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Big data and public health
Published in Sridhar Venkatapuram, Alex Broadbent, The Routledge Handbook of Philosophy of Public Health, 2023
Reducing health disparities is routinely affirmed as a central goal of public health practice. Big data enables some forms of public health work that are important for addressing health disparities. For example, big data facilitates research to identify or rule out rare, but serious, adverse events, such as those that may not be detected in the trials that are required for the approval of new medications. Since selective serotonin reuptake inhibitors are used in fewer than 2% of pregnancies and congenital disorders occur in about 3% of live births, studies with hundreds of thousands of participants were required to produce convincing evidence against the frequent warnings that antidepressants could harm fetuses (Ehrenstein et al. 2017).
Inflammatory Disorders of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
The treatment of depression is similar to that of a patient who does not have MS, but particular attention needs to be paid to adverse effects, as they may exaggerate existing problems such as sexual dysfunction: Psychologic counseling.Serotonin reuptake inhibitors.Tricyclic antidepressants.
The Chemistry of the Brain
Published in Gail S. Anderson, Biological Influences on Criminal Behavior, 2019
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant drugs that are used to treat depression and other similar disorders.33 In general, they increase the levels of serotonin to improve mood and feelings of well-being. They have also been successfully used to reduce impulsive aggression in highly impulsive-aggressive individuals, and although it only completely prevents aggression in 30% of patients, almost half benefit from treatment.27 Work has shown that for SSRIs to work, the serotonin synaptic function must be working at least partially, as SSRIs attach to serotonin transporters, increasing serotonin levels within the synapse.27 Evidence suggests that low serotonin transporter numbers predispose to high levels of aggression, so fewer transporters would mean less to which the SSRIs could bind, resulting in blocking serotonin uptake and so reducing serotonin at the synapse.27 This explains why individuals carrying the S allele of 5-HTTLPR do not respond well to SSRI treatment, as they have lower levels of synthesis of the transporter protein.27 Neuroimaging studies have shown that SSRIs and other aggression treatments normalize the brain’s overreaction to threatening stimuli (from 122% to less than 0.1%).27
Acute bacterial skin and skin structure infections in pediatric patients: potential role of dalbavancin
Published in Expert Review of Anti-infective Therapy, 2023
Lorenzo Volpicelli, Mario Venditti, Alessandra Oliva
Linezolid is another commonly used drug when treating pediatric skin infections; it belongs to the oxazolidinone class and acts by inhibition of bacterial protein synthesis. Linezolid has an extremely high bioavailability (close to 100%), allowing it to be easily switched from intravenous to oral administration [37]. Moreover, this drug has activity against many vancomycin-resistant Enterococcus spp and Staphylococcus spp [37]. A meta-analysis was conducted to compare linezolid to vancomycin for pediatric SSTI. Clinical and microbiological cure rates resulted significantly better in patients treated with linezolid in the overall population and among the group affected by MRSA and the median length of hospital stay was shorter than vancomycin [38]. Careful evaluation of drug–drug interactions (i.e. with selective serotonin reuptake inhibitors, SSRIs, due to serotonin syndrome reaction) is nevertheless required before prescribing. Thrombocytopenia is the most frequent linezolid-related toxicity. Although generally mild and reversible with discontinuation, it occurred in 14.5% of a cohort with a median age of 4 years. In adults, this side effect is usually observed after a 14-day treatment course, but in children, it was shown to happen in a shorter period of 7–10 days. Also, peripheral neuropathy may occur during the linezolid treatment [39].
Assessment of clinical outcomes in patients with post-traumatic stress disorder: analysis from the UK Medical Cannabis Registry
Published in Expert Review of Neurotherapeutics, 2022
Manaswini Pillai, Simon Erridge, Lara Bapir, Martha Nicholas, Nishaanth Dalavaye, Carl Holvey, Ross Coomber, Daniela Barros, Urmila Bhoskar, Gracia Mwimba, Kavita Praveen, Chris Symeon, Simmi Sachdeva-Mohan, James J Rucker, Mikael H Sodergren
Management of PTSD involves a biopsychosocial approach, with psychotherapy being the mainstay at present, although long-term effectiveness remains unclear [7,8]. The data on pharmacotherapy suggest that selective serotonin reuptake inhibitors (SSRIs) are not appropriate first-line agents if sustained long-term symptom improvement is intended [7]. Side-effects such as agitation may explain why SSRIs are poorly tolerated, since hyperarousal is a common symptom of PTSD [9]. Other pharmacological options that have also been evaluated for the treatment of PTSD include prazosin, an alpha-1 adrenoceptor antagonist [10], trazodone, a serotonin receptor antagonist and reuptake inhibitor [11], and agomelatine, a melatonin antagonist [12]. However, these have demonstrated variable efficacy. As such, there is a need for continued research into novel PTSD therapies that offer long-term symptom relief and minimal side-effects.
A comparison of real-world effectiveness of vortioxetine along the treatment algorithm for major depressive disorder
Published in Current Medical Research and Opinion, 2022
Rohini Bose, Syed Usman Hamdani, Fareed Aslam Minhas, Keira Joann Herr
Major depressive disorder (MDD), a condition defined by depressed mood and markedly reduced interest or pleasure, is one of the leading causes of disability worldwide1,2. Early and accurate diagnosis with appropriate treatment regimens are the key to achieving long-term treatment success3. The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial shows that first-line treatment with an antidepressant elicits a response in approximately half of the patients and remission in roughly one-third. Subsequent second-line or later treatments are associated with even lower response and remission rates4. This evidence greatly underscores the importance of an appropriate choice of treatment earlier in the treatment paradigm. International guidelines recommend pharmacotherapy as first-line treatment for patients suffering from moderate-to-severe MDD5–8. While the use of selective serotonin-reuptake inhibitors is supported by the most evidence, their use is often associated with side effects, reduced treatment adherence and inadequate response.