Treating Schizophrenia Without Drugs? There's Good Evidence for It

2010 ◽  
Author(s):  
Brent Robbins
Keyword(s):  
Good Evidence

Male Osteoporosis

2013 ◽  
Vol 22 (04) ◽  
pp. 260-266 ◽  
Author(s):  
S. P. Tuck ◽  
R. M. Francis ◽  
B. C. Hanusch
Keyword(s):  
Prostate Cancer ◽  
Older Men ◽  
Good Evidence ◽  
Male Osteoporosis ◽  
Fracture Rate ◽  
Common Cause ◽  
Increased Risk ◽  
Osteoporosis In Men ◽  
Considerable Morbidity ◽  
Secondary Causes

SummaryMale osteoporosis is common and results in considerable morbidity and mortality. There are distinct differences in the normal aging of bone between the genders, which result in a lower fracture rate in men. Men who suffer from osteoporosis are much more likely than women to have secondary causes. The identification and treatment of these secondary causes, wherever possible, will result in substantial improvements in BMD. There is now evidence for use of many of the existing agents to treat osteoporosis in men. In younger hypogonadal men testosterone replacement is worth considering, but in older men especially the over sixties this is less effective and there is an increased risk of adverse cardiovascular and prostatic outcomes. Prostate cancer is an increasingly common cause, which is partially the result of the success of ADT. There is now good evidence for the use of bisphosphonates and denosumab in this group of patients. HIV, whilst not being specific to men, is an increasingly recognised cause of male osteoporosis. The reasons for this are multifactorial and some may well be attributable to the anti-retroviral therapy itself. There is emerging evidence of an increased fracture risk in HIV infected individuals. The bone loss can be prevented by the use of bisphosphonates.

Isn't it eyeronic? Little evidence for consistent eye colour choices across relationships

2018 ◽  
Author(s):  
Amy Victoria Newman ◽  
Thomas V. Pollet ◽  
Kristofor McCarty ◽  
Nick Neave ◽  
Tamsin Saxton
Keyword(s):  
Good Evidence ◽  
Random Permutations ◽  
Three Samples ◽  
Eye Colour ◽  
A Priority

This study examined the anecdotal notion that people choose partners based on preferred characteristics that constitute their ‘type’. We gathered the eye colours of participants’ partners across their entire romantic history in three samples (student-centred, adult, and celebrity). We calculated the proportion of partners’ eye colours, and compared that to 100,000 random permutations of our observed dataset using t-tests. This was to investigate if the eye colour choices in the original datasets had greater consistency than in the permutations. Across all samples, we observed no good evidence that individuals make consistent eye colour choices, suggesting that eye colour may not be a priority when choosing a partner.

Non-Traditional Cardiovascular Risk Markers in the Era of Established Major Risk Factors and Multiple Guidelines

2019 ◽  
Vol 17 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Thomas F. Whayne
Keyword(s):  
Risk Factors ◽  
Interleukin 1 ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Arterial Disease ◽  
Good Evidence ◽  
Ldl Particles ◽  
Cv Disease ◽  
Peripheral Arterial

The non-traditional cardiovascular (CV) risk factors that appear to be of most clinical interest include: apolipoprotein A (ApoA), apolipoprotein B (ApoB), high-sensitivity C-Reactive protein (hsCRP), homocysteine, interleukin 1 (IL1), lipoprotein (a) [Lp(a)], the density of low-density lipoprotein (LDL) particles, the LDL particle number, tissue/tumor necrosis factor-α (TNF-α) and uric acid. These non-traditional risk factors may be of value in adding further confirmation and attention to suspected significant CV risk. They can also provide a better understanding of current concepts of atherogenesis (e.g. various potential mechanisms associated with inflammation) as an etiology and in guiding current plus future therapies. In the mid-20th century, atherosclerosis and CV disease were considered mechanistic occurrences with essentially no attention to possible metabolic and molecular etiologies. Therefore, the only treatments then centered around mainly surgical procedures to try to improve blood flow, first with peripheral arterial disease (PAD) and later coronary artery disease (CAD). Now, failure to treat CV risk factors, especially where there is good evidence-based medicine, as in the case of statins for high CV risk patients, is considered medical negligence. Nevertheless, many problems remain to be solved regarding atherosclerosis prevention and treatment.

Evidence-Based Treatment for the Eating Disorders

2010 ◽  
pp. 451-451
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

Evidence-Based Treatment for the Eating Disorders

2012 ◽  
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

scholarly journals PINDAR, OLYMPIAN 2.5–7, TEXT AND COMMENTARY—WITH EXCURSIONS TO ‘PERICTIONE’, EMPEDOCLES AND EURIPIDES’ HIPPOLYTUS

2020 ◽  
Vol 70 (2) ◽  
pp. 499-517
Author(s):  
M.S. Silk
Keyword(s):  
Present Article ◽  
Good Evidence ◽  
Fifth Century ◽  
Divine Retribution ◽  
As If

In 1998, I suggested a new text for a notably corrupt passage in Pindar's Isthmian 5. This article is in effect a sequel to that earlier discussion. In the 1998 article, I proposed, inter alia, that the modern vulgate text of I. 5.58, ἐλπίδων ἔκνισ’ ὄπιν, is indefensible and the product of scribal corruption in antiquity, and that chief among the indefensible products of corruption there is the supposed secular use of ὄπις, as if used to mean something like ‘zeal’. This (as I hope to have demonstrated) is a sense for which there is no good evidence in classical Greek, where ὄπις always has a delimited religious denotation, meaning either (a) ‘gods’ response’, ‘divine retribution’, or else (b) ‘religious awe’ or ‘reverence’ towards the gods, through fear of that response or that retribution. If we discount I. 5.58 itself (and likewise the focus of the present article, O. 2.6), all the pre-Hellenistic attestations can be straightforwardly listed under these headings: (a) Il. 16.388 θεῶν ὄπιν οὐκ ἀλέγοντες, Od. 14.88 ὄπιδος κρατερὸν δέος, Hes. Theog. 221–2 θεαὶ . . . | . . . ἀπὸ τῷ δώωσι κακὴν ὄπιν, Pind. P. 8.71–2 θεῶν δ’ ὄπιν | ἄφθονον αἰτέω, sim. Od. 20.215, 21.28, Hes. Op. 187, 251, 706, along with, seemingly, a fragmentary fifth-century Thessalian verse inscription, CEG 1.120.1 Hansen; (b) Hdt. 9.76.2 θεῶν ὄπιν ἔχοντας, 8.143.2. In addition, one other instance can be interpreted as either (a) or (b), or in effect both: Od. 14.82 (of the suitors) οὐκ ὄπιδα φρονέοντες . . . οὐδ’ ἐλεητύν. In all cases, though, ‘gods’ are specified, usually as a dependent genitive with ὄπις, or else separately but in the near context. Hellenistic and later occurrences of the word are few, and (as I argued in 1998) hints there of a secular reading can actually be taken to reflect misunderstandings based on, precisely, the early corruption in I. 5.

scholarly journals Contraindications to the Initiation of Veno-Venous ECMO for Severe Acute Respiratory Failure in Adults: A Systematic Review and Practical Approach Based on the Current Literature

Membranes ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 584
Author(s):  
Lars-Olav Harnisch ◽  
Onnen Moerer
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Right Heart Failure ◽  
Lung Parenchyma ◽  
Good Evidence ◽  
Difficult Time ◽  
Cerebral Herniation ◽  
Saps Ii Score ◽  
Ecmo Treatment

(1) Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used for acute respiratory failure with few absolute but many relative contraindications. The provider in charge often has a difficult time weighing indications and contraindications to anticipate if the patient will benefit from this treatment, a decision that often decides life and death for the patient. To assist in this process in coming to a good evidence-based decision, we reviewed the available literature. (2) Methods: We performed a systematic review through a literature search of the MEDLINE database of former and current absolute and relative contraindications to the initiation of ECMO treatment. (3) Results: The following relative and absolute contraindications were identified in the literature: absolute—refusal of the use of extracorporeal techniques by the patient, advanced stage of cancer, fatal intracerebral hemorrhage/cerebral herniation/intractable intracranial hypertension, irreversible destruction of the lung parenchyma without the possibility of transplantation, and contraindications to lung transplantation; relative—advanced age, immunosuppressed patients/pharmacological immunosuppression, injurious ventilator settings > 7 days, right-heart failure, hematologic malignancies, especially bone marrow transplantation and graft-versus-host disease, SAPS II score ≥ 60 points, SOFA score > 12 points, PRESERVE score ≥ 5 points, RESP score ≤ −2 points, PRESET score ≥ 6 points, and “do not attempt resuscitation” order (DN(A)R status). (4) Conclusions: We provide a simple-to-follow algorithm that incorporates absolute and relative contraindications to the initiation of ECMO treatment. This algorithm attempts to weigh pros and cons regarding the benefit for an individual patient and hopefully assists caregivers to make better, informed decisions.

Possible Biological Advantages among Schizophrenics' Relatives

1971 ◽  
Vol 118 (545) ◽  
pp. 453-460 ◽  
Author(s):  
Michael Carter ◽  
C. A. H. Watts
Keyword(s):  
Medical Research ◽  
Research Council ◽  
Genetic Factors ◽  
Annual Report ◽  
Medical Research Council ◽  
Good Evidence ◽  
Fraternal Twin

There is good evidence that genetic factors are necessary, though by no means sufficient, for the development of schizophrenia. Several studies have compared the incidence of schizophrenia in identical and in fraternal twin pairs: these studies are discussed, for example, in the Medical Research Council Annual Report 1965–66 (pp. 54–61), where Essen-Möller's (1963) cumulative figures are quoted: Identical (MZ) pairs: 69 per cent concordant for schizophrenia (both schizophrenic) (194/280 pairs). Fraternal (DZ) pairs: 13 per cent concordant for schizophrenia (both schizophrenic) (59/448 pairs).

scholarly journals Steroid Sulphatase and Its Inhibitors: Past, Present and Future

Molecules ◽  
2021 ◽  
Vol 26 (10) ◽  
pp. 2852
Author(s):  
Paul A. Foster
Keyword(s):  
Good Evidence ◽  
The Past ◽  
Steroid Sulphatase ◽  
University Of Oxford ◽  
Therapeutic Value ◽  
Breast And Prostate Cancer ◽  
The University ◽  
Further Development ◽  
Hydrolysis Of

Steroid sulphatase (STS), involved in the hydrolysis of steroid sulphates, plays an important role in the formation of both active oestrogens and androgens. Since these steroids significantly impact the proliferation of both oestrogen- and androgen-dependent cancers, many research groups over the past 30 years have designed and developed STS inhibitors. One of the main contributors to this field has been Prof. Barry Potter, previously at the University of Bath and now at the University of Oxford. Upon Prof. Potter’s imminent retirement, this review takes a look back at the work on STS inhibitors and their contribution to our understanding of sulphate biology and as potential therapeutic agents in hormone-dependent disease. A number of potent STS inhibitors have now been developed, one of which, Irosustat (STX64, 667Coumate, BN83495), remains the only one to have completed phase I/II clinical trials against numerous indications (breast, prostate, endometrial). These studies have provided new insights into the origins of androgens and oestrogens in women and men. In addition to the therapeutic role of STS inhibition in breast and prostate cancer, there is now good evidence to suggest they may also provide benefits in patients with colorectal and ovarian cancer, and in treating endometriosis. To explore the potential of STS inhibitors further, a number of second- and third-generation inhibitors have been developed, together with single molecules that possess aromatase–STS inhibitory properties. The further development of potent STS inhibitors will allow their potential therapeutic value to be explored in a variety of hormone-dependent cancers and possibly other non-oncological conditions.

scholarly journals Predictive Value of Rotterdam Score and Marshall Score in Traumatic Brain Injury: A Contemporary Review

2021 ◽  
Author(s):  
Rakesh Mishra ◽  
Harold Enrique Vasquez Ucros ◽  
William Andres Florez-Perdomo ◽  
José Rojas Suarez ◽  
Luis Rafael Moscote-Salazar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Meta Analysis ◽  
Poor Performance ◽  
Scoring Systems ◽  
Good Evidence ◽  
Medical Subject Headings ◽  
Comparative Review ◽  
Marshall Score ◽  
Ct Classification

AbstractThis article conducts a contemporary comparative review of the medical literature to update and establish evidence as to which framework among Rotterdam and Marshall computed tomography (CT)-based scoring systems predicts traumatic brain injury (TBI) outcomes better. The scheme followed was following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for literature search. The search started on August 15, 2020 and ended on December 31, 2020. The combination terms used were Medical Subject Headings terms, combination keywords, and specific words used for describing various pathologies of TBI to identify the most relevant article in each database. PICO question to guide the search strategy was: “what is the use of Marshall (I) versus Rotterdam score (C) in TBI patients (P) for mortality risk stratification (O).” The review is based on 46 references which included a full review of 14 articles for adult TBI patients and 6 articles for pediatric TBI articles comparing Rotterdam and Marshall CT scores. The review includes 8,243 patients, of which 2,365 were pediatric and 5,878 were adult TBI patients. Marshall CT classification is not ordinal, is more descriptive, has better inter-rater reliability, and poor performance in a specific group of TBI patients requiring decompressive craniectomy. Rotterdam CT classification is ordinal, has better discriminatory power, and a better description of the dynamics of intracranial changes. The two scoring systems are complimentary. A combination of clinical parameters, severity, ischemic and hemodynamic parameters, and CT scoring system could predict the prognosis of TBI patients with significant accuracy. None of the classifications has good evidence for use in pediatric patients.

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