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Prophylaxis pharmacotherapy to prevent the onset of post traumatic brain injury depression: a systematic review
YesBackground: Depression is a common psychiatric problem following traumatic brain injury (TBI) with reported prevalence rates of 30-77% in the first year post-TBI. Given the negative influence of post-TBI depression on cognition, interpersonal, social, physical and occupational functioning; early initiation of pharmacotherapy to prevent post-TBI depression has been considered. This systematic review will synthesize the available evidence from published studies on the effectiveness and harms of pharmacotherapy for the secondary prevention of post-TBI depression.
Method: Studies published before November 2017 were reviewed. Six databases were searched, with additional searching of key additional documents. Studies meeting inclusion criteria were evaluated for methodological quality.
Results: Six articles addressing five studies met inclusion criteria. Study designs included three randomised controlled trials (RCT), two retrospective cohorts and one case-control. Prophylactic pharmacotherapy included antidepressants, beta-blockers and statins. In one RCT, the number-needed-to-treat with sertraline to prevent one case of depression post-TBI at 24 weeks was 5.9 (95%CI: 3.1-71.1). Prescribing beta-blockers prior to TBI reduced the depression risk regardless of the specific brain trauma. TBI patients with pre-existing hyperlipidemia not treated with statins had an increased depression risk compared to those without hyperlipidemia.
Conclusion: Early initiation of sertraline prophylaxis in nondepressed TBI patients shows promise to reduce the odds of post-TBI depression developing. However, in the absence of rigorous study of tolerability, existing data are insufficient to recommend sertraline prophylaxis. Optimal timing and treatment duration with identification of patients most likely to benefit from prophylaxis require further consideration. Dedicated prospective studies assessing the effects of beta-blockers and statins on post-TBI depression are required.The Transport Accident Commission (TAC), through the Institute for Safety, Compensation and Recovery Research (ISCRR) at Monash University, provided funding for this review
Ramucirumab for Treating Advanced Gastric Cancer or Gastro-Oesophageal Junction Adenocarcinoma Previously Treated with Chemotherapy
The National Institute for Health and Care Excellence (NICE) invited the company that manufactures ramucirumab (Cyramza®, Eli Lilly and Company) to submit evidence of the clinical and cost effectiveness of the drug administered alone (monotherapy) or with paclitaxel (combination therapy) for treating adults with advanced gastric cancer or gastro-oesophageal junction (GC/GOJ) adenocarcinoma that were previously treated with chemotherapy, as part of the Institute’s single technology appraisal (STA) process. Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Erasmus University Rotterdam, was commissioned to act as the Evidence Review Group (ERG). This paper describes the company’s submission, the ERG review, and NICE’s subsequent decisions. Clinical effectiveness evidence for ramucirumab monotherapy (RAM), compared with best supportive care (BSC), was based on data from the REGARD trial. Clinical effectiveness evidence for ramucirumab combination therapy (RAM + PAC), compared with paclitaxel monotherapy (PAC), was based on data from the RAINBOW trial. In addition, the company undertook a network meta-analysis (NMA) to compare RAM + PAC with BSC and docetaxel. Cost-ef
A measurement of the tau mass and the first CPT test with tau leptons
We measure the mass of the tau lepton to be 1775.1+-1.6(stat)+-1.0(syst.) MeV
using tau pairs from Z0 decays. To test CPT invariance we compare the masses of
the positively and negatively charged tau leptons. The relative mass difference
is found to be smaller than 3.0 10^-3 at the 90% confidence level.Comment: 10 pages, 4 figures, Submitted to Phys. Letts.
Star Formation and Dynamics in the Galactic Centre
The centre of our Galaxy is one of the most studied and yet enigmatic places
in the Universe. At a distance of about 8 kpc from our Sun, the Galactic centre
(GC) is the ideal environment to study the extreme processes that take place in
the vicinity of a supermassive black hole (SMBH). Despite the hostile
environment, several tens of early-type stars populate the central parsec of
our Galaxy. A fraction of them lie in a thin ring with mild eccentricity and
inner radius ~0.04 pc, while the S-stars, i.e. the ~30 stars closest to the
SMBH (<0.04 pc), have randomly oriented and highly eccentric orbits. The
formation of such early-type stars has been a puzzle for a long time: molecular
clouds should be tidally disrupted by the SMBH before they can fragment into
stars. We review the main scenarios proposed to explain the formation and the
dynamical evolution of the early-type stars in the GC. In particular, we
discuss the most popular in situ scenarios (accretion disc fragmentation and
molecular cloud disruption) and migration scenarios (star cluster inspiral and
Hills mechanism). We focus on the most pressing challenges that must be faced
to shed light on the process of star formation in the vicinity of a SMBH.Comment: 68 pages, 35 figures; invited review chapter, to be published in
expanded form in Haardt, F., Gorini, V., Moschella, U. and Treves, A.,
'Astrophysical Black Holes'. Lecture Notes in Physics. Springer 201
First Measurement of Z/gamma* Production in Compton Scattering of Quasi-real Photons
We report the first observation of Z/gamma* production in Compton scattering
of quasi-real photons. This is a subprocess of the reaction e+e- to
e+e-Z/gamma*, where one of the final state electrons is undetected.
Approximately 55 pb-1 of data collected in the year 1997 at an e+e-
centre-of-mass energy of 183 GeV with the OPAL detector at LEP have been
analysed. The Z/gamma* from Compton scattering has been detected in the
hadronic decay channel. Within well defined kinematic bounds, we measure the
product of cross-section and Z/gamma* branching ratio to hadrons to be
(0.9+-0.3+-0.1) pb for events with a hadronic mass larger than 60 GeV,
dominated by (e)eZ production. In the hadronic mass region between 5 GeV and 60
GeV, dominated by (e)egamma* production, this product is found to be
(4.1+-1.6+-0.6) pb. Our results agree with the predictions of two Monte Carlo
event generators, grc4f and PYTHIA.Comment: 18 pages, LaTeX, 5 eps figures included, submitted to Physics Letters
Measurement of the B0 Lifetime and Oscillation Frequency using B0->D*+l-v decays
The lifetime and oscillation frequency of the B0 meson has been measured
using B0->D*+l-v decays recorded on the Z0 peak with the OPAL detector at LEP.
The D*+ -> D0pi+ decays were reconstructed using an inclusive technique and the
production flavour of the B0 mesons was determined using a combination of tags
from the rest of the event. The results t_B0 = 1.541 +- 0.028 +- 0.023 ps, Dm_d
= 0.497 +- 0.024 +- 0.025 ps-1 were obtained, where in each case the first
error is statistical and the second systematic.Comment: 17 pages, 4 figures, submitted to Phys. Lett.
Search for Higgs Bosons in e+e- Collisions at 183 GeV
The data collected by the OPAL experiment at sqrts=183 GeV were used to
search for Higgs bosons which are predicted by the Standard Model and various
extensions, such as general models with two Higgs field doublets and the
Minimal Supersymmetric Standard Model (MSSM). The data correspond to an
integrated luminosity of approximately 54pb-1. None of the searches for neutral
and charged Higgs bosons have revealed an excess of events beyond the expected
background. This negative outcome, in combination with similar results from
searches at lower energies, leads to new limits for the Higgs boson masses and
other model parameters. In particular, the 95% confidence level lower limit for
the mass of the Standard Model Higgs boson is 88.3 GeV. Charged Higgs bosons
can be excluded for masses up to 59.5 GeV. In the MSSM, mh > 70.5 GeV and mA >
72.0 GeV are obtained for tan{beta}>1, no and maximal scalar top mixing and
soft SUSY-breaking masses of 1 TeV. The range 0.8 < tanb < 1.9 is excluded for
minimal scalar top mixing and m{top} < 175 GeV. More general scans of the MSSM
parameter space are also considered.Comment: 49 pages. LaTeX, including 33 eps figures, submitted to European
Physical Journal
A Measurement of the Product Branching Ratio f(b->Lambda_b).BR(Lambda_b->Lambda X) in Z0 Decays
The product branching ratio, f(b->Lambda_b).BR(Lambda_b->Lambda X), where
Lambda_b denotes any weakly-decaying b-baryon, has been measured using the OPAL
detector at LEP. Lambda_b are selected by the presence of energetic Lambda
particles in bottom events tagged by the presence of displaced secondary
vertices. A fit to the momenta of the Lambda particles separates signal from B
meson and fragmentation backgrounds. The measured product branching ratio is
f(b->Lambda_b).BR(Lambda_b->Lambda X) = (2.67+-0.38(stat)+0.67-0.60(sys))%
Combined with a previous OPAL measurement, one obtains
f(b->Lambda_b).BR(Lambda_b->Lambda X) = (3.50+-0.32(stat)+-0.35(sys))%.Comment: 16 pages, LaTeX, 3 eps figs included, submitted to the European
Physical Journal
WW Production Cross Section and W Branching Fractions in e+e- Collisions at 189 GeV
From a data sample of 183 pb^-1 recorded at a center-of-mass energy of roots
= 189 GeV with the OPAL detector at LEP, 3068 W-pair candidate events are
selected. Assuming Standard Model W boson decay branching fractions, the W-pair
production cross section is measured to be sigmaWW = 16.30 +- 0.34(stat.) +-
0.18(syst.) pb. When combined with previous OPAL measurements, the W boson
branching fraction to hadrons is determined to be 68.32 +- 0.61(stat.) +-
0.28(syst.) % assuming lepton universality. These results are consistent with
Standard Model expectations.Comment: 22 pages, 5 figures, submitted to Phys. Lett.
Genuine Correlations of Like-Sign Particles in Hadronic Z0 Decays
Correlations among hadrons with the same electric charge produced in Z0
decays are studied using the high statistics data collected from 1991 through
1995 with the OPAL detector at LEP. Normalized factorial cumulants up to fourth
order are used to measure genuine particle correlations as a function of the
size of phase space domains in rapidity, azimuthal angle and transverse
momentum. Both all-charge and like-sign particle combinations show strong
positive genuine correlations. One-dimensional cumulants initially increase
rapidly with decreasing size of the phase space cells but saturate quickly. In
contrast, cumulants in two- and three-dimensional domains continue to increase.
The strong rise of the cumulants for all-charge multiplets is increasingly
driven by that of like-sign multiplets. This points to the likely influence of
Bose-Einstein correlations. Some of the recently proposed algorithms to
simulate Bose-Einstein effects, implemented in the Monte Carlo model PYTHIA,
are found to reproduce reasonably well the measured second- and higher-order
correlations between particles with the same charge as well as those in
all-charge particle multiplets.Comment: 26 pages, 6 figures, Submitted to Phys. Lett.
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