SEARCH · PubMed Health

Results for “Conjunctivitis, Inclusion”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources

PubMed2002

Sensitization to sunflower pollen and lung functions in sunflower processing workers.

BACKGROUND: This study aimed to investigate whether exposure to sunflower pollen (Helianthus annuus) increases both sensitization and respiratory symptoms, and whether or not it affects lung functions in sunflower processing workers. METHODS: The largest sunflower processing factories in the Thrace region of Turkey participated in this study. Workers from the units directly exposed to sunflower seed enrolled as the study group (n = 102) and workers who were not directly exposed to Helianthus annuus pollen (n = 102) were the control group. Detailed questionnaires covering respiratory and allergic symptoms were completed, and skin prick tests and lung function tests were performed. RESULTS: We found a very high rate (23.5%) of sensitization to Helianthus annuus in the study group compared to the controls (P<0.001). Logistic regression analysis showed that the risk of sensitization to H. annuus was increased 4.7-fold (odds ratio = 4.17, 95%) confidence interval = 1.3-16.7) if subjects were exposed to sunflower pollen in the workplace. While asthmatic symptoms and allergic skin diseases were not different between the two groups, workers in the study group had a higher rate of allergic rhinitis and conjunctivitis (P<0.05). We found that pulmonary function was significantly impaired in the study group (P<0.01). Using a multivariate analysis model, inclusion in the study group was found to be a predictive factor for impairment of lung function (P=0.002). CONCLUSIONS: We conclude that sunflower pollen has high allergenic potential, especially when there is close contact, and exposure to sunflower pollen in the workplace can result in impairment in lung function.

Agricultural Workers' Diseases↗

PubMed2000

Family therapy for asthma in children.

BACKGROUND: Psychosocial and emotional factors are important in childhood asthma. Nevertheless, drug therapy alone continues to be the main treatment. Treatment programmes that include behavioural or psychological interventions have been developed to improve disturbed family relations in the families of children with severe asthma. These approaches have been extended to examine the efficacy of family therapy to treat childhood asthma in a wider group of patients. This review systematically examines these studies. OBJECTIVES: Recognition that asthma can be associated with emotional disturbances has led to the investigation of the role of family therapy in reducing the symptoms and impact of asthma in children. The objective of this review was to assess the effects of family therapy as an adjunct to medication for the treatment of asthma in children. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, Psychlit and Psychinfo. SELECTION CRITERIA: Randomised trials comparing children undergoing systematic therapy focusing on the family in conjunction with asthma medication, with children taking asthma medication only. DATA COLLECTION AND ANALYSIS: One reviewer applied the study inclusion criteria. MAIN RESULTS: Two trials with a total of 55 children were included. It was not possible to combine the findings of these two studies because of differences in outcome measures used. In one study, gas volume, peak expiratory flow rate and daytime wheeze showed improvement in family therapy patients compared to controls. In the other study, there was an improvement in overall clinical assessment and number of functionally impaired days in the patients receiving family therapy. There was no difference in forced expiratory volume or medication use in both studies. REVIEWER'S CONCLUSIONS: There is some indication that family therapy may be a useful adjunct to medication for children with asthma. This conclusion is limited by small study sizes and lack of standardisation in the choice of outcome measures.

Adult↗

PubMed2004

Selenium supplementation for asthma.

BACKGROUND: Selenium deficiency may be important in chronic asthma. Observational studies have demonstrated that patients with chronic asthma may have lower levels of selenium than their control. Nevertheless, selenium supplementation has not been recommended with drug therapy for asthma. This review systematically examines RCTs that evaluated the role of selenium supplementation in chronic asthma. OBJECTIVES: Recognition that chronic asthma can be associated with selenium deficiency has led to the investigation of the role of selenium supplementation in reducing the symptoms and impact of chronic asthma. The objective of this review was to assess the efficacy of selenium supplementation as an adjunct to medication for the treatment of chronic asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, MEDLINE/PUB MED, and EMBASE. Searches were current as of August 2003. SELECTION CRITERIA: Randomised trials comparing patients with chronic asthma receiving selenium supplementation in conjunction with asthma medication, with patients taking asthma medication only. DATA COLLECTION AND ANALYSIS: Two reviewers applied the study inclusion criteria MAIN RESULTS: One trial with a total of 24 patients suffering from chronic asthma was included. The study reported significant clinical improvement in the selenium-supplemented group, as compared with the placebo group, in terms of a 'clinical evaluation'. However, this improvement could not be validated by significant changes in separate objective parameters of lung function and airway hyper-responsiveness. REVIEWERS' CONCLUSIONS: There is some indication that selenium supplementation may be a useful adjunct to medication for patients with chronic asthma. This conclusion is limited because of insufficient studies and lack of improvement in the clinical parameters of lung function.

Asthma↗

PubMed2005

Immunogenicity of enterovirus 70 capsid protein VP1 and its non-overlapping N- and C-terminal fragments.

Currently no practical treatment method or effective virus vaccine is available for acute hemorrhagic conjunctivitis (AHC) caused by enterovirus 70 (EV70). Antibodies to UV-inactivated EV70 (J670/71 epidemic isolate) and to the inclusion bodies of recombinant proteins of full-length EV70 VP1 (GST-VP1m), its non-overlapping terminal fragments N138 (1-138 aa) and C170 (141-310 aa) (or GST-N138m and GST-C170) were developed in rabbits. The anti-EV70 neutralizing activities of the rabbit sera were determined by standard neutralization assays. The antibodies to UV-inactivated EV70, were immuno-reactive with EV70 capsid proteins VP1 and VP3 of four EV70 epidemic isolates (KW/97, T260/74, J670/71 and AE/72) in Western-blot analysis, and immunoprecipitated the capsid proteins VP1 and VP3 from the cell lysates of virus-infected human Chang's conjunctival (HCC) cells. The antibodies to GST-VP1m, GST-N138m and GST-C170, immunoprecipitated only the VP1 proteins of the four EV70 isolates. Anti-EV70 J670/71 antibodies and the antibodies to the three recombinant VP1 proteins were all capable of immunoprecipitating EV70 whole-virus of the four EV70 epidemic isolates grown in HCC cells. The anti-EV70 virion antibodies neutralized EV70 isolates with titers of 6000-10,000 units/ml while the antibodies to GST-VP1m, GST-N138m or GST-C170 neutralized EV70 isolates with titers of 20-320units/ml. The results suggest that (a) immunization with bacterially produced recombinant EV70 VP1 and its non-overlapping N- and C-terminal fragments, was capable of eliciting EV70-neutralizing antibodies; (b) the neutralization titers of antibodies to the recombinant VP1 proteins were lower than that of antibodies to the UV-inactivated EV70 virions; and (c) the non-overlapping N138 and C170 fragments of EV70 VP1 both harbor independent anti-EV70 neutralization antigenic sites.

Antibodies, Viral↗

PubMed1997

Breast, lung and colorectal cancer incidence and survival in South Thames Region, 1987-1992: the effect of social deprivation.

BACKGROUND: This paper describes the relationship between social deprivation and incidence of, and survival from, breast, lung, and colorectal cancers among residents of the South Thames regions. We analysed 23,505 cases of breast cancer, 29,903 cases of lung cancer and 21,905 cases of colorectal cancer, aged 40-99 inclusive at diagnosis and diagnosed between 1 January 1987 and 31 December 1992. METHODS: Using the 1991 Census in conjunction with the Townsend index on social deprivation, we derived proxy indicators of deprivation based on patients' home postal codes. Cumulative relative five-year survival rates (per cent) were calculated for each cancer. We then compared our results with the relevant standardized incidence and mortality ratios by deprivation status. RESULTS: A clear trend was observed in standardized mortality rates across deprivation tenths for the three tumour sites: mortality increased with deprivation. A strong positive correlation was found between deprivation and the incidence of lung cancers (p < 0.0001), but no association was found between deprivation and incidence of breast and colorectal cancers. Significantly lower five-year relative survival rates were found for breast and colorectal cancer patients in the most deprived Townsend tenths. Breast cancer patients resident in the most affluent tenth of enumeration districts had a 70 per cent relative survival ratio compared with 57 per cent in the most deprived tenth. The corresponding figures for colorectal cancer patients were 40 per cent and 32 per cent, respectively. CONCLUSIONS: Survival differences by deprivation status exist in South Thames among patients suffering from breast or colorectal cancers and are not explained by differences in the incidences of these diseases. For lung cancer, incidence and mortality were positively correlated with deprivation, but no socio-economic gradient was found for survival.

Adult↗

PubMed2003

Avipox sp. in a colony of gray-crowned rosy finches (Leucosticte tephrocotis).

Members of a wild-caught colony of 16 gray-crowned rosy finches (Leucosticte tephrocotis) were presented with dermal and mucosal lesions, anorexia, emaciation, lethargy, and sudden death. Lesions included dermatitis, conjunctivitis, and glossitis. Skin scrapings from and bacterial culture of dermal lesions yielded Staphylococcus aureus and Candida albicans. Necropsy and histologic examination revealed characteristic epidermal and mucosal pox lesions, with the presence of characteristic Bollinger body intracellular inclusions. Electron microscopy (EM) provided confirmation of pox virus infection. This epornitic resulted in the death or euthanasia of 12 birds (75% morbidity and associated mortality) and was brought to conclusion through culling of affected birds. The source of infection remains unknown, although multiple modes of introduction exist. Similar epornitics may be prevented through indoor, species-specific housing, and quarantine. Vaccination and antiparasitic treatment may reduce the risk of disease spread.

Animals↗

PubMed2006

Persistent conjunctivitis associated with drinking arsenic-contaminated water.

PURPOSE: The aim of this study was to report on 2 cases of bilateral chronic conjunctivitis that were associated with the drinking of arsenic-contaminated underground water for a long time. DESIGN: Interventional case reports comprised the study. METHODS: This study was a review of clinical data and laboratory investigations. RESULTS: Papillary conjunctivitis developed in 2 members of a family who has been drinking underground water for 15 years. There were severe dermatological changes, including hyperkeratosis, on palms and soles, hypo- and hyperpigmented lesions (rain-drop) on the abdomen, chest, and back. Arsenic levels estimated in the nails and hair of both patients were very high. The arsenic level of the drinking water was above the permissible limit. Histopathological examination of conjunctival tissue confirmed the inflammatory response of a papillary type; however, an arsenic estimation in conjunctival tissue was not possible. There were no inclusions of bodies in conjunctival smears stained with hematoxylin and eosin (H&E) stain. There was no response to the usual treatment for papillary conjunctivitis, which only subsided, along with a regression of dermatological changes, when patients were treated with the chelating agent, dimercaprol, and multivitamin preparations, as well as no longer drinking the contaminated water. CONCLUSIONS: This is a rare association and, to the best of our knowledge, the first report of successful treatment with dimercarpol. The source of arsenic was contaminated underground drinking water (from a deep tube-well). The pathophysiology is thought to be the result of an inflammatory response caused by accumulated arsenic in local tissues. Papillary conjunctivitis and dermatological changes can be successfully managed with dimercaprol and multivitamins. Further studies are required to find out the possible link between the papillary response of conjunctiva and arsenic accumulation within the body.

Adolescent↗

PubMedDate not supplied

[Incidence of Chlamydia ocular infections in patients with conjunctivitis, at a private clinic of Uberaba, MG].

780 patients with recurrent conjunctival infections or persistent complaints of itching, burning pain, lacrimation and conjunctival hyperemia were subject to conjunctival smear examination for cytology and the presence of inclusion bodies. Two hundred and forty seven (31.7%) showed cytoplamic inclusions; 235 of them were subject to a direct specific immunofluorescency test with 90 (38.3%) positive results. The importance of the clinical manifestations and laboratory methods (direct immunofluorescence and research cytoplasmic inclusions) were considered. The patients are clients of a private clinic and have a moderate to hightor socioeconomic level.

Adolescent↗

PubMed2004

Serological methods and selective agars to enumerate Campylobacter from broiler carcasses: data from inter- and intralaboratory analyses.

Routine analytical means to estimate Campylobacter numbers per milliliter of carcass rinses are needed in high-sample-throughput poultry laboratories. We compared three serological confirmatory tests that were amenable to such a setting when used in conjunction with Campy-Line and Campy-Cefex Campylobacter selective agars. Pre- and post-chlorinated chiller carcass rinse samples were obtained and held on ice, then analyzed 24 h later in two separate laboratories. Presumptive counts on both pre- and postchiller samples from between laboratories on individual agars and between both agars were highly correlated. Agreement among the three serological tests was nearly complete. The use of a premeasured and dried latex anti-Campylobacter antibody agglutination test format was superior to that of either a liquid latex agglutination format or a direct phosphate-buffer microscopic technique in terms of practicality as was the inclusion of an unarmed latex control to detect auto agglutination. A routine procedure for Campylobacter level estimation was suggested. This procedure, when used in conjunction with a serological confirmatory step, should provide processors with a means to assess reductions in numbers per milliliter of carcass rinses versus strictly presence-absence testing.

Agar↗

PubMed2005

Family therapy for chronic asthma in children.

BACKGROUND: Psychosocial and emotional factors are important in childhood asthma. Nevertheless, drug therapy alone continues to be the main treatment. Treatment programmes that include behavioural or psychological interventions have been developed to improve disturbed family relations in the families of children with severe asthma. These approaches have been extended to examine the efficacy of family therapy to treat childhood asthma in a wider group of patients. This review systematically examines these studies. OBJECTIVES: Recognition that asthma can be associated with emotional disturbances has led to the investigation of the role of family therapy in reducing the symptoms and impact of asthma in children. The objective of this review was to assess the effects of family therapy as an adjunct to medication for the treatment of asthma in children. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, Psychlit and Psychinfo. Searches are current as of January 2005. SELECTION CRITERIA: Randomised trials comparing children undergoing systematic therapy focusing on the family in conjunction with asthma medication, with children taking asthma medication only. DATA COLLECTION AND ANALYSIS: Two reviewers assessed the studies for inclusion in the review. MAIN RESULTS: Two trials with a total of 55 children were included. It was not possible to combine the findings of these two studies because of differences in outcome measures used. In one study, gas volume, peak expiratory flow rate and daytime wheeze showed improvement in family therapy patients compared to controls. In the other study, there was an improvement in overall clinical assessment and number of functionally impaired days in the patients receiving family therapy. There was no difference in forced expiratory volume or medication use in both studies. AUTHORS' CONCLUSIONS: There is some indication that family therapy may be a useful adjunct to medication for children with asthma. This conclusion is limited by small study sizes and lack of standardisation in the choice of outcome measures.

Adult↗

PubMed2005

Unit-dose packaged drugs for treating malaria.

BACKGROUND: Unit-dose packaging of antimalarial drugs may improve malaria cure by making it easier for patients to take their treatment correctly. OBJECTIVES: To summarize the effects of unit-dose packaged treatment on cure and treatment adherence in people with uncomplicated malaria. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group Specialized Register (November 2004), CENTRAL (The Cochrane Library Issue 4, 2004), MEDLINE (1966 to November 2004), EMBASE (1980 to November 2004), LILACS (November 2004), conference proceedings, and reference lists of articles. We also contacted pharmaceutical companies, organizations, and researchers in the field. SELECTION CRITERIA: Randomized controlled trials (RCTs), cluster-RCTs, quasi-RCTs, and controlled before-and-after studies of unit-dose packaged drugs for treating uncomplicated malaria. DATA COLLECTION AND ANALYSIS: We independently assessed study eligibility and methodological quality, and extracted data for an intention to treat analysis, where possible. We combined binary data using relative risk (RR) and the fixed-effect model, and presented them with 95% confidence intervals (CI). We attempted to contact study authors for additional information. MAIN RESULTS: Three quasi-RCTs (895 participants) and one cluster-RCT (6 health facilities) met the inclusion criteria. Trials were of poor methodological quality, and none adequately assessed treatment failure. Unit-dose packaged drugs (in conjunction with prescriber training and patient information) appeared to be associated with higher participant-reported treatment adherence in all trials.A meta-analysis of two trials (596 participants) showed that participant-reported treatment adherence was higher with blister-packed tablets compared with tablets in paper envelopes (RR 1.18, 1.12 to 1.25). Two trials using tablets in sectioned polythene bags as the intervention also noted an increase in participant-reported treatment adherence: the cluster-RCT (6 clusters) compared it with tablets in paper envelopes, and the other trial compared it with syrup in bottles (RR 2.15, 1.76 to 2.61; 299 participants). AUTHORS' CONCLUSIONS: There is insufficient evidence to determine the effect of unit-dose packaged antimalarial drugs on treatment failure. Unit-dose packaging supported by prescriber training and patient information appears to improve participant-reported treatment adherence, but these data come from trials with methodological limitations.

Antimalarials↗

PubMed1996

Role of Wetlands in Reducing Phosphorus Loading to Surface Water in Eight Watersheds in the Lake Champlain Basin

A landscape-level approach was applied to eight rural watersheds to assess the role that wetlands play in reducing phosphorus loading to surface waters in the Lake Champlain Basin. Variables summarizing various characteristics of wetlands within a watershed were calculated using a geographic information system and then compared to measured phosphorus loading through multiple regression analyses. The inclusion of a variable based on the area of riparian wetlands located along low- and medium-order streams in conjunction with the area of agricultural and nonwetland forested lands explained 88% of the variance in phosphorus loading to surface waters. The best fit model coefficients (Pload=0.86Ag+0.64For-30Ripwet+160) suggest that a hectare of riparian wetland may be many times more important in reducing phosphorus than an agricultural hectare is in producing phosphorus. These results provide additional support for the concept that protection of riparian wetlands is an important management strategy for controlling stream water quality in multiuse landscapes.KEY WORDS: Wetlands; Phosphorus; Landscape; Regression model; Riparian; Vermont

Journal Article↗

PubMed1990

Enhancement of chemotherapy and nitroimidazole-induced chemopotentiation by the vasoactive agent hydralazine.

Nitroimidazoles have been shown to be potent sensitisers of certain clinically active chemotherapeutic agents. This process of chemopotentiation has been shown to be hypoxia-mediated. The present studies evaluated whether increasing the level of hypoxia in the tumour tissue, by treatment with the vasoactive agent hydralazine, could modify the chemosensitising ability of nitroheterocyclics. Administering either misonidazole or RSU 1164 before, or hydralazine after, the chemotherapeutic agents melphalan, cyclophosphamide or the nitrosourea CCNU, increased the extent of cell kill in both the KHT sarcoma and RIF-1 tumour. However, even greater enhancements could be achieved when hydralazine was used in treatment protocols in which a nitroimidazole was combined with chemotherapy. For example, a 5.0 mg kg-1 dose of hydralazine given 30 min after melphalan, or a 2.5 mmol kg-1 dose of misonidazole administered 30 min before melphalan, increased, compared to melphalan alone, the resultant tumour cell kill by factors of approximately 1.9 and approximately 1.3, respectively. By comparison, when hydralazine was given after the melphalan plus misonidazole combination, treatment efficacy was enhanced approximately 3-fold compared to melphalan alone. Yet in contrast to the results of the tumour response studies, the inclusion of hydralazine did not increase the bone marrow toxicity associated with the chemotherapeutic agent when used alone or in conjunction with a nitroimidazole. The results, therefore, imply that the addition of hydralazine to the chemotherapy, or chemotherapy-sensitiser protocol, led to a therapeutic advantage.

Animals↗

PubMed2002

[Epidemic nephropathy. An important differential diagnosis of acute renal failure in Reutlingen, an endemic area].

BACKGROUND AND OBJECTIVE: Hantavirus ("epidemic") nephropathy (HN), or hemorrhagic fever with renal syndrome (WHO nomenclature), is an infection caused by strains (e.g. Puumala) of Hantavirus, which is often accompanied by acute renal failure. Although its typical symptomatology has been fully reported, it is rarely included in the differential diagnosis of renal nephropathy. This study investigated whether, in the presence of typical symptoms, specific search for a certain constellation of laboratory values in association with a typical history can more often provide the diagnosis of HN. PATIENTS AND METHODS: 18 patients (4 females, 14 males; average age 41 years) fulfilled the following inclusion criteria: abnormal values for creatinine, LDH and C-reactive protein, proteinuria and hematuria, as well as thrombocytopenia in conjunction with fever, back- and headache. After the diagnosis had been confirmed by demonstrating antibodies against the Puumala strain of hantavirus, follow-up included laboratory tests and clinical observation. RESULTS: All patients fully recovered without any sequelae. There was a clearly increased frequency of cases at the Reutlingen Clinic compared with the previous years (maximally 7 cases per year in 1995-1999). The incidence in the Reutlingen region was probably at least 6.5/100 000 inhabitants. CONCLUSION: At least in endemic regions HN is one of the most common causes of acute renal failure. The increase of cases can, among other reasons, be explained by the described prospective diagnostic schema. But climatic factors with changes in the density of the vector (bank vole) cannot be excluded.

Acute Kidney Injury↗

PubMed1996

Strength-duration properties of human peripheral nerve.

The strength-duration time constant (tau SD) is a property of nodal membrane and, while it depends on a number of factors, its measurement may shed light on axonal properties when taken in conjunction with measurements of axonal excitability. For example, tau SD increases with demyelination as the exposed membrane is enlarged by inclusion of paranodal and internodal membrane, it decreases with hyperpolarization and it increases with depolarization. The present study was undertaken in 20 normal volunteers to compare strength-duration curves for compound sensory and muscle action potentials, to determine the most appropriate curve fitting equation for the data, and to examine the reproducibility of the calculated time constant on different days, for potentials of different amplitude and at different sites along the nerve. Using a computerized threshold-tracking system, stimulus intensity was adjusted to produce an antidromic compound sensory action potential (CSAP) or an orthodromic muscle action potential of 30% of maximum. Stimulus duration was increased every minute in 20 microseconds steps from 20 microseconds to 1 ms. The time constant for compound sensory potentials (665 +/- 182 microsecond) was longer than that for compound EMG potentials (459 +/- 126 microseconds). Weiss's formula, which relates threshold charge to stimulus duration, provided an accurate fit for the experimental data, and the study validated that, using it, relatively few experimental measurements were required to calculate the time constant. In repeated studies on the same subject, time constants usually differed by < 400 microseconds for sensory axons and < 250 microseconds for motor axons. They were identical at different sites along the nerve and did not alter with the size of the compound action potential. These characteristics suggest that the determinations of strength-duration time constant could be suitable for clinical usage.

Adult↗

PubMed1994

Direct immunofluorescence and scraping conjunctival cytology in the study of 912 patients affected by microfollicular conjunctivitis.

912 patients affected by microfollicular conjunctivitis were submitted to a scraping conjunctival cytology before taking specimens for direct immunofluorescence. 264 patients proved to be positive to the direct immunofluorescence test for Chlamydia trachomatis (CT). In all cases the infection turned out to be bilateral with different degrees of positivity between one eye and the other. In 43 patients out of the 264 positive ones, the cytological examination showed the presence of eosinophils in both eyes. The presence of eosinophils poses the problem of a certain allergizing power of Chlamydia and of the possibility that the CT infection might easily develop in subjects with a preexistent allergic conjunctivitis.

Adolescent↗

PubMed1994

Prevalence of depression in the terminally ill: effects of diagnostic criteria and symptom threshold judgments.

OBJECTIVE: Two issues that may influence the diagnosis of depression in the medically ill are 1) the severity with which symptoms must be expressed before they are considered clinically significant and 2) how to deal with somatic symptoms that may be caused by medical illness. This study used different approaches to case identification to examine prevalence rates for major and minor depression in a group of terminally ill cancer patients. METHODS: Semistructured diagnostic interviews were conducted with 130 patients receiving palliative care. Diagnoses according to the Research Diagnostic Criteria (RDC) were compared with diagnoses according to Endicott's revised criteria (which involve replacing somatic symptoms with non-somatic alternatives) when either a low-severity or a high-severity threshold for classifying RDC criterion A symptoms was used. RESULTS: A low-threshold (less stringent) diagnostic approach greatly increased the overall prevalence of major and minor depressive episodes with both the RDC and the Endicott criteria. With high thresholds, the RDC and the Endicott criteria were equivalent, whereas with low thresholds the Endicott substitutions identified fewer cases of major (but not minor) depression. CONCLUSIONS: Small differences between investigators in the applications of symptom-severity thresholds can result in large differences in prevalence rates for depression. However, the inclusions of somatic symptoms in the diagnostic criteria inflates the rates of diagnosis only when these symptoms are used in conjunction with a low-threshold approach.

Aged↗

PubMed2002

The pharmacologic treatment of depression: is gender a critical factor?

BACKGROUND: In the medical literature, there is a lack of sex-specific information regarding the efficacy, metabolism, and side effects associated with psychopharmacologic treatment. In part, this lack results from the historic underinclusion of women in clinical trials during early drug development, but it also occurs because investigators of treatment and metabolic studies do not routinely analyze results according to sex. In 1993, the U.S. Food and Drug Administration (FDA) announced changes that encourage the inclusion of women in early pharmacokinetic studies and emphasize the need for subset analyses using sex and age parameters. In conjunction with advances in basic science regarding drug metabolism, these modifications have led to modest increases in information regarding sex differences in drug metabolism and efficacy. In this article, current information regarding potential sex differences in the pharmacotherapy of major depressive disorder is reviewed. DATA SOURCES: A MEDLINE search was conducted using the terms antidepressants, sex-factors, gender differences, and women for the years 1966 to 2000. DATA SYNTHESIS AND CONCLUSIONS: There are data supporting sex differences in the activity of various antidepressant-metabolizing enzymes. However, there is a paucity of investigation regarding how these differences might translate into differences in clinical efficacy. Notably, there is little work using existing databases to perform the subgroup analyses recommended by the FDA. The widespread dissemination of such work is needed, and, if conducted, investigations in this area have the potential to enhance psychopharmacologic treatment for both men and women.

Adult↗