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药物试验中的MCI标准能否准确识别痴呆前阿尔茨海默病患者

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世界核心医学期刊文摘(神经病学分册) 2006年第1期 23-23页

作者： Visser P.J. Scheltens P. Verhey F.R.J. 王孝文 Department of psychiatry and Neuropsychology University of Maastricht PO Box 616 6200 MD Maastricht Netherlands Dr.

Background: Drugs effective in Alzheimer-type dementia have been tested in subjects with mild cognitive impairment (MCI)because these are supposed to have Alzheimer's disease in the predementia stage. Objectives: To investigate whether MCI criteria used in these drug trials can accurately diagnose subjects with predementia Alzheimer's disease. Methods: MCI criteria of the Gal-Int 11 study, InDDEx study, ADCS memory impairment study, ampakine CX 516 study, piracetam study, and Merck rofecoxib study were applied retrospectively in a cohort of 150 non-demented subjects from a memory clinic. Forty two had progressed to Alzheimer type dementia during a five year follow up period and were considered to have predementia Alzheimer's disease at baseline. Outcome measures were the odds ratio, sensitivity, specificity, and positive and negative predictive value. Results: The odds ratio of the MCI criteria for predementia Alzheimer's disease varied between 0.84 and 11. Sensitivity varied between 0.46 and 0.83 and positive predictive value between 0.43 and 0.76. None of the criteria combined a high sensitivity with a high positive predictive value. Exclusion criteria for depression led to an increase in positive predictive value and specificity at the cost of sensitivity. In subjects older than 65 years the positive predictive value was higher than in younger subjects. Conclusions: The diagnostic accuracy of MCI criteria used in trials for predementia Alzheimer's disease is low to moderate. Their use may lead to inclusion of many patients who do not have predementia Alzheimer's disease or to exclusion of many who do. Subjects with moderately severe depression should not be excluded from trials in order not to reduce the sensitivity.

关键词：阿尔茨海默病阳性预测值敏感度 MCI 患者药物试验

Reporting and understanding the safety and adverse effect profile of mobile apps for psychosocial interventions: An update

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World Journal of psychiatry 2016年第2期6卷 187-191页

作者： Farooq Naeem Nadeem Gire Shuo Xiang Megan Yang Yumeen Syed Farhad Shokraneh Clive Adams Saeed Farooq Department of psychiatry Queens UniversityKingston Addiction and Mental Health Services-Kingston FrontenacLennox and Addington School of Psychology University of Central Lancashire Trenlogic Cochrane Schizophrenia Group Nottingham University Research Institute for Primary Care and Health Sciences Keele University

Recent years have seen a rapidly increasing trend towards the delivery of health technology through mobile devices. Smartphones and tablet devices are thus becoming increasingly popular for accessing information and a wide range of services, including health care services. Modern mobile apps can be used for a variety of reasons, ranging from education for the patients and assistance to clinicians to delivery of interventions. Mobile phone apps have also been established to benefit patients in a scope of interventions across numerous medical specialties and treatment modalities. Medical apps have their advantages and disadvantages. It is important that clinicians have access to knowledge to make decisions regarding the use of medical apps on the basis of risk-benefit ratio. Mobile apps that deliver psycho social interventions offer unique challenges and opportunities. A number of reviews have highlighted the potential use of such apps. There is a need to describe, report and study their side effects too. The adverse effects associated with these apps can broadly be divided into:(1) those resulting from the security and safety concerns;(2) those arising from the use of a particular psycho social intervention; and(3) those due to the interaction with digital technology. There is a need to refine and reconsider the safety and adverse effects in this area. The safety profile of a mobile PSI app should describe its safety profile in:(1) privacy and security;(2) adverse effects of psychotherapy; and(3) adverse effects unique to the use of apps and the internet. This is, however, a very new area and further research and reporting is required to inform clinical decision making.

关键词： Mobile Psycho social Side effects Health Media Security Privacy

Imaging plaque inflammation in asymptomatic cocaine addicted individuals with simultaneous positron emission tomography/magnetic resonance imaging

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World Journal of Radiology 2019年第5期11卷 62-73页

作者： Keren Bachi Venkatesh Mani Audrey E Kaufman Nadia Alie Rita Z Goldstein Zahi A Fayad Nelly Alia-Klein Department of psychiatry Icahn School of Medicine at Mount SinaiOne Gustave L.Levy PlaceNew YorkNY 10029United States Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount SinaiOne Gustave L.Levy PlaceNew YorkNY 10029United States Translational and Molecular Imaging Institute Icahn School of Medicine at Mount SinaiOne Gustave L.Levy PlaceNew YorkNY 10029United States Children's Hospital of Philadelphia 3401 Civic Center BlvdPhiladelphiaPA 19104United States Department of Neuroscience Icahn School of Medicine at Mount SinaiOne Gustave L.Levy PlaceNew YorkNY 10029United States

BACKGROUND Chronic cocaine use is associated with stroke, coronary artery disease and myocardial infarction, resulting in severe impairments or sudden mortality. In the absence of clear cardiovascular symptoms, individuals with cocaine use disorder (iCUD) seeking addiction treatment receive mostly psychotherapy and psychiatric pharmacotherapy, with no attention to vascular disease (i.e., atherosclerosis). Little is known about the pre-clinical signs of cardiovascular risk in iCUD and early signs of vascular disease are undetected in this underserved population. AIM To assess inflammation, plaque burden and plaque composition in iCUD aiming to detect markers of atherosclerosis and vascular disease. METHODS The bilateral carotid arteries were imaged with positron emission tomography/magnetic resonance imaging (PET/MRI) in iCUD asymptomatic for cardiovascular disease, healthy controls, and individuals with cardiovascular risk. PET with 18F-fluorodeoxyglucose (18F-FDG) evaluated vascular inflammation and 3-D dark-blood MRI assessed plaque burden including wall area and thickness. Drug use and severity of addiction were assessed with standardized instruments. RESULTS The majority of iCUD and controls had carotid FDG-PET signal greater than 1.6 but lower than 3, indicating the presence of mild to moderate inflammation. However, the MRI measure of wall structure was thicker in iCUD as compared to the controls and cardiovascular risk group, indicating greater carotid plaque burden. iCUD had larger wall area as compared to the healthy controls but not as compared to the cardiovascular risk group, indicating structural wall similarities between the non-control study groups. In iCUD, wall area correlated with greater cocaine withdrawal and craving. CONCLUSION These preliminary results show markers of carotid artery disease burden in cardiovascular disease-asymptomatic iCUD. Broader trials are warranted to develop protocols for early detection of cardiovascular risk and prevent

关键词： 3-D dark-blood magnetic resonance imaging 18F-fluorodeoxyglucose positron emission tomography Simultaneous positron emission tomography Magnetic resonance Substance use disorder Cocaine addiction Atherosclerosis Plaque burden Vascular inflammation

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深入理解脑卒中后抑郁的临床状态

中华医学杂志 2019年第21期99卷 1611-1614页

作者：王红星张文睿杨晓桐马青峰宋海庆张道龙 Ricardo E.Jorge 朱遂强朱舟王玉平谢鹏首都医科大学宣武医院神经内科北京100053 美国芝加哥退伍军人医学中心精神医学系伊利诺伊大学芝加哥分校精神医学系美国芝加哥60612 psychiatry and Behavioral Sciences Baylor College of MedicineHoustonTX 77030USA 华中科技大学同济医学院附属同济医院神经精神病学教研室武汉430030 重庆医科大学附属第一医院神经内科重庆400016

脑卒中后抑郁是卒中后最为常见的大脑功能失调状态,其能延缓卒中后的康复进程,增加脑卒中致残率、病死率与复发率。深入理解脑卒中所致的抑郁,有利于对脑卒中后抑郁的及时识别,便于早期干预,促进患者恢复。

关键词：脑卒中脑卒中后抑郁

Psychiatric morbidities in respiratory disorders:a cross sectional report providing insight into consultation-liaison psychiatry services in India

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Psychosomatic Medicine Research 2023年第1期5卷 6-10页

作者： Roshan Sutar Santosh Kumar Chaturvedi Akshata Jayachamarajapura Shivananjaiah Department of psychiatry All India Institute of Medical Sciences(AIIMS)BhopalMadhya Pradesh 462026India Leicestershire Partnership NHS Trust Leicester LE48BLUK SDS TRC and Rajiv Gandhi Institute of chest diseases Bangalore Karnataka 560011India.

Background:Respiratory disorders are among the leading disorders contributing to extensive morbidity and mortality *** variants,like Chronic Obstructive Pulmonary Diseases(COPD)in developed and developing countries,as well as infectious causes,like Tuberculosis(TB)in developing countries,contribute to significant disease *** literature points towards the coexistence of psychiatric disorders with respiratory disorders responsible for poorer *** the extensive burden of respiratory disorders and the presence of concurrent psychiatric disorders,studies focusing on their prevalence are limited in ***:A cross-sectional psychiatric screening was carried out on sequential patients attending the tertiary respiratory unit over eight *** screened positive were interviewed in detail for psychiatric diagnosis and challenges in the management were *** diagnosis,pulmonary TB and medical comorbidity were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version ***:Psychiatric morbidity was present in 100 out of 350 patients(28.57%).Tuberculosis was the most common diagnosis(46%)in subjects attending the respiratory clinic services while common mental disorders like depression,anxiety,and insomnia were the most common psychiatric concern(88%)in this ***:Psychiatric disorders and medical morbidities are common in patients with respiratory *** factors determine the treatment adherence in both respiratory and psychiatric *** for psychiatric disorders with the help of a consultation-liaison psychiatrist in respiratory units is *** studies should focus on developing dedicated psychiatry services to enhance overall outcomes in patients with respiratory disorders.

关键词： psychiatric morbidity depression tuberculosis consultation-liaison psychiatry respiratory disorders psychosomatic

Risk Factors for Viral Non-Suppression among People Living with HIV and Major Depressive Disorder in Uganda

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World Journal of AIDS 2022年第2期12卷 43-54页

作者： Lilian Bulage Benedict Akimana Justine D. Namuli Seggane Musisi Josephine Birungi Micheal Etukoit Ramin Mojtabai Jean B. Nachega Edward J. Mills Etheldreda Nakimuli-Mpungu African Field Epidemiology Network Kampala Uganda Uganda Public Health Fellowship Program Kampala Uganda Ministry of Health Butabika National Referral Mental Hospital Kampala Uganda Department of psychiatry College of Health Sciences Makerere University Kampala Uganda The AIDS Support Organization (TASO) Kampala Uganda Department of Mental Health Bloomberg’s School of Public Health Johns Hopkins University Baltimore USA Departments of Epidemiology Infectious Diseases and Microbiology Graduate School of Public Health University of Pittsburgh Pittsburgh USA Center for Infectious Disease Department of Medicine Faculty of Medicine and Health Sciences Stellenbosch University Cape Town South Africa Departments of International Health and Epidemiology Bloomberg’s School of Public Health Johns Hopkins University Baltimore USA Department of clinical Epidemiology & Biostatistics McMaster University Hamilton Canada

Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder;we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.

关键词： Depression Suicide Risk Anti-Retroviral Therapy Viral Suppression Uganda

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

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World Journal of psychiatry 2016年第1期6卷 128-135页

作者： Sasraku Amanor-Boadu MariaMananita S Hipolito Narayan Rai Charlee K McLean Kyla Flanagan Flora T Hamilton Valerie Oji Sharon F Lambert Huynh Nhu Le Suad Kapetanovic Evaristus A Nwulia Bloomberg School of Public Health Johns Hopkins University Department of psychiatry and Behavioral Sciences Translational Neuroscience LaboratoryHoward University Family and Medical Counseling Service Inc. Lifefountain Center Ministries Inc. Department of Psychology George Washington University National Institutes of Health National Institute of Mental Health

AIM: To determine if efforts to improve antiretroviral therapy(ART) adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV) outcomes. METHODS: A cross-sectional study of a clinic-based cohort of 158 HIV seropositive(HIV+) African Americans screened for major depressive disorder(MDD) in 2012. CD4 T lymphocyte(CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count( 350 cells/mm^3 CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

关键词： Human immunodeficiency virus positive Depression CD4 T lymphocyte count Antiretroviral Therapy African Americans

Staying psychologically safe as a doctor during the COVID-19 pandemic

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Family Medicine and Community Health 2022年第1期10卷 43-47页

作者： Jill Benson Roger Sexton Christopher Dowrick Christine Gibson Christos Lionis Joana Ferreira Veloso Gomes Maria Bakola Abdullah AlKhathami Shimnaz Nazeer Alkisti Igoumenaki Jinan Usta Bruce Arroll Evelyn van Weel-Baumgarten Claudia Allen Discipline of General Practice The University of Adelaide School of MedicineAdelaideSouth AustraliaAustralia Prideaux Centre for Health Professionals Education Flinders University College of Medicine and Public HealthBedford ParkSouth AustraliaAustralia Doctors Health SA AdelaideSouth AustraliaAustralia Department of Primary Medical Care University of LiverpoolLiverpoolUK Department of Family Medicine and psychiatry University of Calgary Cumming School of MedicineCalgaryAlbertaCanada clinic of Social and Family Medicine University of Crete School of MedicineHeraklionGreece Universidade do Algarve FaroPortugal Research Unit for General Medicine and Primary Health Care University of Ioannina Faculty of MedicineIoanninaGreece Innovative Primary Mental Health Program Eastern ProvinceSaudi Arabia Ministry of HealthRiyadhSaudi Arabia Family Medicine in clinical Medicine Department Weill Cornell Medical College in QatarDohaQatar University clinic University Hospital of DüsseldorfDusseldorfGermany Family Medicine Department American University of BeirutBeirutLebanon Department of General Practice and Primary Care The University of AucklandAucklandNew Zealand Department of Primary and Community Care Radboud Institute for Health SciencesUniversity NijmegenNijmegenThe Netherlands Department of Family Medicine University of Virginia School of MedicineCharlottesvilleVirginiaUSA

INTRODUCTION As we face the ongoing global pandemic of COVID-19,doctors,nurses,ambulance officers,paramedics and many other health workers answer the call to serve in time-pressured,unfamiliar,chaotic and often-traumatic environments.1 We know how to look after ourselves in an infectious physical environment,but it is equally important to look after ourselves psychologically at this time.

关键词： doctor nurse ongoing

NEW ADVANCES OF SLEEP RESEARCH IN CHINA

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现代电生理学杂志 2019年第B3期26卷 28-32页

作者： Gu Aiming Guo Ruya Fu Weida Lin Xiaodong Chen Ce Chen Xingshi Zhang Li Li Xiaoping Department of Neurology Jiaxing Maternity and Child Health Care Hospitaljiaxing 314001China Department of Internal Medicine The First Hospital of JiaxingJiaixng 314001China Department of psychiatry Wenzhou Seventh People’s HospitalWenzhou 325005China Department of Electrophysiology Shanghai Mental ealth CenterShanghai Jiaotong UniversityShanghai 200030China

It is a big topic on sleep research in China,current sleep research in China will be introduced from basic and clinic research in the *** researches Current sleep research in China began with the study on hybernation using urchin at Peking University in the early *** 1960-2017,lots of agencies such as Shanghai Institute of Physiology of Academia Sinica,Institute of Psychology of Academia Sinica,Henan Medical University have accumulated large investigative and experimental data on sleep,but the most of those data focused on the descriptive researches of animal assortment(feline,dog,goat,mouce,rat and macque)and sleep classicification[1].

关键词： classic Henan Peking