| 1. |
- Goodwin, G. M., et al.
(författare)
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Evidence-based guidelines for treating bipolar disorder : Revised third edition recommendations from the British Association for Psychopharmacology
- 2016
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Ingår i: Journal of Psychopharmacology. - : SAGE PUBLICATIONS LTD. - 0269-8811 .- 1461-7285. ; 30:6, s. 495-553
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Forskningsöversikt (refereegranskat)abstract
- The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.
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| 2. |
- Goodwin, GM, et al.
(författare)
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Aripiprazole in patients with bipolar mania and beyond: an update of practical guidance
- 2011
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Ingår i: CURRENT MEDICAL RESEARCH AND OPINION. - 0300-7995. ; 27:12, s. 2285-2299
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Aripiprazole is an atypical antipsychotic with a pharmacological and clinical profile distinct from other atypical antipsychotics. SCOPE: A European multidisciplinary advisory panel of university-based experts in bipolar disorders convened in April 2010 to review new clinical guidelines for the management of mania and the role of aripiprazole in its treatment. This report describes the consensus reached on how best to use aripiprazole in the treatment of mania. FINDINGS: Current guidelines recommending aripiprazole for first-line treatment of mania have not generally translated to clinical practice. The panel agreed that clinicians may not feel sufficiently knowledgeable on how to use aripiprazole effectively in mania, and that the perception that aripiprazole is less sedating than other antipschotics may hamper its use. There was consensus about the importance of ensuring that clinicians understood the distinction between antimanic efficacy and sedation. Most acutely manic patients may require night-time sedation, but continuous daytime sedation is not necessarily indicated and may interfere with long-term compliance. If sedation is necessary, guidelines recommend the use of adjunctive benzodiazepines only for a short-time. CONCLUSIONS: Clinical practice guidelines widely recommend aripiprazole as a first-line treatment for mania. Although clinical trials may not represent all patient subpopulations, they show that aripiprazole is well tolerated and has a long-term stabilizing potential. The successful use of aripiprazole rests on using the appropriate initial dose, titrating and adjusting the dose as needed and using appropriate concomitant medication to minimize any short-term adverse events. Low incidence of sedation makes aripiprazole a reasonable long-term treatment choice. If short-term sedation is required an adjunctive sedative agent can be added and removed when no longer needed. Clinical considerations should influence treatment choice, and a better distinction between sedation and antimanic effects should be an educational target aimed to overcome potential barriers for using non-sedative antimanic agents such as aripiprazole.
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| 3. |
- Heister, K., et al.
(författare)
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Odd-even efffects at the S-metal interface and in the aromatic matrix in biphenyl-substituted alkanethiol self-assembled monolayers
- 2001
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Ingår i: Journal of Physical Chemistry B 105, 6888 (2001).
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Tidskriftsartikel (refereegranskat)abstract
- Synchrotron-based high-resolution X-ray photoelectron spectroscopy was applied to characterize self-assembled monolayers (SAM) of biphenyl-substituted alkanethiols CH3(C6H4)2(CH2)nSH (BPn, n = 1-4) on Au and Ag substrates. Beyond previously identified odd-even changes in the packing density and the tilt angle of the biphenyl moieties, the high-resolution spectra reveal a number of additional odd-even effects upon variation of the number of methylene groups in the aliphatic part in the BPn molecule. Their occurrence and mutual correlation suggests that a BPn SAM represents a strongly correlated, highly ordered molecular assembly. In particular, periodical changes of a shake up feature in the C 1s region are observed, which are related to the differences in the arrangement of the aromatic matrix. The width and binding energy position of the S 2p signals also exhibit odd-even changes. The width changes are associated with the occupation of either equivalent or nonequivalent adsorption sites on the polycrystalline (111) Au and Ag substrates. The comparison of the width values with those for conventional alkanethiols implies that the substrate bonding of alkanethiols on gold cannot be described by a single adsorption site
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| 4. |
- Maleshlijski, S., et al.
(författare)
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Imaging SPR combined with stereoscopic 3D tracking to study barnacle cyprid-surface interactions
- 2016
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Ingår i: Surface Science. - : ELSEVIER SCIENCE BV. - 0039-6028 .- 1879-2758. ; 643, s. 172-177
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Tidskriftsartikel (refereegranskat)abstract
- Barnacle larvae (cyprids) explore surfaces to identify suitable settlement sites. This process is selective, and cyprids respond to numerous surface cues. To better understand the settlement process, it is desirable to simultaneously monitor both the surface exploration behavior and any close interactions with the surface. Stereoscopic 3D tracking of the cyprids provides quantitative access to surface exploration and pre-settlement rituals. Imaging surface plasmon resonance (SPR) reveals any interactions with the surfaces, such as surface inspection during bipedal walking and deposition of temporary adhesives. We report on a combination of both techniques to bring together information on swimming behavior in the vicinity of the interface and physical interactions of the cyprid with the surface. The technical requirements are described, and we applied the setup to cyprids of Balanus amphitrite. Initial data shows the applicability of the combined instrument to correlate exploration and touchdown events on surfaces with different chemical termination. (C) 2015 Published by Elsevier B.V.
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| 5. |
- Radua, J, et al.
(författare)
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Meta-Analysis of the Risk of Subsequent Mood Episodes in Bipolar Disorder
- 2017
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 1423-0348 .- 0033-3190. ; 86:2, s. 90-98
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Reported relapse and recurrence rates in bipolar disorder (BD) differ significantly between studies. Most data originate from highly selective patients participating in sponsored randomized controlled trials with narrow inclusion criteria. To estimate the true risk of a subsequent mood episode (SME) under real-world conditions, we conducted a meta-analysis of rates of SME as reported in naturalistic BD studies. <b><i>Methods:</i></b> PubMed, ScienceDirect, Scopus, and Web of Knowledge were searched until July 2015. Studies reporting the time until the emergence of an SME, from which individual data or Kaplan-Meier plots with censors marked could be retrieved, were included. <b><i>Results:</i></b> Twelve studies comprising 5,837 patients met the inclusion criteria. The median time to an SME in adults after an index episode was 1.44 years. The risk of an SME was 44% during the first year. Not having a SME during this first year lowered this risk to 19% in the second year. The risk was higher in bipolar II disorder (BD-II) than in bipolar I disorder (BD-I; HR = 1.5). In BD-I, the risk of a subsequent manic, mixed, or depressive mood episode was higher after an index episode of the same polarity (HR = 1.89-5.14). The overall risk of an SME was higher in patients with persisting subsyndromal symptoms (HR = 2.17). <b><i>Conclusions:</i></b> The data from this study provide a more reliable estimate of the risk of an SME in BD in real-world settings. Further research into the longitudinal course of BD-II is warranted to confirm its role as a risk factor for SME.
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