Patient and physician satisfaction in an observational study with methyl aminolevulinate daylight-photodynamic therapy in the treatment of multiple actinic keratoses of the face and scalp in 6 European countries

BACKGROUND Guidelines recommend treating actinic keratoses (AKs) as they are recognized as precursors of invasive squamous cell carcinoma. OBJECTIVE The objective of this study was to collect real-world clinical data on the use of methyl aminolevulinate daylight photodynamic therapy (MAL DL-PDT) for the treatment of face and scalp AK in Europe. METHODS A prospective, multicenter, non-interventional study was conducted in six European countries in patients receiving a single treatment of MAL DL-PDT for face and/or scalp AK. Patient-reported outcomes were assessed by patient questionnaires at baseline and at 3 months after treatment, efficacy was assessed at 3 months using a 6-point global improvement scale, and adverse events (AE) were recorded at each visit. RESULTS Overall, 325 patients were enrolled from 52 investigational centres, 314 of whom attended the 3-month visit. Most patients had multiple lesions (58.4% had >10 lesions) with lesions mainly located on the scalp (60.0%) and/or forehead (54.2%). AKs were predominantly grade I (39.4%) or grade II (33.2%), and 10.5% of patients had grade III lesions. The proportions of patients and physicians that were overall satisfied to very satisfied with the MAL DL-PDT treatment were 80.4% and 90.3%, respectively. The vast majority of patients (90.0%) would consider using MAL DL-PDT again if needed. Physician-assessed efficacy at 3 months was at least much improved in 83.5% of patients, with 45.9% of patients requiring no retreatment. Related AEs were reported in 15% of patients. CONCLUSION Use of MAL DL-PDT for multiple face and/or scalp AKs resulted in high levels of patient and physician satisfaction in clinical practice in Europe, reflecting the good efficacy and high tolerability of this convenient procedure

European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. METHODS: The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. RESULTS: Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? CONCLUSIONS: ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group

Evidence confirms an anthropic origin of Amazonian Dark Earths

Archaeology of the America

Evidence confirms an anthropic origin of Amazonian Dark Earths.

Arising from: Silva et al. Nature Communications https://doi.org/10.1038/s41467-020-20184-2 (2021

Extreme makeover: The case of a young adult man with severe ADHD

Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent behavioral disorder among children in the United States. Many of these children continue to experience prominent functional difficulties through adolescence and into adulthood. Specific impairments common to adults with ADHD have only recently come to light. The goal of this article is to discuss the case of a young man, Ralph, who was first diagnosed with ADHD in early childhood. Although pharmacotherapy helped him function better at school as a child, he encountered newfound difficulties as an adult, which reactivated his sense of rejection and failure in virtually every domain of his life. His case illustrates the degree of impairment experienced by many adults with ADHD and the benefit of a multimodal treatment package, which, in Ralph\u27s case, included pharmacotherapy, cognitive-behavioral psychotherapy, and marital therapy modified for adults with ADHD. © 2008 Sage Publications

Make a Joyful Noise: Integrating Music Into Child Psychiatry Evaluation and Treatment

Music is a significant part of daily life for most youth, affording clinical opportunities to cultivate positive emotions, engagement, relationships, meaning, and accomplishment. Clinical inquiry into what types of music elicit different emotions, how music fits into daily life routines, how music connects one to others, and how music anchors life events can improve the clinician-patient alliance and patient well-being practices. Music may be useful in home and school settings to help youth manage diverse moods. Practicing an instrument effectively accelerates accomplishment and pleasure, which applies to other life activities