Future Reports (future + report)

Distribution by Scientific Domains

Selected Abstracts

Design and implementation of a randomized trial evaluating systematic care for bipolar disorder

Gregory E Simon
Objectives: Everyday care of bipolar disorder typically falls short of evidence-based practice. This report describes the design and implementation of a randomized trial evaluating a systematic program to improve quality and continuity of care for bipolar disorder. Methods: Computerized records of a large health plan were used to identify all patients treated for bipolar disorder. Following a baseline diagnostic assessment, eligible and consenting patients were randomly assigned to either continued usual care or a multifaceted intervention program including: development of a collaborative treatment plan, monthly telephone monitoring by a dedicated nurse care manager, feedback of monitoring results and algorithm-based medication recommendations to treating mental health providers, as-needed outreach and care coordination, and a structured psychoeducational group program (the Life Goals Program by Bauer and McBride) delivered by the nurse care manager. Blinded assessments of clinical outcomes, functional outcomes, and treatment process were conducted every 3 months for 24 months. Results: A total of 441 patients (64% of those eligible) consented to participate and 43% of enrolled patients met criteria for current major depressive episode, manic episode, or hypomanic episode. An additional 39% reported significant subthreshold symptoms, and 18% reported minimal or no current mood symptoms. Of patients assigned to the intervention program, 94% participated in telephone monitoring and 70% attended at least one group session. Conclusions: In a population-based sample of patients treated for bipolar disorder, approximately two-thirds agreed to participate in a randomized trial comparing alternative treatment strategies. Nearly all patients accepted regular telephone monitoring and over two-thirds joined a structured group program. Future reports will describe clinical effectiveness and cost-effectiveness of the intervention program compared with usual care. [source]

Amperometric Determination of Glucose at Conventional vs.

Nanostructured Gold Electrodes in Neutral Solutions
Abstract The conventional gold electrodes were compared with recently published electrodes based on gold nanoparticles and gold nanostructured films as amperometric sensors for glucose in pH,7.40 phosphate buffer solutions. The conventional electrodes provided similar electroanalytical benefits while required much simpler and shorter preparation. It is recommended that the future reports on the development of electrochemical sensors based on metal nanoparticles/nanostructures include also the analytical figures of merit obtained at relevant conventional metal electrodes. The voltammetric studies indicated that, in contrast to phosphate buffers, the Tris buffers were not suitable for activation of gold surface toward the direct oxidation of glucose. [source]

Intermediary Spleen Microvasculature in Canis familiaris, Morphological Evidences of a Closed and Open Type

G. Alexandre-Pires
Summary Numerous studies have been made regarding circulation via the red pulp of the spleen, and intense controversy surrounds the question as to whether or not endothelial continuity exists between arterial and venous vessels. Aware of this intense controversy, and in order to perform investigation over the spleen of dogs infected with a parasitic disease (future reports shall be done), the authors studied the vascularization of the normal dog spleen in order to define its normal pattern and evaluate the eventual changes of the circulation pattern under the parasitic condition. These studies led us to report, unequivocally, using complementary vascular replective techniques, that the normal dog's intermediary circulation is morphologically closed and of the open kind also. These findings are contrary to the thesis that defends the existence of a physiologically closed and morphologically open circulation in the dog spleen. Lymphatic vessels in the spleen of the dog are also demonstrated. [source]

Nomenclature and Definitions for Emergency Department Human Immunodeficiency Virus (HIV) Testing: Report from the 2007 Conference of the National Emergency Department HIV Testing Consortium

Michael S. Lyons MD
Abstract Early diagnosis of persons infected with human immunodeficiency virus (HIV) through diagnostic testing and screening is a critical priority for individual and public health. Emergency departments (EDs) have an important role in this effort. As EDs gain experience in HIV testing, it is increasingly apparent that implementing testing is conceptually and operationally complex. A wide variety of HIV testing practice and research models have emerged, each reflecting adaptations to site-specific factors and the needs of local populations. The diversity and complexity inherent in nascent ED HIV testing practice and research are associated with the risk that findings will not be described according to a common lexicon. This article presents a comprehensive set of terms and definitions that can be used to describe ED-based HIV testing programs, developed by consensus opinion from the inaugural meeting of the National ED HIV Testing Consortium. These definitions are designed to facilitate discussion, increase comparability of future reports, and potentially accelerate wider implementation of ED HIV testing. [source]

Prenatal diagnosis, pregnancy terminations and prevalence of Down syndrome in Atlanta,

Csaba Siffel
Abstract BACKGROUND The impact of prenatal diagnosis on the live birth prevalence of Down syndrome (trisomy 21) has been described. This study examines the prevalence of Down syndrome before (1990,1993) and after inclusion of prenatally diagnosed cases (1994,1999) in a population-based registry of birth defects in metropolitan Atlanta. METHODS We identified infants and spontaneous fetal deaths with Down syndrome (n = 387), and pregnancies electively terminated after a prenatal diagnosis of Down syndrome (n = 139) from 1990 to 1999 among residents of metropolitan Atlanta from a population-based registry of birth defects, the Metropolitan Atlanta Congenital Defects Program (MACDP). Only diagnoses of full trisomy 21 were included. Denominator information on live births was derived from State of Georgia birth certificate data. We compared the prevalence of Down syndrome by calendar period (1990,1993, 1994,1999), maternal age (<35 years, 35+ years), and race/ethnicity (White, Black, other), using chi-square and Fisher's exact tests. RESULTS During the period when case ascertainment was based only on hospitals (1990,1993), the prevalence of Down syndrome was 8.4 per 10,000 live births when pregnancy terminations were excluded and 8.8 per 10,000 when terminations were included. When case ascertainment also included perinatal offices (1994,1999), the prevalence of Down syndrome was 10.1 per 10,000 when terminations were excluded and 15.3 when terminations were included. During 1990,1993, the prevalence of Down syndrome was 24.7 per 10,000 among offspring to women 35+ years of age compared to 6.8 per 10,000 among offspring to women <35 years of age (rate ratio [RR] = 3.65, 95% confidence interval [CI] = 2.53,5.28). During 1994,1999, the prevalence of Down syndrome was 55.3 per 10,000 among offspring to women 35+ years compared to 8.5 per 10,000 among offspring to women <35 years (RR = 6.55, 95% CI = 5.36,7.99). There was no statistically significant variation in the prevalence of Down syndrome by race/ethnicity within maternal age and period of birth strata. During 1994,1999, the proportion of cases that were electively terminated was greater for women 35+ years compared to women <35 years (RR = 5.10, 95% CI = 3.14,8.28), and lower for Blacks compared to Whites among women 35+ years of age (RR = 0.33, 95% CI = 0.16,0.66). CONCLUSIONS In recent years, perinatal offices have become an important source of cases of Down syndrome for MACDP, contributing at least 34% of cases among pregnancies in women 35+ years of age. Variation in the prevalence of Down syndrome by race/ethnicity, before or after inclusion of cases ascertained from perinatal offices, was not statistically significant. Among Down syndrome pregnancies in mothers 35+ years we found a lower proportion of elective termination among Black women compared to White women. We suggest that future reports on the prevalence of Down syndrome by race/ethnicity take into account possible variations in the frequency of prenatal diagnosis or elective termination by race/ethnicity. Birth Defects Research (Part A) 70565,571, 2004. Published 2004 Wiley-Liss, Inc. [source]