Follow-up studies of anorexia nervosa: a review of four decades of outcome research

In 1983 we presented a systematic analysis of the available literature on the course of anorexia nervosa (Steinhausen & Glanville, 1983 a). The survey was based on 45 English and German language studies published between 1953 and 1981. During the past decade there has been a striking increase of publications related to eating disorders in general. This pertains as well to follow-up studies on anorexia nervosa. In addition to studies compiled in our previous report, we were able to locate another 22 follow-up studies published in major English and German language journals between 1981 and 198

A reexamination of the cytochrome P-450-catalyzed free radical production from a dihydropyridine. Evidence of trace transition metal catalysis.

Radical production from 3,5-bis(ethoxycarbonyl)-4-ethyl-2,6-dimethyl-1,4- dihydropyridine (DDEP) in rat liver microsomes has been attributed to one-electron oxidation via cytochrome P-450 followed by extrusion of an ethyl radical. In the presence of the spin trap alpha-(4-pyridyl 1-oxide)-N-tert-butylnitrone (4-POBN), this radical was detected as the 4-POBN/ethyl radical adduct by electron paramagnetic resonance spectroscopy. The addition of catalase resulted in over a 50% decrease in radical production. The concentration of the 4-POBN/ethyl radical adduct increased about 9-fold in the presence of EDTA and approximately 2-fold in the presence of either diethylenetriaminepentaacetic acid (DTPA) or deferoxamine mesylate. When DDEP was incubated with deferoxamine mesylate-washed microsomes and NADPH in Chelex-treated incubation buffer, much less 4-POBN/ethyl radical formation occurred. Addition of either DTPA, EDTA, or the ferric complexes of these chelators greatly stimulated production of the 4-POBN/ethyl radical adduct in this system. These results suggest that the ethyl radicals produced from DDEP in a microsomal system arise via trace transition metal-catalyzed reactions

The matreoshka of supersymmetric self-dual theories

Extended super self-dual systems have a structure reminiscent of a ``matreoshka''. For instance, solutions for N=0 are embedded in solutions for N=1, which are in turn embedded in solutions for N=2, and so on. Consequences of this phenomenon are explored. In particular, we present an explicit construction of local solutions of the higher-N super self-duality equations starting from any N=0 self-dual solution. Our construction uses N=0 solution data to produce N=1 solution data, which in turn yields N=2 solution data, and so on; each stage introducing a dependence of the solution on sufficiently many additional arbitrary functions to yield the most general supersymmetric solution having the initial N=0 solution as the helicity +1 component. The problem of finding the general local solution of the $N>0$ super self-duality equations therefore reduces to finding the general solution of the usual (N=0) self-duality equations. Another consequence of the matreoshka phenomenon is the vanishing of many conserved currents, including the supercurrents, for super self-dual systems.Comment: 19 pages, Bonn-HE-93-2

Incommensurate Charge and Spin Fluctuations in d-wave Superconductors

We show analytic results for the irreducible charge and spin susceptibilities, $\chi_0 (\omega, {\bf Q})$, where ${\bf Q}$ is the momentum transfer between the nodes in d-wave superconductors. Using the BCS theory and a circular Fermi surface, we find that the singular behavior of the irreducible charge susceptibility leads to the dynamic incommensurate charge collective modes. The peaks in the charge structure factor occur at a set of wave vectors which form an ellipse around ${\bf Q}_{\pi}=(\pi,\pi)$ and ${\bf Q}_0=(0,0)$ in momentum space with momentum dependent spectral weight. It is also found that, due to the non-singular irreducible spin susceptibility, an extremely strong interaction via random phase approximation is required to support the magnetic peaks near ${\bf Q}_{\pi}$. Under certain conditions, the peaks in the magnetic structure factor occur near ${\bf Q}=(\pi,\pi (1 \pm \delta))$ and $(\pi (1 \pm \delta),\pi)$.Comment: 5 pages, 3 figure

Drug survival of adalimumab, ustekinumab and secukinumab in patients with psoriasis: a prospective cohort study from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR).

BACKGROUND: Real-world biologic drug survival is an important proxy measure for effectiveness. Predictors of drug survival may help patients with psoriasis choose between biologic therapies. OBJECTIVES: (i) To assess the relative drug survival of adalimumab, ustekinumab and secukinumab in patients with psoriasis. (ii) To investigate predictors of biologic drug survival. METHODS: A prospective cohort study was performed in the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) between November 2007 and August 2019. We performed survival analysis and fitted a flexible parametric survival model for biologic discontinuation due to ineffectiveness. RESULTS: In total 9652 patients were included: 5543 starting on adalimumab (57·4%), 991 on secukinumab (10·3%) and 3118 on ustekinumab (32·3%). The overall drug survivals of adalimumab, secukinumab and ustekinumab in year 1 were 0·78 [95% confidence interval (CI) 0·77-0·79], 0·88 (95% CI 0·86-0·91) and 0·88 (95% CI 0·87-0·89), respectively. The adjusted hazard ratios (adjHRs) for discontinuation of adalimumab and secukinumab compared with ustekinumab were 2·11 (95% CI 1·76-2·54) and 0·67 (95% CI 0·40-1·11), respectively. The presence of psoriatic arthritis predicted for survival in the adalimumab and secukinumab cohorts (adjHR 0·67, 95% CI 0·51-0·88 and 0·70, 95% CI 0·40-1·24, respectively), but for discontinuation in the ustekinumab cohort (adjHR 1·42, 95% CI 1·12-1·81). Previous exposure to biologic therapies predicted for discontinuation in the ustekinumab and secukinumab cohorts (adjHR 1·54, 95% CI 1·26-1·89 and 1·49, 95% CI 0·91-2·45, respectively) and for survival in the adalimumab cohort (adjHR 0·71, 95% CI 0·55-0·92). CONCLUSIONS: Secukinumab and ustekinumab have similar sustained drug survival, while adalimumab has a lower drug survival in patients with psoriasis. Psoriatic arthritis and previous biologic experience were predictors with differential effects between the biologic therapies. What is already known about this topic? There is conflicting evidence over the real-world drug survival of secukinumab in patients with psoriasis. Data from registries to date suggest that secukinumab has a lower drug survival than that reported from clinical trials. What does this study add? This study found that secukinumab and ustekinumab had similar sustained drug survival in the real world, while the drug survival of adalimumab was lower, suggesting that the real-world drug survival of secukinumab is higher than previously reported. We found that psoriatic arthritis and previous biologic experience had differential effects on drug discontinuation in the three biologic cohorts. These predictors may help patients and clinicians choose the most appropriate biologic therapy

A standardization approach to compare treatment safety and effectiveness outcomes between clinical trials and real‐world populations in psoriasis

Background: Patients recruited in randomized controlled trials (RCTs) for biologic therapies in psoriasis are not fully representative of the real‐world psoriasis population. Objectives: Firstly, to investigate whether patient characteristics are associated with being included in a psoriasis RCT. Secondly, to estimate the differences in the incidence of severe adverse events (SAEs) and the response rate between RCT and real‐world populations of patients on biologic therapies for psoriasis using a standardization method. Methods: Data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) were appended to individual participant‐level data from two RCTs assessing ustekinumab in patients with psoriasis. Baseline variables were assessed for association of being in an RCT using a multivariable logistic regression model. Propensity score weights were derived to reweigh the registry population so that variables had the distribution of the trial population. We measured the C‐statistic of the model with trial status as the dependent variable, and the risk differences in the incidence rate of SAEs in the first year and Psoriasis Area and Severity Index (PASI) after 6 months in the BADBIR cohort before and after weighting. Results: In total 6790 registry and 2021 RCT participants were included. The multivariable logistic regression model had a C‐statistic of 0.82 [95% confidence interval (CI) 0.81–0.83]. The risk differences for the incidence rate of SAEs and the proportion of patients with PASI < 1.5 were 9.27 (95% CI −3.91–22.5) per 1000 person‐years and 0.95 (95% CI −1.98–4.15), respectively. Conclusions: Our results suggest that RCTs of biologic therapies in patients with psoriasis are not fully representative of the real‐world population, but this lack of external validity does not account for the efficacy–effectiveness gap

XHIP-II: Clusters and associations

Context. In the absence of complete kinematic data it has not previously been possible to furnish accurate lists of member stars for all moving groups. There has been an unresolved dispute concerning the apparent inconsistency of the Hipparcos parallax distance to the Pleiades. Aims. To find improved candidate lists for clusters and associations represented among Hipparcos stars, to establish distances, and to cast light on the Pleiades distance anomaly. Methods. We use a six dimensional fitting procedure to identify candidates, and plot CMDs for 20 of the nearest groups. We calculate the mean parallax distance for all groups. Results. We identify lists of candidates and calculated parallax distances for 42 clusters and 45 associations represented within the Hipparcos catalogue. We find agreement between parallax distance and photometric distances for the most important clusters. For single stars in the Pleiades we find mean parallax distance 125.6 \pm 4.2 pc and photometric distance 132 \pm 3 pc calibrated to nearby groups of similar in age and composition. This gives no reason to doubt either the Hipparcos database or stellar evolutionary theory.Comment: Accepted for publication in Astronomy Letters, 10 pages, 2 fig

Systematic Study of Short Range Antiferromagnetic Order and The Spin-Glass State in Lightly Doped La2-xSrxCuO4

Systematic measurements of the magnetic susceptibility were performed on single crystals of lightly doped La2-xSrxCuO4 (x=0.03, 0.04 and 0.05). For all samples the temperature dependence of the in-plane magnetic susceptibility shows typical spin-glass features with spin-glass transition temperatures Tg of 6.3K, 5.5K and 5.0K for x=0.03, 0.04 and 0.05, respectively. The canonical spin-glass order parameter extracted from the in-plane susceptibility of all the samples follows a universal scaling curve. On the other hand, the out-of-plane magnetic susceptibility deviates from Curie law below a temperature Tdv, higher than Tg. Comparing with previous neutron scattering results with an instrumental energy resolution of 0.25 meV from Wakimoto et al., the x-dependence of Tdv is qualitatively the same as that of Tel, the temperature below which the elastic magnetic scattering develops around (pi, pi). Thus, a revised magnetic phase diagram in the lightly doped region of La2-xSrxCuO4 is proposed. The Curie constants calculated from the in-plane susceptibility are independent of the Sr concentration. On the basis of the cluster spin-glass model, this fact might reflect an inhomogeneous distribution of doped holes in the CuO2 plane, such as in a stripe structure.Comment: 7 pages, 6 figure

Adrenal Dysfunction in Hemodynamically Unstable Patients in the Emergency Department

Objective: Adrenal failure, a treatable condition, can have catastrophic consequences if unrecognized in critically ill ED patients. The authors' objective was to prospectively study adrenal function in a case series of hemodynamically unstable (high-risk) patients from a large, urban ED over a 12-month period. Methods: In a prospective manner, critically ill adult patients presenting to the ED were enrolled when presenting with a mean arterial blood pressure ≤60 mm Hg requiring vasopressor therapy for more than one hour after receiving fluid resuscitation (central venous pressure of 12-15 mm Hg or a minimum of 40 mL/kg of crystalloid). Patients were excluded if presenting with hemorrhage, trauma, or AIDS, or if steroids were used within the previous six months. An adrenocorticotropic hormone (ACTH) stimulation test was performed and serum cortisol was measured. Treatment for adrenal insufficiency was not instituted. Results: A total of 57 consecutive patients were studied. Of these, eight (14%) had baseline serum cortisol concentrations of <20 Μg/dL (<552 nmol/L), which was considered adrenal insufficiency (AI). Three additional patients (5%) had subnormal 60-minute post-ACTH-stimulation cortisol responses (<30 Μg/dL) and a delta cortisol ≤9 Μg/dL, which is the difference between the baseline and 60-minute levels. This is functional hypoadrenalism (FH). There were no laboratory abnormalities that distinguished patients with AI or FH from those with preserved adrenal function (PAF). Rates of survival to discharge did not differ between the AI group (7 of 8) and PAF patients (21 of 46; p = 0.052). Conclusions: Adrenal dysfunction is common in high-risk ED patients. Overall, it has a frequency of 19% among a homogeneous population of hemodynamically unstable vasopressor-dependent patients. The effect of physiologic glucocorticoid replacement in this setting remains to be determined.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71956/1/j.1553-2712.1999.tb00417.x.pd