Olanzapine and fluoxetine combination therapy for treatment-resistant depression: review of efficacy, safety, and study design issues

Treatment-resistant depression (TRD) is a common occurrence in clinical practice. Up to 30% of patients with major depression do not respond to conventional antidepressant treatment, while a significantly greater number of patients experience only partial symptom reduction. Numerous strategies may be applied by the practicing clinician to overcome limitations in the effectiveness of antidepressant monotherapy, including combining drug treatment with evidence-supported psychotherapies, combining antidepressants (combination pharmacotherapy), and combining antidepressants with other non-antidepressant psychotropic medications (augmentation treatment). One such augmentation strategy, the combination of the selective serotonin reuptake inhibitor, fluoxetine (FLX), with the atypical antipsychotic drug, olanzapine (OLZ), is supported by the results of four randomized, double-blind, acute phase studies of patients who had responded inadequately to antidepressant monotherapy. In each study, the FLX/OLZ combination caused rapid reduction in Montgomery-Asberg Depression Rating scale scores, with two of the four studies showing significantly greater improvement than antidepressant monotherapy at study endpoint. Effects of the FLX/OLZ combination were strongest in cases where failure to respond to two antidepressants prior to randomization was established during the current depressive episode. The FLX/OLZ combination was well-tolerated; however, body weight gain and increases in prolactin were greater than that of the antidepressant monotherapy groups, and were comparable to that of OLZ monotherapy. While effective during acute-phase treatment, questions remain regarding the long-term efficacy and safety of FLX/OLZ relative to antidepressant monotherapy and other combination strategies. Efforts aimed at determining the placement of FLX/OLZ among the available options for addressing TRD are limited by lack of comparison and sequential treatment studies. Important aspects of study design and directions for future research are discussed

Enhanced magnetic moment and conductive behavior in NiFe2O4 spinel ultrathin films

Bulk NiFe2O4 is an insulating ferrimagnet. Here, we report on the epitaxial growth of spinel NiFe2O4 ultrathin films onto SrTiO3 single-crystals. We will show that - under appropriate growth conditions - epitaxial stabilization leads to the formation of a spinel phase with magnetic and electrical properties that radically differ from those of the bulk material : an enhanced magnetic moment (Ms) - about 250% larger - and a metallic character. A systematic study of the thickness dependence of Ms allows to conclude that its enhanced value is due to an anomalous distribution of the Fe and Ni cations among the A and B sites of the spinel structure resulting from the off-equilibrium growth conditions and to interface effects. The relevance of these findings for spinel- and, more generally, oxide-based heterostructures is discussed. We will argue that this novel material could be an alternative ferromagetic-metallic electrode in magnetic tunnel junctions.Comment: accepted for publication in Phys. Rev.

Electric field control of exchange bias in multiferroic epitaxial heterostructures

The magnetic exchange bias between epitaxial thin films of the multiferroic (antiferromagnetic and ferroelectric) hexagonal YMnO3 oxide and a soft ferromagnetic (FM) layer is used to couple the magnetic response of the ferromagnetic layer to the magnetic state of the antiferromagnetic one. We will show that biasing the ferroelectric YMnO3 layer by an appropriate electric field allows modifying and controlling the magnetic exchange bias and subsequently the magnetotransport properties of the FM layer. This finding may contribute to pave the way towards a new generation of electric-field controlled spintronics devices.Comment: 15 pages, 5 figures, submitte

Electric field effects on magnetotransport properties of multiferroic Py/YMnO3/Pt heterostructures

We report on the exchange bias between antiferromagnetic and ferroelectric hexagonal YMnO3 epitaxial thin films sandwiched between a metallic electrode (Pt) and a soft ferromagnetic layer (Py). Anisotropic magnetoresistance measurements are performed to monitor the presence of an exchange bias field. When the heteroestructure is biased by an electric field, it turns out that the exchange bias field is suppressed. We discuss the dependence of the observed effect on the amplitude and polarity of the electric field. Particular attention is devoted to the role of current leakage across the ferroelectric layer.Comment: Accepted for publication in Philosophical Magazine Letters (Special issue on multiferroics

Effect of storage on total phenolics, antioxidant capacity, and physicochemical properties of blueberry (Vaccinium corymbosum L.) jam

This study investigated the effects of storage on the physicochemical and nutritional aspects ofblueberry jam. Jams were stored at either 4, 25, or 358C during a 56-day period. The pH was sig-nificantly reduced during storage (p<.05). Overall, results demonstrated the significant effect ofstorage temperature and time on the color degradation and on the texture of the samples studied(p<.05). The total antioxidant activity was significantly affected by temperature as the total anti-oxidant activity retention of samples stored at 48C was significantly higher to that of the samplesstored at either 25 or 358C after a 56-day storage period (p<.05). A strong positive correlationwas found between the total phenolic content and the antioxidant activity withR2ranging from0.617 to 0.716. Results obtained herein suggested that blueberry jams should be refrigerated tobetter retain their overall quality attributes and their antioxidant capacityinfo:eu-repo/semantics/acceptedVersio

Exchange biasing and electric polarization with YMnO3

We report on the growth and functional characterization of epitaxial thin films of the multiferroic YMnO3. We show that using Pt as a seed layer on SrTiO3(111) substrates, epitaxial YMnO3 films (0001) textured are obtained. An atomic force microscope has been used to polarize electric domains revealing the ferroelectric nature of the film. When a Permalloy layer is grown on top of the YMnO3(0001) film, clear indications of exchange bias and enhanced coercivity are observed at low temperature. The observation of coexisting antiferromagnetism and electrical polarization suggests that the biferroic character of YMnO3 can be exploited in novel devices.Comment: 15 pages, 4 figures, Applied Physics Letters (in press

Exchange bias effect in alloys and compounds

The phenomenology of exchange bias effects observed in structurally single-phase alloys and compounds but composed of a variety of coexisting magnetic phases such as ferromagnetic, antiferromagnetic, ferrimagnetic, spin-glass, cluster-glass and disordered magnetic states are reviewed. The investigations on exchange bias effects are discussed in diverse types of alloys and compounds where qualitative and quantitative aspects of magnetism are focused based on macroscopic experimental tools such as magnetization and magnetoresistance measurements. Here, we focus on improvement of fundamental issues of the exchange bias effects rather than on their technological importance

Bicultural identity among economical migrants from three south European countries living in Switzerland. Adaptation and validation of a new psychometric instrument

<p>Abstract</p> <p>Background</p> <p>Acculturation is one of the determinants of mental health among immigrants. Evaluating adaptation to the host culture is insufficient, since immigrants will develop various degrees of bi- or multicultural identity. However, mental health professionals lack simple and easy to use instruments to guide them with bicultural identity evaluation in their practice. Our aim was to develop such an instrument to be used for clinical purposes among economical migrants from three South European countries living in Geneva, Switzerland.</p> <p>Methods</p> <p>We adapted from existing instruments a 24 item bi-dimensional scale to assess involvement in both culture of origin and host culture. The study included 93 immigrant adults from three south European countries (Italy, Portugal and Spain). Thirty-eight patients were recruited in an outpatient treatment program for alcohol-related problems and 55 participants were hospital employees.</p> <p>Results</p> <p>The questionnaire was rated as easy or rather easy by 97.8% of participants. Median time to complete it was 5 minutes. The instrument allowed discriminating between patients and healthy subjects, with scores for Swiss culture significantly higher among hospital workers. The subscales related to culture of origin and host culture displayed adequate internal consistency (Cronbach's alpha 0.77 and 0.73 respectively).</p> <p>Conclusion</p> <p>It is possible to assist clinicians' assessment of cultural identity of Italian, Portuguese and Spanish economical immigrants in Switzerland with a single and easy to use instrument.</p

Positive predictive value of automated database records for diabetic ketoacidosis (DKA) in children and youth exposed to antipsychotic drugs or control medications: a tennessee medicaid study

<p>Abstract</p> <p>Background</p> <p>Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of treatment with some atypical antipsychotic drugs in children and <b>youth</b>. Because drug-associated DKA is rare, large automated health outcomes databases may be a valuable data source for conducting pharmacoepidemiologic studies of DKA associated with exposure to individual antipsychotic drugs. However, no validated computer case definition of DKA exists. We sought to assess the positive predictive value (PPV) of a computer case definition to detect incident cases of DKA, using automated records of Tennessee Medicaid as the data source and medical record confirmation as a "gold standard."</p> <p>Methods</p> <p>The computer case definition of DKA was developed from a retrospective cohort study of antipsychotic-related type 2 diabetes mellitus (1996-2007) in Tennessee Medicaid enrollees, aged 6-24 years. Thirty potential cases with any DKA diagnosis (ICD-9 250.1, ICD-10 E1x.1) were identified from inpatient encounter claims. Medical records were reviewed to determine if they met the clinical definition of DKA.</p> <p>Results</p> <p>Of 30 potential cases, 27 (90%) were successfully abstracted and adjudicated. Of these, 24 cases were confirmed by medical record review (PPV 88.9%, 95% CI 71.9 to 96.1%). Three non-confirmed cases presented acutely with severe hyperglycemia, but had no evidence of acidosis.</p> <p>Conclusions</p> <p>Diabetic ketoacidosis in children and youth can be identified in a computerized Medicaid database using our case definition, which could be useful for automated database studies in which drug-associated DKA is the outcome of interest.</p

Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149731/1/bdi12715_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149731/2/bdi12715.pd