RESUMO
BACKGROUND: Antipsychotic medications are increasingly used for difficult-to-treat depression in young people. However, the evidence-base for this is unclear. Our aim was to assess the evidence for the efficacy of atypical antipsychotics in treating unipolar and bipolar depression in adolescents and young adults. METHOD: We conducted a comprehensive systematic review and meta-analysis of randomized-control-trial studies (RCTs) of antipsychotic medications for 10- to 25-year-olds with unipolar and bipolar depression. The primary outcome of interest was change in depressive symptoms from baseline to trial endpoint. RESULTS: No studies were identified that evaluated the use of antipsychotics in the treatment of unipolar depression. However, we identified four studies, of quetiapine, lurasidone and olanzapine/fluoxetine combination, comprising a total of 866 randomized patients, that evaluated treatment of bipolar depression. All studies used the Children's Depression Rating Scale-Revised (CDRS-R). Our meta-analysis revealed the weighted mean difference (WMD) was -4.58 (95 % CI, -6.59 to -2.57) between antipsychotic and placebo-treated groups. Response and remission rates were also significantly in favor of antipsychotic treatment. LIMITATIONS: There were few studies, several did not address risk-of-bias domains and there was a lack of non-industry sponsored studies. CONCLUSION: There is an absence of evidence for the use of antipsychotic medications in treatment of youth unipolar depression, and no recommendations can be made. There is some evidence for the efficacy of antipsychotics, specifically lurasidone and olanzapine/fluoxetine combination, in the treatment of young people with bipolar depression. However, this evidence is limited and more studies investigating the use of these medications in young people are needed.
Assuntos
Antipsicóticos , Transtorno Bipolar , Criança , Adolescente , Adulto Jovem , Humanos , Antipsicóticos/uso terapêutico , Transtorno Bipolar/diagnóstico , Fluoxetina/uso terapêutico , Olanzapina/uso terapêutico , Cloridrato de Lurasidona/uso terapêuticoRESUMO
OBJECTIVE: The objective of this study was to determine if homeless men with psychosis in central Melbourne have spent a greater proportion of the past 12 months in homeless settings as compared with the same group 15 years previously. METHOD: A 12-month accommodation history was collected from all men with psychosis assessed by a homeless outreach mental health team over a 12-month period commencing 2018 and compared with data from 2006. RESULTS: Between 2006 and 2018, the percentage of time spent homeless in the previous 12 months rose from 50% to 80% (p = 0.0001). The mean time spent shelterless increased from 72 days to 149 days (p = 0.0001). CONCLUSIONS: The amount of time spent homeless has increased in men with psychosis assessed in central Melbourne. This finding suggests that men with psychosis are becoming increasingly entrenched in homeless settings. Addressing this trend requires an increased emphasis on assertive outreach, greater access to acute inpatient and long-term rehabilitation units, and more low cost affordable housing, including housing first facilities.
Assuntos
Continuidade da Assistência ao Paciente , Habitação , Pessoas Mal Alojadas/psicologia , Pessoas Mal Alojadas/estatística & dados numéricos , Serviços de Saúde Mental , Transtornos Psicóticos/reabilitação , Adulto , Austrália/epidemiologia , Humanos , Masculino , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologiaRESUMO
This study aimed to characterize the in vitro antioxidant and antibacterial properties of oregano (Origanum vulgare) essential oil, as well as its chemical composition. To our best knowledge, there are few studies on oregano grown in the arid Andes region, but none on the metabolites produced and their bioactivity. This work identified fifty metabolites by Gas Chromatography-Mass Spectrometry (GC-MS)-monoterpene hydrocarbons, oxygenated monoterpenes, phenolic monoterpenes, sesquiterpene hydrocarbons, and oxygenated sesquiterpenes-present in the essential oil of oregano collected in the Atacama Desert. The main components of essential oregano oil were thymol (15.9%), Z-sabinene hydrate (13.4%), γ-terpinene (10.6%), p-cymene (8.6%), linalyl acetate (7.2%), sabinene (6.5%), and carvacrol methyl ether (5.6%). The antibacterial tests showed that the pathogenic bacteria Staphylococcus aureus and Salmonella enterica and the phytopathogenic bacteria Erwinia rhapontici and Xanthomonas campestris were the most susceptible to oregano oil, with the lowest concentrations of oil necessary to inhibit their bacterial growth. Moreover, oregano oil showed antibacterial activity against bacteria associated with food poisoning. In conclusion, O. vulgare from the arid Andean region possesses an important antibacterial activity with a high potential in the food industry and agriculture.
RESUMO
BACKGROUND: Methamphetamine has an adverse effect on the ability to drive safely. Police need to quickly screen potentially impaired drivers therefore a rapid disposable test for methamphetamine is highly desirable. This is the first proof-of-concept report of a disposable electrochemical test for methamphetamine in undiluted saliva. RESULTS: A screen printed carbon electrode is used for the N,N'-(1,4-phenylene)-dibenzenesulfonamide mediated detection of methamphetamine in saliva buffer and saliva. The oxidized mediator reacts with methamphetamine to give an electrochemically active adduct which can undergo electrochemical reduction. Galvanostatic oxidation in combination with a double square wave reduction technique resulted in detection of methamphetamine in undiluted saliva with a response time of 55 s and lower detection limit of 400 ng/mL. CONCLUSIONS: Using a double square wave voltammetry technique, rapid detection of methamphetamine in undiluted saliva can be achieved, however there is significant donor variation in response and the detection limit is significantly higher than desired. Further optimization of the assay and sensor format is required to improve the detection limit and reduce donor effects.