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- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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| 5. |
- Murray, Greg, et al.
(författare)
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Relief of Chronic or Resistant Depression (Re-ChORD): A pragmatic, randomized, open-treatment trial of an integrative program intervention for chronic depression
- 2010
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 123:1-3, s. 243-248
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic depression is a particularly disabling mood disorder and treatment outcomes are poor with either psychotherapy or pharmacotherapy alone. There is growing evidence that an integrative treatment approach may be optimal. A novel multi-modal, multi-disciplinary treatment program, Re-ChORD, was developed at the University of British Columbia and evaluated in this pilot study. Methods: Re-ChORD consisted of guidelines-based medication management, and group-based interpersonal psychotherapy and occupational therapy. A randomized, parallel-groups, open-treatment trial was conducted comparing Re-ChORD to treatment as usual (TAU). Inclusion criteria were current depression (17-item Ham-D >= 15) and a diagnosis of a chronic depressive disorder. The primary outcome variable was clinical remission (17-item Ham-D <= 7) at 4 month assessment. Results: A total of 64 patients were randomised to Re-ChORD (N = 34) and TAU (N = 30). Under both intention to treat (ITT) and completer analyses, the remission rate was significantly higher in the Re-ChORD than TAU groups. Treatment effect size for remission was of medium magnitude (22.2% and 29.6% over TAU under ITT and completer analyses). Limitations: We did not collect sufficient follow-up data to investigate maintenance of gains. Re-ChORD shares elements with other combined treatments, and the present positive findings cannot be interpreted as being specific to the Re-ChORD program. Conclusions: Consistent with growing evidence that integrative treatments are necessary for chronic depressive disorders. Re-ChORD was demonstrated in this pilot study to produce significantly greater rates of remission than treatment as usual. A larger-scale trial is warranted. (C) 2009 Elsevier By. All rights reserved.
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| 6. |
- Tariot, Pierre N., et al.
(författare)
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Relationships of change in Clinical Dementia Rating (CDR) on patient outcomes and probability of progression : observational analysis
- 2024
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Ingår i: Alzheimer's Research and Therapy. - 1758-9193. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Understanding the relationship among changes in Clinical Dementia Rating (CDR), patient outcomes, and probability of progression is crucial for evaluating the long-term benefits of disease-modifying treatments. We examined associations among changes in Alzheimer’s disease (AD) stages and outcomes that are important to patients and their care partners including activities of daily living (ADLs), geriatric depression, neuropsychiatric features, cognitive impairment, and the probabilities of being transitioned to a long-term care facility (i.e., institutionalization). We also estimated the total time spent at each stage and annual transition probabilities in AD. Methods: The study included participants with unimpaired cognition, mild cognitive impairment (MCI) due to AD, and mild, moderate, and severe AD dementia in the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS) database. The associations among change in AD stages and change in relevant outcomes were estimated using linear mixed models with random intercepts. The probability of transitioning to long-term care facilities was modeled using generalized estimating equations. The total length of time spent at AD stages and annual transition probabilities were estimated with multistate Markov models. Results: The estimated average time spent in each stage was 3.2 years in MCI due to AD and 2.2, 2.0, and 2.8 years for mild, moderate, and severe AD dementia, respectively. The annual probabilities of progressing from MCI to mild, moderate, and severe AD dementia were 20, 4, and 0.7%, respectively. The incremental change to the next stage of participants with unimpaired cognition, MCI, and mild, moderate, and severe AD dementia (to death) was 3.2, 20, 26.6, 31, and 25.3%, respectively. Changes in ADLs, neuropsychiatric features, and cognitive measures were greatest among participants who transitioned from MCI and mild AD dementia to more advanced stages. Participants with MCI and mild and moderate AD dementia had increasing odds of being transitioned to long-term care facilities over time during the follow-up period. Conclusions: The findings demonstrated that participants with early stages AD (MCI or mild dementia) were associated with the largest changes in clinical scale scores. Early detection, diagnosis, and intervention by disease-modifying therapies are required for delaying AD progression. Additionally, estimates of transition probabilities can inform future studies and health economic modeling.
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| 7. |
- Wesolowska, O., et al.
(författare)
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Benzo [a] phenoxazines: A new group of potent P-glycoprotein inhibitors
- 2006
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Ingår i: In Vivo. - 0258-851X. ; 20:1, s. 109-113
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Tidskriftsartikel (refereegranskat)abstract
- The ability of fifteen novel phenoxazine derivatives (four phenoxazines and eleven benzo[a]phenoxazines) to modulate multidrug resistance (MDR) in a P-gp-overexpressing mouse T lymphoma cell line (L5178 MDR) was studied. A flow cytometric functional test, based on the differential accumulation of rhodamine 123 by sensitive and multidrug-resistant cells, was employed. Seven benzo[a]phenoxazines were observed to increase the amount of rhodamine 123 accumulated by resistant cells, i.e. to be new effective MDR modulators. The results allowed us to draw preliminary conclusions about the structural features of benzo[a]phenoxazines which are important for MDR modulation.
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