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Biomedical subjects

Ben Green

Publications and source records attributed to Ben Green.

10 recordsLinked to original sources

Lack of serum bactericidal activity in preschool children two years after a single dose of serogroup C meningococcal polysaccharide-protein conjugate vaccine.

BACKGROUND: There is an increased risk of invasive meningococcal disease during the teenage years. A cohort of children vaccinated with a single dose of meningococcal C protein-polysaccharide conjugate (MenC) vaccine in early childhood during the U.K. catch up campaign will enter this age group during the coming decade. The duration of protective immunity against invasive meningococcal C disease provided by this single dose regimen is uncertain.A serum bactericidal titer of <1/8 correlates with susceptibility to invasive meningococcal disease. We assessed this correlate of protection in a cohort of children approximately 2 years after a single dose of vaccine. METHODS: Serum bactericidal activity was assessed in 94 children (median age, 4.0 years) at a median time of 1.8 years after vaccination. RESULTS: Of the 94 children, 59 (63%) had a serum bactericidal titer <1/8. CONCLUSION: The data from this study add to previous evidence indicating that immunity wanes rapidly after vaccination with serogroup C meningococcal glycoconjugate vaccines in infancy and early childhood. Such observations suggest that booster doses of MenC vaccine may be needed to maintain the successful contribution this vaccine has made to child health in the United Kingdom.

Antibodies, Bacterial↗

Post-traumatic stress disorder in UK police officers.

Prevalence rates for post-traumatic stress disorder (PTSD) in police officers may be six or more times the prevalence rates for the community. Once established, is PTSD in police officers more severe than PTSD in civilians? This small study looks at the symptom frequencies in established cases of PTSD in 31 police officers and 72 civilians and compares the two. No significant differences were found, although there was a tendency for higher use of alcohol and to try not to think about the trauma. Police officers had more experiences of reliving the trauma or acting as if the trauma were recurring but, again, not to a significant degree.

Adult↗

Focus on aripiprazole.

This paper is an overview of recently published research concerning the neuroleptic drug aripiprazole. Aripiprazole is an antipsychotic drug with high affinity for D(2)- and D(3)-receptors and the dopamine autoreceptor. It also has serotonin 5-HT(1A)-receptor partial agonist and 5-HT(2A)-receptor antagonist properties. It is prescribed in the treatment of schizophrenia and is under the treatment of schizophrenia and schizoaffective investigation for treatment of bipolar disorder. The drug is given by mouth in an initial dose of 10 or 15 mg once daily. The dose may be adjusted at intervals of not less than 2 weeks up to a maximum of 30 mg daily. It appears to be useful in disorder and has a better side-effect profile than haloperidol.

Alzheimer Disease↗

Focus on levomepromazine.

This is a review of the uses of levomepromazine in psychiatry, based upon MEDLINE, PSYCLIT and EMBASE literature searches. The main indications for this drug in psychiatry are schizophrenia and schizoaffective disorder. Levomepromazine's sedative properties particularly fit it to use in psychiatric intensive care. There is also some evidence to suggest it has efficacy in drug-resistant psychosis, although this property of the drug does require further research. In other areas of medicine levomepromazine has been used in: alleviating bronchoconstriction; as a preoperative sedative; in terminal pain control and postoperative analgesia; and in the control of nausea. Some antimycobacterial properties have been recorded. The drug should not be prescribed to patients at high risk of accidental or suicidal overdose.

Antipsychotic Agents↗

Focus on paroxetine.

This review of paroxetine is based on Medline and PsycLit searches and a manual search of the available research literature. It aims to cover the pharmacology of this frequently prescribed SSRI antidepressant in terms of its indications, efficacy and adverse effects. Overall, paroxetine is a well-tolerated and safe first-line SSRI antidepressant with anxiolytic qualities. It has been found useful in depression, anxiety and other conditions such as obsessive compulsive disorder and post-traumatic stress disorder. The antidepressant has some advantages over earlier tricyclic medication in terms of a lack of cardiovascular side-effects and relative safety in overdose. Cessation of use, however, is associated with withdrawal or discontinuation symptoms and patients should be counselled as to how these might be avoided. A 3- or 4-week graded withdrawal regimen, perhaps with concomitant fluoxetine to cover serotonergic discontinuation symptoms, may be advisable.

Animals↗

Post-traumatic stress disorder: symptom profiles in men and women.

OBJECTIVE: To investigate the symptom frequencies of a relatively large sample of post-traumatic stress disorder (PTSD) sufferers and compare male and female symptom profiles. RESEARCH DESIGN AND METHODS: A total of 103 consecutive attendees at a clinic for PTSD were examined using a checklist of DSM-IV PTSD characteristics. The presence and absence of all symptoms was evaluated in a research interview. Some additional symptoms were also routinely asked about, such as mood lability, substance use, sex drive or libido. Symptom profiles of male and female sufferers of PTSD were compared using the chi-squared statistical test. MAIN OUTCOME MEASURES: Structured interview using checklist of DSM-IV PTSD characteristics. RESULTS: Certain symptoms were present in more than 30% of sufferers. Symptom frequencies for anxiety, insomnia, distressing and recurrent dreams, flashback imagery and intrusive thoughts, irritability, poor concentration, avoidance behaviour and detachment all reached frequencies above 70%. Some symptoms (such as inability to recall parts of the trauma and restricted affect) occurred in no more than 35% of sufferers. CONCLUSIONS: Men are significantly more likely than women to suffer with irritability (p < 0.05) and to use alcohol to excess (p < 0.05). Symptoms tend to follow an acute stress reaction, occur early and persist for many months. A case is made for restricting the diagnosis to the most prevalent symptoms and for including some often overlooked symptoms in the diagnostic guidelines, namely low mood, mood lability, and impaired libido.

Adult↗

Lamotrigine in mood disorders.

Lamotrigine is an anticonvulsant drug with good efficacy and safety in the treatment of epilepsy. There is now substantial evidence that lamotrigine is also useful in treating resistant depression, rapid cycling bipolar affective disorder, depressive episodes in bipolar affective disorder and in the maintenance phase or prophylaxis of bipolar affective disorder. There are possible roles in managing mood changes in borderline personality disorder, reducing chronic pain and treating schizoaffective disorder. The general range of doses found effective in affective disorders is from 50 to 300 mg daily. Clinical use seems to involve a titration of dose upwards over several weeks until the desired effect is obtained. However, further definitive double-blind, randomised controlled trials against gold standard treatments are required. Lamotrigine has a preferable side-effect profile compared to standard agents for bipolar affective disorder such as lithium or carbamazepine. Further research is certainly warranted and, given its tolerability, could point to lamotrigine as the treatment of choice for some affective disorders.

Analgesics↗

Focus on amisulpride.

Amisulpride is a second-generation antipsychotic, a substituted benzamide. It appears to be an effective agent in treating schizophrenia for what are characterised as positive and negative symptoms. The recommended doses are between 400 mg/day and 800 mg/day. Amisulpride demonstrates a good global safety profile, particularly when compared with first-generation antipsychotics, such as haloperidol. There are interesting studies that point towards amisulpride's antidepressant effect in dysthymia speculative on possible roles in affective psychoses and chronic fatigue syndrome.

Amisulpride↗