bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survey of Atypical Antipsychotic Medication Use by Child and Adolescent Psychiatrists
Authors: Sivaprasad Leela , Hassan Tariq , Handy Sumi 
Published: May 2006

Background:  Atypical antipsychotics could be replacing traditional antipsychotics in the treatment of childhood disorders.Method:  A postal survey was conducted of Child Psychiatrists in a region of the United Kingdom to evaluate their use of atypical antipsychotics for psychotic and non‐psychotic conditions.Results:  97% of respondents reported prescribing atypical antipsychotics and at least 65% did so for non‐psychotic indications although several concerns were raised. Differences in prescribing and monitoring practices between Community and Specialist services were noted.Conclusions:  Atypical antipsychotics appear to play a significant role in current child psychiatry practice. Further discussions and research needs to occur about their use and guidelines produced.
A Clinical Trial of Trimethobenzamide/Diphenhydramine Versus Sumatriptan for Acute Migraines
Authors: Friedman Benjamin W. , Hochberg Michael , Esses David , Bijur Polly E. , Corbo Jill , Paternoster Joseph , Solorzano Clemencia , Toosi Babak , Lipton Richard B. , Gallagher E. John 
Published: May 2006

Background.—Although various classes of medication are used to treat acute migraine in the emergency department (ED), no treatment offers complete pain relief without side effects or recurrence of headache. Consequently, even though several antiemetic medications as well as SQ sumatriptan have demonstrated efficacy and tolerability for the ED treatment of migraine, there remains a need for more effective parenteral therapies. Open‐label studies suggest that the combination of trimethobenzamide and diphenhydramine (TMB/DPH) may provide effective relief in a high proportion of migraineurs.Objective.—To test the hypothesis that ED patients with acute migraine, given intramuscular TMB/DPH, would have a larger reduction in their pain scores than patients given SQ sumatriptan.Methods.—This was an ED‐based, randomized, double‐blind, “double‐dummy” clinical trial comparing 2 parenteral treatments for acute migraine headaches. Subjects received a combination of TMB 200 mg and DPH 25 mg as a single intramuscular injection or 6 mg of SQ sumatriptan. Pain scores, disability scores, associated symptoms, and adverse effects were assessed for 2 hours in the ED and by telephone 24 hours after medication administration. The primary outcome was the between‐group difference in reduction of pain intensity as measured by a validated numerical rating scale 2 hours after medication administration. This study was designed to detect superiority of TMB/DPH; therefore, a 1‐tailed t‐test was used. An interim analysis was planned to terminate the trial if predetermined endpoints in the primary outcome variable were reached.Results.—The trial was stopped by the data monitoring committee after 40 subjects were enrolled because a substantial benefit in the primary outcome was found favoring sumatriptan. Baseline pain scores were comparable between the 2 groups. By 2 hours, sumatriptan subjects had improved by a mean of 6.1 and the TMB/DPH subjects had improved by a mean of 4.4 (95% CI for difference of 1.7: −0.1 to 3.4). By 24 hours after medication administration, sumatriptan subjects had a mean improvement from baseline of 4.9 as compared to 5.3 for TMB (95% CI for difference of −0.4: −2.4 to 1.6). The need for rescue medication was comparable between the groups. No serious or frequent adverse effects were noted in either group.Conclusions.—SQ sumatriptan is probably superior to TMB/DPH for treating the pain of acute migraine at 2 hours. However, TMB/DPH was well‐tolerated, efficacious, and relieved pain comparably to sumatriptan at 24 hours. TMB/DPH might have a role in select populations in which sumatriptan is contraindicated or likely to be ineffective.
The Prevalence and Impact of Migraine Headache in Bipolar Disorder: Results From the Canadian Community Health Survey
Authors: McIntyre Roger S. , Konarski Jakub Z. , Wilkins Kathryn , Bouffard Beverley , Soczynska Joanna K. , Kennedy Sidney H. 
Published: May 2006

Objective.—To report on the prevalence of comorbid migraine in bipolar disorder and the implications for bipolar age of onset, psychiatric comorbidity, illness course, functional outcome, and medical service utilization.Background.—Migraine comorbidity is differentially reported in bipolar versus unipolar depressed clinical samples. The bipolar disorder‐migraine association and its consequences have been infrequently reported in epidemiological studies.Methods.—Data for this analysis were derived from respondents (n = 36 984) to the Canadian Community Health Survey – Mental Health and Well‐Being (CCHS). Respondents reporting a lifetime WHO‐CIDI‐defined manic episode and physician‐diagnosed migraine (lifetime) were compared to respondents without migraine on sociodemography, course of illness, and medical service utilization indices.Results.—An estimated 2.4% of the sample met criteria for bipolar disorder. Persons with bipolar disorder had a relatively higher prevalence of migraine versus the general population (24.8% vs. 10.3%;P< .05). The sex‐specific prevalence of comorbid migraine in bipolar disorder was 14.9% for males and 34.7% for females. Bipolar males with comorbid migraine were more likely to live in a low income household (P< .05); receive welfare and social assistance (P< .05); report an earlier age of onset of bipolar disorder (P< .05); and have a higher lifetime prevalence of comorbid anxiety disorders (P< .05). Bipolar males with comorbid migraine were also more likely to utilize primary (P< .05) and mental health care services (P< .05) . Bipolar females with comorbid migraine had more comorbid medical disorders (P< .05) and were more likely to require help with personal or instrumental activities of daily living when compared to bipolar females without migraine.Conclusion.—Bipolar disorder with comorbid migraine is prevalent and associated with greater dysfunction and medical service utilization, notable in males. Opportunistic screening and surveillance for bipolar and comorbid migraine is warranted.
Tremor in Patients With Migraine
Authors: Duval Christian , Norton Loretta 
Published: May 2006

Background.—It has been suggested that patients with migraine are at a higher risk of developing essential tremor (ET). In addition, it was shown that patients with migraine are at higher risk of subclinical vascular infarcts in the cerebellum, a structure believed to be implicated in ET.Objective.—Determine whether patients with migraine who do not show clinically detectable ET have subtle alteration in their physiological tremor characteristics that may serve as a predictor for the eventual appearance of ET.Methods.—The physiological tremor of 30 patients with migraine (25 women, mean age: 41 ± 8 years) was examined using a laser displacement sensor. Tremor was recorded in 5 conditions: hand‐rest, hand‐postural, finger‐rest, finger‐postural, and finger‐loading (70 g). We also recorded tremor in healthy controls who never experienced migraine. Amplitude, median power frequency, power dispersion (width of a frequency band containing 68% of the power), and power distribution within 3 predetermined frequency bands of interest (3.5 to 7.5, 7.5 to 12.5, and 16 to 30 Hz) were assessed in each condition.Results.—All tremor characteristics described above were very similar between the migraine group and controls. These results were supported by the lack of correlation between tremor characteristics and the number of years of experiencing migraine (ranging from 3 to 41 years; mean: 20 ± 10). Patients with aura (N = 21) had tremor characteristics similar to that of patients without aura (N = 9) and controls.Conclusion.—These results suggest that, if a link exists between migraine and ET, the latter might be the result of an “acute event” (eg, stroke) rather than a progressive alteration of tremorogenic mechanisms.
Cerebrospinal Profiling of Proteins, Lipids, Small Molecules, and Elements: Application to the Study of Migraine Pathophysiology
Authors: Harrington Michael G. 
Published: May 2006

Background and objectives.—The fundamental reason that the migraine phenotype is experienced by sufferers and not by the more fortunate populace is not known. We believe a common biochemical pathway is involved, and are attempting to reveal this by using an objective and broad survey of molecular composition, rather than the conventional hypothesis‐driven approaches that are narrowly focused and subjective.Methods.—This article discusses the application of CSF bioanalysis in a clinical sample and summarizes preliminary findings, which are described more fully in papers currently in press.Results.—In migraineurs during a migraine attack, compared with a migraine‐free period, changes have been documented in the concentrations of specific proteins, lipids, small molecules, and elements in the CSF. The degree to which these changes are specific to migraine remains to be determined.Conclusions.—As the CSF profiles for proteins, lipids, small molecules, and elements become better delineated in both healthy individuals and in disease states such as migraine, measurement of changes in CSF composition will provide the potential for improving diagnosis, correlating molecular events with symptoms, developing new therapeutic strategies, and enhancing the ability to monitor the results of therapy.
Release of potential immunomodulatory factors during platelet storage
Authors: Cognasse Fabrice , Boussoulade Françoise , Chavarin Patricia , Acquart Sophie , Fabrigli Patrick , Lamy Bernard , Garraud Olivier 
Published: May 2006

BACKGROUND:  Blood platelets (PLTs) link the processes of hemostasis and inflammation. Recent studies have demonstrated that PLTs promote immunity and inflammation mainly by means of the CD40/CD40L pathway. Our objective was to describe the accumulation of cytokines in PLT concentrates during storage.STUDY DESIGN AND METHODS:  Pools of PLT concentrates were prepared, separated from plasma, and resuspended in clinical‐grade storage medium; samples were taken on Days 0, 1, 2, 3, and 5 for analysis, without replacement (i.e., without soluble protein dilution). Interleukin (IL)‐6, IL‐8, PLT‐derived growth factor (PDGF)‐AA, soluble CD40 ligand (sCD40L), RANTES, and transforming growth factor‐β production were measured by specific enzyme‐linked immunosorbent assays.RESULTS:  Over time, the levels of RANTES, IL‐8, and IL‐6 were stable. In contrast, the levels of PDGF‐AA and sCD40L increased. Ex vivo production of sCD40L was quantified at levels sufficient to induce B‐cell effects based on previous studies of in vitro induced B‐cell activation and differentiation by sCD40L. Cytokine and/or chemokine levels were generally higher in PLT concentrate supernatants and/or PLT lysates in comparison to PLT‐free plasma, allowing the determination of which cytokine and/or chemokine was absorbed or secreted by transfusion‐grade PLTs over time.CONCLUSION:  Our data provide evidence that stored PLTs contain molecules with known immunomodulatory competence and secrete them differentially over time during storage for transfusion purposes.
Assessment of cord blood unit characteristics on the day of transplant: comparison with data issued by cord blood banks
Authors: Wagner Eric , Duval Michel , Dalle Jean‐Hugues , Morin Hugo , Bizier Sonia , Champagne Josette , Champagne Martin A. 
Published: May 2006

BACKGROUND:  Selection of a cord blood (CB) unit for allogeneic transplantation relies on graft characterization results provided by cord blood banks (CBBs). The goal was to compare the graft characterization results obtained upon thawing and washing to those provided by CBBs at selection.STUDY DESIGN AND METHODS:  With tests that assess CB graft characteristics known to impact engraftment, CB units have been analyzed after thaw and before infusion. Our results were compared to data provided by CBBs to determine the impact on engraftment and assess how CBB‐supplied information can affect future CB unit selection.RESULTS:  Variability was noted as to the type of information provided by the different CBBs. Also, variability was found between the information provided by CBBs and the graft characterization results obtained upon thawing and washing. In some cases, CB measures known to be predictive of engraftment were found much lower than reported by CBBs. Only the total nucleated cell count, which is the main CB graft selection criterion besides HLA matching, correlated favorably.CONCLUSIONS:  Our data reveal a high degree of variability in graft characteristics provided by CBBs and often poor correlation with results obtained on thawed and washed CB units. We suggest that standardized laboratory procedures aimed at graft characterization should be used by both CBBs and transplant centers to avoid unacceptable discrepancies.
Enhancing effect of platelet‐derived microvesicles on the invasive potential of breast cancer cells
Authors: Janowska‐Wieczorek Anna , Marquez‐Curtis Leah A. , Wysoczynski Marcin , Ratajczak Mariusz Z. 
Published: May 2006

BACKGROUND:  Platelets (PLTs) have been postulated to play a role in cancer progression and metastasis. Recently, it was demonstrated that PLT‐derived microvesicles (PMVs) transfer various surface receptors and/or adhesion molecules to target cells and modulate their biological responses. In this work, it was hypothesized that PMVs interact with breast cancer cells, increasing their invasiveness.STUDY DESIGN AND METHODS:  PMVs (isolated from outdated PLT concentrates) were incubated with three human breast cancer cell lines (MDA‐MB‐231, BT‐549, and T47D), and their effects on in vitro invasiveness of these cells (adhesion, expression of matrix metalloproteinases [MMPs], and chemoinvasion), as well as their interactions with stroma, were evaluated.RESULTS:  We found that PMVs 1) transferred PLT‐derived integrin CD41 to the surface of breast cancer cells and enhanced their adhesion to endothelial cells; 2) increased CXCR4 expression and chemotaxis toward a stromal‐derived factor‐1 gradient in invasive MDA‐231 and BT‐549 cells; 3) increased phosphorylation of the mitogen‐activated protein kinase p42/44 and AKT signaling pathways; 4) stimulated the production of MMPs in invasive MDA‐231 and BT‐549 cells and their chemoinvasion across the reconstituted basement membrane Matrigel; and 5) induced the secretion of MMP‐9 by marrow fibroblasts and stimulated the secretion of both MMP‐2 and MMP‐9 in cocultures of fibroblasts with MDA‐MB‐231 cells.CONCLUSION:  It was shown than PMVs enhance the in vitro invasive potential of invasive breast cancer cell lines and therefore could mediate the progression of breast cancer. These findings warrant further evaluation of the implications of PLT transfusions in cancer patients.
Tetanus toxoid provides efficient T‐cell help for the induction of HA‐1H cytotoxic T cells
Authors: Eiz‐Vesper Britta , Horn Peter A. , Daubert Claudia , Khattab Barbara , Blasczyk Rainer 
Published: May 2006

BACKGROUND:  In vitro generation and expansion of leukemia‐reactive T cells may improve the efficacy and specificity of cellular immunotherapy against hematologic malignancies in the context of allogeneic stem cell transplantation. Since the expression of minor histocompatibility antigen HA‐1H is limited to hematopoietic cells, ex vivo generated HA‐1H‐specific CD8+ cytotoxic T lymphocytes (CTLs) can be used for adoptive immunotherapy.STUDY DESIGN AND METHODS:  Numerous studies have shown that primary CTL induction from naïve precursors requires professional antigen‐presenting cells. Here, the feasibility of ex vivo induction of HA‐1H‐specific CD8+ CTLs is demonstrated from unfractionated peripheral blood mononuclear cells (PBMNCs) from healthy blood donors when CD4+ T‐cell help is provided during primary stimulation. As a stimulus for the induction of T‐cell help, tetanus toxoid (TT) was used.RESULTS:  After the second restimulation cycle, approximately 1 percent of CD8+ T cells stained positively with the HLA‐A*0201/HA‐1H pentamer. Positive T cells were further expanded more than 1000‐fold by antigen‐independent stimulation with anti‐CD3/CD28 monoclonal antibodies. HA‐1H‐induced T cells showed the classical phenotype for CD8+ memory effector cells: the phenotype changed from a mixed CD45RA/RO phenotype to an activated phenotype characterized by high expression of CD45RO and no expression of CCR7. The generated T cells revealed a very potent CTL response, even at low E:T ratios.CONCLUSION:  This study demonstrates that TT provides a very potent and cost‐effective tool for the in vitro induction of antigen‐specific CTLs from precursor PBMNCs that can easily be adapted to GMP conditions for translational purposes.
Disseminated histoplasmosis presenting as thrombotic microangiopathy
Authors: Dwyre Denis M. , Bell Adam M. , Siechen Kathleen , Sethi Sanjeev , Raife Thomas J. 
Published: May 2006

BACKGROUND: Thrombotic microangiopathies (TMA) are systemic vasoocclusive disorders associated with significant morbidity and mortality. Rapid and reliable diagnosis of TMA is critical. The diagnosis is complicated by a lack of objective and sensitive laboratory testing as well as multiple concurrent diseases, including infectious processes.CASE STUDY: We report two cases of disseminated histoplasmosis associated with TMA manifestations in renal transplant recipients, including one patient with histologically documented renal microthrombi; both patients were referred for plasma exchange. After the diagnosis of histoplasmosis, the treatment plan was changed to antifungal medications, reduced immuno‐suppression, and supportive care, with progressive resolution of TMA manifestations.CONCLUSION: TMA occurs in transplant populations in association with infections, medications, and other factors. Appropriate management includes recognition and treatment of possible etiological factors. Disseminated histoplasmosis should be considered in transplant patients presenting with TMA.
Lower hemoglobin levels in human immunodeficiency virus–infected patients with a positive direct antiglobulin test (DAT): relationship with DAT strength and clinical stages
Authors: Lai Marco , Visconti Elena , D’Onofrio Giuseppe , Tamburrini Enrica , Cauda Roberto , Leone Giuseppe 
Published: May 2006

BACKGROUND: There are conflicting opinions regarding the effect of positive direct antiglobulin test (DAT) on hemoglobin (Hb) levels in human immunodeficiency virus–infected (HIV+) patients.STUDY DESIGN AND METHODS: A total of 166 samples from HIV+ outpatients were studied. The DAT was performed with the tube test and column agglutination technology (CAT).RESULTS: The DAT was positive in 18.67 percent with the tube method and 33.73 percent with the CAT. Patients with DAT‐positive results showed lower Hb levels than DAT‐negative patients, 12.3 g per dL versus 14.3 g per dL (p = 0.0002). The univariate logistic regression enabled us to study the phenomenon better and fit the probability of having a DAT‐positive result on the basis of the Hb levels. The relationship between the CAT and the tube test when washing the red blood cells (RBC) at 4°C was stronger than when washing these at room temperature (φ = 0.8156; p = 0.000). The Hb levels were significantly lower in the positive DATs of Stage C (acquired immune deficiency syndrome [AIDS]) and Stage B (symptomatic non‐AIDS patients), which showed decreasing Hb values for increasing agglutination strengths (p = 0.000). Anemia was related with the DAT results (odds ratio [OR], 8.005; p = 0.000) but not to the AIDS condition (OR, 1.741; p = 0.221).DISCUSSION: Our study indicates that the DAT‐positive results may be specifically related to lower Hb levels in HIV+ patients. The immunologic RBC clearance could be part of the anemic multifactorial condition in HIV+ patients.
Increased antidepressant use and fewer suicides in Jämtland county, Sweden, after a primary care educational programme on the treatment of depression
Authors: Henriksson S. , Isacsson G. 
Published: May 2006

Objective:  To consider and evaluate a continuing medical education programme for general practitioners (GPs) on depression in Jämtland county, Sweden, inspired by the Gotland study.Method:  Interactive seminars were conducted between 1995 and 2002 in Jämtland county. For evaluation, suicide rates and annual sales statistics of antidepressants were compared with national averages. Questionnaires were used for information about attitudes and prescribing habits.Results:  The suicide rate in Jämtland decreased to the same level as the national average. The use of antidepressants increased from 25% below the Swedish average to the same level. The selective serotonin re‐uptake inhibitors (SSRIs) were preferred because of their tolerability. Suicide issues were considered to be most important in the management of depressed patients.Conclusion:  A trend towards a greater prescription of antidepressants and fewer suicides after an educational programme on depression for GPs replicated the findings from the Gotland study. The educational programme will be conducted annually and could be a model for other regions.
Clinical outcome in bipolar disorder in a community‐based follow‐up study in Butajira, Ethiopia
Authors: Fekadu A. , Kebede D. , Alem A. , Fekadu D. , Mogga S. , Negash A. , Medhin G. , Beyero T. , Shibre T. 
Published: May 2006

Objective:  To determine the clinical outcome of bipolar disorder in a developing country setup.Method:  After assessing 68 378 individuals, aged 15–49 years, in a double‐sampling design in a rural community in Ethiopia, 312 patients with bipolar disorder were prospectively monitored with symptom rating scales and clinically for an average of 2.5 years.Results:  Overall, 65.9% of the cohort experienced a relapse – 47.8% manic, 44.3% depressive and 7.7% mixed episodes – and 31.1% had persistent illness. Female gender predicted depressive relapse, while male gender predicted manic relapse. Being on psychotropic medication was associated with remission.Conclusion:  This large community‐based study confirms the relapsing nature of bipolar disorder and a tendency for chronicity. This may be partly because of lack of appropriate interventions in this setting; however, it may also indicate the underlying severity of the disorder irrespective of setting.
Altered omega‐3 polyunsaturated fatty acid status in depressed post‐myocardial infarction patients
Authors: Schins A. , Crijns H. J. , Brummer R.‐J. M. , Wichers M. , Lousberg R. , Celis S. , Honig A. 
Published: May 2006

Objective:  Lower levels of long‐chain omega‐3 polyunsaturated fatty acids (n‐3 LCPUFAs) and increased inflammation have been associated with both depressive disorder and myocardial infarction (MI). The present study investigated whether patients who develop depression post‐MI, have higher arachidonic acid/eicosapentanoic acid (AA/EPA) ratios than non‐depressed post‐MI patients and whether depressed post‐MI patients have signs of increased inflammation as measured by C‐reactive protein (CRP).Method:  Serum AA/EPA ratio and plasma CRP levels were quantified in 50 post‐MI patients, of which 29 were depressed and 21 non‐depressed.Results:  Compared with the non‐depressed group, depressed post‐MI patients had significantly higher AA/EPA ratios. No significant difference was observed in CRP levels.Conclusion:  Depressed post‐MI patients had lower levels of n‐3 LCPUFAs as measured by mean AA/EPA ratio and no signs of increased inflammation as determined by CRP levels.