Regional origin and decrease of pain in patients with depressive symptoms under treatment with venlafaxine

Objective: Patient's language, tradition, conventions, and customs may all determine integration into a society and are also part of the doctor-patient relationship that influences diagnostic and therapeutic outcome. Language barrier and sociocultural disparity of Eastern and Southern European patients may hamper recovery from pain and depression compared to Middle European patients in Switzerland. Methods: In a prospective naturalistic observational trial we investigated the influence of regional origin on treatment outcome in 420 pain sufferers with depressive symptoms from all over Switzerland who were treated with venlafaxine by 122 physicians in primary care. Physicians rated severity of depressive symptoms using the clinical global impression severity scale and pain intensity by means of visual analogue scales. We hypothesized that in Eastern and Southern European patients the magnitude of pain reduction under treatment with venlafaxine is less compared to Middle European patients. Results: Three months after study entry, Middle European patients were found to profit more from treatment with venlafaxine in terms of severity of depression and pain intensity than patients from Eastern Europe and Southern Europe. Conclusion: Regional origin may contribute to the magnitude of pain reduction in patients with depressive symptoms under treatment with venlafaxine. Our results provide a rational for care provider educational programs aimed at improving capacities in treating patients from different regional origin with psychosomatic complaints such as depression and comorbid pai

Charakteristika chronischer Schmerzpatienten mit depressiver Begleitsymptomatik in drei unterschiedlichen Behandlungssettings

Zusammenfassung : Hintergrund: : Über demographische und medizinische Charakteristika von chronischen Schmerzpatienten mit depressiven Symptomen in der Praxis ist bisher wenig bekannt. Methodik: : Die Charakteristika hinsichtlich regionaler Herkunft und Schmerz intensität zu Beginn einer antidepressiven Behandlung werden von 585 chronischen Schmerzpatienten mit depressiver Symptomatik aus 122 Arztpraxen der ganzen Schweiz (Innere Medizin, Allgemeinmedizin, Psychiatrie) beschrieben. Aufgrund der klinischen Erfahrungen im Schweizer Gesundheitssystem wurde vermutet, dass Internisten und Allgemeinpraktiker im Vergleich zu Psychiatern eher ältere und geringergradig depressive Patienten mit weniger intensiven chronischen Schmerzen behandeln, die vermehrt aus mitteleuropäischen Ländern stammen. Ergebnisse: : Tatsächlich behandelten Internisten (und Allgemeinpraktiker) gegenüber Psychiatern häufiger ältere Patienten aus Mitteleuropa mit leichteren depressiven Symptomen und geringerer Schmerzintensität sowie seltener Schmerzen im Kopfbereich. Weiter litten Patienten aus Ost- und Südeuropa gegenüber Mitteleuropäern unter intensiveren Gesamtschmerzen, und dies vor allem im Kopf-, Extremitäten-, Rücken- und Brustbereich, während Südeuropäer gegenüber Mitteleuropäern zusätzlich auch vermehrt unter Brustschmerzen litten. Schlussfolgerung: : Es handelt sich um eine vergleichsweise große Stichprobe, die praxisnah und aus allen Regionen der Schweiz niedergelassene, in Schmerzbehandlungen involvierte Internisten, Allgemeinpraktiker und Psychiater einbezieht und damit die Verhältnisse von Patienten mit körperlichen Schmerzen und einer depressiven Begleitsymptomatik hinsichtlich regionaler Herkunft und Schmerzintensität gut repräsentier

Ligand‐induced donor state destabilisation – a new route to panchromatically absorbing cu(I) complexes

The intense absorption of light to covering a large part of the visible spectrum is highly desirable for solar energy conversion schemes. To this end, we have developed novel anionic bis(4 H ‐imidazolato)Cu(I) complexes (cuprates), which feature intense, panchromatic light absorption properties throughout the visible spectrum and into the NIR region with extinction coefficients up to 28,000 M −1  cm −1 . Steady‐state absorption, (spectro)electrochemical and theoretical investigations reveal low energy (Vis to NIR) metal‐to‐ligand charge‐transfer absorption bands, which are a consequence of destabilized copper‐based donor states. These high‐lying copper‐based states are induced by the σ‐donation of the chelating anionic ligands, which also feature low energy acceptor states. The optical properties are reflected in very low, copper‐based oxidation potentials and three ligand‐based reduction events. These electronic features reveal a new route to panchromatically absorbing Cu(I) complexes.Cu(I) and two chelating , anionic polymethine‐type ligands form a novel type of photoactive cuprate. The ligands induce the destabilisation of the Cu(I)‐based donor states and act themselves as acceptors. This leads to an unusually broad and intense absorption spectrum with metal‐to‐ligand charge‐transfer transitions from the visible to near‐infrared region. imag

[Characteristics of patients suffering from chronic pain with depressive symptoms in three different treatment settings]

Only few studies considered demographic and medical characteristics of pain patients with depressive symptoms

Alzheimer's disease diagnosis and management: Perspectives from around the world

Alzheimer's disease (AD) and other dementias are a global challenge. Early diagnosis is important to manage the disease. However, there are barriers to diagnosis that differ by region. Researchers from Brazil, China, Nigeria, Spain, and Sweden have identified key barriers to AD diagnosis in their countries. In Brazil, socioeconomic inequalities and poor recognition of dementia by physicians can prevent diagnosis. In China, a very large population and lack of physician training in dementia make diagnosis problematic. In Nigeria, socioeconomic inequalities and cultural stigma can stand in the way of diagnosis. In Spain, patient hesitancy and an overloaded health-care system are barriers to diagnosis. In Sweden, inconsistent use of biomarkers is a prominent barrier to diagnosis of AD. To support diagnosis, more focus is needed on education of patients and physicians, increased use of support services, and improved access to biomarkers to accurately diagnose AD

Recombinant human activated protein C attenuates cardiovascular and microcirculatory dysfunction in acute lung injury and septic shock

Introduction: This prospective, randomized, controlled, experimental animal study looks at the effects of recombinant human activated protein C (rhAPC) on global hemodynamics and microcirculation in ovine acute lung injury (ALI) and septic shock, resulting from smoke inhalation injury