing the integration of synaptic and intrinsic dendritic currents in spinal motoneurons are reviewed. When two or more sources of synaptic input are activated concurrently, their combined postsynaptic effects on cat spinal motoneurons with 'passive dendrites' are generally equal to or slightly less than those predicted from the linear sum of their individual effects. However, for experimental preparations in which active conductances on motoneuron dendrites are enabled, instances of greater-than- or less-than linear summation can occur. Further, these studies demonstrate that the persistent inward currents that are generated by motoneuron dendrites provide an intrinsic source of excitatory drive that is larger than those associated with any of the individual synaptic input systems studied to date. Since these intrinsic depolarizing currents can be rapidly inactivated by a hyperpolarizing input, they are ideally suited to providing a major source of the alternating 'drive' to motoneurons during locomotion.

Animals↗
PubMed2005

Antibiotic utilisation in community practices: guideline concurrence and prescription necessity.

PURPOSE: To evaluate the indications, concurrence with prescribing guidelines and potential necessity for antibiotic (AB) prescriptions written in community practice. METHODS: We reviewed the charts of all patients with infection-related illnesses seen by family physicians during two random days of regular practice between 1 Oct 1997 and 30 Jan 1998. Guideline concurrence of AB prescribing was assessed using regional AB prescribing guidelines. Likelihood of AB indication for respiratory tract infections was assessed using published clinical practice guidelines for determination of likely viral versus bacterial etiology. RESULTS: Of 4218 visits captured, 949 (22%) were for newly acquired infections. Sixty four percent (n=604) of consultations for newly acquired infections resulted in an AB prescription. Based on the doctors' diagnoses, 61% of AB prescriptions were concurrent with prescribing guidelines, 10% were for the wrong drug, 20% were not indicated and in 10% of cases a lower line AB was available. For respiratory tract infections, 12% of these infections were likely bacterial, whereas the physicians determined that 56% were bacterial. CONCLUSIONS: A large proportion of ABs administered in community practices were not in concurrence with community AB prescribing guidelines. Improvements can be made in AB choice and in decisions about likely viral etiology for respiratory tract infections.

Adolescent↗
PubMedDate not supplied

Depression in diabetic patients: the relationship between mood and glycemic control.

PROBLEM: Evidence from prospective and cross-sectional studies demonstrates that the presence of diabetes doubles the risk of comorbid depression. This commonly overlooked comorbidity affects more than one quarter of the diabetic population, making its recognition and treatment in diabetic patients clinically relevant. METHODS: PubMed, PsycINFO, and MEDLINE databases were searched (search words: diabetes, depression, metabolic control, hyperglycemia, hypoglycemia) for articles that evaluated outcomes, relationships, and/or management of comorbid depression and diabetes published between 1980 and 2002. This review represents a synthesis of the findings including treatment recommendations. RESULTS: Concurrent depression is associated with a decrease in metabolic control, poor adherence to medication and diet regimens, a reduction in quality of life, and an increase in health care expenditures. In turn, poor metabolic control may exacerbate depression and diminish response to antidepressant regimens. Psychotherapy and pharmacotherapy are effective in the presence of diabetes; both cognitive behavior therapy and selective serotonin reuptake inhibitors are weight neutral and have been associated with glycemic improvement in some studies. CONCLUSION: Depression is common in both type 1 and type 2 diabetes and has significant effects on the course and outcome of this medical illness. Conventional antidepressant management strategies are effective and the regimen should be tailored to the individual patient. Enhanced efforts toward good glycemic control may also contribute to improvements in mood and perceptions of well-being.

Adult↗
PubMed2026

De novo Genes in Plants: Origins, Mechanisms, and Functional Implications.

De novo genes originate from previously non-coding genomic regions. They provide an important source of lineage-specific innovation. In plants, these genes may contribute to adaptation, trait diversity and crop evolution. This review summarizes recent progress in plant de novo gene research. It first discusses major routes of gene birth, including transcription-first, open reading frame (ORF)-first and concurrent models. It also examines how nascent loci acquire regulatory control and enter existing biological networks. The review then summarizes their evolutionary features, including weak early constraint, rapid molecular change, restricted expression and structural refinement. It further discusses plant de novo genes involved in stress responses, seed germination, kernel dehydration, subspecies divergence, reproductive isolation and floral scent diversification. Current methods for identifying de novo genes remain limited by rapid sequence evolution, genome annotation quality, polyploidy and transposable elements. Whole-genome synteny alignment, multi-omics evidence and machine-learning approaches can improve candidate discovery. However, each method has important limitations. Finally, this review highlights key future questions in functional validation, latent coding potential in long non-coding RNAs, epigenetic activation, regulatory-network integration and crop improvement. These perspectives clarify how de novo genes shape plant adaptation and how they may be used in precision breeding and synthetic biology.

adaptive evolution↗
PubMed2003

Effect of tenofovir on didanosine absorption in patients with HIV.

OBJECTIVE: To evaluate the pharmacokinetic interaction between tenofovir and didanosine when used in combination as a highly active antiretroviral therapy regimen. DATA SOURCES: Literature retrieval was accessed through MEDLINE (1966-January 2003) using the terms tenofovir and didanosine. Abstracts from recent meetings, including the International AIDS Society, Interscience Conference on Antimicrobial Agents and Chemotherapy, and the Infectious Diseases Society of America, were reviewed for relevant abstracts and poster presentations. DATA SYNTHESIS: Pharmacokinetic studies evaluating the concurrent use of tenofovir and didanosine have been performed in healthy volunteers. Tenofovir 300 mg administered concurrently with 400 mg didanosine results in a 48-64% increase in the didanosine maximum plasma concentration and AUC with no significant alterations in the tenofovir pharmacokinetic parameters. Tenofovir 300 mg and didanosine 250 mg has been compared with didanosine 400 mg alone. The results demonstrated equivalent didanosine AUCs. CONCLUSIONS: When used concurrently, tenofovir significantly increases the maximum plasma concentration and the AUC of didanosine. Additional data in HIV-infected patients are needed to determine the long-term toxicities of this combination therapy. Didanosine dose reduction should be considered when these 2 agents are used concurrently.

Adenine↗
PubMed2005

The incidence of vision loss due to perioperative ischemic optic neuropathy associated with spine surgery: the Johns Hopkins Hospital Experience.

STUDY DESIGN: Twenty-year retrospective review of 14,102 spine surgeries. OBJECTIVE: To determine the incidence of perioperative ischemic optic neuropathy (POION) in spine surgery at our institution. SUMMARY OF BACKGROUND DATA: In recent years, perioperative vision loss in patients undergoing spine surgery has become an issue of increasing concern to physicians, patients, and medicolegal experts. The incidence of POION in spine surgery has been addressed in two separate studies that found incidences of 0% and 0.12%. METHODS: We performed a 20-year database search for all patients who underwent spine surgery and had a concurrent ICD-9 discharge diagnosis pertaining to vision loss. Patient charts were reviewed in detail to confirm the diagnosis of POION. RESULTS: Of 14,102 cases of spine surgery during the study time frame, we identified 4 cases of POION, for an incidence of 0.028%. In 3 of the 4 cases, surgery was performed with the patient in the prone position; the fourth patient was placed in the lateral decubitus position. All affected patients had experienced intraoperative anemia, hypotension, or both. The average time of surgery was 420 minutes. CONCLUSIONS: POION is a rare but potentially devastating and untreatable complication of spine surgery, particularly that performed with the patient in the prone position. Anemia, hypotension, long duration of surgery, and significant intraoperative hydration may all be risk factors for this condition. All patients undergoing spine surgery should be informed about the low but definite risk of this condition, and every attempt should be made during surgery to maintain stable hemoglobin and mean arterial pressure and to avoid overhydration.

Academic Medical Centers↗
PubMed1986

Spontaneous remission of acute myeloid leukemia. A report of a case and brief review of the literature.

A patient with acute myelomonocytic leukemia who experienced a spontaneous remission, is reported. He had precedent and concurrent bacterial infections as most of these cases described. Low peripheral WBC and myeloblasts, Auer-rod positive blasts, bone marrow eosinophilia with atypical eosinophils, and a partial deletion of chromosome 16 were favorable prognostic parameters. A brief review of the literature and possible explanations for the regulation of granulopoiesis are presented.

Adult↗
PubMed1998

Predictive performance of a vancomycin-aminoglycoside population model.

OBJECTIVE: To evaluate the Wragge-Cooper method of predicting vancomycin serum concentrations utilizing knowledge of aminoglycoside pharmacokinetic parameters in general medicine and intensive care unit populations, and to develop a revised model if necessary. DESIGN: This study consists of two phases evaluating 50 adults receiving concurrent vancomycin and aminoglycoside therapy. Patients were identified by a retrospective review of medical records. Bayesian analysis of measured serum aminoglycoside and vancomycin concentrations was performed to determine the individualized pharmacokinetic parameters. Phase I of the study tested the predictive performance of a published model incorporating aminoglycoside elimination (Wragge-Cooper) in 25 patients (group 1), and a revised model was developed. Phase II determined the predictive performance of the revised model (revised) and its performance relative to the Wragge-Cooper model and a traditional model incorporating estimated creatinine clearance (traditional) in an additional 25 patients (group 2). SETTING: Two tertiary care university teaching hospitals. MAIN OUTCOME MEASURES: The predictive performance of the models was determined by comparing predicted with measured vancomycin serum concentrations. Bias and precision were evaluated by calculating the mean prediction error (ME) and mean absolute error (MAE), respectively. Linear regression was performed to determine relationships between parameters. RESULTS: The Wragge-Cooper model consistently underpredicts vancomycin serum concentrations in general medicine and intensive care unit populations (ME = -5.18, MAE = 6.63). Relative predictive performance analysis indicates no significant difference in bias or precision between the traditional and Wragge-Cooper models (delta ME 1.17, delta MAE -0.80). Regression analysis of individualized aminoglycoside and vancomycin elimination derived from patients in group 1 reveals the following relationship: vancomycin k10 (1/h) = 0.081 + 1.037ke,amg, r = 0.73. The revised model is significantly less biased and more precise compared with the traditional model (delta ME -4.48; delta MAE 1.22), and is significantly less biased (delta ME 4.29) but no more precise than the Wragge-Cooper model (delta MAE -0.58), using patients from group 2. CONCLUSIONS: The revised model is an accurate method of predicting vancomycin serum concentrations in both general medicine and intensive care unit populations. Use of this model enables individualization of vancomycin dosage in patients receiving concurrent aminoglycoside therapy and minimizes vancomycin serum concentration monitoring.

Adult↗
PubMed2005

Therapeutic strategies for combined-modality therapy of locally advanced non-small-cell lung cancer: rationale for consolidation docetaxel therapy.

Currently, there is no accepted standard of care for locally advanced and surgically unresectable non-small-cell lung cancer. Typically, treatment for patients with good performance status consists of a combination of chemotherapy and thoracic radiation therapy (RT), but the integration of these modalities and the respective dose schedules vary considerably. Herein, we review the rationale for a treatment paradigm employing consolidation docetaxel therapy after concurrent chemotherapy/RT and the results of recent clinical trials using this approach.

Antineoplastic Agents, Phytogenic↗
PubMedDate not supplied

Midfacial rejuvenation via a minimal-incision brow-lift approach: critical evaluation of a 5-year experience.

OBJECTIVE: To evaluate the surgical technique, cosmetic results, and complications of patients who underwent a midface-lift via a minimal-incision brow-lift performed by the senior author (E.F.W.). SETTING: Private, ambulatory surgical center. DESIGN: A retrospective review of 325 midface-lifts performed over a 5-year period by a single surgeon. Patients A total of 325 consecutive patients who underwent a midface-lift, with or without concurrent rhytidectomy and other adjunctive procedures, and who completed 3 months of follow-up were reviewed for perioperative complications. One hundred patients who had complete photographic and chart records and who had a minimum of 6 months of follow-up were randomly selected for photographic rating and chart review. Of the patients who had a minimum of 1 year of follow-up, 50 were randomly selected to determine if midfacial elevation led to any evidence of lateral-canthal distortion. MAIN OUTCOME MEASURES: Midfacial elevation was assessed in 3 facial zones by 3 independent evaluators. Zone I represents the malar-infraorbital complex; zone II, the nasolabial sulcus; and zone III, the jawline. The zones were rated on a scale from 0 to 2 (0, no improvement; 1, mild improvement; and 2, marked improvement). Change in the lateral-canthal position was measured in the vertical and horizontal axis for each eye. All complications were recorded. RESULTS: The 3 independent evaluators correlated well in their scores (kappa = 0.643) and found that most patients showed the best improvements in zone I, with 70% of patients showing marked improvement (P<.001). Moderate improvement was noted in zone III (marked improvement, 30%; mild improvement, 50%; and no improvement, 20%). Little or no improvement was noted in zone II (marked improvement, 4%; mild improvement, 60%; and no improvement, 36%). Patients who underwent a rhytidectomy along with a midface-lift showed better elevation in zone III. However, patients who underwent a brow/midface-lift alone also showed favorable improvement along the jawline (zone III). Although the postoperative lateral-canthal position revealed statistically significant vertical elevation of the lateral canthus on the right side, this finding did not correlate with any perceived clinical significance by the reviewer or patient (P<.01). Temporary morbidity included 2 subperiosteal abscesses and 3 frontal and 1 buccal facial nerve neuropraxias that resolved by 6 months. Permanent complications included 1 case of unilateral cranial nerve V2 paresthesia. Five patients had alopecia requiring scar revision. Many of these complications, including subperiosteal abscess and alopecia, have subsequently been avoided by minor technique modifications. CONCLUSION: The technique of midface-lift via transbrow approach is a safe, reliable method of midfacial rejuvenation and avoids the unnatural lateral-canthal distortion previously described in the literature.

Adult↗
PubMed1996

The normal menopause transition: an overview.

OBJECTIVES: This review emphasizes results from population based studies in order to provide a reliable knowledge base and define major knowledge gaps for future research. METHODS: The review systematically addresses the following aspects of menopause research: definition of menopause and menopause transitions; age at natural menopause and at inception of perimenopause; factors affecting timing and length of menopause transitions; concurrent hormone, menstrual and vascular changes. Under each substantive heading, available reports of original research are reviewed, assessed for reliability and summarized with respect to their contribution to the knowledge base. RESULTS: From this review, the following reliable information can be summarized: median age at natural menopause in Caucasian women occurs between 50 and 51-55 years of age, is not affected by timing of surgical menopause and is affected by cigarette smoking, with current smokers having an earlier menopause by 1.5-2.0 years. No other factors appear to have an independent effect on age at menopause. There is no evidence of any secular trend in age at menopause. Evidence is accumulating that most physiological change associated with menopause either occurs or begins before the final menstrual period. CONCLUSIONS: We lack reliable information on the following: estimates of age at menopause from non-industrialized countries and diverse ethnic groups; information on perimenopause; differing perceptions of menopause, cross culturally; multi-disciplinary prospective data that can link various processes into coherent patterns.

Adult↗
PubMed2004

An update on ureteroscopic instrumentation for the treatment of urolithiasis.

PURPOSE OF REVIEW: Ureteroscopic instruments, both endoscopic and working devices, continue to evolve. Changes in instrumentation have necessitated concurrent modifications in ureteroscopic techniques over the years. The safety and efficacy of the ureteroscopic approach for the treatment of renal and ureteral calculi, however, have continued to improve. RECENT FINDINGS: This review emphasizes the recent advances in the major groups of instruments employed for ureteroscopy. Among the endoscopic instruments, the flexible ureteroscopes have undergone the most notable advances, benefiting from greatly improved deflection and durability. Progress has been made in adjunctive instruments as well. Current stone retrieval devices composed of nitinol-based wire technology are able to easily secure fragments from the most peripheral calices. The holmium laser is a versatile device with proven safety and effectiveness as an endoscopic lithotrite. SUMMARY: The availability and coordinated use of the latest ureteroscopic instruments have resulted in better treatment outcomes, thus expanding the use of ureteroscopy as a first-line option for the treatment of calculi in appropriate cases. Urologists should be familiar with currently available instrumentation in order to optimize their equipment.

Device Removal↗
PubMed2006

Renal parenchymal tumors and lymphoma in the same patient: case series and review of the literature.

We reviewed the incidence of diagnosis of renal cell carcinoma and lymphoma in the same patient and analyzed the characteristics of this association. Nine patients in 4 years had the diagnosis of renal cell carcinoma (RCC) and lymphoma, including 2 with Hodgkin disease, 1 with chronic lymphocytic leukemia (CLL), and 3 each with low-grade follicular and intermediate-grade non-Hodgkin lymphoma (NHL). In SEER data, the observed/expected (O/E) ratio of NHL and RCC is 1.86 to 2.07. In our series, 2 patients were diagnosed with NHL after the diagnosis of RCC, 1 was diagnosed concurrently, and in the other 6, lymphoma preceded diagnosis of RCC. In reviews of second malignancies following treatment of Hodgkin disease, RCC is less common (O/E 1.5, with 1/3 being transitional cell carcinoma and 2/3 being adenocarcinoma). We report 2 cases with Hodgkin disease preceding RCC, and in both, Hodgkin disease occurred as an adult. There is a male predominance for patients with both diagnoses, which is greater than the male predominance for either RCC or NHL alone (2.2 vs. 2.0 vs. 1.2). There is an increased likelihood of the lymphoma being extranodal. There is an increased association of RCC and NHL more often among male patients, and often with extranodal lymphoma. Potential common etiological factors include prior treatment for malignancy, genetic predisposition, environmental factors, including a search for viral sequences, and possible immune dysregulation generating the lymphoma and subsequently leading to solid tumors such as RCC or melanoma.

Adult↗
PubMed1977

Review of local soft tissue recurrence of breast cancer irradiated with and without actinomycin-D.

Between 1962 and 1973, regionally recurrent breast cancer was treated in 156 patients by irradiation alone or irradiation with concurrent actinomycin-D. Thirty-two patients were entered into a randomized trial, and 124 patients were retrospectively reviewed. Local control with irradiation alone was achieved in 48 of 80 patients (60%) and in 60 of 76 patients (79%) treated with irradiation and actinomycin-D (p less than .05). Results were remarkably similar in the randomized and retrospective series.

Breast Neoplasms↗
PubMed1990

Concurrent and Close Temporal Administration of Lithium and ECT.

The clinical effects of concurrent and close temporal administration of electroconvulsive therapy (ECT) and lithium (Li) were investigated by chart review. Three groups of patients were compared on the basis of ECT-related complications, total length of hospital stay (LOS), and post-ECT hospital stay. The groups consisted of patients administered concurrent ECT and Li (n = 27); patients administered Li within 24 h prior to ECT or within 48 h post-ECT (n = 49); and patients administered ECT without concurrent or close temporal administration of Li (n = 100). Prolonged or severe post-ECT confusion was significantly associated with close timing of administration of Li relative to the ECT course. The groups did not differ in the number of complications or the total LOS, although the post-ECT LOS was significantly longer in the group administered Li in close temporal association with ECT. These data suggest that caution should be exercised in the combined use of these treatment modalities.

Journal Article↗
PubMed2004

HIV-associated dementia, Alzheimer's disease, multiple sclerosis, and schizophrenia: gene expression review.

RNA and protein gene expression technologies are revolutionizing our view and understanding of human diseases and enable us to analyze the concurrent expression patterns of large numbers of genes. These new technologies allow simultaneous study of thousands of genes and their changes in regulation and modulation patterns in relation to disease state, time, and tissue specificity. This review summarizes the application of this modern technology to four common neurological and psychiatric disorders: HIV-1-associated dementia, Alzheimer's disease, multiple sclerosis, and schizophrenia and is a first comparison of these diseases using this approach.

AIDS Dementia Complex↗