scholarly journals Decoding the Mechanism of Action of Rapid-Acting Antidepressant Treatment Strategies: Does Gender Matter?

2019 ◽  
Vol 20 (4) ◽  
pp. 949 ◽  
Author(s):  
David Herzog ◽  
Gregers Wegener ◽  
Klaus Lieb ◽  
Marianne Müller ◽  
Giulia Treccani
Keyword(s):  
Depressive Disorders ◽  
Treatment Guidelines ◽  
Antidepressant Treatment ◽  
Animal Experiments ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Specific Effects ◽  
Precise Understanding ◽  
Developed Nations ◽  
Gender Specific

Gender differences play a pivotal role in the pathophysiology and treatment of major depressive disorder. This is strongly supported by a mean 2:1 female-male ratio of depression consistently observed throughout studies in developed nations. Considering the urgent need to tailor individualized treatment strategies to fight depression more efficiently, a more precise understanding of gender-specific aspects in the pathophysiology and treatment of depressive disorders is fundamental. However, current treatment guidelines almost entirely neglect gender as a potentially relevant factor. Similarly, the vast majority of animal experiments analysing antidepressant treatment in rodent models exclusively uses male animals and does not consider gender-specific effects. Based on the growing interest in innovative and rapid-acting treatment approaches in depression, such as the administration of ketamine, its metabolites or electroconvulsive therapy, this review article summarizes the evidence supporting the importance of gender in modulating response to rapid acting antidepressant treatment. We provide an overview on the current state of knowledge and propose a framework for rodent experiments to ultimately decode gender-dependent differences in molecular and behavioural mechanisms involved in shaping treatment response.

Treatment of interictal psychiatric disorder in epilepsy. II. Chronic psychosis

2002 ◽  
Vol 14 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Cm van der Feltz-Cornelis
Keyword(s):  
Treatment Guidelines ◽  
Antidepressant Treatment ◽  
Treatment Strategies ◽  
Mood Stabilizers ◽  
Psychotic Symptoms ◽  
Systematic Research ◽  
Comorbid Condition ◽  
General Psychiatry ◽  
Patients With Epilepsy ◽  
Chronic Psychosis

Background:Interictal psychosis is a serious comorbid condition in epilepsy patients that would benefit from treatment with psychotropic medication.Objective:This paper gives an overview of the pathophysiology, symptomatology and treatment of the schizophrenia-like psychosis of epilepsy. Use of the term ‘interictal chronic psychosis’ is suggested, to conform to current DSM-IV classification of schizophrenia.Methods:Literature review supplemented by clinical experience. There is a lack of randomized control trials (RCTs) concerning effectiveness and side-effects of neuroleptics in epilepsy patients.Results:Hypotheses concerning the pathophysiology of the interictal chronic psychosis are discussed. The concept of forced normalization and alternative psychosis is based on case descriptions, and was not substantiated by systematic research. The kindling hypothesis seems promising, but was never confirmed in humans. A third theory, supported by some studies, suggests that inhibitory cerebral mechanisms enhance psychotic symptoms in epilepsy patients. Treatment strategies are based on case studies and open studies by lack of RCTs. Treatment should consider the optimalization of the dosage of antiepileptics in combination with one or two antidepressants, mood stabilizers and/or atypical neuroleptics. Surgery plays no significant role in the treatment of treatment-refractive epilepsy with interictal chronic psychotic symptoms.Conclusion:There is a prominent role of antidepressant or double antidepressant treatment strategies in patients with epilepsy and interictal chronic psychosis compared with treatment guidelines of chronic psychotic patients in general psychiatry.

Correlations Between Neuroendocrine Disorders and Biochemical Brain Metabolites Alterations in Antidepressant Treatment

2018 ◽  
Vol 69 (3) ◽  
pp. 621-626
Author(s):  
Luminita Ageu ◽  
Cristina Talpos ◽  
Ghizela Kanalas ◽  
Simina Crisan ◽  
Carmen Lacramioara Zamfir ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Mr Spectroscopy ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Treatment Strategies ◽  
Antidepressant Medication ◽  
Brain Metabolites ◽  
Gamma Aminobutyric Acid ◽  
Pharmacogenetic Testing

We approach the theme of modern investigation and treatment strategies, based on biochemical, clinical-biological, metabolic, pharmacogenetic, neuro-imagistic, and neuroendocrine integrative correlations in the management of depressive disorders. Our main objective was to investigate: the biochemical brain metabolites [N-acetyl-aspartate (NAA), gamma-aminobutyric acid (GABA), aspartate (Asp), creatine (CR), glutamine (Gln), glicerophosphocholine (GPC), phosphocholine (PC), phosphocreatine (PCr), taurine (Tau), N-methyl-D-aspartate (N-MDA), serine, glycine, choline (Cho)]; the neuroimagistic and neurobiological markers and the metabolic abnormalities in correlation with the molecular pharmacogenetic testing in children and adolescents treated with antidepressant medication. Our research was conducted between 2009-2016 on 90 children and adolescents with depressive disorders -45 children-G1, who benefited of pharmacogenetic testing tailored pharmacotherapy, and 45 without pharmacogenetic testing-G2. The patients were also evaluated by MR spectroscopy at baseline and after pharmacotherapy. The efficacy of the chosen therapy in correlation with the pharmacogenetic testing was evaluated by the mean change in the CDRS (Child Depression Rating Scale) total scores, in the CGI-S/I (Clinical Global Impression Severity/Improvement), CGAS (Clinical Global Assessment of Functioning) and by the change of the relevant neurobiological markers and MR spectroscopy biochemical brain metabolites. Our results showed statistically significant differences in the clinical scores between the studied groups. Our research could represent a proof that the biochemical brain metabolites registered in depressive disorders modified values in the MR spectroscopy and the administration of antidepressants could determine metabolic and neuroendocrine abnormalities (changed lipid profiles, high insulin and plasma glucose levels, weight gain, obesity), especially when chosen without prior pharmacogenetic testing.

scholarly journals Alternative Strategies in the Treatment of Clostridioides difficile Infection

2021 ◽  
pp. 38-45
Author(s):  
Ryan Goon Hon Au
Keyword(s):  
Treatment Guidelines ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Incidence Rates ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Resistant Strains ◽  
Antibiotic Agents

Clostridioides difficile (C. diff.) is a leading cause of nosocomial infections worldwide and is a major challenge to public health. Widespread use of antibiotic agents have caused increasing incidence rates of C. diff. infections and the emergence of antibiotic-resistant strains of the potentially-deadly bacteria. The current treatment guidelines include the use of various antibiotics, which further contributes to the problem of antibiotic resistance. There is an urgent need for novel treatment methods in order to halt the emergence of even more antibiotic-resistant bacteria. This review discusses the pathogenesis of C. diff. infections, current treatment strategies, and possible alternative treatment strategies based on breakthrough scientific research.

Management of APL in Developing Countries: Epidemiology, Challenges and Opportunities for International Collaboration

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 162-168 ◽  
Author(s):  
Raul C. Ribeiro ◽  
Eduardo Rego
Keyword(s):  
Developing Countries ◽  
Latin American ◽  
Treatment Guidelines ◽  
Clinical Investigation ◽  
Hematologic Malignancy ◽  
Treatment Strategies ◽  
Population Based ◽  
Current Treatment ◽  
International Committee ◽  
Outcome Data

Abstract Acute promyelocytic leukemia (APL), a relatively rare hematologic malignancy, is highly curable with current treatment strategies. However, these strategies may be unavailable in countries with limited resources. A review of records in several Latin American countries revealed that approximately 30% of deaths among children and adults with APL were caused by early complications associated with the disease or its treatment. Further, APL accounts for 20% to 25% of cases of AML in these countries, consistent with the previous observation of increased incidence of APL in Latin Americans. The lack of population-based registries in developing countries has made it difficult to determine the real incidence of APL. Moreover, APL appears to have other unique epidemiologic characteristics, including association of primary APL with an increased body mass index at diagnosis and association of secondary APL with breast cancer. To facilitate the development of local capacity and implement effective treatment of APL in developing countries, the International Committee of the American Society of Hematology has assembled a working group to formulate treatment guidelines based on evidence from clinical trials results in the developed world but adapted to local resources. It is hoped that uniform treatment, careful documentation of specific outcome data, and ongoing monitoring of treatment efficacy and toxicity will improve the cure rate and provide biologic and epidemiologic information about APL in developing countries. This initial demonstration project may be joined by other countries, providing a framework for additional clinical investigation in this highly curable form of leukemia.

Current concepts of the interventional treatment of proximal supraaortic vessel stenosis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 313-318 ◽  
Author(s):  
Ernemann ◽  
Bender ◽  
Melms ◽  
Brechtel ◽  
Kobba ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Carotid Bifurcation ◽  
Current Treatment ◽  
Long Term Results ◽  
Clinical Indication ◽  
Interventional Treatment ◽  
Special Focus ◽  
Brachiocephalic Artery ◽  
Treatment Concepts ◽  
Angioplasty And Stenting

Interventional therapies using angioplasty and stenting of symptomatic stenosis of the proximal supraaortic vessels have evolved as safe and effective treatment strategies. The aim of this paper is to summarize the current treatment concepts for stenosis in the subclavian and brachiocephalic artery with regard to clinical indication, interventional technique including selection of the appropriate vascular approach and type of stent, angiographic and clinical short-term and long-term results and follow-up. The role of hybrid interventions for tandem stenoses of the carotid bifurcation and brachiocephalic artery is analysed. A systematic review of data for angioplasty and stenting of symptomatic extracranial vertebral artery stenosis is discussed with a special focus on restenosis rate.

312-OR: Gender-Specific Effects on Hepatic Fat Metabolism in Type 2 Diabetes before and after Remission

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 312-OR
Author(s):  
AHMAD AL-MRABEH ◽  
SHADEN MELHEM ◽  
SVIATLANA V. ZHYZHNEUSKAYA ◽  
CARL PETERS ◽  
ALISON C. BARNES ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fat Metabolism ◽  
Specific Effects ◽  
Before And After ◽  
Hepatic Fat ◽  
Gender Specific

Treatment of Anderson-Fabry Disease

2020 ◽  
Vol 26 (40) ◽  
pp. 5089-5099 ◽  
Author(s):  
Irene Simonetta ◽  
Antonino Tuttolomondo ◽  
Mario Daidone ◽  
Salvatore Miceli ◽  
Antonio Pinto
Keyword(s):  
Fabry Disease ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Viral Gene ◽  
Pharmacological Chaperone ◽  
Enzyme Replacement ◽  
Cell Based Therapy ◽  
Organ Manifestations ◽  
Alpha Galactosidase

: Fabry disease is an X-linked disorder of glycosphingolipid metabolism that results in progressive accumulation of neutral glycosphingolipids, predominantly globotriaosylsphingosine (Gb3) in lysosomes, as well as other cellular compartments of several tissues, causing multi-organ manifestations (acroparesthesias, hypohidrosis, angiokeratomas, signs and symptoms of cardiac, renal, cerebrovascular involvement). Pathogenic mutations lead to a deficiency of the lysosomal enzyme alpha-galactosidase A (GLA). In the presence of high clinical suspicion, a careful physical examination and specific laboratory tests are required. Finally, the diagnosis of Fabry’s disease is confirmed by the demonstration of the absence of or reduced alpha-galactosidase A enzyme activity in hemizygous men and gene typing in heterozygous females. Measurement of the biomarkers Gb3 and Lyso Gb3 in biological specimens may facilitate diagnosis. The current treatment of Anderson-Fabry disease is represented by enzyme replacement therapy (ERT) and oral pharmacological chaperone. Future treatments are based on new strategic approaches such as stem cell-based therapy, pharmacological approaches chaperones, mRNA therapy, and viral gene therapy. : This review outlines the current therapeutic approaches and emerging treatment strategies for Anderson-Fabry disease.

scholarly journals The Meniscus in Normal and Osteoarthritic Tissues: Facing the Structure Property Challenges and Current Treatment Trends

2019 ◽  
Vol 21 (1) ◽  
pp. 495-521 ◽  
Author(s):  
Caroline A. Murphy ◽  
Atul K. Garg ◽  
Joana Silva-Correia ◽  
Rui L. Reis ◽  
Joaquim M. Oliveira ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Biological Function ◽  
Treatment Strategies ◽  
Meniscal Repair ◽  
Current Treatment ◽  
Structure Property ◽  
Biological Structure ◽  
Treatment Techniques ◽  
Treatment Trends ◽  
Meniscus Injuries

The treatment of meniscus injuries has recently been facing a paradigm shift toward the field of tissue engineering, with the aim of regenerating damaged and diseased menisci as opposed to current treatment techniques. This review focuses on the structure and mechanics associated with the meniscus. The meniscus is defined in terms of its biological structure and composition. Biomechanics of the meniscus are discussed in detail, as an understanding of the mechanics is fundamental for the development of new meniscal treatment strategies. Key meniscal characteristics such as biological function, damage (tears), and disease are critically analyzed. The latest technologies behind meniscal repair and regeneration are assessed.

scholarly journals Dermatillomania: Strategies for Developing Protective Biomaterials/Cloth

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 341
Author(s):  
Priusha Ravipati ◽  
Bice Conti ◽  
Enrica Chiesa ◽  
Karine Andrieux
Keyword(s):  
Alternative Treatment ◽  
Negative Impact ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Primary Objective ◽  
Neuropsychiatric Disorder ◽  
Physical Barrier ◽  
Physical Treatment ◽  
Pubmed Database ◽  
Prevention Of Infections

Dermatillomania or skin picking disorder (SPD) is a chronic, recurrent, and treatment resistant neuropsychiatric disorder with an underestimated prevalence that has a concerning negative impact on an individual’s health and quality of life. The current treatment strategies focus on behavioral and pharmacological therapies that are not very effective. Thus, the primary objective of this review is to provide an introduction to SPD and discuss its current treatment strategies as well as to propose biomaterial-based physical barrier strategies as a supporting or alternative treatment. To this end, searches were conducted within the PubMed database and Google Scholar, and the results obtained were organized and presented as per the following categories: prevalence, etiology, consequences, diagnostic criteria, and treatment strategies. Furthermore, special attention was provided to alternative treatment strategies and biomaterial-based physical treatment strategies. A total of six products with the potential to be applied as physical barrier strategies in supporting SPD treatment were shortlisted and discussed. The results indicated that SPD is a complex, underestimated, and underemphasized neuropsychiatric disorder that needs heightened attention, especially with regard to its treatment and care. Moreover, the high synergistic potential of biomaterials and nanosystems in this area remains to be explored. Certain strategies that are already being utilized for wound healing can also be further exploited, particularly as far as the prevention of infections is concerned.

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