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Daily Assessment (daily + assessment)
Selected AbstractsClinical Evaluation of the Daily Assessment of Symptoms-Anxiety (DAS-A): A New Instrument to Assess the Onset of Symptomatic Improvement in Generalized Anxiety DisorderCNS: NEUROSCIENCE AND THERAPEUTICS, Issue 1 2009Douglas E. Feltner Introduction: Rapid onset of symptomatic improvement is a desirable characteristic of new generalized anxiety disorder (GAD) treatments. A validated rating scale is needed to assess GAD symptoms during the first days of treatment. Aims: To provide clinical data to support the validation of the Daily Assessment of Symptoms-Anxiety (DAS-A), a new instrument to assess onset of symptomatic improvement in GAD. Methods: We assessed the ability of the DAS-A to detect onset of symptomatic improvement during the first week of therapy in 169 GAD patients randomized to paroxetine 20 mg/day, lorazepam 4.5 mg/day, or placebo for 4 weeks. Results: On the primary outcome measure, average change from baseline over the first 6 days of DAS-A assessments, lorazepam (,14.5 ± 1.8 [LS mean, SE]; P= 0.006 vs. placebo) showed a significant improvement versus placebo (,7.85 ± 1.7), whereas paroxetine (,8.3 ± 1.7; P= 0.83 vs. placebo) did not. Lorazepam produced a significant treatment effect on the DAS-A at 24 h (P= 0.0004), whereas paroxetine did not (P= 0.5666). Both active drugs produced statistically significant improvement versus placebo on the DAS-A total change score (last-observation carried forward method; LOCF, endpoint). On the DAS-A total change score (observed cases analysis), lorazepam produced statistically significant improvement versus placebo at weeks 1, 2, and 4 (P < 0.05; no week 3 visit), whereas paroxetine, separated from placebo at weeks 2 and 4 (P < 0.05). Both active drugs produced results on the Hamilton Anxiety Rating Scale (HAM-A) at weeks 1 through 4 that were similar to those found on the DAS-A. Conclusions: These data indicate that the DAS-A can detect symptomatic improvement in GAD patients treated with lorazepam during the first week of treatment, and, in a secondary analysis, as early as 24 h. [source] Daily assessment of coping in patients with gastrointestinal cancerPSYCHO-ONCOLOGY, Issue 1 2002Elisabet Wasteson Ninety-five patients with gastrointestinal (GI) cancer participated in a study concerning stressful events, coping and emotional well-being. Participants were either potentially cured (n=62) after radical surgery or non-cured (n=33). For a period of 1 week, close to being informed about their diagnosis, they performed daily recordings of stressful events, the distress occasioned by these events and their perception of control over them, coping, worry and happiness/sadness. Anxiety and depression were assessed by a single retrospective assessment at the end of the week (Hospital Anxiety and Depression (HAD) scale). The most commonly recorded stressful events were ,Somatic aspects' and ,Everyday concerns'. ,Somatic aspects', ,Social aspects' and ,Other consequences of the disease' were rated as most bothersome. Patients perceived that they had the highest degree of control over ,Returning home after hospital stay', whereas ,Contact with the medical services' was assigned low control. The most commonly used coping strategies were ,Acceptance' and ,Relaxation', and the least used was ,Religion'. Significant positive correlations between the occurrence of stressful events and the use of coping strategies were demonstrated between ,Somatic Aspects' and ,Acceptance'/,Direct Action', and between ,Social Aspects' and ,Seeking Social Support'. Daily assessment of stress-coping relationships represents a promising approach to the understanding of adaptation among cancer patients. Copyright © 2002 John Wiley & Sons, Ltd. [source] Suppressive role of leukocyte cell,derived chemotaxin 2 in mouse anti,type II collagen antibody,induced arthritisARTHRITIS & RHEUMATISM, Issue 2 2008Akinori Okumura Objective We previously reported that the Val58Ile polymorphism of the leukocyte cell,derived chemotaxin 2 gene (LECT2) is associated with the severity of rheumatoid arthritis (RA). To define the role of LECT2 in inflammatory arthritides, we investigated the development of collagen antibody,induced arthritis (CAIA) in LECT2-deficient (LECT2,/,) mice. Methods CAIA was induced in mice by administering anti,type II collagen antibodies followed by lipopolysaccharide. Daily assessment of hind paw swelling was used to monitor the development of arthritis. The histopathologic features and expression of inflammatory cytokines were also analyzed. We confirmed the role of LECT2 by introducing a LECT2 expression vector into LECT2,/, mice, using a hydrodynamic gene transfer method. Results Arthritis in LECT2,/, mice was significantly exacerbated compared with that in wild-type (WT) controls. Histopathologic assessment of the tarsal joints showed that inflammation and erosion of cartilage and bone in LECT2,/, mice were more severe than that in controls. Interleukin-1, (IL-1,), IL-6, and certain chemokines were present at significantly higher levels in the arthritic hind paws of LECT2,/, mice. In contrast, the amount of LECT2 in the serum and locally in the hind paws was higher in arthritic WT mice. Finally, hydrodynamic gene transfer experiments revealed that the severity of arthritis was reduced by the systemic expression of exogenous mouse LECT2 protein in LECT2,/, mice. Conclusion These results strongly suggest that LECT2 directly suppresses the development of CAIA. Manipulation of LECT2 might provide a rationale for novel therapeutic approaches to the treatment of inflammatory arthritides such as RA. [source] Violence from young women involuntarily admitted for severe drug abuseACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007T. Palmstierna Objective:, To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse. Method:, All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates. Results:, Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found. Conclusion:, In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics. [source] The Overlap Syndrome of Depression and Delirium in Older Hospitalized PatientsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Jane L. Givens MD OBJECTIVES: To measure the prevalence, predictors, and posthospitalization outcomes associated with the overlap syndrome of coexisting depression and incident delirium in older hospitalized patients. DESIGN: Secondary analysis of prospective cohort data from the control group of the Delirium Prevention Trial. SETTING: General medical service of an academic medical center. Follow-up interviews at 1 month and 1 year post-hospital discharge. PARTICIPANTS: Four hundred fifty-nine patients aged 70 and older who were not delirious at hospital admission. MEASUREMENTS: Depressive symptoms assessed at hospital admission using the 15-item Geriatric Depression Scale (cutoff score of 6 used to define depression), daily assessments of incident delirium from admission to discharge using the Confusion Assessment Method, activities of daily living at admission and 1 month postdischarge, and new nursing home placement and mortality determined at 1 year. RESULTS: Of 459 participants, 23 (5.0%) had the overlap syndrome, 39 (8.5%) delirium alone, 121 (26.3%) depression alone, and 276 (60.1%) neither condition. In adjusted analysis, patients with the overlap syndrome had higher odds of new nursing home placement or death at 1 year (adjusted odds ratio (AOR)=5.38, 95% confidence interval (CI)=1.57,18.38) and 1-month functional decline (AOR=3.30, 95% CI=1.14,9.56) than patients with neither condition. CONCLUSION: The overlap syndrome of depression and delirium is associated with significant risk of functional decline, institutionalization, and death. Efforts to identify, prevent, and treat this condition may reduce the risk of adverse outcomes in older hospitalized patients. [source] | ||||||||||