• 【自闭症谱系障碍儿童的医学调查。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2214.2006.00630.x 复制DOI
    作者列表:Cass H,Sekaran D,Baird G
    BACKGROUND & AIMS: :Few well-constructed studies have systematically evaluated medical investigation protocols for children with autistic spectrum disorders. This is in large part due to the heterogeneous nature of the population and changing diagnostic frameworks. This review outlines the studies that have directed investigation strategies to date, and discusses how these might be applied in the clinical situation. The importance of listing the conditions that may be present on the basis of the specific clinical presentation, and using a thorough history and examination to generate a pre-test probability of the target disorders is emphasized if tests are to be useful in directing therapy or broader management approaches.
    背景与目标: : 很少有精心构建的研究系统地评估了自闭症谱系障碍儿童的医学调查方案。这在很大程度上是由于人口的异质性和不断变化的诊断框架。这篇综述概述了迄今为止指导研究策略的研究,并讨论了如何将这些策略应用于临床情况。如果要在指导治疗或更广泛的治疗方法中有用,则强调了根据特定临床表现列出可能存在的条件并使用全面的病史和检查来产生目标疾病的预测试概率的重要性。管理方法。
  • 【生长激素-胰岛素样生长因子-I轴中的遗传疾病。】 复制标题 收藏 收藏
    DOI:10.1159/000095161 复制DOI
    作者列表:Walenkamp MJ,Wit JM
    BACKGROUND & AIMS: :In the last few years, our knowledge of genetically determined causes of short stature has greatly increased by reports of challenging patients, who offered the opportunity to study genes that play a role in growth. Since the first paper that showed the etiology of Laron syndrome [Godowski PJ, et al: Proc Natl Acad Sci USA 1989;86:8083-8087], many mutations in the growth hormone (GH) receptor have been identified. Recently, new mutations or deletions have been found in several components of the GH-insulin-like growth factor-I (IGF-I) axis: a homozygous mutation of the GH1 gene, resulting in a bio-inactive GH; mutations in the STAT5b gene, which plays a major role in the GH signal transduction; a homozygous missense mutation in the IGF-I gene; heterozygous mutations in the IGF-I receptor gene and a homozygous deletion of the acid-labile subunit gene. In this mini review, we describe the clinical and biochemical features of these genetic defects. Genetic analysis has become essential in the diagnostic workup of a patient with short stature. However, regarding the time consuming nature of molecular analysis, it is important to carefully select the patient for specific genetic evaluation. To help in this selection process, we developed flowcharts, based on the recently described patients, that can be used as guidelines in the diagnostic process of patients with severe short stature of unknown origin.
    背景与目标: : 在过去的几年中,由于有挑战性的患者的报道,我们对基因确定的矮小原因的了解大大增加了,他们提供了研究在生长中起作用的基因的机会。自从第一篇显示拉隆综合征病因的论文 [Godowski PJ等人: Proc Natl Acad Sci USA 1989;86:8083-8087] 以来,已经鉴定出生长激素 (GH) 受体的许多突变。最近,在GH-胰岛素样生长因子-I (igf-i) 轴的几个组成部分中发现了新的突变或缺失: GH1基因的纯合突变,导致了具有生物活性的GH; STAT5b基因的突变,在GH信号转导中起主要作用; Igf-i基因中的纯合错义突变; Igf-i受体基因中的杂合突变和酸不稳定亚基基因的纯合缺失。在这篇小型综述中,我们描述了这些遗传缺陷的临床和生化特征。基因分析在身材矮小的患者的诊断检查中已变得至关重要。但是,关于分子分析的耗时性质,重要的是要仔细选择患者以进行特定的遗传评估。为了帮助这一选择过程,我们根据最近描述的患者开发了流程图,该流程图可作为不明原因严重矮小患者诊断过程的指南。
  • 【对象偏好对自闭症儿童任务表现和刻板印象的影响。】 复制标题 收藏 收藏
    DOI:10.1016/s0891-4222(96)00046-7 复制DOI
    作者列表:Morrison K,Rosales-Ruiz J
    BACKGROUND & AIMS: The relationship between preferred objects associated with stereotypy, stereotypic behavior, and accuracy of responding during a counting task by a child with autism was analyzed. Object preference was determined by presenting the child with different sets of objects and asking him to choose one. His choices were then rank ordered into three groupslow, medium, and high preference objects. Counting performance within each of the three object groups was then analyzed in a multi-element design, alternating preference groups. Teaching with high-preference objects occasioned more stereotypic behavior and less accurate counting than teaching with medium- and low-preference objects. Thus, there exists the possibility that teaching may be less successful with certain teaching materials, especially if those materials evoke high rates of incompatible behaviors.

    背景与目标: 分析了与自闭症儿童在计数任务中与刻板印象相关的首选对象,刻板行为和响应准确性之间的关系。对象偏好是通过向孩子展示不同的对象集并要求他选择一个来确定的。然后将他的选择排序为三个慢,中和高偏好对象。然后,在多元素设计 (交替的偏好组) 中分析了三个对象组中每个对象组的计数性能。与中低偏好对象的教学相比,高偏好对象的教学产生了更多的刻板行为和更不准确的计数。因此,存在使用某些教材进行教学可能不太成功的可能性,尤其是如果这些教材引起高度的不相容行为。
  • 【使用红色光谱中的发光二极管灯进行光活化消毒: 牙周炎患者在维护中的临床和微生物短期发现。一项随机对照的裂口临床试验。】 复制标题 收藏 收藏
    DOI:10.1007/s10103-012-1225-x 复制DOI
    作者列表:Mongardini C,Di Tanna GL,Pilloni A
    BACKGROUND & AIMS: :Eradication or suppression of pathogens is a major goal in periodontal therapy. Due to the increase in antibiotic resistance, the need of new disinfection therapies is raising. Photodynamic therapy (PDT) has demonstrated anti-infective potential. No data are available on the use of light-emitting diode (LED) lights as the light source in PDT. The aim of this study was to investigate the microbiological and clinical adjunctive outcome of a new photodynamic LED device, compared to scaling and root planing in periodontitis patients in maintenance [supportive periodontal therapy (SPT)]. In this masked, split-mouth design study, 30 treated chronic periodontitis subjects (mean age, 46.2 years; 13 males) in SPT were included. Two residual interdental sites with probing pocket depth (PPD) ≥ 5 mm in two opposite quadrants, with positive bleeding on probing (BOP) and comparable periodontal breakdown, were selected. PPD, BOP and subgingival microbiological samples for real-time PCR analysis (Carpegen® PerioDiagnostics, Carpegen GmbH, Münster, Germany) were recorded at baseline and 1 week after treatment. Scaling and root planing was performed under local anesthesia. Randomly one of the sites was selected to receive adjunctive photodynamic therapy by inserting a photosensitizer (toluidine blue O solution) and exposing it to a LED light in the red spectrum (Fotosan, CMS Dental, Copenhagen, Denmark), according to the manufacturer's instructions. After 1 week, 73 % of the control sites and 27 % of the test sites were still BOP+. These differences compared to baseline values and in-between groups were statistically significantly different (p < 0.001). Mean PPD decreased from 5.47 mm (±0.68) to 4.73 mm (±0.74, p < 0.001) in control sites and from 5.63 mm (±0.85) to 4.43 mm (±1.25, p < 0.001, test vs control p = 0.01) in the test group. Microbiologically, higher reductions of relative proportions of red complex bacteria were observed in test sites (68.1 vs. 4.1 %; p = 0.01). This study showed that adjunctive photodynamic treatment by LED light may enhance short-term clinical and microbiological outcome in periodontitis subjects in SPT.
    背景与目标: : 根除或抑制病原体是牙周治疗的主要目标。由于抗生素耐药性的增加,新的消毒疗法的需求正在增加。光动力疗法 (PDT) 已显示出抗感染潜力。没有关于在PDT中使用发光二极管 (LED) 灯作为光源的数据。这项研究的目的是研究一种新型光动力LED设备的微生物学和临床辅助结果,与牙周炎患者在维持 [支持性牙周治疗 (SPT)] 中的牙周炎患者进行结垢和牙根平整相比。在这项蒙面的裂口设计研究中,包括30名接受治疗的SPT慢性牙周炎受试者 (平均年龄46.2岁; 13名男性)。选择了两个相对象限中探查袋深度 (PPD) ≥   5毫米的两个残留齿间部位,探查出血 (BOP) 阳性,牙周分解相当。用于实时PCR分析的PPD,BOP和龈下微生物样品 (Carpegen®在基线和治疗后1周记录PerioDiagnostics,Carpegen GmbH,m ü nster,德国)。在局部麻醉下进行了缩放和根刨除。根据制造商的说明,通过插入光敏剂 (甲苯胺蓝O溶液) 并将其暴露于红色光谱的LED光 (Fotosan,CMS Dental,哥本哈根,丹麦),随机选择其中一个部位接受辅助光动力疗法。1周后,73% 对照部位和27% 试验部位仍为BOP +。这些差异与基线值和组间比较在统计学上有显著差异 (p <0.001)。在对照组中,平均PPD从5.47毫米 (± 0.68) 降至4.73毫米 (± 0.74,p <0.001),在试验组中从5.63毫米 (± 0.85) 降至4.43毫米 (± 1.25,p <0.001,测试vs对照p = 0.01)。在微生物学上,在测试部位观察到红色复合细菌相对比例的较高降低 (68.1对4.1%; p = 0.01)。这项研究表明,通过LED光辅助光动力治疗可能会增强SPT牙周炎受试者的短期临床和微生物学结果。
  • 【天花叶提取物对四氧嘧啶糖尿病大鼠代谢紊乱和氧化应激的保护作用。】 复制标题 收藏 收藏
    DOI:10.1186/s12906-017-1835-8 复制DOI
    作者列表:Ben Salem M,Ben Abdallah Kolsi R,Dhouibi R,Ksouda K,Charfi S,Yaich M,Hammami S,Sahnoun Z,Zeghal KM,Jamoussi K,Affes H
    BACKGROUND & AIMS: BACKGROUND:Diabetes mellitus (DM) is associated with hyperglycemia, inflammatory disorders and abnormal lipid profiles, currently the extracts from leaves of cynara scolymus has been discovered to treat metabolic disorders and has been stated by multitudinous scientists according to a good source of polyphenols compounds. The present study aimed to evaluate the protective effect of the ethanol leaves extract of C. scolymus in alloxan induced stress oxidant, hepatic-kidney dysfunction and histological changes in liver, kidney and pancreas of different experimental groups of rats. METHODS:We determinate the antioxidant activity by ABTS .+ and antioxidant total capacity (TAC) of all extracts of C. scolymus leaves, the inhibition of α-amylase activity in vitro was also investigated. Forty male Wistar rats were induced to diabetes with a single dose intraperitoneal injection (i.p.) of alloxan (150 mg/kg body weight (b.w.)). Diabetic rats were orally and daily administrated of ethanol extract from C. scolymus at two doses (200-400 mg/kg, b.w) or (12 mg/kg, b.w) with anti-diabetic reference drug, Acarbose for one month. Ethanol extract of C. scolymus effect was confirmed by biochemical analysis, antioxidant activity and histological study. RESULTS:The results indicated that the ethanol extract from leaves of C. scolymus showed the highest antioxidant activity by ABTS .+ (499.43g± 39.72 Trolox/g dry extract) and (128.75 ± 8.45 mg VC /g dry extract) for TAC and endowed the powerful inhibition in vitro of α-amylase activity with IC50=72,22 ug/uL. In vivo, the results showed that ethanol extract from the leaves of C. scolymus (200-400 mg/kg) decreased significantly (p < 0.001) the α-amylase levels in serum of diabetic rats, respectively associated with significant reduction (p < 0.001) in blood glucose rate of 42,84% and 37,91% compared to diabetic groups after 28 days of treatment, a significant lowered of plasma total cholesterol (T-Ch) by 18,11% and triglyceride (TG) by 60,47%, significantly and low-density lipoproteins (LDL-C) by 37,77%, compared to diabetic rats, moreover, the administration of ethanol extract appears to exert anti-oxidative activity demonstrated by the increase of CAT, SOD and GSH activities in liver, kidney and pancreas of diabetic rats. This positive effect of the ethanol extract from C. scolymus was confirmed by histological study. CONCLUSION:These observed strongly suggest that ethanol extract from the leaves of C. scolymus has anti-hyperglycemic properties, at least partly mediated by antioxidant and hypolipidemic effects.
    背景与目标:
  • 【临床医生评分中揭示的dsm-iv人格障碍的结构。】 复制标题 收藏 收藏
    DOI:10.1016/j.comppsych.2012.10.014 复制DOI
    作者列表:Blais MA,Malone JC
    BACKGROUND & AIMS: :The revisions proposed for the DSM-5 would greatly alter how personality pathology is conceptualized, assessed, and diagnosed. One aspect of the proposed changes, elimination of four current personality disorders, has raised considerable controversy. The present study attempts to inform this debate by exploring clinicians' views of the structure of Personality Disorders using the current diagnostic system, the DSM-IV. An exploratory factor analysis was conducted on the DSM-IV Personality Disorder criteria using clinician ratings for 280 patients. The factor analysis revealed eight clear and meaningful factors. The eight factors contained all six personality disorders proposed for retention in DSM-5 but also contained clear representations of two disorders (Paranoid and Schizoid) identified for removal from the system. These conditions appear to have clinical utility and their removal may have unintended negative consequences in clinical practice. Dependent and Avoidant criteria also merged to form a new construct with interesting clinical implications. These findings provide new insights into the complex typologies clinicians employ when applying the DSM-IV system to personality disordered patients. Lastly we argue that successful refinement of clinically significant constructs, like diagnostic systems, requires a balanced appraisal of evidence for clinical utility as well as external and internal validity.
    背景与目标: : 为DSM-5提出的修订将极大地改变人格病理学的概念化,评估和诊断方式。拟议更改的一个方面,即消除当前的四种人格障碍,引起了相当大的争议。本研究试图通过使用当前的诊断系统dsm-iv探索临床医生对人格障碍结构的看法来为这一辩论提供信息。使用280名患者的临床医生评分,对dsm-iv人格障碍标准进行了探索性因素分析。因子分析揭示了八个明确而有意义的因子。这八个因素包含建议保留在DSM-5中的所有六种人格障碍,但也包含明确表示要从系统中删除的两种障碍 (偏执狂和精神分裂症)。这些疾病似乎具有临床实用性,并且在临床实践中可能会产生意想不到的负面后果。依赖和回避标准也合并形成了具有有趣临床意义的新结构。这些发现为临床医生在将dsm-iv系统应用于人格障碍患者时所采用的复杂类型提供了新的见解。最后,我们认为,成功完善具有临床意义的结构,例如诊断系统,需要对临床实用性以及外部和内部有效性的证据进行平衡评估。
  • 【从抑制到激活,从情绪不活跃到情绪过度反应: 区分双相情感障碍的两种途径。】 复制标题 收藏 收藏
    DOI:10.1016/j.psychres.2012.10.008 复制DOI
    作者列表:Atzeni T,Henry C,Minois I,Gard S,Desage A,Zanouy L,M'bailara K
    BACKGROUND & AIMS: :To better explore the clinical heterogeneity of bipolar mood states, we developed a dimensional scale for assessing all mood episodes (depressive, hypomanic, manic, mixed states) using the same tool. The Multidimensional Assessment of Thymic States (MATHYS) (Henry et al., 2008) provides two scores, a total score measuring a level of activation and a sub-score of emotional reactivity. The aim of this study was to establish the appropriate cut-off in total activation versus inhibition and in the emotional reactivity sub-score in bipolar disorders. Patients (n=187) during an acute episode and controls (n=89) filled in the MATHYS. Receiver Operating Characteristic (ROC) curves were obtained to estimate the sensitivity and specificity of the global score and the emotional reactivity sub-score of the MATHYS, in order to differentiate patients from controls. ROC curves showed very satisfactory sensitivity and specificity levels both for the total score and the sub-score of emotional reactivity, thus providing an appropriate cut-off. Concerning the total score between 0 and 200, patients with a score lower than 91 had significant global inhibition and those with a score higher than 109 had significant global activation. Regarding the emotional reactivity sub-score between 0 and 40, patients with a score lower than 16 had significant emotional hyporeactivity and those with a score higher than 24 had significant emotional hyperreactivity. Our results provide cut-offs for the MATHYS to identify patients in an acute phase.
    背景与目标: : 为了更好地探索双相情绪状态的临床异质性,我们使用相同的工具开发了用于评估所有情绪发作 (抑郁,躁狂,躁狂,混合状态) 的维度量表。胸腺状态的多维评估 (MATHYS) (Henry等人,2008) 提供两个分数,测量激活水平的总分和情绪反应性的子分数。这项研究的目的是在双相情感障碍的总激活与抑制以及情绪反应性子评分中建立适当的临界值。急性发作期间的患者 (n = 187) 和对照组 (n = 89) 填充了MATHYS。获得受试者工作特征 (ROC) 曲线,以估计MATHYS的整体评分和情绪反应性子评分的敏感性和特异性,以区分患者与对照组。ROC曲线对情绪反应性的总评分和子评分均显示出非常令人满意的敏感性和特异性水平,从而提供了适当的临界值。关于总得分在0和200之间,得分低于91的患者具有显着的整体抑制,而得分高于109的患者具有显着的整体激活。关于0到40之间的情绪反应性子评分,得分低于16的患者具有显着的情绪低反应性,而得分高于24的患者具有显着的情绪高反应性。我们的结果为MATHYS识别急性期患者提供了截止日期。
  • 【Hla-g * 14bp插入和自闭症谱系障碍儿童行为障碍的KIR2DS1-HLAC2复杂影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.neuroscience.2017.06.012 复制DOI
    作者列表:Guerini FR,Bolognesi E,Chiappedi M,Ghezzo A,Manca S,Zanette M,Sotgiu S,Mensi MM,Zanzottera M,Agliardi C,Costa AS,Balottin U,Clerici M
    BACKGROUND & AIMS: :Activating KIR-HLA-C ligand complexes and HLA-G∗14bp insertion/deletion (+/-) polymorphism were associated to Autism Spectrum Disorders (ASD) and were suggested to correlate with inflammation during fetal development. We evaluated whether HLA-G∗14bp(+/-) and KIR-HLA-C complexes are associated with cognitive and behavioral scores and EEG profile in 119 ASD children (58 from Sardinia, 61 from Peninsular Italy). KIR2DS1-C2; KIR2DS2-C1; KIR2DL1-C2; KIR2DL2-C1; KIR2DL3-C1 and HLA-G∗14bp(+/-) were molecularly genotyped by Single Specific Primer PCR and gel electrophoresis. Univariate linear model analysis adjusted for age, gender and provenience showed statistically higher scores of Childhood Autism Rating Scale (CARS) and Autistic Core Behavior in KIR2DS1-C2+/HLA-G∗14bp+ASD children (43.7±1.5, p=0.03; 3.3±0.1, p=0.03, respectively). These results suggested a synergistic polygenic association of KIR2DS1-HLAC2+/HLA-G∗14bp+ pattern with behavioral impairment in ASD children.
    背景与目标: : 激活KIR-hla-c配体复合物和hla-g ∗ 14bp插入/缺失 (+/-) 多态性与自闭症谱系障碍 (ASD) 相关,并被认为与胎儿发育过程中的炎症相关。我们评估了119名ASD儿童 (58名来自撒丁岛,61名来自意大利半岛) 的hla-g * 14bp(+/-) 和KIR-hla-c复合物是否与认知和行为评分以及脑电图谱相关。KIR2DS1-C2; KIR2DS2-C1; KIR2DL1-C2; KIR2DL2-C1; KIR2DL3-C1和hla-g * 14bp(+/-) 通过单特异性引物PCR和凝胶电泳进行分子分型。调整年龄,性别和出血率的单变量线性模型分析显示,KIR2DS1-C2/hla-g * 14bp ASD儿童的儿童自闭症评分量表 (CARS) 和自闭症核心行为得分在统计学上更高 (43.7 ± 1.5,p = 0.03; 3.3 ± 0.1,p = 0.03)。这些结果表明,ASD儿童的KIR2DS1-HLAC2/hla-g ∗ 14bp模式与行为障碍具有协同的多基因关联。
  • 【在ALS4-like运动神经元疾病患者中评估的SETX错义变异谱。】 复制标题 收藏 收藏
    DOI:10.1007/s10048-012-0347-4 复制DOI
    作者列表:Arning L,Epplen JT,Rahikkala E,Hendrich C,Ludolph AC,Sperfeld AD
    BACKGROUND & AIMS: :Mutations in the senataxin (SETX) gene can cause amyotrophic lateral sclerosis 4 (ALS4), an autosomal dominant form of juvenile onset amyotrophic lateral sclerosis, or result in autosomal recessive ataxia with oculomotor apraxia type 2. Great caution regarding the possible disease causation, especially of missense variations, has to be taken. Here, we evaluated the significance of all previously reported SETX missense mutations as well as six newly identified variations in 54 patients suspected of having ALS4. Yet, epidemiologic and in silico evidence indicates that all newly identified variations and two previously published ALS4-related missense variations (C1554G and I2547T) are most likely non-pathogenic, demonstrating the problems of interpretation of SETX missense alleles in the absence of functional assays.
    背景与目标: : senataxin (SETX) 基因的突变可导致肌萎缩性侧索硬化症4 (ALS4),这是一种常染色体显性遗传形式的少年性肌萎缩性侧索硬化症,或导致常染色体隐性遗传性共济失调并伴有动眼失用2型。对于可能的疾病原因,尤其是错义变异,必须谨慎行事。在这里,我们评估了所有先前报道的SETX错义突变以及54例怀疑患有als4的患者中新发现的六个变异的重要性。然而,流行病学和计算机证据表明,所有新发现的变异和两个先前发表的ALS4-related错义变异 (C1554G和I2547T) 最有可能是非致病性的,证明了在缺乏功能测定的情况下解释SETX错义等位基因的问题。
  • 【[进食障碍患者综合治疗的训练模型]。】 复制标题 收藏 收藏
    DOI:10.3305/nh.2012.27.3.5690 复制DOI
    作者列表:Calvo Sagardoy R,Gallego Morales LT,García de Lorenzo y Mateos A
    BACKGROUND & AIMS: :The need to find effective treatments for patients with Anorexia or Bulimia nervosa has led to the professionals who care for them to develop new forms of treatment that take into account the variables that cause resistance to change. Patients in this study (2006-2009) have the following characteristics: 340 patients who have 7 or more years of evolution and/or have tried numerous previous treatments without having succeeded in starting and / or maintaining the desired changes, that allowed them to recover steadily. As the proposed treatment, the patient-treatment team is based on the principles of the training model. It considers the patient holistically, it informs and provides him with resources to increase its commitment to change. Teaches the patient to take care physically and mentally as a way to regain their health and leave the disorder in a stable way. Includes family members as essential support in the recovery of their closest. Therapists require extensive experience in the treatment of ED, flexibility, ability to integrate with other team members even if they use different theoretical models, skills for group sessions, ability to handle negative emotions and frustration tolerance. Finally, the model presented below has been implemented, recovered patients whose stay in the disorder exceeded 15 years of development and led to permanent occupational disability.
    背景与目标: : 需要为厌食症或神经性贪食症患者找到有效的治疗方法,这导致了照顾他们的专业人员开发新的治疗方法,其中考虑了导致耐药性变化的变量。该研究中的患者 (2006-2009) 具有以下特征: 340具有7年或更长时间的进化和/或尝试了许多先前治疗而没有成功开始和/或维持期望的变化的患者,这使他们能够稳定地恢复。作为建议的治疗方法,患者治疗团队基于培训模型的原理。它从整体上考虑患者,告知并为他提供资源,以增加其对变革的承诺。教导患者在身体和精神上保持谨慎,以恢复健康并以稳定的方式离开疾病。包括家庭成员作为他们最亲近的恢复的基本支持。治疗师需要在治疗ED方面的丰富经验,灵活性,与其他团队成员整合的能力,即使他们使用不同的理论模型,小组会议的技能,处理负面情绪和挫折承受能力。最后,下面介绍的模型已经实施,康复的患者在疾病中的停留时间超过15年,并导致永久性职业残疾。
  • 【在一般实践中治疗抑郁症状和障碍的混合护理与常规护理 [混合]: 非劣效性随机试验的研究方案。】 复制标题 收藏 收藏
    DOI:10.1186/s12888-017-1376-1 复制DOI
    作者列表:Massoudi B,Blanker MH,van Valen E,Wouters H,Bockting CLH,Burger H
    BACKGROUND & AIMS: BACKGROUND:The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients' own GP or general practice mental health worker (MHW) in routine primary care is unknown. We aim to demonstrate non-inferiority of blended care compared with usual care in patients with depressive symptoms or a depressive disorder in general practice. Additionally, we will explore the real-time course over the day of emotions and affect, and events within individuals during treatment. METHODS:This is a pragmatic non-inferiority trial including 300 patients with depressive symptoms, recruited by collaborating GPs and MHWs. After inclusion, participants are randomized to either blended care or usual care in routine general practice. Blended care consists of the 'Act and Feel' treatment: an eight-week web-based program based on behavioral activation with integrated monitoring of depressive symptomatology and automatized feedback. GPs or their MHWs coach the participants through regular face-to-face or telephonic consultations with at least three sessions. Depressive symptomatology, health status, functional impairment, treatment satisfaction, daily activities and resource use are assessed during a follow-up period of 12 months. During treatment, real-time fluctuations in emotions and affect, and daily events will be rated using ecological momentary assessment. The primary outcome is the reduction of depressive symptoms from baseline to three months follow-up. We will conduct intention-to-treat analyses and supplementary per-protocol analyses. DISCUSSION:This trial will show whether blended care might be an appropriate treatment strategy for patients with depressive symptoms and depressive disorder in general practice. TRIAL REGISTRATION:Netherlands Trial Register: NTR4757; 25 August 2014. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4757 . (Archived by WebCite® at http://www.webcitation.org/6mnXNMGef ).
    背景与目标:
  • 【墨西哥传统医学中用于治疗胃肠道疾病的某些植物的解痉潜力。】 复制标题 收藏 收藏
    DOI:10.1016/S0944-7113(11)80049-8 复制DOI
    作者列表:Rojas A,Cruz S,Rauch V,Bye R,Linares E,Mata R
    BACKGROUND & AIMS: :The present investigation describes the effect on the isolated rat ileum of methanolic extracts derived from Conyza filaginoides (D. C.) Hieron (Asteraceae), Croton fragilis HBK. (Euphorbiaceae), Dodonaea viscosa Jacq. (Sapindaceae), Gymnosperma glutinosum (Spreng) Less. (Asteraceae), Parthenium tomentosum DC. var. stramonium (Greene) Rollins (Asteraceae), Potentilla thurberi A. Gray (Rosaceae), Pterogonum atrorubens (Englem.) H. Gross (Polygonaceae), Zornia venosa Mohlenbr. (Fabaceae) and Datura lanosa Barclay ex Bye (Solanaceae). In all the cases the extracts inhibited, in a concentration-dependent manner, the spontaneous contraction of the intestinal smooth muscle. The most active extract was that of D. viscosa. These findings tend to support the ethnomedical use of the selected species as spasmolytic agents in Mexican traditional medicine. Additionally, the potential antimicrobial activity of the extracts against pathogenic enterobacteria was investigated. Seven of the nine plants evaluated displayed antibacterial effects.
    背景与目标: : 本研究描述了源自Conyza filainoides (d.c.) 的甲醇提取物对分离的大鼠回肠的影响希龙 (菊科),巴豆脆弱。(大戟科),Dodonaea viscosa Jacq。(无患子科),裸子植物谷草 (Spreng) 较少。(菊科),多叶parthentosum DC。变种stramonium (Greene) Rollins (菊科),委陵菜thurberi A.灰色 (蔷薇科),Pterogonum atrorubens (Englem.) H. Gross (蓼科),Zornia venosa Mohlenbr。(豆科) 和曼陀罗·拉诺萨·巴克莱 (Solanaceae)。在所有情况下,提取物均以浓度依赖性方式抑制肠平滑肌的自发收缩。最具活性的提取物是粘多糖。这些发现倾向于支持所选物种在墨西哥传统医学中作为解痉剂的民族医学用途。此外,还研究了提取物对致病性肠杆菌的潜在抗菌活性。评估的9种植物中有7种具有抗菌作用。
  • 【印度三级护理中心的原发性免疫缺陷疾病综合报告。】 复制标题 收藏 收藏
    DOI:10.1007/s10875-012-9829-2 复制DOI
    作者列表:Madkaikar M,Mishra A,Desai M,Gupta M,Mhatre S,Ghosh K
    BACKGROUND & AIMS: OBJECTIVES:There is paucity of data on Primary immunodeficiency disorders (PID) from India. Here we describe the frequency of different primary immunodeficiency disorders, their clinical features and disease complications of 159 patients with PID diagnosed in a tertiary care center from India over the last 3 years. METHODS:We retrospectively reviewed the records of all the patients identified to have specific PID from 2008 to 2011. The diagnosed patients were classified according to guidelines of International Union of Immunological Society (IUIS) into eight different sub groups. RESULTS:The distribution pattern was as follows: diseases of immune dysregulation (29 %), phagocytic defects (29 %), predominant antibody deficiency (13 %), combined T and B cell deficiency (19 %) and other well defined diseases (10 %). CONCLUSION:The distribution pattern of PID varied significantly from those reported by western studies. This study highlights the need for development of more advanced facilities for diagnosis and management of PID in India and also the need for establishing population and hospital based registries.
    背景与目标:
  • 14 Integrative neuroimaging in mood disorders. 复制标题 收藏 收藏

    【情绪障碍的综合神经影像学。】 复制标题 收藏 收藏
    DOI:10.1097/YCO.0b013e32835a0b63 复制DOI
    作者列表:Keedwell PA,Linden DE
    BACKGROUND & AIMS: PURPOSE OF REVIEW:Neuroimaging has become a central technique of biological psychiatry and is uniquely suited to assess functional and structural brain changes in psychiatric patients in vivo. In this review, we highlight several recent developments that may enable the transition of psychiatric neuroimaging from laboratory to clinic. RECENT FINDINGS:We describe recent trends in refining imaging techniques for brain microstructure (diffusion imaging) and neurochemistry (magnetic resonance spectroscopy of neurotransmitters and metabolites) and their application to patients with mood disorders and individuals at risk, such as first-degree relatives. We also survey recent progress in imaging-guided deep brain stimulation (DBS), imaging-based (neurofeedback) therapies and studies looking at their convergent anatomical targets. These new interventional techniques, which aim to modulate brain circuits of emotion and motivation highlighted by functional imaging studies, have shown promising effects in several small studies. SUMMARY:The mapping of brain patterns associated with risk to develop mood disorders may pave the way for diagnostic/prognostic applications of neuroimaging. The neuromodulation techniques of DBS and neurofeedback, which target dysfunctional or compensatory circuits identified by functional imaging, may take neuroimaging into a new, therapeutic domain.
    背景与目标:
  • 【轴突运输和轴突运输障碍的遗传学。】 复制标题 收藏 收藏
    DOI:10.1371/journal.pgen.0020124 复制DOI
    作者列表:Duncan JE,Goldstein LS
    BACKGROUND & AIMS: :Neurons are specialized cells with a complex architecture that includes elaborate dendritic branches and a long, narrow axon that extends from the cell body to the synaptic terminal. The organized transport of essential biological materials throughout the neuron is required to support its growth, function, and viability. In this review, we focus on insights that have emerged from the genetic analysis of long-distance axonal transport between the cell body and the synaptic terminal. We also discuss recent genetic evidence that supports the hypothesis that disruptions in axonal transport may cause or dramatically contribute to neurodegenerative diseases.
    背景与目标: 神经元是特殊的细胞,具有复杂的结构,包括精心制作的树突分支和从细胞体延伸到突触末端的狭长轴突。需要在整个神经元中组织基本生物材料的运输,以支持其生长,功能和生存能力。在这篇综述中,我们专注于从细胞体和突触末端之间的长距离轴突运输的遗传分析中获得的见解。我们还讨论了最近的遗传证据,这些证据支持以下假设: 轴突运输的中断可能导致或极大地促进神经退行性疾病。

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