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Predictors of the placebo response in a nutraceutical randomized controlled trial for depression

Journal of Integrative Medicine 2024年第1期22卷 46-53页

作者： Rosemary Arnold Jenifer Murphy-Smith Chee H.Ng David Mischoulon Gerard J.Byrne Chad A.Bousman Con Stough Michael Berk Jerome Sarris Professorial Unit the Melbourne ClinicDepartment of PsychiatryUniversity of MelbourneRichmond 3121Australia Depression Clinical and Research Program Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMA 02115USA Faculty of Medicine Discipline of PsychiatryCentre for Clinical ResearchRoyal Brisbane&Women’s HospitalHerstonthe University of QueenslandBrisbane 4006Australia Departments of Medical Genetics PsychiatryPhysiology&Pharmacology and Community Health SciencesUniversity of CalgaryCalgaryAB T2N 1N4Canada Department of Psychiatry the University of MelbourneMelbourne 3052Australia Centre for Human Psychopharmacology Swinburne UniversityMelbourne 3122Australia The Institute for Mental and Physical Health and Clinical Translation School of MedicineBarwon HealthDeakin UniversityGeelong 3220Australia The Centre of Excellence in Youth Mental Health the University of MelbourneParkville 3052Australia Florey Institute of Neuroscience and Mental Health the University of MelbourneParkville 3052Australia NICM Health Research Institute Western Sydney UniversityWestmeadNSW 2145Australia

Objective The placebo response in depression studies is the change in symptoms amongst those who receive an inactive *** well-designed randomized controlled trials(RCTs)of depression have a high proportion of placebo responders,with little understanding as to *** present study assesses characteristics associated with the placebo response in a nutraceutical trial with a large proportion of placebo *** This is a secondary analysis of a nutraceutical depression RCT which identified no overall treatment benefit relative to placebo(n=69 in placebo group).We investigated participant characteristics such as socio-demographics,clinical features,and recruitment methods,and their association with the placebo *** genetic polymorphisms were also *** response was measured based on change in Montgomery-Asberg Depression Rating Scale *** association of these hypothesis-driven variables of interest and the placebo response was examined using linear mixed effects *** Greater levels of education,particularly pursuing post-high school education,better self-reported general health,marriage/de facto,greater improvement in the first trial week,and more failed antidepressant therapies in the current depressive episode were associated with greater placebo *** increased placebo response was not found in those recruited via social media nor in those with concomitant antidepressant *** nucleotide polymorphisms from the tryptophan hydroxylase 1(TPH1)gene(A779C and A218C)were weakly associated with greater placebo response,although the evidence was attenuated after accounting for multiple *** This is,to our knowledge,the first study within nutraceutical research for depression to assess the association between participant characteristics and variation in the placebo *** variables appeared to predict the placebo *** findings may encourage future trial design

关键词： Randomized controlled trial Placebo Depression Nutraceutical Psychiatry

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Male fertility following childhood cancer: current conceptsand future therapies

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Asian Journal of Andrology 2003年第4期5卷 325-337页

作者： Mark F. H. Brougham Christopher J. H.Kelnar Richard M.Sharpe W.Hamish B.Wallace royal hospital for Sick Children Edinburgh United KingdomRoyal Hospital for Sick Children Edinburgh United KingdomMRC Human Reproductive Sciences Unit Centre for Reproductive Biology University of Edinburgh United KingdomRoyal Hospital for Sick Children Edinburgh United Kingdom

Prepubertal boys treated for cancer may exhibit impaired fertility in later life. A number of chemotherapeu tic agents have been identified as being gonadotoxic, and certain treatment regimens, such as that used for Hodgkin's disease, are particularly associated with subsequent infertility. Radiotherapy may also cause gonadal damage, most notably following direct testicular irradiation or total body irradiation. Because of the varied nature of the cytotoxic insult, it can be difficult to predict the likelihood of infertility in later life. Currently it is not possible to detect gonadal damage early due to the lack of a sensitive marker of gonadal function in the prepubertal age *** cryopreservation is currently the only method of preserving fertility in patients receiving gonadotoxic therapy. This is only applicable to postpubertal patients and can be problematic in the adolescent age group. At present there is no provision for the prepubertal boy, although there are a number of experimental methods currently being investigated. By harvesting testicular tissue prior to gonadotoxic therapy, restoration of fertility could be achieved following treatment, either by germ cell transplantation or by in vitro maturation of the germ cells harvested. Alternatively, rendering the testes quiescent during cytotoxic treatment may protect the germ cells from subsequent damage. In addition to the many scientific and technical issues to be overcome prior to clinical application of these techniques, a number of ethical and legal issues must also be addressed to ensure a safe and realistic prospect for future fertility in these patients.

关键词： infertility childhood cancer semen cryopreservation germ cell transplantation In vitro germ cell maturation assisted reproductive techniques

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Sphincter of Oddi dysfunction:Psychosocial distress correlates with manometric dyskinesia but not stenosis

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World Journal of Gastroenterology 2009年第48期15卷 6080-6085页

作者： Ethelle Bennett Peter Evans John Dowsett John Kellow Department of Gastroenterology and Medicine Royal NorthShore HospitalUniversity of Sydney

AIM:To compare postcholecystectomy patients with Sphincter of Oddi(SO)dyskinesia and those with normal SO motility to determine the psychosocial distress,gender and objective clinical correlates of dyskinesia,and contrast these findings with comparisons between SO stenosis and normal SO ***:Within a cohort of seventy-two consecutive postcholecystectomy patients with suspected SO dysfunction,manometric assessment identified subgroups with SO dyskinesia(n=33),SO stenosis(n=18)and normal SO motility(n=21).Each patient was categorized in terms of Milwaukee Type,sociodemographic status and the severity of stress-coping ***:Logistic regression revealed that in combination certain psychological,sociodemographic and clinical variables significantly differentiated SO dyskinesia,but not SO stenosis,from normal SO *** of psychosocial stress and of coping with this stress(*** suppressed more frequently and the use of significantly more psychological coping strategies)were highest among patients with SO dyskinesia,especially *** levels of neuroticism(the tendency to stressproneness)further increased the likelihood of SO ***:A motility disturbance related to psychosocial distress may help to explain the finding of SO dyskinesia in some postcholecystectomy patients.

关键词： Gender Functional gastrointestinal disorders Psychosocial distress Sphincter of Oddi dyskinesia

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Intraoperative radiation therapy deserves to be made more readily available to patients

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Chinese Journal of Cancer Research 2016年第4期28卷 461-462页

作者： Mohammed Keshtgar Norman R.Williams The Breast Unit Royal Free HospitalRoyal Free London Foundation Trust

Whole breast external beam radiotherapy is an effective adjuvant treatment for early breast cancer, and was a key factor in the move from mastectomy to breast-conserving surgery for women with low-risk disease. The logical development from partial surgical removal of the breast is partial breast radiotherapy. Several methods of delivery have been investigated, but as yet none has been widely accepted.

关键词： more Intraoperative radiation therapy deserves to be made more readily available to patients IMRT

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Long term outcomes for patients treated with half-fluence photodynamic therapy for chronic central serous chorioretinopathy: a case series

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International Journal of Ophthalmology(English edition) 2018年第2期11卷 333-336页

作者： Jennifer Doyle Bhaskar Gupta Irfan Tahir Department of Ophthalmology Royal Berkshire NHS Foundation Trust Royal Berkshire Hospital

A case series was used to evaluate the efficacy of halffluence photodynamic therapy（PDT） for chronic central serous chorioretinopathy（CSCR）. Patients were treated with standard-dose verteporfin and half-fluence PDT. Totally 13 eyes from 11 patients were included. The mean patient age was 52.0 y. There was a mean reduction in central retinal thickness of 107.0 microns. Totally 7/13 eyes（53.8%） achieved resolution of subretinal fluid（SRF） on optical coherence tomography（OCT） scan after 1 treatment with PDT. Four eyes had further treatment with PDT; of these 1 eye achieved resolution of SRF. Seven of the 13 eyes（53.8%） achieved an improvement of more than 5 ETDRS letters. One patient experienced acute macula oedema 1 d post PDT treatment. These results support the hypothesis that half-fluence PDT can have a positive effect in chronic CSCR for a gain in visual acuity and reduction in sub-retinal fluid. Acute macula oedema is a rare but potential adverse effect of half-fluence PDT.

关键词： central serous chorioretinopathy photodynamic therapy fluence

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Proximal gastric motility in critically ill patients with type 2 diabetes mellitus

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World Journal of Gastroenterology 2007年第2期13卷 270-275页

作者： Nam Q Nguyen Robert J Fraser Laura K Bryant Marianne Chapman Richard H Holloway Department of Gastroenterology Hepatology and General Medicine Royal Adelaide Hospital South Australia Investigation and Procedures Unit Repatriation General Hospital South Australia Anaesthesia and Intensive Care Royal Adelaide Hospital South Australia

AIM： To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with longstanding type 2 diabetes ***： Proximal gastric motility was assessed （using a barostat） in 10 critically ill patients with type 2 diabetes mellitus （59±3 years） during two 60-min duodenal infusions of Ensure （1 and 2 kcal/min）, in random order, separated by 2h fasting. Data were compared with 15 non-diabetic critically ill patients （48 ± 5 years） and 10 healthy volunteers （28 ±3 years）. RESULTS： Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during I kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/ min infusion was initially reduced in diabetic patients （P 〈 0.05） but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic ***： In patients with diabetes mellitus, proximal gastric motility is less disturbed than nondiabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.

关键词： Proximal gastric function Diabetes mellitus type 2 Critical illness Enteral nutrition

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Sympathetic stimulation with norepinephrine may come at a cost

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Neural Regeneration Research 2019年第6期14卷 977-978页

作者： Lakshini Y.Herat Markus P.Schlaich Vance B.Matthews Dobney Hypertension Centre School of Biomedical Science-Royal Perth Hospital UnitUniversity of Western Australia Dobney Hypertension Centre School of Medicine - Royal Perth Hospital UnitUniversity of Western Australia Department of Cardiology and Department of Nephrology Royal Perth Hospital

Norepinephrine(NE;also known as noradrenaline)is the body’s primary adrenergic neurotransmitter which belongs to the catecholamine *** has pharmacologic effects on theα1(Suita et al.,2015),α2(Schwartz,1997),β1,β2 andβ3(Tsukada et al.,2003)*** the brain,norepinephrine increases arousal and alertness,promotes vigilance,enhances formation and retrieval of memory,and focuses *** also increases restlessness and *** the remainder of the body,norepinephrine increases heart rate and blood pressure,triggers the release of glucose from energy stores,increases blood flow to skeletal muscle and increases muscle contraction,reduces blood flow to the gastrointestinal system and its motility and lastly,inhibits voiding of the bladder(Goldstein,2010).This last point is particularly interesting in the context of this perspective piece.

关键词： neurotransmitter norepinephrine increases focuses attention

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Transarterial chemoembolization and bland embolization for hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第12期20卷 3069-3077页

作者： Emmanuel A Tsochatzis Evangelia Fatourou James O'Beirne Tim Meyer Andrew K Burroughs Sheila Sherlock Liver Centre Royal Free Hospital and UCL Institute of Liver and Digestive Health Department of Oncology Royal Free Hospital and UCL

Transarterial chemoembolization(TACE)is the first line treatment for patients with intermediate stage hepatocellular carcinoma but is also increasingly being used for patients on the transplant waiting list to prevent further tumor *** its widespread use,TACE remains an unstandardized procedure,with variation in type and size of embolizing particles,type and dose of chemotherapy and interval between *** evidence from randomized controlled trials suggest that bland transarterial embolization(TAE)has the same efficacy with *** the current article,we review the use of TACE and TAE for hepatocellular carcinoma and we focus on the evidence for their use.

关键词： Cirrhosis Hepatocellular carcinoma Mortality Embolization Transarterial chemoembolization Transarterial embolization Prognosis

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Trends in mortality among the geriatric population undergoing Surgical aortic valve replacement (SAVR) and potential racial disparities: a 20-year perspective via the National (Nationwide) Inpatient Sample

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Journal of Geriatric Cardiology 2024年第7期21卷 716-722页

作者： Nomesh Kumar Kamleshun Ramphul FNU Bawna Nitish Behary Paray Mansimran Si-ngh Dulay Jasninder Singh Dhaliwal Shruti Aggarwal Sebastian Mactaggart Suma Sri Chennapragada Shaheen Sombans Renuka Verma Hemamalini Sakthivel Raheel Ahmed Department of Internal Medicine Detroit Medical Center Sinai Grace-Wayne State UniversityMichiganUSA In-dependent Researcher TrioletMauritius Independent researcher Farmington HillsMichiganUSA royal Devon University Healthcare NHS Foundation Trust ExeterUnited Kingdom royal Brompton hospital part of Guy’s and St.Thomas’NHS Foundation TrustLondonUnited Kingdom Department of Internal Medicine University of Cali-forniaRiversideUSA Independent Researcher New DelhiIndia Northumbria hospitals NHS Foundation Trust NewcastleUnited Kingdom Department of Internal Medicine Louisiana State UniversityShreveportUSA Sha-heen Sombans Independent ResearcherHyderabadIndia Department of Internal Medicine Kirk Kerkorian School of Medicine at UNLVLas VegasUSA One Brooklyn Health System/Interfaith Medical Ctr Program BrooklynNYUSA

Background Racial disparities in cardiovascular conditions are well *** similar race-based discrepancies in health outcomes also exist among elderly patients undergoing surgical aortic valve replacement(SAVR) for aortic stenosis remains *** We abstracted data from the National(Nationwide) Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 *** included patients aged ≥ 60 and ≤ 80 years with races recorded as White,African American,or Hispanic at the time of their hospitalization for *** analyzed and reported the baseline characteristics,risk-adjusted inhospital mortality,and complications stratified by *** Of 420,181 patients studied,90.0% identified as White,4.0% as African American and 6.0% as *** a decrease in overall in-hospital mortality rates from 3.8% between 2001-2005 to 1.8% between 2016-2020,African Americans had higher odds of all-cause in-hospital deaths compared to Whites(a OR = 1.390,P hospital mortality rates of geriatric patients undergoing SAVR for aortic stenosis,racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital morbidity and mortality.

关键词： mortality likely spite

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Does high intraocular pressure exclude an open globe injury?

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International Journal of Ophthalmology(English edition) 2014年第2期7卷 389-390页

作者： Aruna Dharmasena Dong Young Park Mandagere Vishwanath Manchester royal Eye hospital

Dear Sir,Ocular trauma is a topic of unresolved controversies and there are continuous controversial and debatable diagnostic and management strategies for open-globe injuries[1].Amongst many types of ocular trauma,the open globe injury is the most serious due to its very poor visual prognosis and young population of patients are mostly affected[2].The treatment outcome may be improved by prompt diagnosis,and immediate surgical repair performed to high standard[3].Amongst the other clinical signs the intraocular pressure(IOP)is found to be particularly reduced and conventionally this is considered as a very reliable indicator of occult globe

关键词： IOP Does high intraocular pressure exclude an open globe injury high

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