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Hill H, Wagenhäuser I, Schuller P, Diessner J, Eisenmann M, Kampmeier S, Vogel U, Wöckel A, Krone M. Establishing semi-automated infection surveillance in obstetrics and gynaecology. J Hosp Infect 2024; 146:125-133. [PMID: 38295904 DOI: 10.1016/j.jhin.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Surveillance is an acknowledged method to decrease nosocomial infections, such as surgical site infections (SSIs). Electronic healthcare records create the opportunity for automated surveillance. While approaches for different types of surgeries and indicators already exist, there are very few for obstetrics and gynaecology. AIM To analyse the sensitivity and workload reduction of semi-automated surveillance in obstetrics and gynaecology. METHODS In this retrospective, single-centre study at a 1438-bed tertiary care hospital in Germany, semi-automated SSI surveillance using the indicators 'antibiotic prescription', 'microbiological data' and 'administrative data' (diagnosis codes, readmission, post-hospitalization care) was compared with manual analysis and categorization of all patient files. Breast surgeries (BSs) conducted in 2018 and caesarean sections (CSs) that met the inclusion criteria between May 2013 and December 2019 were included. Indicators were analysed for sensitivity, number of analysed procedures needed to identify one case, and potential workload reduction in detecting SSIs in comparison with the control group. FINDINGS The reference standard showed nine SSIs in 416 BSs (2.2%). Sensitivities for the indicators 'antibiotic prescription', 'diagnosis code', 'microbiological sample taken', and the combination 'diagnosis code or microbiological sample' were 100%, 88.9%, 66.7% and 100%, respectively. The reference standard showed 54 SSIs in 3438 CSs (1.6%). Sensitivities for the indicators 'collection of microbiological samples', 'diagnosis codes', 'readmission/post-hospitalization care', and the combination of all indicators were 38.9%, 27.8%, 85.2% and 94.4%, respectively. CONCLUSIONS Semi-automated surveillance systems may reduce workload by maintaining high sensitivity depending on the type of surgery, local circumstances and thorough digitalization.
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Affiliation(s)
- H Hill
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - I Wagenhäuser
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany; Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - P Schuller
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - J Diessner
- Department of Obstetrics and Gynaecology, University Hospital Würzburg, Würzburg, Germany
| | - M Eisenmann
- Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - S Kampmeier
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - U Vogel
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany
| | - A Wöckel
- Department of Obstetrics and Gynaecology, University Hospital Würzburg, Würzburg, Germany
| | - M Krone
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, Würzburg, Germany.
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Ludwig VM, Reinhard I, Mühlbauer E, Hill H, Severus WE, Bauer M, Ritter P, Ebner-Priemer UW. Limited evidence of autocorrelation signaling upcoming affective episodes: a 12-month e-diary study in patients with bipolar disorder. Psychol Med 2024:1-9. [PMID: 38284217 DOI: 10.1017/s0033291723003811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND Increased autocorrelation (AR) of system-specific measures has been suggested as a predictor for critical transitions in complex systems. Increased AR of mood scores has been reported to anticipate depressive episodes in major depressive disorder, while other studies found AR increases to be associated with depressive episodes themselves. Data on AR in patients with bipolar disorders (BD) is limited and inconclusive. METHODS Patients with BD reported their current mood via daily e-diaries for 12 months. Current affective status (euthymic, prodromal, depressed, (hypo)manic) was assessed in 26 bi-weekly expert interviews. Exploratory analyses tested whether self-reported current mood and AR of the same item could differentiate between prodromal phases or affective episodes and euthymia. RESULTS A total of 29 depressive and 20 (hypo)manic episodes were observed in 29 participants with BD. Self-reported current mood was significantly decreased during the two weeks prior to a depressive episode (early prodromal, late prodromal), but not changed prior to manic episodes. The AR was neither a significant predictor for the early or late prodromal phase of depression nor for the early prodromal phase of (hypo)mania. Decreased AR was found in the late prodromal phase of (hypo)mania. Increased AR was mainly found during depressive episodes. CONCLUSIONS AR changes might not be better at predicting depressive episodes than simple self-report measures on current mood in patients with BD. Increased AR was mostly found during depressive episodes. Potentially, changes in AR might anticipate (hypo)manic episodes.
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Affiliation(s)
- V M Ludwig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - I Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - E Mühlbauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - H Hill
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - W E Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
- Asklepios Klinik Nord-Ochsenzoll, Hamburg, Germany
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - P Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - U W Ebner-Priemer
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
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Nikolaou E, German EL, Howard A, Nabwera HM, Matope A, Robinson R, Shiham F, Liatsikos K, McNamara C, Kattera S, Carter K, Parry CM, Read JM, Allen SJ, Urban BC, Hawcutt DB, Hill H, Collins AM, Ferreira DM. Assessing the use of minimally invasive self-sampling at home for long-term monitoring of the microbiota within UK families. Sci Rep 2023; 13:18201. [PMID: 37875557 PMCID: PMC10598218 DOI: 10.1038/s41598-023-45574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/21/2023] [Indexed: 10/26/2023] Open
Abstract
Monitoring the presence of commensal and pathogenic respiratory microorganisms is of critical global importance. However, community-based surveillance is difficult because nasopharyngeal swabs are uncomfortable and painful for a wide age range of participants. We designed a methodology for minimally invasive self-sampling at home and assessed its use for longitudinal monitoring of the oral, nasal and hand microbiota of adults and children within families. Healthy families with two adults and up to three children, living in and near Liverpool, United Kingdom, self-collected saliva, nasal lining fluid using synthetic absorptive matrices and hand swabs at home every two weeks for six months. Questionnaires were used to collect demographic and epidemiological data and assess feasibility and acceptability. Participants were invited to take part in an exit interview. Thirty-three families completed the study. Sampling using our approach was acceptable to 25/33 (76%) families, as sampling was fast (76%), easy (76%) and painless (60%). Saliva and hand sampling was acceptable to all participants of any age, whereas nasal sampling was accepted mostly by adults and children older than 5 years. Multi-niche self-sampling at home can be used by adults and children for longitudinal surveillance of respiratory microorganisms, providing key data for design of future studies.
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Affiliation(s)
- E Nikolaou
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, 3050, Australia.
- Microbiology and Immunology Department, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia.
| | - E L German
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A Howard
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - H M Nabwera
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Alder Hey Children's Hospital, Liverpool, UK
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - A Matope
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - R Robinson
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - F Shiham
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - K Liatsikos
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - C McNamara
- Alder Hey Children's Hospital, Liverpool, UK
| | - S Kattera
- Alder Hey Children's Hospital, Liverpool, UK
| | - K Carter
- Alder Hey Children's Hospital, Liverpool, UK
| | - C M Parry
- Alder Hey Children's Hospital, Liverpool, UK
| | - J M Read
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - S J Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - B C Urban
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, OX3 7LE, UK
| | - D B Hawcutt
- Alder Hey Children's Hospital, Liverpool, UK
- University of Liverpool, Liverpool, UK
| | - H Hill
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A M Collins
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - D M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, OX3 7LE, UK.
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Williams J, Hill H, Wendel E, Laborde E. The Urethral Microbiome During Inflatable Penile Prosthesis Placement. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hubber J, Person A, Jecha L, Flodin-Hursh D, Stiffler J, Hill H, Bassham S, McCotter OZ, Oltean HN. Knowledge, attitudes, and practices regarding coccidioidomycosis among healthcare providers in four counties in Washington State, 2017. Med Mycol 2021; 58:730-736. [PMID: 31711221 DOI: 10.1093/mmy/myz111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/24/2019] [Accepted: 10/22/2019] [Indexed: 11/12/2022] Open
Abstract
Coccidioidomycosis is an emerging infection in Washington State. The epidemiology of the disease in Washington is poorly understood at present; underrecognition and underreporting of coccidioidomycosis is suspected based on reports of only severe disease. We sought to characterize healthcare provider knowledge, attitudes, and practices regarding coccidioidomycosis awareness, diagnosis, and treatment in south-central Washington. We conducted a cross-sectional survey of actively practicing healthcare providers in four counties in south-central Washington, an area recently described as endemic for Coccidioides. Survey results were used to assess awareness of reporting requirements, confidence in ability to diagnose and treat, confidence that knowledge is current, calculated knowledge score, and consideration of risk in patient population. The majority of respondents were unaware of the reporting requirement for coccidioidomycosis in Washington and further unaware that the disease had been reported in the state. Less than a third of survey respondents reported confidence in their ability to diagnose coccidioidomycosis and confidence that their knowledge is current. The majority of respondents never or rarely consider a diagnosis of coccidioidomycosis, and <25% of respondents indicated a working knowledge of serologic tests for the infection. The average knowledge score for respondents was 65%. Previous education, training, or practice regarding coccidioidomycosis was the only identified predictor of confidence and consideration of risk. These data indicate the substantial need for education and training among healthcare providers in south-central Washington and support the concern that a small proportion of existing cases of coccidioidomycosis are reported to the health department.
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Affiliation(s)
- J Hubber
- Washington State Department of Health, Communicable Disease Epidemiology, Shoreline, Washington, USA
| | - A Person
- Benton-Franklin Health District, Pasco, Washington, USA
| | - L Jecha
- Walla Walla County Health Department, Walla Walla, Washington, USA
| | | | - J Stiffler
- Walla Walla County Health Department, Walla Walla, Washington, USA
| | - H Hill
- Benton-Franklin Health District, Pasco, Washington, USA
| | - S Bassham
- Walla Walla County Health Department, Walla Walla, Washington, USA
| | - O Z McCotter
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - H N Oltean
- Washington State Department of Health, Communicable Disease Epidemiology, Shoreline, Washington, USA
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Seernani D, Ioannou C, Damania K, Hill H, Foulsham T, Smyrnis N, Biscaldi M, Klein C. Social and non-social gaze cueing in autism spectrum disorder, attention-deficit/hyperactivity disorder and a comorbid group. Biol Psychol 2021; 162:108096. [PMID: 33891995 DOI: 10.1016/j.biopsycho.2021.108096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 01/31/2023]
Abstract
Recent trends in literature, along with the changes to the Diagnostic and Statistical Manual (DSM), make it imperative to study Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) together, in order to better understand potential aetiological commonalities between these highly comorbid disorders. The present study examines social cueing, a highly studied construct in ASD, and intra-subject variability (ISV), a potential endophenotype of ADHD, in four groups of typically developing (TD), ADHD, ASD- (ASD without ADHD), ASD+ (ASD with ADHD) participants (N = 85) aged 10-13 years. Results showed that social cueing is intact in the 'pure' ASD group when task expectations are clear. The ADHD group showed faster saccadic reaction times, no increased ISV and a pattern of viewing comparable to the TD group. However, the ASD + group showed a differences in processing style and ISV. A secondary analysis gives evidence of non-additive effects of the ASD and ADHD factors.
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Affiliation(s)
- D Seernani
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Germany
| | - C Ioannou
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Germany
| | | | - H Hill
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Germany
| | - T Foulsham
- Department of Psychology, University of Essex, UK
| | - N Smyrnis
- 2nd Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON", Athens, Greece
| | - M Biscaldi
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Germany
| | - C Klein
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Germany; 2nd Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON", Athens, Greece; Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Germany.
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Seernani D, Damania K, Ioannou C, Penkalla N, Hill H, Foulsham T, Kingstone A, Anderson N, Boccignone G, Bender S, Smyrnis N, Biscaldi M, Ebner-Priemer U, Klein C. Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders? Eur Child Adolesc Psychiatry 2021; 30:549-562. [PMID: 32314021 PMCID: PMC8041680 DOI: 10.1007/s00787-020-01535-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 04/09/2020] [Indexed: 01/25/2023]
Abstract
Recent debates in the literature discuss commonalities between Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) at multiple levels of putative causal networks. This debate requires systematic comparisons between these disorders that have been studied in isolation in the past, employing potential markers of each disorder to be investigated in tandem. The present study, choose superior local processing, typical to ASD, and increased Intra-Subject Variability (ISV), typical to ADHD, for a head-to-head comparison of the two disorders, while also considering the comorbid cases. It directly examined groups of participants aged 10-13 years with ADHD, ASD with (ASD+) or without (ASD-) comorbid ADHD and a typically developing (TD) group (total N = 85). A visual search task consisting of an array of paired words was designed. The participants needed to find the specific pair of words, where the first word in the pair was the cue word. This visual search task was selected to compare these groups on overall search performance and trial-to-trial variability of search performance (i.e., ISV). Additionally, scanpath analysis was also carried out using Recurrence Quantification Analysis (RQA) and the Multi-Match Model. Results show that only the ASD- group exhibited superior search performance; whereas, only the groups with ADHD symptoms showed increased ISV. These findings point towards a double dissociation between ASD and ADHD, and argue against an overlap between ASD and ADHD.
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Affiliation(s)
- D. Seernani
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | | | - C. Ioannou
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | - N. Penkalla
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | - H. Hill
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - T. Foulsham
- Department of Psychology, University of Essex, Colchester, UK
| | - A. Kingstone
- Brain, Attention and Reality Lab, University of British Columbia, Vancouver, Canada
| | - N. Anderson
- Brain, Attention and Reality Lab, University of British Columbia, Vancouver, Canada
| | - G. Boccignone
- Department of Computer Science, University of Milan, Milan, Italy
| | - S. Bender
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - N. Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - M. Biscaldi
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104 Freiburg, Germany
| | | | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Hauptstrasse 8, 79104, Freiburg, Germany. .,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany. .,Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
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Seernani D, Ioannou C, Damania K, Spindler K, Hill H, Foulsham T, Smyrnis N, Bender S, Fleischhaker C, Biscaldi M, Ebner-Priemer U, Klein C. Studying global processing in autism and attention-deficit/hyperactivity disorder with gaze movements: The example of a copying task. PLoS One 2020; 15:e0224186. [PMID: 32497045 PMCID: PMC7272031 DOI: 10.1371/journal.pone.0224186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 04/19/2020] [Indexed: 11/23/2022] Open
Abstract
Recent discussions in the literature, along with the revision of the Diagnostic and Statistical Manual (DSM) (American Psychiatric Association 2013), suggest aetiological commonalities between the highly comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Addressing this discussion requires studying these disorders together by comparing constructs typical to each of them. In the present study, we investigate global processing, known to be difficult for participants with ASD, and Intra-Subject Variability (ISV), known to be consistently increased in participants with ADHD, in groups, aged 10–13 years, with ADHD (n = 25), ASD without comorbid ADHD (ASD-) (n = 13) and ASD with ADHD (ASD+) (n = 18) in comparison with a typically developing group (n = 22). A Copying task, typically requiring global processing and in this case particularly designed using equally complex stimuli to also measure ISV across trials, was selected. Oculomotor measures in this task proved to be particularly sensitive to group differences. While increased ISV was not observed in the present task in participants with ADHD, both ASD groups looked longer on the figure to be drawn, indicating that global processing takes longer in ASD. However, the ASD+ group fixated on the figure only between drawing movements, whereas the ASD- group did this throughout the drawing process. The present study provides evidence towards ASD and ADHD being separate, not-overlapping, disorders. Since the pure ASD- group was affected more by central coherence problems than the ASD+ group, it may suggest that neuropsychological constructs interact differently in different clinical groups and sub-groups.
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Affiliation(s)
- D. Seernani
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - C. Ioannou
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - K. Damania
- Independent Researcher, Seattle, Washington, United States of America
| | - K. Spindler
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - H. Hill
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - T. Foulsham
- Department of Psychology, University of Essex, Colchester, England, United Kingdom
| | - N. Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - S. Bender
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Köln, Germany
| | - C. Fleischhaker
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - M. Biscaldi
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - U. Ebner-Priemer
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - C. Klein
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Köln, Germany
- * E-mail:
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Keitel WA, Voronca DC, Atmar RL, Paust S, Hill H, Wolff MC, Bellamy AR. Effect of recent seasonal influenza vaccination on serum antibody responses to candidate pandemic influenza A/H5N1 vaccines: A meta-analysis. Vaccine 2019; 37:5535-5543. [PMID: 31160101 DOI: 10.1016/j.vaccine.2019.04.066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 01/02/2023]
Abstract
Recent studies have suggested that among those receiving seasonal influenza vaccine (SIV), reduced immunogenicity is observed in recently vaccinated (RV; within the past season or 2) persons when compared with those not recently vaccinated (NRV). We performed a meta-analysis to assess the effect of recent immunization with SIV on serum H5 hemagglutination inhibition (HAI) antibody responses after influenza A/H5N1 vaccination using data from a series of randomized controlled trials. The primary outcome was seroconversion measured by HAI assays following receipt of 2 doses of H5N1 vaccine. The geometric mean titer (GMT) of serum HAI antibody after vaccination was the secondary outcome. Analyses were performed using propensity score (PS) matching. The PS for each individual in the meta-analysis cohort was calculated using logistic regression and covariates included age, gender, race, antigen dose, adjuvant, statin use and vaccine manufacturer. 2015 subjects enrolled in 7 clinical trials were eligible for inclusion in the meta-analysis cohort; among these, 915 (45%) were RV. 901 RV subjects were matched (1:1) with replacement to a subject who was NRV. Subjects who received SIV within the previous season were significantly less likely to seroconvert following H5N1 vaccination (adjusted odds ratio 0.76; 95%CI 0.60-0.96; p = 0.024), and the GMT was 18% higher among NRV subjects (GM ratio of HAI antibody 1.18; 95%CI 1.04-1.33; p = 0.008). Further work is needed to better define the effects of, and mechanisms contributing to, reduced immune responses to H5N1 vaccine among RV subjects.
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Affiliation(s)
- W A Keitel
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States.
| | | | - R L Atmar
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | - S Paust
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Pediatrics-Center for Human Immunobiology, Texas Children's Hospital, Houston, TX, United States
| | - H Hill
- Emmes, Rockville, MD, United States
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Hoft DF, Xia M, Zhang GL, Blazevic A, Tennant J, Kaplan C, Matuschak G, Dube TJ, Hill H, Schlesinger LS, Andersen PL, Brusic V. PO and ID BCG vaccination in humans induce distinct mucosal and systemic immune responses and CD4 + T cell transcriptomal molecular signatures. Mucosal Immunol 2018; 11:486-495. [PMID: 28853442 PMCID: PMC5832504 DOI: 10.1038/mi.2017.67] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 06/13/2017] [Indexed: 02/06/2023]
Abstract
Protective efficacy of Bacillus Calmette-Guérin (BCG) may be affected by the methods and routes of vaccine administration. We have studied the safety and immunogenicity of oral (PO) and/or intradermal (ID) administration of BCG in healthy human subjects. No major safety concerns were detected in the 68 healthy adults vaccinated with PO and/or ID BCG. Although both PO and ID BCG could induce systemic Th1 responses capable of IFN-γ production, ID BCG more strongly induced systemic Th1 responses. In contrast, stronger mucosal responses (TB-specific secretory IgA and bronchoalveolar lavage T cells) were induced by PO BCG vaccination. To generate preliminary data comparing the early gene signatures induced by mucosal and systemic BCG vaccination, CD4+ memory T cells were isolated from subsets of BCG vaccinated subjects pre- (Day 0) and post-vaccination (Days 7 and 56), rested or stimulated with BCG infected dendritic cells, and then studied by Illumina BeadArray transcriptomal analysis. Notably, distinct gene expression profiles were identified both on Day 7 and Day 56 comparing the PO and ID BCG vaccinated groups by GSEA analysis. Future correlation analyses between specific gene expression patterns and distinct mucosal and systemic immune responses induced will be highly informative for TB vaccine development.
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Affiliation(s)
- DF Hoft
- Division of Infectious Diseases, Allergy & Immunology,
Department of Internal Medicine, Saint Louis University, Saint Louis, MO, USA,Department of Molecular Microbiology & Immunology, Saint Louis
University, Saint Louis, MO, USA
| | - M Xia
- Division of Infectious Diseases, Allergy & Immunology,
Department of Internal Medicine, Saint Louis University, Saint Louis, MO, USA
| | - GL Zhang
- Computer Science Department, Metropolitan College, Boston
University, Boston, MA, USA
| | - A Blazevic
- Division of Infectious Diseases, Allergy & Immunology,
Department of Internal Medicine, Saint Louis University, Saint Louis, MO, USA
| | - J Tennant
- Division of Infectious Diseases, Allergy & Immunology,
Department of Internal Medicine, Saint Louis University, Saint Louis, MO, USA
| | - C Kaplan
- Division of Pulmonary, Critical Care & Sleep Medicine,
Department of Internal Medicine, Saint Louis University, Saint Louis, MO, USA
| | - G Matuschak
- Division of Pulmonary, Critical Care & Sleep Medicine,
Department of Internal Medicine, Saint Louis University, Saint Louis, MO, USA
| | - TJ Dube
- Emmes Corporation, Rockville Pike, MD, USA
| | - H Hill
- Emmes Corporation, Rockville Pike, MD, USA
| | - LS Schlesinger
- Center for Microbial Interface Biology, Ohio State University,
Columbus, OH, USA
| | | | - V Brusic
- Computer Science Department, Metropolitan College, Boston
University, Boston, MA, USA,School of Medicine and Bioinformatics Center, Nazarbayev University,
Astana, Khazakstan
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Hill H, Birch S, Tickle M, McDonald R, Brocklehurst P. Productive efficiency and its determinants in the Community Dental Service in the north-west of England. Community Dent Health 2017; 34:102-106. [PMID: 28573841 DOI: 10.1922/cdh_4028hill05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/03/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England. SETTING AND SAMPLE 40 Community Dental Services sites operating across the North-West of England. BASIC RESEARCH DESIGN A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency. MAIN OUTCOME MEASURE Relative efficiency rankings in Community Dental Services production of dental healthcare. RESULTS Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services. CONCLUSIONS Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels.
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Affiliation(s)
- H Hill
- School of Dentistry, University of Manchester, Manchester, M13 9PL
| | - S Birch
- Manchester Centre for Health Economics, University of Manchester, M13 9PL, UK.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, ON L8S 4K1,Canada
| | - M Tickle
- School of Dentistry, University of Manchester, Manchester, M13 9PL
| | - R McDonald
- Manchester Business School, University of Manchester, M13 9PL, UK
| | - P Brocklehurst
- NWORTH Clinical Trials Unit, Bangor University, Bangor, Gwynedd, LL57 2PZ, UK
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Abstract
BackgroundInternet gaming disorder appears to be associated with self-concept deficits and increased identification with one's avatar. For increased social network use, the few existing studies suggest striatal-related positive social feedback as an underlying factor. Furthermore, few study findings indicate that internet addicts generally have problems in emotional inhibitory control processing.MethodsPathological and addicted internet gamers as well as social network users were compared with healthy controls regarding psychometric and neurobiological measures of self-concept-related characteristics, avatar identification and emotional inhibitory control processing.Results and conclusionPsychometric results indicated that both subgroups showed higher self-concept deficits compared to healthy controls. Neurobiologically, different brain activation patterns were observed in the subgroups during self-knowledge retrieval and inhibition of emotional stimuli. Furthermore, addicted internet gamers showed a higher identification with the own avatar, mirrored in an increased left angular gyrus activation, a region functionally associated with identification processing and feelings of empathy.These findings provide a starting point for the deduction of specific psychotherapeutic treatment approaches for addicted internet gamers and social network users.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Brocklehurst P, O'Malley L, Hill H, Ozaki T, Nomura M, Matsuda R. The development and piloting of a leadership questionnaire for general dental practitioners: preliminary results from the North West of England and Tokyo. Br Dent J 2016; 217:E17. [PMID: 25377846 DOI: 10.1038/sj.bdj.2014.980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Key reforms in England and Japan have called for greater clinical leadership from general dental practitioners to deliver improvements in the quality of care for patients. In England, the reorganisation of the National Health Service has led to the development of Local Professional Networks to ensure services are clinically led, patient and outcome focused. In Japan, the rapidly changing demographics have led to calls for general dental practitioners to become more active in meeting the emerging population health challenges. Both require engagement at a strategic and a local level. However, little is known about what is meant by clinical leadership in dentistry or what training needs exist. The aim of this study was to develop and pilot a questionnaire to understand what general dental practitioners feel is important about clinical leadership and how they rate themselves. METHODS A 61-item questionnaire was developed from the literature, an earlier qualitative study and refined through cognitive interviews. Questionnaires were distributed to general dental practitioners across the North West of England and Tokyo, using random sequence generation. For each item, the participant had to record whether they thought the statement was an important component of clinical leadership and how they rated themselves. Both were rated using a seven-point Likert scale. Data reduction was undertaken using principal component analysis to examine for factor loadings within the questionnaire. Differences in mean scores were also used to highlight substantive differences in how general dental practitioners rated the different components of leadership and how they rated themselves. RESULTS The response rate for the pilot was low (22.9% and 7.5% for North West and Tokyo respectively). The items that were considered to be important in leadership reduced to two components in the North West (accounting for 62.1% of the total variance): 'How to lead' and 'How not to lead'. In Tokyo, 56.4% of the total variance was explained by three components: 'Demonstrating personal qualities', 'Working with others' and 'How not to lead'. When the self-rated items were reduced, three factors were found to be important in the North West: 'Working with others', 'Setting direction' and 'Managing services' (55.1% of the variance). 'Working with others', 'Demonstrating personal qualities', 'Pragmatism', 'Setting direction' and 'Improving services' were found to be important in Tokyo (52.8% of the variance). The questionnaire items relating to integrity, team-working and having a positive attitude during difficult times were rated highly by both groups. Items relating to providing vision for team, being assertive and having a positive attitude had the greatest mean difference, suggesting possible areas of training need. CONCLUSION The nature of the pilot study and the poor response rate makes any conclusion difficult to infer. Among those that participated, leadership was understood to be more important at a practice level rather than at a strategic level. The questionnaire should be refined further based on the results of the pilot and the data reduction.
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Affiliation(s)
- P Brocklehurst
- Department of Dental Public Health, University of Manchester
| | - L O'Malley
- Department of Dental Public Health, University of Manchester
| | - H Hill
- Department of Dental Public Health, University of Manchester
| | - T Ozaki
- Nihon University Dental School, Japan
| | | | - R Matsuda
- College of Social Sciences, Ritsumeikan University, Japan
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Abstract
The first task of any face processing system is detection of the face. We studied how the human visual system achieves face detection using a 2AFC task in which subjects were required to detect a face in the image of a natural scene. Luminance noise was added to the stimuli and performance was measured as a function of orientation and orientation bandwidth of the noise. Sensitivity levels and the effects of orientation bandwidth were similar for horizontally and vertically oriented noise. Performance was reduced for the smallest orientation bandwidth (5.6°) noise but sensitivity did not decrease further with increasing bandwidth until a point between 45° and 90°. The results suggest that important information may be oriented close to the vertical and horizontal. To test whether the results were specific to the task of face detection the same noise was added to the images in a man-made natural decision task. Equivalent levels of noise were found to be more disruptive and the effect of orientation bandwidth was different. The results are discussed in terms of models of face processing making use of oriented filters (eg Watt and Dakin, 1993 Perception22 Supplement, 12) and local energy models of feature detection (Morrone and Burr, 1988 Proceedings of the Royal Society of London B235 221 – 245).
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Marsden-Haug N, Goldoft M, Ralston C, Limaye AP, Chua J, Hill H, Jecha L, Thompson GR, Chiller T. Coccidioidomycosis Acquired in Washington State. Clin Infect Dis 2012; 56:847-50. [DOI: 10.1093/cid/cis1028] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rose J, Seraj H, Huseby D, Rojas M, Hill H, Carlson N. Gender Based Differences in Clinical and MRI Outcomes in Multiple Sclerosis with Low Vitamin D (S50.004). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s50.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Heikal N, Hill H, Martins T, Pavlov I, Wilson A, Stehlik J, Kfoury A, Delgado J, Bader F. 478 TNF -α and IL-8 Predict Cardiac Vasculopathy after Cardiac Transplantation. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Otsuka Y, Motoyoshi I, Kobayashi M, Hill H, Kanazawa S, Yamaguchi MK. Face discrimination in infants and adults: The role of contrast polarity of the eyes. J Vis 2010. [DOI: 10.1167/9.8.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Foster C, Wright D, Hill H, Hopkinson J, Roffe L. Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. Eur J Cancer Care (Engl) 2010; 18:223-47. [PMID: 19432917 DOI: 10.1111/j.1365-2354.2008.01001.x] [Citation(s) in RCA: 163] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mortality associated with cancer remains high, but more people are surviving cancer. Some people experience long-term problems associated with cancer and its treatment, and there is a need to know how to support them. This systematic literature review explores primary research for psychosocial implications of long-term survival (>or=5 years) following a cancer diagnosis and interventions designed to address psychosocial problems in the long term. A systematic search of BIDS, BNI, Cancer.gov, CINAHL, Medline, PsychINFO and Web of Science was conducted to identify research publications from 1960 to 2006. Papers were selected on the basis of pre-defined criteria and rated by three independent coders. Forty-three studies met the eligibility criteria. These indicated that most people experience few problems five or more years after their diagnosis of cancer. However, 20-30% of survivors consistently reported problems associated with cancer and its treatment including physical problems, poorer quality of life, psychological distress, sexual problems, problems with social relationships and financial concerns. Not all cancer types are represented in this review. Only two intervention studies met the eligibility criteria. Research is needed to establish appropriate interventions to support those experiencing problems in the long term to enhance well-being.
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Affiliation(s)
- C Foster
- Macmillan Research Unit, School of Health Sciences, University of Southampton, Southampton, UK.
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Höller H, Sallmann HP, Piedrabuena A, Hill H. Untersuchungen über die Verwendung von Tierfett und Tiermehl in der Fütterung junger Schweine. ACTA ACUST UNITED AC 2009. [DOI: 10.1111/j.1439-0396.1968.tb01480.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
In competitive rowing, the fluctuations in boat velocity during the rowing cycle are associated with an increased water resistance of the boat as compared with a boat moving at a constant velocity. We aimed to quantify the influence of the increased water resistance on race time using a mathematical approximation, based on the increase in physiological power being proportional to the 2nd power of boat speed. Biomechanical data (oar force, rowing angle, boat velocity, and boat acceleration) were measured when eight elite coxless pair crews performed a rowing test with a stepwise increasing stroke rate (SR: 20, 24, 28, and 32 min(-1)) that successively increased the mean boat speed. The results revealed a +4.59 s (SR 24.2) to +5.05 s (SR 31.5) 2000-m race-time difference compared with a boat hypothetically moving without velocity fluctuations. Velocity fluctuations were highly correlated with SR (r=0.93) because the accelerations of the rowers' body mass and the mass of the counteracting boat increase with SR. The possibilities to reduce velocity fluctuations and therefore race time are limited. For elite rowers, race time may be slightly reduced by a moderate reduction in SR that is compensated by an increased force output for each stroke.
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Affiliation(s)
- H Hill
- Department of Psychology, Johann-Wolfgang-Goethe-Universität Frankfurt, Frankfurt, Germany.
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Such E, Hill H, Kick H. Spektralanalytische Differenzierung des EEGs bei Patienten mit affektiver Psychose nach therapeutischem Schlafentzug. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Such E, Hill H, Petri I, Kick H. Prädiktion der Schlafentzug-Reaktion (Response) durch quantitative EEG-Parameter bei Depression. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Petri I, Hill H, Richter P, Kick H. Akustisch evozierte Potentiale (N1, P2, P3) bei depressiven Schlafentzugs-Respondern und Non-Respondern im Vergleich. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Plaschke K, Hill H, Engelhardt R, Thomas C, von Haken R, Scholz M, Kopitz J, Bardenheuer HJ, Weisbrod M, Weigand MA. EEG changes and serum anticholinergic activity measured in patients with delirium in the intensive care unit. Anaesthesia 2007; 62:1217-23. [PMID: 17991256 DOI: 10.1111/j.1365-2044.2007.05255.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim of this study was to examine whether serum anticholinergic activity (SAA) is a reliable indicator of delirium in the ICU, and whether there is a significant correlation between SAA and quantitative electroencephalographic (EEG) data in delirious patients. In a prospective cohort study, we assessed ICU patients diagnosed with delirium (n = 37). EEG measurements and blood analysis including SAA were performed 48 h following ICU admission. The presence of delirium was evaluated using the Confusion Assessment Method for critically ill patients in ICU (CAM-ICU). The SAA level was measured using a competitive radioreceptor binding assay for muscarinergic receptors and quantitative EEG was measured using the CATEEM system. We found that, under comparable conditions, patients in the delirium group showed a higher relative EEG theta power and a reduced alpha power (n = 17) than did the non-delirious patients (n = 20). No difference in measured SAA levels were seen; therefore, there was no correlation between SAA and EEG measurements in delirious patients. We conclude that, in contrast to the EEG, the SAA level cannot be proposed as a tool for diagnosing delirium in ICU patients.
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Affiliation(s)
- K Plaschke
- Department of Anaesthesiology, Medical Faculty of the University of Heidelberg, Germany.
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Frey S, Gorse G, DiBisceglie A, Rosa D, Stamataki Z, McKeating J, Ray R, Coates S, Schultze V, Abrignan S, Houghton M, Hill H, Belshe R. O.015 A phase 1 trial of a novel E1E2/MF59C.1 hepatitis C vaccine candidate in healthy HCV-negative adults (DMID 01-002). J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80024-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bensalem M, Hartwell E, Hartwell S, Hill H, Fell AF. High-resolution method for regulatory control of Echinacea species in Nutraceuticals by CD-MEKC. J Pharm Biomed Anal 2005; 37:885-91. [PMID: 15862662 DOI: 10.1016/j.jpba.2004.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2004] [Revised: 10/04/2004] [Accepted: 10/04/2004] [Indexed: 10/26/2022]
Abstract
One problem in the international regulatory control of Echinacea, a therapeutic Nutraceutical, is recognition of caffeoyl solutes and alkamides in different products. Cyclodextrin-modified micellar electrokinetic chromatography (CD-MEKC) has been applied to Echinacea spp. in combination with pattern recognition of some caffeoyl solutes. A novel metric based on relative migration time (RMT) data has been developed in CE to address the problem of variable reported migration time. The CD-MEKC method of Gotti's group using hydroxypropyl-beta-cyclodexrin (HP-beta-CD; 100 mM) with sodium dodecyl sulphate (SDS; 110 mM), in a triacid background electrolyte (10 mM, pH 8) under 19 kV was adapted to identify two key hydrophilic solutes: chlorogenic acid and cichoric acid present in all commercial products. Two internal markers were taken as reference points to calculate the RMT of any target peak: RMT=t(m (target))/t(m (marker)). The RMT method was robust to temperature change from 20 to 40 degrees C, but sensitive to pH. The lateral shift and reproducibility of the target peak t(m (target)) were significantly reduced by this novel transformation. In the worst cases migration time variability ranged up to 12% (n=6); the RMT algorithm reduced this to less than 1%. In general, the RMT transformation reduced the variability of migration time data by a factor of 2-5. For systematic comparison of electrophoretic profiles for test sample and standard, a new pattern recognition algorithm permits sequential peak-by-peak comparison using specified segments of the electropherograms for comparison of test and Echinacea purpurea (root product) as a standard. This algorithm was capable of rapidly characterising the similarity of target peaks in a test sample relative to those in the reference standard. Combination of the RMT algorithm and pattern recognition in CE is expected to offer a robust approach to international regulatory characterisation and control of Nutraceuticals.
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Affiliation(s)
- M Bensalem
- School of Pharmacy, University of Bradford, Bradford BD7 1DP, UK
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Hill H, Deppe H, Huchzermeyer H, Dormann AJ. [Duodenal ileus due to an intramural duodenal haematoma. Conservative therapy using a multiple lumen intestinal probe]. Dtsch Med Wochenschr 2005; 130:92-4. [PMID: 15650958 DOI: 10.1055/s-2005-837380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
HISTORY AND ADMISSION FINDINGS A 68-year-old woman was admitted with upper abdominal symptoms, epigastric fullness and nausea, eight days after initiation of heparin anticoagulation for deep-vein thrombosis. There were no other clinical abnormalities. INVESTIGATIONS Abdominal ultrasound and computed tomography showed an intramural duodenal haematoma. Endoscopy revealed a stenosing lesion in the duodenum. TREATMENT AND COURSE Instead of conventional parenteral nutrition, a triple-lumen feeding tube was placed, one lumen in the jejunum for feeding, the other for gastric decompression. Six months later the symptoms had completely disappeared and ultrasound, endoscopy and computed tomography no longer detected any lesion. CONCLUSION Intrajejunal feeding and gastric decompression via a multi-lumen tube provided effective conservative treatment of duodenal ileus together with gastric decompression.
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Affiliation(s)
- H Hill
- Medizinische Klinik, Klinikum Minden
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Weisbrod M, Hill H, Sauer H, Niethammer R, Guggenbühl S, Hell D, Stassen HH. Nongenetic pathologic developments of brain-wave patterns in monozygotic twins discordant and concordant for schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2004; 125B:1-9. [PMID: 14755436 DOI: 10.1002/ajmg.b.20080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Evidence from previous studies has suggested that the inter-individual differences in human brain-wave patterns (EEG) are predominantly determined by genetic factors. In particular, the within-pair EEG concordance of monozygotic (mz) twins was found to be typically as high as r = 0.81 across channels and frequency bands, thus being comparable to that between repeated assessments on the same individual with typically r = 0.83. Yet our investigations into mz twins discordant and concordant for schizophrenia yielded a significantly reduced within-pair EEG concordance for both, the pairs discordant for schizophrenia and the pairs concordant for schizophrenia (with concordance for schizophrenia assessed through a syndrome-oriented approach). A multivariate discriminant function of EEG parameters distinguished in a reproducible way between affected and unaffected subjects at an overall performance of >75% correctly classified subjects, while the severity of illness, as derived from EEG-differences between affected and unaffected subjects, was closely related to the severity of illness as provided by psychopathology syndrome scores. Consequently, EEG anomalies associated with schizophrenia and manifested differently in the mz co-twins concordant for schizophrenia are likely the effect of nongenetic, pathologic processes that evolved independently in the co-twins' genetically identical brains once the illness began to progress. The existence of such nongenetic processes would suggest a modification of the standard phenotype-to-genotype search strategies of molecular-genetic studies that aim to link the schizophrenia phenotype to genetic vulnerability factors.
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Affiliation(s)
- M Weisbrod
- Psychiatric University Hospital Heidelberg, Section Experimental Psychopathology, Heidelberg, Germany
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Kuriakose MA, Loree TR, Rubenfeld A, Anderson TM, Datta RV, Hill H, Rigual NR, Orner J, Singh A, Hicks WL. Simultaneously presenting head and neck and lung cancer: a diagnostic and treatment dilemma. Laryngoscope 2002; 112:120-3. [PMID: 11802049 DOI: 10.1097/00005537-200201000-00021] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS Synchronous tumors are defined as malignancies presenting within 6 months of the index tumors. A significant subset of patients present at initial evaluation with malignant tumors of both the head and neck (head and neck squamous cell carcinoma) and the lung, which are termed simultaneous primaries. The management and treatment outcomes in this cohort of patients have not been clearly defined and are the subject of the present review. STUDY DESIGN Retrospective chart review of previously untreated patients. METHODS From January 1974 to December 1997, a total of 2964 patients were treated for mucosal squamous cell carcinoma of the head and neck. Forty-two patients fulfilled the criteria for synchronous head and neck and lung malignancy. Of these, 27 patients had simultaneous tumors of the head and neck and the lung. This cohort of patients (n = 27) was stratified into three treatment groups. Patients in group A (n = 10) had resectable head and neck and lung primaries treated with curative intent. Group B (n = 8) was composed of patients who could have been treated with curative intent but declined and were given only palliative therapy. Patients in group C (n = 9) were candidates for only palliative treatment. RESULTS The estimated 5-year disease-specific survival in group A was 47%, whereas patients in group B had a 5-year disease-specific survival of only 13% (P =.05). There were no survivors beyond 1 year in group C. The presence of mediastinal adenopathy in patients in group A portended poor clinical outcome. There was an estimated 5-year disease-specific survival of 51% in patients with no preoperative evidence of mediastinal adenopathy (n = 7), whereas 67% of patients with radiological evidence of mediastinal adenopathy died (two of three patients). CONCLUSION The presence of simultaneous head and neck squamous cell carcinoma and pulmonary malignancies should not be a deterrent to aggressive surgical therapy because a potentially satisfactory outcome can be expected in these patients.
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MESH Headings
- Aged
- Carcinoma, Non-Small-Cell Lung/diagnosis
- Carcinoma, Non-Small-Cell Lung/mortality
- Carcinoma, Non-Small-Cell Lung/surgery
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/surgery
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/surgery
- Female
- Humans
- Lung Neoplasms/diagnosis
- Lung Neoplasms/mortality
- Lung Neoplasms/surgery
- Lymphatic Metastasis
- Male
- Middle Aged
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/mortality
- Neoplasms, Multiple Primary/surgery
- Otorhinolaryngologic Neoplasms/diagnosis
- Otorhinolaryngologic Neoplasms/mortality
- Otorhinolaryngologic Neoplasms/surgery
- Palliative Care
- Prognosis
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- M A Kuriakose
- Department of Head and Neck Surgery, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, U.S.A
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43
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Elsass WP, Fiedler E, Skop B, Hill H. Susceptibility to maladaptive responses to stress in basic military training based on variants of temperament and character. Mil Med 2001; 166:884-8. [PMID: 11603240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
The purpose of this study was to compare the relationship of Temperament and Character Inventory (TCI) scores of three groups of U.S. Air Force basic trainees. The following groups were used: those who were psychiatrically hospitalized, a control group, and a group identified as being at risk for early separation from basic training because of psychological reasons. The instrument used was the TCI. The data were analyzed with analysis of variance, Tukey post hoc comparisons, and stepwise backward discriminant analysis. The controls were found to have healthier temperament and character profiles than both the at-risk (p < 0.01) and hospitalized (p < 0.01) groups. No difference was found between the at-risk and hospitalized groups on TCI scores. The TCI was found to successfully predict 82% of controls, 25% of at-risk, and 64% of hospitalized recruits. Risk factors for maladaptive responses to stress and possible ways of primary prevention are presented.
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Affiliation(s)
- W P Elsass
- Child and Adolescent Psychiatry Service, Neurobehavioral Sciences Flight, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX, USA
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Sabel MS, Hill H, Jong YS, Mathiowitz E, Bankert RB, Egilmez NK. Neoadjuvant therapy with interleukin-12-loaded polylactic acid microspheres reduces local recurrence and distant metastases. Surgery 2001; 130:470-8. [PMID: 11562672 DOI: 10.1067/msy.2001.115839] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND We previously demonstrated that the intratumoral injection of biodegradable polylactic acid microspheres that were loaded with interleukin (IL)-12 can induce a systemic antitumor immunity. We sought to investigate the clinical potential as neoadjuvant therapy. METHODS Mice were inoculated with 5 x 10(7) Line-1 cells subcutaneously. Six days later, a single intratumoral injection of IL-12- or BSA-loaded microspheres were given; 14 days later, autopsy was performed to document metastases. Mice were inoculated with 5 x 10(7) Line-1 cells and 10 days later either treated with IL-12- or BSA-loaded microspheres or resected. Treated tumors were resected 6 days after treatment. Mice were observed 45 days for local recurrence before autopsy. RESULTS Intratumoral injection of IL-12 microspheres resulted in significant suppression of tumor growth compared with controls (599 +/- 255 mm(3) vs 1591 +/- 372 mm(3); P =.001) and pulmonary metastases (0.4 vs 3.8 nodules per mouse; P =.003). Given before the operation, IL-12-loaded microspheres both decreased the local recurrence rate (100% to 40%) and pulmonary metastases (5.2 vs 0.6 nodules per mouse; P =.06). Earlier resection did not improve local recurrence or distant metastases. CONCLUSIONS Intratumoral injection of IL-12-loaded polylactic acid microspheres promotes the development of systemic antitumor immunity that can eradicate micrometastases. As a neoadjuvant therapy, this can result in decreased local and distant recurrence.
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Affiliation(s)
- M S Sabel
- Division of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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45
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Fridkin SK, Edwards JR, Courval JM, Hill H, Tenover FC, Lawton R, Gaynes RP, McGowan JE. The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 U.S. adult intensive care units. Ann Intern Med 2001; 135:175-83. [PMID: 11487484 DOI: 10.7326/0003-4819-135-3-200108070-00009] [Citation(s) in RCA: 193] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patient-specific risk factors for acquisition of vancomycin-resistant enterococci (VRE) among hospitalized patients are becoming well defined. However, few studies have reported data on the institutional risk factors, including rates of antimicrobial use, that predict rates of VRE. Identifying modifiable institutional factors can advance quality-improvement efforts to minimize hospital-acquired infections with VRE. OBJECTIVE To determine the independent importance of any association between antimicrobial use and risk factors for nosocomial infection on rates of VRE in intensive care units (ICUs). DESIGN Prospective ecologic study. SETTING 126 adult ICUs from 60 U.S. hospitals from January 1996 through July 1999. PATIENTS All patients admitted to participating ICUs. MEASUREMENTS Monthly use of antimicrobial agents (defined daily doses per 1000 patient-days), nosocomial infection rates, and susceptibilities of all tested enterococci isolated from clinical cultures. RESULTS Prevalence of VRE (median, 10%; range, 0% to 59%) varied by type of ICU and by teaching status and size of the hospital. Prevalence of VRE was strongly associated with VRE prevalence among inpatient non-ICU areas and outpatient areas in the hospital, ventilator-days per 1000 patient-days, and rate of parenteral vancomycin use. In a weighted linear regression model controlling for type of ICU and rates of VRE among non-ICU inpatient areas, rates of vancomycin use (P < 0.001) and third-generation cephalosporin use (P = 0.02) were independently associated with VRE prevalence. CONCLUSIONS Higher rates of vancomycin or third-generation cephalosporin use were associated with increased prevalence of VRE, independent of other ICU characteristics and the endemic VRE prevalence elsewhere in the hospital. Decreasing the use rates of these antimicrobial agents could reduce rates of VRE in ICUs.
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Affiliation(s)
- S K Fridkin
- Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, MS A-35, 1600 Clifton Road, Atlanta, GA 30333, USA.
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Abstract
Head and facial movements can provide valuable cues to identity in addition to their primary roles in communicating speech and expression [1-8]. Here we report experiments in which we have used recent motion capture and animation techniques to animate an average head [9]. These techniques have allowed the isolation of motion from other cues and have enabled us to separate rigid translations and rotations of the head from nonrigid facial motion. In particular, we tested whether human observers can judge sex and identity on the basis of this information. Results show that people can discriminate both between individuals and between males and females from motion-based information alone. Rigid head movements appear particularly useful for categorization on the basis of identity, while nonrigid motion is more useful for categorization on the basis of sex. Accuracy for both sex and identity judgements is reduced when faces are presented upside down, and this finding shows that performance is not based on low-level motion cues alone and suggests that the information is represented in an object-based motion-encoding system specialized for upright faces. Playing animations backward also reduced performance for sex judgements and emphasized the importance of direction specificity in admitting access to stored representations of characteristic male and female movements.
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Affiliation(s)
- H Hill
- Department of Psychology, University College London, Gower Street, WC1E 6BT, London, United Kingdom.
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47
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Heller R, Fritzsche M, Hill H, Kick H. [Sleep deprivation as a predictor of response to light therapy in major depression]. Fortschr Neurol Psychiatr 2001; 69:156-63. [PMID: 11386120 DOI: 10.1055/s-2001-12678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Light therapy (LT) is regarded as the treatment of choice for seasonal affective disorder (SAD). In nonseasonal depression the results of light therapy are nonconclusive. Sleep deprivation (SD), however, is effective in 50-60% of the patients with major depression. The predictive value of Total Sleep Deprivation (TSD) for the treatment outcome of antidepressiva has been already examined. Purpose of the present study was to test whether light therapy is more beneficial in TSD responders than in TSD nonresponders. 40 inpatients with major depressive disorder completed one night of TSD. Twenty TSD responders and 20 TSD nonresponders were randomly assigned to 14 days of bright light therapy (2500 lux, 7-9 a.m.) or 14 days of dim light therapy (red light 50 lux, 7-9 a.m.). Manova with repeated measurements revealed a significant difference in the course of depression over the time between TSD responders and nonresponders, but no significant difference between bright and dim light. Questions of placebo effect, of SAD and of personality variables as predictors of response to SD and LT are being discussed.
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Affiliation(s)
- R Heller
- Psychiatrische Klinik, Universität Heidelberg
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Friend KE, Khandwala HM, Flyvbjerg A, Hill H, Li J, McCutcheon IE. Growth hormone and insulin-like growth factor-I: effects on the growth of glioma cell lines. Growth Horm IGF Res 2001; 11:84-91. [PMID: 11472074 DOI: 10.1054/ghir.2000.0183] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Growth hormone (GH) and insulin-like growth factor-I (IGF-I) are known to be mitogens for many types of neoplasms. To investigate their role in tumors of glial origin, in vitro and in vivo experiments were performed with a panel of immortalized glioma cell lines (D54, SNB-19, U87, U251 and U373). Initial analysis for mRNA expression demonstrated the following: GH receptor (5/5 cell lines positive), IGF-I (0/5), IGF-II (0/5), IGF-I receptor (5/5), IGF-II receptor (2/5). Thus, each cell line expressed the necessary receptors to respond to GH and the IGFs but there was no autocrine IGF production by the tumors themselves. IGF-I stimulated mitogenesis as measured by [(3)H]thymidine uptake experiments in U251 and U373 cells. However, when these two IGF-responsive cell lines were xenografted into mice, tumor development and growth rates were not significantly different in GH-deficient animals (despite having IGF-I serum concentrations only 31% of normal). Because our studies were performed in immunocompromised animals, GH or IGF effects on immune surveillance, known to be important from some syngeneic glioma models, would not be likely to contribute to our findings. Nevertheless, these studies are important because they demonstrate that the growth of glioma cell lines in an in vivo environment can remain robust in a GH/IGF-I-deficient setting, even if in vitro experiments indicate that IGF-I is mitogenic.
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Affiliation(s)
- K E Friend
- Section of Endocrine Neoplasia and Hormonal Disorders, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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49
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McCutcheon IE, Flyvbjerg A, Hill H, Li J, Bennett WF, Scarlett JA, Friend KE. Antitumor activity of the growth hormone receptor antagonist pegvisomant against human meningiomas in nude mice. J Neurosurg 2001; 94:487-92. [PMID: 11235955 DOI: 10.3171/jns.2001.94.3.0487] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The authors have previously demonstrated that modulation of the growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis can significantly affect meningioma growth in vitro. These studies were performed to evaluate the efficacy of GH receptor blockade in vivo. METHODS Primary cultures from 15 meningioma tumors obtained in humans were xenografted into athymic mice. Approximately 1.5 million cells from each of the 15 tumors were implanted into the flanks of two female mice, one pair for each tumor. One animal from each of the 15 pairs was then treated with the GH receptor antagonist pegvisomant and the other with vehicle alone for 8 weeks. The tumor volume was measured using digital calipers three times per week. The mean tumor volume at the initiation of injections was 284 +/- 18.8 mm3 in the vehicle group and 291.1 +/- 20 mm3 in the pegvisomant group. After 8 weeks of treatment, the mean volume of tumors in the pegvisomant group was 198.3 +/- 18.9 mm3 compared with 350.1 +/- 23.5 mm3 for the vehicle group (p < 0.001). The serum IGF-I concentration in the vehicle group was 319 +/- 12.9 microg/L compared with 257 +/- 9.7 in the pegvisomant group (p < 0.02). A small but significant decrease was observed in circulating IGF binding protein (IGFBP)-3 levels, whereas slight increases occurred with respect to serum IGFBP-1 and IGFBP-4 levels. In the placebo group the tumor weight was 0.092 +/- 0.01 g compared with 0.057 +/- 0.01 g in the pegvisomant group (p < 0.02). The IGF-I and IGF-II concentrations were measured in the tumors by using a tissue extraction method. These human-specific immunoassays demonstrated that there was no autocrine production of IGF-I in any of the tumors, either in the pegvisomant or vehicle group. The IGF-I levels were highly variable (0-38.2 ng/g tissue) and did not differ significantly between treatment groups. CONCLUSIONS In an in vivo tumor model, downregulation of the GH/IGF-I axis significantly reduces meningioma growth and, in some instances, causes tumor regression. Because the concentrations of IGF-II in tumor did not vary with pegvisomant treatment and there was no autocrine IGF-I production by the tumors, the mechanism of the antitumor effect is most likely a decrease of IGF-I in the circulation and/or surrounding host tissues. Because the authors have previously demonstrated that the GH receptor is ubiquitously expressed in meningiomas, direct blockade of the GH receptor on the tumors may also be contributing to inhibitory actions.
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Affiliation(s)
- I E McCutcheon
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, USA.
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Abstract
BACKGROUND While the majority of depressed patients benefit from total sleep deprivation (TSD), light therapy is regarded as a first-line treatment only for seasonal affective disorder (SAD). The results of light therapy in nonseasonal major depressive disorder have been non-conclusive. We examined the correlation of TSD response and light therapy response in major depressed patients. METHODS 40 inpatients with major depressive disorder (seven with seasonal pattern, 33 without seasonal pattern) were deprived of a night's sleep. The TSD responders, as well as the TSD nonresponders, were randomly assigned to receive adjunct light therapy either with bright white light (2500 lux) or dim red light (50 lux) during 2 weeks beginning on the third day after TSD. RESULTS The 20 TSD responders improved significantly better under the light therapy than the 20 TSD nonresponders (according to the Hamilton Depression Rating Scale and the self-rating depression scale Bf-S; v. Zerssen). LIMITATIONS No significant difference could be found between the two light intensities. Since the patients were additionally treated with medication an interaction with the two adjunctive therapies cannot be excluded. CONCLUSION Our results indicate that a positive TSD response in major depressed patients can be predicative of beneficial outcome of subsequent light therapy.
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Affiliation(s)
- M Fritzsche
- Voss-Str. 2, Department of Psychiatry, University of Heidelberg, D-69115 Heidelberg, Germany
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